COVID-19 Resource Centre

COVID 19 banner April 2020 min

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.


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."




EAACI Allergy Journal 

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2 April 2021
Vaccines and allergic reactions: the past, the current COVID‐19 pandemic, and future perspectives.

"Vaccines are essential public health tools with a favorable safety profile and prophylactic effectiveness that have historically played significant roles in reducing infectious disease burden in populations, when the majority of individuals are vaccinated. The COVID‐19 vaccines are expected to have similar positive impacts on health across the globe."

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 2 April 2021

Skin tests in urticaria/angioedema and flushing to Pfizer‐BioNTech SARS‐CoV‐2 vaccine: limits of intradermal testing                   

"During clinical approval studies and early post‐marketing phases, mucous‐cutaneous adverse reactions have been rarely observed. Among hypersensitivity reactions, immediate reactions (anaphylaxis, urticaria‐angioedema syndrome) were more frequently observed than delayed reactions (maculo‐papular eruptions)."


27 March 2021

Real‐life impact of COVID‐19 pandemic lockdown on the management of pediatric and adult asthma: a survey by the EAACI Asthma Section  

"The restrictions imposed by the COVID‐19 pandemic impact heavily the management of chronic diseases like asthma. This study aimed to evaluate the management of adults and children with asthma during COVID‐19‐related lockdown."



25 March 2021
Detection of SARS‐CoV‐2 Specific Memory B cells to Delineate Long‐Term COVID‐19 Immunity

ur study performed on a central-European cohort is in line with the data on the recently  published US-American and Australian cohorts and accordingly, confirms and extends the knowledge on  the  B  cell-response  against  SARS-CoV-2.  Demonstrating  the  persistence  of  SARS-CoV-2-specific  B  cell- response,  our  results point  towards  an  additional  hallmark  of  immunization  beyond  specific  serum  antibodies."

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 18 March 2021

Pros and Cons for the role of air pollution on COVID-19 Development

"As SARS‐CoV‐2 has spread across the globe, it has been difficult to ignore patterns suggesting that regions with poor air quality are witnessing disproportionate impacts in terms of the frequency and severity of COVID‐19 infection. Consequently, researchers have rightly recognized the importance of considering the role of air pollution inthe COVID‐19 pandemic.Here, we discussthe pros and cons of air pollution as a contributing factorto COVID‐19, according to existing research questions."


17 March 2021

Differentiation of COVID-19 signs and symptoms from allergic rhinitis and common cold - an ARIA- EAACI - GA2LEN consensus

"Although there are many asymptomatic patients, one of the problems of COVID‐19 is early recognition of the disease. COVID‐19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID‐19 symptoms may be mistaken withthe common cold or allergic rhinitis. An ARIA‐EAACI study group attempted to differentiate upper respiratory symptoms betweenthe three diseases"


3 March 2021

Allergenic components of the mRNA‐1273 vaccine for COVID‐19: possible involvement of polyethylene glycol and IgG‐mediated complement activation

"Following the emergency use authorization of the mRNA‐1273 vaccine on the 18thof December 2020,two mRNA vaccines are in current use for the prevention of coronavirus disease 2019 (COVID‐19). For both mRNA vaccines, the phase IIIpivotal trials excluded individuals with a history of allergy to vaccine components."

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 02 March 2021
COVID-19 Pandemic and allergen immunotherapy - an EAACI survey.

"As in many fields of medical care, the coronavirus disease 2019 (COVID‐19) resulted in an increased uncertainty regarding the safety of allergen immunotherapy (AIT). Therefore, the European Academy of Allergy and Clinical Immunology (EAACI) aimed to analyze the situation in different countries and systematically collect all information available regarding tolerability and possible amendments in daily practice of sublingual AIT (SLIT), subcutaneous AIT (SCIT) for inhalant allergies and venom AIT."



 01 March 2021
Impact of anxiety, stress and depression related to COVID-19 pandemic on the course of hereditary angioedema with C1 inhibitor deficiency.

Hereditary angioedema (HAE) attacks can be provoked with psychological factors. The aim of this study was to assess the effects of anxiety, depression and stress related to COVID‐19 pandemic on disease activity of HAE patients during the quarantine period (QP) and the return to normal period (RTNP)."


