COVID-19 Resource Centre
Starting from December 2019, a new strain of human coronavirus was detected, initially called 2019-nCoV, in few patients with viral pneumonia in Wuhan, China. Although a specific treatment is currently still unavailable, physicians have several options to help patients by managing symptoms with drugs and supportive systems. The EAACI community is united in disseminating new research and knowledge on COVID-19. Find some of the most useful related content here, to better serve you and your patients.
More resources on COVID-19 will be added as they are released by our community of experts.
Highlights
June 2020
ECDA statement on COVID-19, chronic diseases and EU health capacity
"This paper outlines recommendations to EU institutions, national governments and relevant groups in Europe concerning the COVID-19 response and recovery plans with regard to chronic diseases.
The lessons from this crisis must be learnt. The below proposals aim to support reflections on preparedness for potential future pandemics or other crises, which may occur as a result of factors like climate change; but also to reinforce healthcare systems’ capacity to achieve long-term public health objectives."
Access here
14 June 2020
A compendium answering 150 questions on COVID‐19 and SARS‐CoV‐2
"This paper answers pressing questions, formulated by young clinicians and scientists, on SARS‐CoV‐2, COVID‐19 and allergy, focusing on the following topics: virology, immunology, diagnosis, management of patients with allergic disease and asthma, treatment, clinical trials, drug discovery, vaccine development and epidemiology. Over 140 questions were answered by experts in the field providing a comprehensive and practical overview of COVID‐19 and allergic disease."
https://onlinelibrary.wiley.com/doi/abs/10.1111/all.14449
EAACI Allergy Journal
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"Survived severe and non‐survived COVID‐19 patients had distinct clinical and laboratory characteristics, which were separated by principle component analysis. Elder age, increased number of affected lobes, higher levels of serum CRP, chest tightness/dyspnea, and smoking history were risk factors for mortality of severe COVID‐19 patients. Longitudinal changes of laboratory findings may be helpful in predicting disease progression and clinical outcome of severe patients." |
13 July 2020 "In order to update information gained, we provide a systematic overview of the skin lesions described in COVID‐19 patients, discuss potential causative factors and describe differential diagnostic evaluations. Moreover, we summarize current knowledge about immunologic, clinical and histologic features of virus‐ as well as drug‐induced lesions of the skin and changes to the vascular system in order to transfer this knowledge to potential mechanisms induced by SARS‐CoV‐2." |
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03 July 2020 "In summary, we have seen a new zoonotic coronavirus, SARS‐CoV‐2, infection that has had a devastating effect on the host immunity via the inhibition of interferons leading to aberrant innate immune response, macrophage inflammation in releasing a cytokine storm and exhaustion of the cellular immunity of T lymphocytes.9 Fortunately, due to chronic and sustained type 2 immune inflammation in the lungs of asthmatic patients, or by the medications they use for asthma control, it seems asthma may not be a major confounding disease in COVID‐19 infection, and this unexpected phenomenon may shed a new light on finding therapies or preventative strategies for SARS‐CoV‐2." |
"The “coronavirus disease 2019 (COVID‐19)” outbreak was first reported in December 2019 (China). Since then, this disease has rapidly spread across the globe and in March 2020 the World Health Organization (WHO) declared the COVID‐19 pandemic.1 Since the outbreak was first announced, our journal has extensively focused on the clinical features, outcomes, diagnosis, immunology, and pathogenesis of COVID‐19 and its infectious agent severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2).." |
26 June 2020 "An ARIA-EAACI statement has been devised to make recommendations on asthma, and not necessarily on severe asthma, based on a consensus from its members." |
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"We also summarize known and potential SARS‐CoV‐2 receptors on epithelial barriers, immune cells, endothelium and clinically involved organs such as lung, gut, kidney, cardiovascular and neuronal system. Finally, we discuss the known and potential mechanisms underlying the involvement of comorbidities, gender and age in development of COVID‐19. Consequently, we highlight the knowledge gaps and urgent research requirements to provide a quick roadmap for ongoing and needed COVID‐19 studies." |
22 June 2020 "For the first time, quantitative psychophysical analyses of olfaction were performed over a full course of COVID-19 in this homogenous cohort of relatively young adults, while previous studies used self-ratings, only. It is well accepted that self-ratings largely underestimate olfactory dysfunction. Usually required face-to-face contact seems to cause this systematic error, while telemedicine consultations allows safe testing for patients and staff. The comprehensive impairment without nasal symptoms supports the suggestion of a neurotropic and neuro-invasive virus that is site-specific for the olfactory system using angiotensin-converting-enzyme-receptor-2 (ACE2) for intracellular invasion." |
