Even 40 percent. Poles may suffer from allergies. Some of its symptoms are somewhat reminiscent of coronavirus infection – cough, conjunctivitis, respiratory problems, headaches or runny nose appear in both cases. Has the epidemic affected the lives of allergy sufferers? Do they have to follow additional rules now? These questions are answered by prof. dr hab. n. med. Marek Kulus, president of the Polish Society of Allergology, head of the Department of Pneumology and Childhood Allergology at the Medical University of Warsaw
Journalists for Health Association: How many people suffer from allergies?
Prof. dr hab. n. med. Marek Kulus: It is a common condition, affecting around 40% of society. Let us remind you – an allergy is nothing more than an overly expressed, inflammatory reaction of the body to factors in our environment.
Has the coronavirus affected the treatment of allergic diseases?
Basically no. There is a belief in almost all areas of allergology that current treatment should be maintained. Almost, because the exception concerns an extremely narrow group of immunosuppressive drugs used in dermatology, the doses of which we are trying to reduce.
How are allergy symptoms different from symptoms of coronavirus infection?
Allergy is itching and is not associated with fever. It is worth knowing that allergies can cause asthma. It is not for nothing that people say “from allergies to asthma”. Common symptoms of asthma and COVID-19 are coughing and shortness of breath. In asthma, dyspnea is associated with impaired bronchial patency, breathing is wheezing and noisy. In coronavirus infection, the alveoli are more affected by the disease, breathing is shallow and fast, fatigue and a sense of lack of oxygen appear. Asthma also has a sense of lack of oxygen, but the predominant feature is difficulty exhaling air.
- Also read: Your doctor explains what the coronavirus means for people with asthma
How do you rate the level of allergy treatment in Poland?
Our treatment regimens are the same as in other developed countries, we have nothing to be ashamed of. We use the drugs recommended by GINA and, as the Polish Society of Allergology (PTA), we try to promote them, adapting some small details to our conditions.
What are the PTA indications for treating asthma during the current epidemic?
It is most important to maintain basic anti-inflammatory treatment. In the treatment of asthma, the mainstay of treatment are inhaled corticosteroids (in the form of pressurized or powder inhalers). There is no evidence from the world that this treatment in any way attenuates the response to coronavirus infection. In justified cases (e.g. very severe asthma), the use of oral glucocorticosteroids is also allowed. There is no data showing their strong immunosuppressive effect. There have even been attempts to use systemic corticosteroids in the treatment of pneumonia caused by coronavirus, although not very effectively – it does not contradict in any way.
In severe forms of asthma, both biological drugs and anti-interleukin-5 antibodies can be used, which allows the dose of oral systemic glucocorticosteroids to be reduced. There is no evidence of a possible immunosuppressive effect of biologics used in the treatment of asthma to increase susceptibility to SARS-CoV2 infection. PTA, however, advises against the use of drugs in nebulization, recommending the use of individual pressure and powder inhalers.
What is the PTA position on the treatment of allergic rhinitis (AR) and other allergic diseases?
AR should be treated in accordance with the current rules, as determined by the allergist. The most effective drugs here are nasal glucocorticosteroids. There is also no reason to be afraid of using antihistamines (they alleviate conjunctival ailments, runny nose) or anti-leukotriene drugs.
In the case of skin diseases – atopic dermatitis or urticaria – treatment regimens are the same as in the non-epidemic period and they can be safely used. What’s more, failure to take medications or discontinuing them without consulting a doctor may predispose them to coronavirus infection. If the patient is hospitalized in an exacerbation, the risk of infection will be increased.
What about immunotherapy during a pandemic?
The current situation may hinder access to healthcare professionals, which is why we are accelerating the end of immunotherapy. And so – in patients who have undergone a 3-year desensitization period (3 to 5 years), its termination may be considered in order not to expose them to contact with other patients.
When it comes to classifying patients and restarting immunotherapy, we suggest that this process be put off. There is one exception here – allergy to insect venoms, as an anaphylactic reaction is a direct threat to life. PTA recommends that these patients should be switched to high doses of desensitizing preparations as quickly as possible, using a method that we allergists call ultra-rush.
What is the diagnosis of allergies today?
We recommend postponing diagnostic methods that may be associated with the risk of coronavirus infection. It is about skin tests, inhalation tests, provocation tests and spirometry. We suggest that you do not perform these tests or limit them to absolutely necessary cases.
However, it is possible to safely draw patients’ blood to assess the concentration of specific IgE antibodies. Thus, doctors need to be more careful not to expose patients to procedures that may be potentially dangerous for them.
To what extent is our susceptibility to allergies dependent on our immunity?
We do not have precise genetic tests to show where our immunity is imperfect. We suspect, however, that the interaction of the environment and our genetic potential plays a fundamental role here.
Should people with allergies during a pandemic take their medication regularly and follow the common rules?
Exactly. Patients who are allergic do not become more severely infected with the coronavirus. And this is good news, because it means that allergies do not include them in the risk group, and the drugs used so far are safe.
This may interest you:
- You can become an allergy at any time and at any age
- Effects of untreated allergies
- Allergy, hypersensitivity or intolerance?
Authorized press interview prepared by the Journalists for Health Association in connection with the World Asthma Day, May 5, 2020, Quo vadis medicina ?, XNUMXst edition, “Asthma in the era of the coronavirus epidemic”