 20 February 2021
Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort.

"The PeARL multinational cohort included 1,054 children with asthma and 505 non‐asthmatic children aged between 4 and 18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID‐19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control."


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 11 February 2021
Management of patients with atopic dermatitis undergoing systemic therapy during COVID‐19 pandemic in Italy: data from the DA‐COVID‐19 registry.

"A national registry, named DA‐COVID‐19 and involving 35 Italian dermatology units, was established in order to evaluate the impact of COVID‐19 pandemic on the management of adult AD patients treated with systemic immunomodulant/immunosuppressive medications or phototherapy. Demographic and clinical data were obtained at different timepoints by teledermatology during COVID‐19 pandemic, when regular visits were not allowed due to sanitary restrictions. Disease severity was assessed by both physician‐ and patient‐reported assessment scores evaluating itch intensity, sleep disturbances, and AD severity."



 31 January 2021
Enzymatic activity of ACE2 regulates type 2 airway inflammation in mice.

Coronavirus disease 2019 (COVID-19), caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a global pandemic. SARS-CoV-2 spike protein binds to angiotensin-converting  enzyme  2  (ACE2),  a  transmembrane  endopeptidase  on  host  cells  of  the  airway  epithelium  surface  for  invasion  and  infection;  therefore,  most  COVID-19  research  has focused on ACE2. Patients with chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis  are  reportedly  at  a  high  risk  of  COVID-19  morbidity  and  mortality,  regardless  of whether they have asthma."


 23 January 2021
Elastase and Exacerbation of Neutrophil Innate Immunity are Involved in Multi‐Visceral Manifestations of COVID‐19.

"Many arguments suggest that neutrophils could play a prominent role in COVID‐19. However, the role of key components of neutrophil innate immunity in severe forms of COVID‐19 has deserved insufficient attention. We aimed to evaluate the involvement of neutrophil elastase, histone‐DNA, and DNases in systemic and multi‐organ manifestations of COVID‐19."


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 16 January 2021
EAACI statement on the diagnosis, management and prevention of severe allergic reactions to COVID‐19 vaccines

"We provide a simplified algorithm of prevention, diagnosis and treatment of severe allergic reactions and a list of recommended medications and equipment for vaccine centres.
We also describe potentially allergenic/immunogenic components of the approved vaccines and propose a workup to identify the responsible allergen. Finally, we identify unmet research needs and propose a concerted international roadmap towards precision diagnosis and management to minimise the risk of allergic reactions to COVID‐19 vaccines and to facilitate their broader and safer use."



 30 December 2020
ARIA‐EAACI statement on severe allergic reactions to COVID‐19 vaccines – an EAACI‐ARIA position paper.

"Coronavirus disease 2019 (COVID‐19) vaccine BNT162b2 received approval and within the first few days of public vaccination several severe anaphylaxis cases occurred. An investigation is taking place to understand the cases and their triggers. The vaccine will be administered to a large number of individuals worldwide and concerns raised for severe adverse events might occur. With the current information, the European Academy of Allergy and Clinical Immunology (EAACI) states its position for the following preliminary recommendations that are to be revised as soon as more data emerges."


 28 November 2020
Association between asthma and clinical mortality/morbidity in COVID‐19 patients using clinical epidemiologic data from Korean Disease Control & Prevention

"Coronavirus disease 2019 (COVID‐19) has rapidly spread worldwide, posing a serious public health problem.1 The prevalence of asthma in COVID‐19 patents differs among studies, with 0.0% reported in Wuhan, China, and markedly higher prevalence rates of 17% and 14% reported in the United States (US) and the United Kingdom (UK), respectively.2-4 Data from the UK showed that asthma was a risk factor for severe COVID‐19; however, another study from the United States showed no association between asthma and severe disease, suggesting that it is still unclear whether asthma is a risk factor for a poor prognosis.."



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 7 January 2021
Association of endopeptidases, involved in SARS‐CoV‐2 infection, with microbial aggravation in sputum of severe asthma.

"High expression of such endopeptidases may be associated not only with a higher risk of SARS‐CoV‐2 infection but also with microbial imbalances in severe asthma. Therefore, the aim of this study was to investigate associations of sputum endopeptidases gene expression with metagenomics composition and whether they could be used to stratify asthma patients according to risk of SARS‐CoV‐2 infection."