20 June 2020 "The majority of COVID‐19 patients (71.7%) had a decrease in circulating EOS counts, which was significantly more frequent than other types of pneumonia patients. EOS counts had good value for COVID‐19 prediction, even higher when combined with NLR. Patients with low EOS counts at admission were more likely to have fever, fatigue and shortness of breath, with more lesions in chest CT and radiographic aggravation, longer length of hospital stay and course of disease than those with normal EOS counts." |
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16 June 2020 "Based on accumulating data, patients with severe COVID-19 show a trend towards eosinopenia, which raises the concern whether eosinopenia is associated with the disease severity. Eosinophil, initially identified as a key effector cell of allergy, has now been demonstrated to possess antiviral capacities and serve to amply immune response and thus dampen inflammation. It is currently not known whether COVID-19 patients with eosinopenia are also more likely to develop into critically illness. This updated analysis aimed to investigate the association between eosinopenia and COVID-19 severity." |
16 June 2020 "ircumstantial evidence suggests that patients with allergic asthma might have a lower risk to develop severe forms of COVID‐19. In addition, the anti‐IgE antibody Omalizumab was shown to enhance anti‐viral immunity. We report a case of a 52‐year‐old man with severe allergic asthma treated with Omalizumab with no evidence of an asthma exacerbation, loss of asthma control or pneumonia during symptomatic COVID‐19 disease. We hypothesize that the underlying disease (allergic asthma) or the antibody used for treatment (Omalizumab), or both, might have exerted protective effects." |
"This international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients whilst ensuring necessary safety in the current COVID‐19 pandemic." |
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07 June 2020 "This paper answers pressing questions, formulated by young clinicians and scientists, on SARS‐CoV‐2, COVID‐19 and allergy, focusing on the following topics: virology, immunology, diagnosis, management of patients with allergic disease and asthma, treatment, clinical trials, drug discovery, vaccine development and epidemiology. Over 140 questions were answered by experts in the field providing a comprehensive and practical overview of COVID‐19 and allergic disease." |
10 June 2020 "Pediatric COVID‐19 patients tended to have a mild clinical course. Patients with pneumonia had higher proportion of fever and cough and increased inflammatory biomarkers than those without pneumonia. There was no difference between allergic and non‐allergic COVID‐19 children in disease incidence, clinical features, laboratory and immunological findings. Allergy was not a risk factor for developing and severity of SARS‐CoV‐2 infection and hardly influenced the disease course of COVID‐19 in children." |
08 June 2020 "This review brings togetherall the published information about the diagnosis and management of drug hypersensitivity reactions due to current and candidate off‐label drugs andhighlights relevant recommendations. Furthermore, it gathers all the dermatologic manifestations reported during the disease for guiding the clinicians to establish a better differential diagnosis of drug hypersensitivity reactionsin the course of the disease." |
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07 June 2020 "(...) we found that combined allergies might reduce the destructive power of SARS-CoV-2 infection. COVID-19 patients combined with allergy had less severe initial conditions and a lower degree of lung lesions, which might owe to the fact that T lymphocytes were less damaged by SARSCOV2. Other underlying diseases may also exist with these patients and often with the worse condition and worse prognosis." |
"Currently, there is very little evidence for an enhanced risk of patients with allergic diseases to develop severe COVID‐19 with studies focusing on severe allergic phenotypes lacking. At present, non‐infected patients on biologicals for the treatment of asthma, atopic dermatitis, chronic rhinosinusitis with nasal polyps or chronic spontaneous urticaria should continue their biologicals targeting type 2 inflammation via self‐application. In case of an active SARS‐CoV‐2 infection, biological treatment needs to be stopped until clinical recovery and SARS‐CoV‐2 negativity is established and treatment with biologicals should be re‐initiated. Maintenance of add‐on therapy and a constant assessment of disease control, apart from acute management is demanded." |
"Our data suggest different receptor repertoire potentially involved in the SARS-CoV-2 infection at the epithelial barriers and in the immune cells. Altered expression of these receptors related with age, gender, obesity and smoking, as well as with the disease status might contribute to COVID-19 morbidity and severity patterns." |
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01 June 2020 "(...) there are no published reports of other type 2 conditions associated with severe COVID-19. Herein, we share some clues supporting the hypothesis that type 2 conditions do not represent a risk factor, despite the most morbidity occurring due to SARS-CoV-2 induced lung damage." |
"In an uncontrolled study, we could not rule out the contribution of COPD to the more severe outcomes of SARS-CoV-2 infection that was shown in the previous studies. However, patients with bronchial asthma do not seem to be at increased risk of SARS-CoV-2 induced ARDS. Our findings suggest that there is no need to change standard treatment for chronic respiratory diseases during pandemic of COVID-19. Additional studies are needed to prove this hypothesis." |
