Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jul 14, 2023
Date Accepted: May 12, 2024
Protective Effect of Allergen Immunotherapy in Patients with Allergic Rhinitis and Asthma Against COVID-19 Infection: An Observational, Nationwide, and Multicenter Study
ABSTRACT
Background:
Allergic diseases are linked to an increased risk of respiratory tract infections. Although allergen immunotherapy (AIT) can modify the allergic trajectory, there is limited real-world evidence supporting its ability to enhance the host's defense against pathogens.
Objective:
To investigate the protective effect of AIT against viral infection in patients with allergic rhinitis (AR) and asthma (AS).
Methods:
The study conducted a real-world, questionnaire-based survey between February 10, 2023, and March 15, 2023, in 81 centers across China including healthy volunteers and patients with AR and AS to compare the clinical outcomes of COVID-19 infection.
Results:
A total of 10515 participants were included. After the screening, 3618 patients and 2192 healthy volunteers who tested positive for COVID-19 were included. Overall, there were no significant differences in COVID-19 outcomes between patients and healthy volunteers. Among the patients, 1752 were undergoing routine medication treatment (RMT group), while 1057 and 394 receiving AIT and a combination of AIT and omalizumab (OMA) as adjunct therapies to RMT, respectively (AIT group and AIT+OMA group). The AIT group showed milder COVID-19 symptoms, shorter recovery periods and a lower likelihood of hospitalization or emergency department visits than the RMT group (all P<.05). After adjusting for confounding factors, including demographic characteristics and vaccination, AIT remained a significant protective factor associated with shorter recovery time (adjusted odds ratio [OR]: 0.62, 95% CI: 0.52–0.75, P<.001) and a lower incidence of hospitalization or emergency department visits (adjusted OR: 0.73, 95% CI: 0.54–0.98, P=.034). Similar results were found when adjusting for pre-infection disease conditions. Moreover, AIT+OMA provided greater protection with a shorter recovery time (adjusted OR: 0.51, 95% CI: 0.34–0.74, P< .001) than AIT.
Conclusions:
Our findings provide real-world evidence supporting the protective effect of AIT against viral infection.
Citation
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