 31 December 2020
Genetic Predisposition to allergic diseases is inversely associated to risk of COVID-19

"Allergic diseases such as allergic rhinitis (hay fever), atopic dermatitis (eczema) and asthma tend to cluster together in individuals, partly because of shared genetic factors that navigate the immune system. However, it is not yet known whether genetic predisposition to allergic disease also relates to COVID‐19 susceptibility. Understanding this relationship may provide mechanistic insight towards uncovering preventative and therapeutic strategies for COVID‐19."


 19 December 2020
SARS-COV-2 Candidate vaccines - composition, mechanisms of action and stages of clinical development

"Due to the extensive scientific‐industry collaborations the vaccine field is evolving at an unprecedented speed. Yet, to stop the pandemics equal access to the vaccine all over the world, limiting the costs of vaccines and logistics, close monitoring and reporting of adverse events are absolutely necessary. Development of a successful SARS‐CoV‐2 vaccine should not slow down the studies on the effective broader antiviral treatments. If not for SARS‐CoV‐2, we will need it for another coronavirus or an inevitably emerging virus X."


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15 December 2020
Allergic reactions to the first COVID‐19 vaccine: a potential role of polyethylene glycol?

"The COVID‐19 vaccine developed by Pfizer and BioNTech was approved by the Medicines and Healthcare Products Regulatory Agency (MHRA) in the United Kingdom (UK) on December 2nd 2020. MHRA is therefore the first regulator agency in the world to approve a vaccine to prevent coronavirus disease (COVID‐19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), a virus that is responsible for a global pandemic."



15 December 2020
The role of circulating eosinophils on COVID‐19 mortality varies by race/ethnicity

"During this rapidly moving international health crisis, varying and seemingly contrasting reports indicate both a protective and exacerbating contribution of atopy to the severity of coronavirus disease 2019 (COVID‐19) caused by severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2). Further, worse outcomes have been reported in association with certain races/ethnicities, highlighting health disparities possibly related to systemic racism, access to care, income inequality, occupational hazards, and disproportionate medical comorbidities."




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 12 December 2020
Multidisciplinary consensus on sputum induction biosafety during the COVID-19 pandemic

"Sputum induction (SI) is the gold standard approach to the non‐invasive study of airway inflammation. The multidisciplinary consensus on SI described in this article was developed by 22 experts in SI from different Spanish hospitals who drew on available scientific evidence in achieving consensuated opinions, compiled by means of an electronic survey."


 7 December 2020
The global impact of the COVID-19 pandemic on the management and course of chronic urticaria

"The COVID‐19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown.The long‐term consequences of these changes, especially the increased use of remote consultations, require careful evaluation."


 19 November 2020
Distinct expression of SARS- CoV-2 receptor ACE2 correlates with endotypes of rhinosinusitis with nasal polyps

"Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) entry factors, ACE2 and TMPRSS2, are highly expressed in nasal epithelial cells. However, the association between SARS‐CoV‐2 and nasal inflammation in chronic rhinosinusitis with nasal polyps (CRSwNP) has not been investigated. We thus investigated the expression of SARS‐CoV‐2 entry factors in nasal tissues of CRSwNP patients, and their associations with inflammatory endotypes of CRSwNP."

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13 November 2020
Risk factors for severe and critically ill COVID-19 patients: A review

"Intranasal corticosteroids remain the standard treatment for CRS in patients with SARS‐CoV‐2 infection. Surgical treatments should be reduced to a minimum and surgery preserved for patients with local complications and for those with no other treatment options. Systemic corticosteroids should be avoided. Treatment with biologics can be continued with careful monitoring in non‐infected patients and should be temporarily interrupted during the course of the COVID‐19 infection."



31 October 2020
Immunological imprint of COVID-19 on human peripheral blood leukocyte populations

"SARS‐CoV‐2 has triggered a pandemic that is now claiming many lives. Several studies have investigated cellular immune responses in COVID‐19‐infected patients during disease but little is known regarding a possible protracted impact of COVID‐19 on the adaptive and innate immune system in COVID‐19 convalescent patients."