20 May 2020 "Hopefully, the efforts of clinical researchers in the fight against the SARS Cov‐2 will result into the identification of effective treatments. To make this possible, clinical research should be oriented by guidelines for more harmonized high‐quality studies and by a united commitment of the scientific community to share personal knowledge and data. Allergists and clinical immunologists should have a leading role in this unprecedent challenge." |
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"Coronavirus disease 2019 (COVID‐19) pandemic is affecting people at any age with a more severe course in patients with chronic diseases or comorbidities, males and elderly patients. The Center for Disease Control and Prevention (CDC) initially proposed that patients with chronic lung diseases, including moderate‐severe asthma, and allergy may have a higher risk of developing severe COVID‐19 than otherwise healthy people" |
13 May 2020 "This spring, the majority of allergic patients are confined to their homes due to COVID‐19 pandemic restrictions. In the following weeks, these restrictions will be reduced andpeople will be allowed to take walks, go jogging, and return to work.Spring is the time for ocular allergy (OA) to emerge with signs and symptoms consequent to increasing pollen counts. Even when wearing a mask, the eyes may remain unprotectedleading to an increase in ocular symptoms and patients seeking treatment forOA. However, access to routine consultation may remain problematic for many patients." |
13 May 2020 "The outbreak of coronavirus disease 2019 (COVID‐19) caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) poses a global health emergency and became a worldwide pandemic. We summarize the recent findings with respect to the function, structure and immunogenicity of the spike (S) protein, arising mutations, and implications on vaccine development and therapeutics." |
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12 May 2020 "Prevention of development to severe disease, cytokine storm, acute respiratory distress syndrome and novel approachs to prevent their development will be main routes for future research areas. As we learn to live amidst the virus, understanding the immunology of the disease can assist in containing the pandemic and in developing vaccines and medicines to prevent and treat individual patients." |
"Currently, the world is facing a global pandemic with a new coronavirus SARS‐CoV‐ 2 (Severe Acute Respiratory Syndrome CoronaVirus Type 2) causing infectious disease named COVID‐19 (CoronaVirus Infectious Disease 2019). Comparing the clinical presentation and epidemiological characteristics of COVID‐19 with previous coronavirus‐associated respiratory diseases (SARS‐CoV1 and MERS) revealedsome remarkable findings and differences. Moreover, the clinical course of SARS‐CoV‐2 infection showed the complexity of COVID‐19 profile with the variable clinical presentations." |
02 May 2020 "My recommendations to people with asthma and those treating them are most importantly to optimize asthma control with standard therapies, but if asthma control is not optimal despite appropriate use of standard therapies, to have a low threshold for starting azithromycin prophylaxis (because of its innate antiviral (IFN-boosting) property, at this time of enormous threat from COVID-19." |
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24 April 2020 "This manuscript outlines the EAACI recommendations regarding AIT during the COVID-19 pandemic and aims at supporting allergists and all physicians performing AIT in their current daily practice with clear recommendations how to perform treatment during the pandemic and in SARS-CoV-2 infected patients." |
27 April 2020 "Even though we are still in the midst of the coronavirus pandemic, the disproportionately smaller number of cases reported from disadvantaged/low income countries remains puzzling. We hypothesize that general BCG vaccination policies adopted by different countries might have impacted the transmission patterns and/or COVID-19 associated morbidity and mortality." |
24 April 2020 "As allergists and immunologists, we are very familiar with the T helper (Th)1 and Th2 balance in addition to orchestral roles of T regulatory and other effector cells, so we have to consider the possible roles of childhood immunizations within the context of the current coronavirus disease 2019 (COVID-19) outbreak." |
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18 April 2020 "Appropriate forecasting model can contribute to define strategic choices both in limiting the spread of SARS-Cov-2 virus, as well as in reducing the related mortality rate. Temporal trends of SARS-CoV-2 key epidemiological indicators (e.g., mortality, incidence of infected cases, etc.) to describe the ongoing pandemic caused by SARS-CoV-2 have been estimated; their accuracy is key to plan and implement adequate health interventions (e.g., increasing ICU availability distribute personal protection gear, an eventual vaccine, etc)." |
13 April 2020 "Since the coronavirus disease 2019 (COVID‐19) caused by SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus 2) first emerged in Wuhan, China in December 2019, the outbreak of COVID‐19 epidemic has become an increasingly serious global health concern. Currently, over 150 countries have reported COVID‐19 cases, and the situation has progressed to a pandemic associated with substantial morbidity and mortality." |
