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Revista Portuguesa de Imunoalergologia
Print version ISSN 0871-9721
Abstract
SILVA, Maria Inês T.; SANTOS, Amélia Spínola and PEDRO, Elisa. Subcutaneous immunotherapy with aeroallergens in a central hospital in Portugal during the COVID-19 pandemic. Rev Port Imunoalergologia [online]. 2021, vol.29, n.3, pp.197-207. Epub Sep 30, 2021. ISSN 0871-9721. https://doi.org/10.32932/rpia.2021.09.065.
Background:
Allergic disease, allergic rhinoconjunctivitis/bronchial asthma, are very prevalent worldwide, and the potentially modifying therapy is immunotherapy with aeroallergens. In December 2019 a new coronavirus (SARS-CoV-2) was identified in China, causing a pandemic with devastating effects. For this reason, the State of Emergency (SE) was declared in Portugal for the first time in this pandemic, between 18 March and 2 May 2020, and all non-urgent activity was suspended in our hospital, including the administration of subcutaneous immunotherapy with aeroallergens (SCITA).
Objective:
Characterize the dose adjustments according to the delay in SCITA administration, verify the safety of the dose administered when resuming SCITA and evaluate the worsening of symptoms of the allergic disease, in patients under SCITA program that interrupted it during the SE.
Material and methods:
An analysis of the SCITA clinical records of the 195 patients who interrupted the maintenance dose during EE was performed. According to the symptoms and the delay interval, the dose was reduced or a new initiation protocol was performed, according to our Allergen Immunotherapy Functional Unit protocol, adapted from international guidelines for this specific time.
Results:
7.7% of patients had worsening of allergic symptoms during the interruption period and 6.2% resorted to rescue therapy. 96.4% decreased the dose in SCITA resumption, with a decrease that was mostly greater than predicted, according to our protocol. Immediate local reactions were recorded in 9.2%, with no anaphylactic reactions. After recovery, 9.7% worsened symptoms and 5.1% resorted to rescue therapy.
Conclusions:
The pandemic made it very difficult to monitor patients’ chronic pathologies, including allergic diseases. The majority of patients did not report worsening of symptoms and few had adverse reactions in the resumption of SCITA, demonstrating the safety of the dose adjustment protocol.
Keywords : COVID-19; dose adjustment; safety; SARS-CoV-2; subcutaneous immunotherapy with aeroallergens..