19 October 2020
Management of patients with chronic rhinosinusitis during the COVID‐19 pandemic – An EAACI Position Paper

"Intranasal corticosteroids remain the standard treatment for CRS in patients with SARS‐CoV‐2 infection. Surgical treatments should be reduced to a minimum and surgery preserved for patients with local complications and for those with no other treatment options. Systemic corticosteroids should be avoided. Treatment with biologics can be continued with careful monitoring in non‐infected patients and should be temporarily interrupted during the course of the COVID‐19 infection."




10 October 2020
Regional differences in ACE2 expression in the sinonasal mucosa of adult Chinese patients with chronic rhinosinusitis

"In summary, our study provides the first evidence of regional differences in ACE2 expression in the sinonasal mucosa of patients with CRS and that ACE2 expression in CRS tissues is associated with type I IFN response and not type 2 response (Figure 2C)."


10 October 2020
Antibody dynamics to SARS‐CoV‐2 in asymptomatic COVID‐19 infections

"Our findings might have important implications for the definition of asymptomatic COVID‐19 infections, diagnosis, serological survey, public health, and immunization strategies."


04 October 2020
Characterization of asthma and risk factors for delayed SARS‐CoV‐2 clearance in adult COVID‐19 inpatients in Daegu

"In summary, despite the differences depending on phenotypes, the prevalence of asthma was not significantly different in patients with COVID-19, and asthma did not affect the outcomes of COVID-19 in multivariate analysis. Dementia, older age, and initial presentation of skin rash and anemia were independently associated with delayed viral clearance. On the other hand, in patients with headache initially, the viral clearance time was shortened"

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30 September 2020
Accuracy of serological testing for SARS‐CoV‐2 antibodies: first results of a large mixed‐method evaluation study

"ELISAs targeting RBD and S1 protein of SARS‐CoV‐2 are promising immunoassays which shall be further evaluated in studies verifying diagnostic accuracy and protective immunity against SARS‐CoV‐2."


23 September 2020
Small droplet emission in exhaled breath during different breathing manoeuvres: Implications for clinical lung function testing during COVID‐19

"In summary, we show that small droplet emission varies for different breath manoeuvre performed during PFTs, with very low production in TV and sVC from FRC and low production during FEV. Consideration of performing PFTs in different clinical settings could account for these differences, with future focus of clinical risk also on room ventilation."


21 September 2020
Dexamethasone, pro‐resolving lipid mediators and resolution of inflammation in COVID‐19

"Coronavirus disease‐19 (COVID‐19) is a new disease caused by SARS‐CoV‐2. Since the beginning of 2020, it has become one of the main challenges of our times, causing a high incidence of severe pneumonia, acute respiratory distress syndrome (ARDS), multiorgan failure and death1. At the root of COVID‐19 lies the sudden development of ‘cytokine storms’, hyper‐inflammatory responses involving the release of pro‐inflammatory cytokines (e.g., TNF, IL‐6, IL‐1, IL‐8, and MCP‐1) that impair the gas exchange function of the lung and lead in select patients, mostly with underlying comorbidities, to multiorgan failure and death."




18 September 2020
Asthma control, self‐management and healthcare access during the COVID‐19 epidemic in Beijing

"The results support the recommendation that patients continue taking their prescribed asthma medications as usual and maintain good asthma control during the ongoing pandemic. For containment of viral transmission, social distancing is being encouraged, but measures should be taken to mitigate the negative impact on asthma"


07 September 2020
Thirty‐six COVID‐19 cases preventively vaccinated with mumps‐measles‐rubella vaccine: all mild course

"Thus, with the here presented cases we support the AMS declaration that MMR vaccination, as a preventive measure, might reduce the severity of COVID-19, although we differ in our view on the mechanisms by which we hypothesize this happens. Though randomized, clinical and mechanistic trials shall be needed to unravel this topic, taking in consideration there are hardly any safety concerns, we maintain our positive attitude toward MMR vaccination during this pandemic."


27 August 2020
Angiotensin‐converting enzyme II expression and its implication in the association between COVID‐19 and allergic rhinitis

"In conclusion, for the first time, we provide the evidence that AR comorbidity may not have significant modifying effect on the development and expression of COVID‐19. ACE2 expression is not altered in AR patients. ACE2 gene expression in airways is regulated, at least in part, by the counter effect of type 2 and IFN inflammation."