02 April 2020 "In a designated hospital outside Hubei Province, COVID‐2019 patients could be effectively managed by properly using the existing hospital system. Mortality may be lowered when cases are relatively mild and there are sufficient medical resources to care and treat the disease." |
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31 March 2020 "Some sources have suggested that “corticosteroids” should be avoided during the for SARS-CoV-2 epidemic. This advice is about the use of oral corticosteroids unless there is a clear indication for their use. Patients with asthma should not stop their prescribed inhaled corticosteroid controller medication (or prescribed oral corticosteroids). Stopping inhaled corticosteroids often leads to potentially dangerous worsening of asthma, and avoiding oral corticosteroids during severe asthma attacks may have serious consequences." |
20 March 2020 "All different clinical characteristics of COVID‐19 should be taken into consideration to identify patients that need to be in strict quarantine for the efficient containment of the pandemic." |
19 February 2020 "Detailed clinical investigation of 140 hospitalized COVID‐19 cases suggests eosinopenia together with lymphopenia may be a potential indicator for diagnosis. Allergic diseases, asthma, and COPD are not risk factors for SARS‐CoV‐2 infection. Older age, high number of comorbidities, and more prominent laboratory abnormalities were associated with severe patients." |
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EAACI Pediatric Allergy and Immunology Journal
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09 June 2020 "The coronavirus disease 2019 (COVID‐19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) appears milder in children but little is known about neonates and about the chains of infections after delivery. When in early March 2020 a midwife in our large maternity and perinatal center returned from vacation in Ischgl, Austria, she triggered a COVID‐19 outbreak affecting 36 midwives, nurses and doctors. We reported previously on the successful containment of this outbreak and characterized the clinical symptoms and immunoglobulin development in staff members exposed to SARS‐CoV‐2." |
29 May 2020 "Infection by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the viral etiology of the novel coronavirus disease 2019 (COVID‐19), was first reported in Wuhan, China in late 2019. Peculiarly, the virus has not caused significant impact on pediatric populations, unlike other coronaviruses (1). Children comprise only 1.7% of COVID‐19 positive cases in the United States (2). Furthermore, children are noted to have a milder disease course (3, 4). However, much is unknown about the age, gender and race risk factors of COVID‐19 among children. There has been recent evidence suggestive of higher rates of COVID‐19 and related fatality rates in African American adult communities around the United States(5). However, there is limited data, to our knowledge, whether any race or ethnicity group is at higher risk for COVID‐19 infection in children." https://onlinelibrary.wiley.com/doi/abs/10.1111/pai.13298 |
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15 May 2020 "We found that a significant number of diseased did not develop relevant antibody responses three weeks after symptom onset. Our data also suggest that exposure to COVID‐19 positive co‐workers in a hospital setting is not leading to the development of measurable immune responses in a significant proportion of asymptomatic contact persons." https://onlinelibrary.wiley.com/doi/10.1111/pai.13278 |
"This allows the virus to bypass the efficient immune barrier of the upper airway mucosa in already infected, young, and otherwise healthy athletes. In conclusion, whether the virus or the adaptive immune response reaches the lungs first is a crucial factor deciding the fate of the patient. This “quantitative and time‐/sequence‐dependent” model has several implications for prevention, diagnosis, and therapy of COVID‐19 at all ages." |
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24 April 2020 "Clear understanding of the immune responses to the virus in children and the transmission potential of asymptomatic children are of paramount importance for the development of specific treatments and vaccine in order to effectively control the ongoing pandemic" https://onlinelibrary.wiley.com/doi/epdf/10.1111/pai.13267 |
22 April 2020 "Our report suggests that XLA patients might present high risk to develop pneumonia after SARS‐Cov2 infection, but can recover from infection, suggesting that B cell response might be important, but not strictly required to overcome the disease. However, there is need of larger observational studies to extend these conclusions to other patients with similar genetic immune defects." https://www.onlinelibrary.wiley.com/doi/10.1111/pai.13263 |
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22 April 2020 "Most countries affected by COVID‐19 have opted for nationwide confinement, which means that communication with the primary clinician is often performed by telemedicine. Optimal disease control of allergic, asthmatic and immunodeficient children should be sought according to usual treatment guidelines. This statement of the EAACI Section on Pediatrics puts forward six recommendations for the management of childhood allergies and immunodeficiencies based on six underlying facts and existing evidence." https://www.onlinelibrary.wiley.com/doi/10.1111/pai.13262 |
"Apart from massive testing of personnel in predefined phases and increased hygiene measures, including a general obligation to wear surgical face masks, we identified the need to monitor cases of illness across all groups of employees, to ensure social distancing within personnel and to evaluate contacts of clinical personnel outside of the hospital environment, in order to be able to interpret chains of infections and to disrupt them. Overall, only a bundle of measures is needed to contain such an outbreak." |
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04 April 2020 "Viral infections are well-known risk factors for an exacerbation of asthma. In the study by Yang et al., 40% of the COVID-19 patients with critical symptoms had an underlying long-term disease before the infection. Another study of 140 cases from Wuhan (China) did not report allergic diseases as co-morbidities among severe cases. However, more information needs to be gathered and analyzed to create reliable reports on risk factors for severe COVID-19." https://patients.eaaci.org/coronavirus-infection-and-asthma-what-do-we-know/ |
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17 June 2020 "We also revealed that the alarmin HMGB1 is critical for SARS-CoV-2 replication. In contrast, loss of the histone H3.3 chaperone complex sensitized cells to virus-induced death. Together this study reveals potential therapeutic targets for SARS-CoV-2 and highlights host genes that may regulate COVID-19 pathogenesis." This article was selected by Adam Klocperk, Marketa Bloomfield, Tomáš Milota, and Anna Sediva
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11 June 2020 "SARS-CoV-2 infection displays immense inter-individual clinical variability, ranging from silent infection to lethal disease. The role of human genetics in determining clinical response to the virus remains unclear. Studies of outliers—individuals remaining uninfected despite viral exposure and healthy young patients with life-threatening disease—present a unique opportunity to reveal human genetic determinants of infection and disease." |
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02 June 2020 "The article describes the initiation of the first clinical trial (ClinicalTrials.gov LY-CoV555) that uses monoclonal antibody binding S-protein of SARS-Cov-2 virus. The antibody was designed using the most potent clones of B cells from COVID-19 patients. Before vaccine available the access to the highly specific monoclonal antibody would be very useful and might enrich treatment strategies in COVID-19." Access here |
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01June 2020 "The dynamically changing epidemiological situation related to SARS-CoV-2 infection poses challenges also for allergists. Both allergic diseases affecting many organs, especially the respiratory system, and the procedures used by allergists give rise a number of questions about
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"Angiotensin-converting enzyme (ACE)2 receptor, an entry receptor for SARS-CoV and present on type 2 pneumocytes in the lung, ileal absorptive enterocytes, and nasal goblet secretory cells in nasal mucosa. Access here |
26 May 2020 "This interesting article shows that the ApoE e4e4 allele increases risks of severe COVID-19 infection, independent of pre-existing dementia, cardiovascular disease, and type-2 diabetes. This article was selected by Adam Klocperk, Marketa Bloomfield, Tomáš Milota, and Anna Sediva Access here |
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"This is a binational (Italian – Chinese) multicenter prospective study to assess cutaneous involvement in COVID-19, performed between 1.01-15.03.2020. The authors state that the dermatological manifestations could not be correlated to COVID-19 severity. Diffuse petechiae, gravity-dependent and multiple, generalized palpable purpura, and acroischemia (primarily finger/toe cyanosis, but no skin bulla nor dry gangrene) were seen in severe cases. Skin manifestations were observed in only 7.8% of the cohort, and these skin findings are generally mild and self-limiting and do not correlate with overall prognosis.” |
"Single center case-control study in Lombardia, Italy, of 1193 psoriasis patients treated with biologics compared to the Lombardia population as controls, assessing the risk of contracting COVID-19, and analysing mortality, and ICU admission rates. Furthermore severity of COVID-19 disease was reviewed. Access here |
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22 April 2020 This article was selected by FJS van der Velden, MD (resident paeds) & G. Tramper, PhD, MD (paediatrician, paediatric infectiologist) Access here |
26 March 2020 "In the event of a global infectious pandemic, drastic measures may be needed that limit or require adjustment of ambulatory allergy services. However, no rationale for how to prioritize service shut down and patient care exists. A consensus-based ad-hoc expert panel of allergy/immunology specialists from the United States and Canada developed a service and patient prioritization schematic to temporarily triage allergy/immunology services." https://www.sciencedirect.com/science/article/pii/S2213219820302531 |
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24 March 2020 "As COVID-19 continues to spread, it is important that we are ready to continue to care for patients, and to recognize patients who may potentially have, or have been exposed to, COVID-19." https://www.worldallergy.org/UserFiles/file/Preparing_your_office_COVID-19.pdf |
16 March 2020 "AIT and COVID-19 |
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