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16 August 2020
Atopic status protects from severe complications of COVID‐19

"In conclusion, atopic status seems to protect against the most severe, often fatal consequences of SARS‐CoV‐2 infection. Such finding may be of help for future studies investigating how to limit the clinical consequences of this infection."


14 August 2020
Severe asthma in adults does not significantly affect the outcome of COVID‐19 disease: results from the Italian Severe Asthma Registry

"Despite the clinical burden of severe asthma is substantial, there is evidence of a neutral effect of severe asthma in the clinical progression and hospitalization due to COVID-19 in a cohort of Italian severe asthma patients. Treatment with biologics for severe asthma also seems to have no significant effect on the outcome of COVID-19"


06 August 2020
Cabbage and fermented vegetables: from death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID‐19

"The nuclear factor (erythroid‐derived 2)‐like 2 (Nrf2) is the most potent antioxidant in humans and can block the AT1R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are given: Kimchi in Korea, westernized foods and the slum paradox. It is proposed that fermented cabbage is a proof‐of‐concept of dietary manipulations that may enhance Nrf2‐associated antioxidant effects helpful in mitigating COVID‐19 severity."



05 August 2020
Delayed virus‐specific antibody responses associate with COVID‐19 mortality

"Collectively, for the first time, our study provides evidence that delayed antibody responses correlate with poor clinical outcome of COVID‐19 patients. This notion is strongly supported by the reduction of SARS‐CoV‐2‐specific IgM and IgG levels and frequencies of ASCs and TFH cells in the early stage of disease in deceased patients compared with survived patients, which highlights the importance of early adaptive immune responses in patients with COVID‐19."


05 August 2020
Cross‐sectional pilot study exploring the feasibility of a rapid SARS‐CoV‐2 immunization test in health and nonhealthcare workers

"(...)the results obtained from this rationale together with the information related to previous pathologies and risk factors will allow the design of personalized strategies of reincorporation into academic activities in the future. This will significantly reduce the human and economic burden of future COVID‐19 infection waves in our community. The proposed strategy can be easily implemented by several research laboratories and might help in better activity plans in other locations to be ready for future outbreaks."


02 August 2020
Blood myeloperoxidase‐DNA, a biomarker of early response to SARS‐CoV‐2 infection?

"In conclusion, our results on a consecutive ambulatory population of COVID‐19 cases suggest that blood level of MPO‐DNA complexes could be a useful biomarker of the early phase of SARS‐CoV‐2 infection. If further studies confirm that the dramatic production of NETs is a pathological mechanism of innate immunity involved in early step of SARS‐CoV‐2 infection, our data could open therapeutic perspectives by targeting NET production with inhibitors already tested in other lung infectious diseases."




01 August 2020
COVID‐19 in Severe Asthma Network in Italy (SANI) patients: Clinical features, impact of comorbidities and treatments

"In conclusion, in our large cohort of severe asthmatics, only a small minority experienced symptoms consistent with COVID‐19, and these patients had peculiar clinical features including high prevalence of NIDDM as comorbidity. Further real‐life registry‐based studies are needed to confirm our findings and to extend the evidence that severe asthmatics are at low risk of developing COVID‐19."


30 July 2020
Antibodies in serum of convalescent patients following mild COVID‐19 do not always prevent virus‐receptor binding

"Our findings suggest that a natural SARS‐CoV‐2 infection, similar to that observed previously for rhinovirus (RV) infections,9 does not induce a protective antibody response inhibiting the virus‐receptor interaction in all infected patients and therefore underline the urgent need for the development of a SARS‐CoV‐2 vaccine. The molecular interaction assays could be useful for identifying subjects having developed protective antibodies and for screening candidate vaccines to induce antibodies that inhibit the RBD‐ACE2 interaction once they have been validated.."


29 July 2020
SARS‐CoV‐2 receptor ACE2 protein expression in serum is significantly associated with age

"In sum, while additional studies are needed to uncover the mechanistic basis of varying COVID‐19 clinical presentations, our data associate significantly higher ACE2 protein expression in the serum of adults compared with infants and toddlers, and in adult males compared with adult females. These data suggest the potential systemic role of ACE2 protein levels in the differential clinical manifestations among various patient populations."

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EAACI Pediatric Allergy and Immunology Journal

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28 October 2020
Is there a role for childhood vaccination against COVID-19?

"Tremendous efforts are undertaken to quickly develop COVID‐19 vaccines that protect vulnerable individuals from severe disease and thereby limit the health and socioeconomic impacts of the pandemic. Potential candidates are tested in adult populations, and questions arise of whether COVID‐19 vaccination should be implemented in children. Compared to adults, the incidence and disease severity of COVID‐19 are low in children, and despite their infectiveness, their role in disease propagation is limited. Therefore, COVID‐19 vaccines will need to have fully demonstrated safety and efficacy in preventing not only complications but transmission to justify childhood vaccination. This work summarizes currently tested vaccine platforms and debates practical and ethical considerations for their potential use in children. It also discusses the already deleterious effect of the pandemic on routine childhood vaccine coverage, calling for action to limit the risks for a rise in vaccine‐preventable diseases."

08 September  2020
The potential threat of multisystem inflammatory syndrome in children during the COVID-19 pandemic

"Multisystem inflammatory syndrome in children (MIS‐C) during the COVID‐19 pandemic raised a global alert from the Centers for Disease Control and Prevention's Health Alert Network. The main manifestations of MIS‐C (also known as pediatric MIS (PMIS)) in the setting of a severe inflammatory state include fever, diarrhea, shock, and variable presence of rash, conjunctivitis, extremity edema, and mucous membrane changes. In some cases, these symptoms progressed to multi‐organ failure. The low percentage of children with asymptomatic cases compared with mild illness and moderate illness could be correlated with the rare cases of MIS‐C. One potential explanation for the progression to severe MIS‐C disease despite the presence of readily detectable anti‐SARS‐CoV‐2 antibodies could be due to the potential role of antibody‐dependent enhancement (ADE). We reason that the incidence of the ADE phenomenon whereby the pathogen‐specific antibodies can promote pathology should be considered in vaccine development against SARS‐CoV‐2."


15 September 2020
The younger the milder clinical course of COVID-19 - even in infants?

"Neonates appeared to bear more severe clinical courses. In addition to higher case fatality rates, newborns with COVID‐19 had much shorter time from symptom onset to death and longer time from symptom onset to discharge. Dyspnoea, sore throat and cough were more prominent in neonate patients, suggestive of both upper and lower respiratory tract infection, as opposed to upper respiratory tract symptoms mostly observed in children."


05 August  2020
Shielding against SARS-CoV-2 infections is not justified in children with severe asthma

"For the EU‐funded project PERMEABLE (PERsonalized MEdicine Approach for asthma and allergy Biologicals SeLEction), which addresses the availability of and access to advanced therapy of asthma in children across Europe, we performed a survey including 37 major pediatric asthma and allergy centres between September 2019 and July 2020. In total, the centres contributing to the survey treated approximately 1.000 young patients with severe asthma in 25 major European countries and Turkey with biologicals. In the light of the corona pandemic, we extended our survey asking the responsible clinicians whether they experienced a SARS‐CoV‐2 infection in any of the children they are caring for. The questions pertaining to corona infections were asked between March and July 2020."


19 July 2020
A male infant with COVID-19 in the context of ARPC1B Deficiency

"The current pandemic of the novel SARS‐CoV‐2 infection has affected over 10 million humans around the planet. The clinical manifestations of coronavirus disease 2019 (COVID‐19) are diverse, ranging from asymptomatic or mild flu‐like symptoms to atypical pneumonia, severe respiratory distress syndrome, systemic inflammation, immune dysregulation, and coagulopathy. Here, we describe a male infant patient with known ARPC1B deficiency, who was hospitalized for COVID‐19 pneumonia and improved without requiring intensive care or mechanical ventilation. Informed consent through protocols approved by the institutional review boards of the National Institute of Pediatrics was obtained from the patient’s family."


09 June 2020
Postnatal SARS‐CoV‐2 Infection and Immunological Reaction: A Prospective Family Cohort Study

"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
African American children are at higher risk for COVID‐19 infection

"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."


15 May 2020
Symptoms and immunoglobulin development in hospital staff exposed to a SARS‐CoV‐2 outbreak

"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."


02 May 2020
The first, holistic immunological model of COVID‐19: Implications for prevention, diagnosis, and public health measures

"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
SARS‐CoV‐2 infection in children – Understanding the immune responses and controlling the pandemic

"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"

22 April 2020
Two X‐linked agammaglobulinemia patients develop pneumonia as COVID‐19 manifestation but recover

"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."


22 April 2020
Managing childhood allergies and immunodeficiencies during respiratory virus epidemics – the 2020 COVID‐19 pandemic - A statement from the EAACI-Section on Pediatrics

"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."

22 April 2020
Successful containment of COVID‐19 outbreak in a large maternity and perinatal center while continuing clinical service

"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."


EAACI Blog Posts

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04 April 2020
Coronavirus infection and allergies: what do we know?

"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."


Other resources


17 June  2020
Genome-wide CRISPR screen reveals host genes that regulate SARS-CoV-2 infection

"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




11 June  2020
A Global Effort to Define the Human Genetics of Protective Immunity to SARS-CoV-2 Infection

"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."

This article was selected by Adam Klocperk, Marketa Bloomfield, Tomáš Milota, and Anna Sediva


02 June  2020
First antibody trial launched in COVID-19 patients

"The article describes the initiation of the first clinical trial ( 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."

This article was selected by Adam Klocperk, Marketa Bloomfield, Tomáš Milota, and Anna

Access here



01June 2020
Position statement of expert panel of the Polish Allergology Society (PTA) on the management of patients with bronchial asthma and allergic diseases during the SARS-CoV-2 pandemic

"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
the proper procedures during the pandemic. This position statement aims to provide allergists with recommendations on the proper management of allergic patients in the current epidemiological situation.."

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28 May  2020
SARS-CoV-2 receptor ACE2 is an interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues

"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.
This paper shows, that ACE2 expression is upregulated by Type 1 IFNs. Furthermore it suggests that SARS-CoV-2 may use species-specific interferon up-regulation of ACE2, a mediator that protects tissues during lung damage, to increase infection. Hence type 1 IFNs, that drive anti-viral immunity on one hand, may paradoxically promote SARS-CoV-2 expansion by upregulating ACE2 expression on the other. As the type 1 IFN regulation in asthma might be impaired, these observations also might be related to the observed underrepresentation of severe Covid-19 among patients with asthma."

This article was selected by FJS van der Velden, MD (resident paeds) & G. Tramper, PhD, MD (paediatrician, paediatric infectiologist)

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26 May 2020
APOE e4 Genotype Predicts Severe COVID-19 in the UK Biobank Community Cohort

"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.
Furthermore, as the novel coronavirus SARSCoV-2 causing COVID-19 uses the ACE2 receptor for cell entry. it is notable that ACE2 is highly expressed in type II alveolar cells in the lungs, where ApoE is one of the highly co-expressed genes."

This article was selected by Adam Klocperk, Marketa Bloomfield, Tomáš Milota, and Anna Sediva

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07 May 2020
Cutaneous manifestations related to coronavirus disease 2019 (COVID-19): A prospective study from China and Italy

"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.”

This article was selected and commented by Dominika Ambrożej and Wojciech Feleszko

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01 May 2020
Biologics increase the risk of SARS-CoV-2 infection and hospitalization, but not ICU admission and death: real-life data from a large cohort during RED-ZONE declaration

"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.
Included psoriasis patients were adults, had moderate to severe disease and used approved anti-psoriatic monotherapy in the maintaining phase. Used medications include: TNFalpha inhibitors, IL 12/23 inhibitors, IL 17, IL 23 inhibitors and small molecules. Demographic and clinical characteristics of cases and controls were similar.
Patients under biologicals were at higher risk of testing positive for COVID 19 (OR 3.43(95% CI 2.25-5.75), more at risk of being self quarantained at home (OR 9.05) and more at risk of being hospitalized (OR 3.49) compared to controls. There was no statistical higher risk of ICU admission or death.
Authors discuss the fact that patients on biologicals might be at risk for respiratory infections, but the detrimental hyperinflammatory phase of COVID-19 as seen in the regular population occurred not in this study group and therefore might have protecte dpatients on biologicals from progression to extrapulmonary manifestations and death.
Limitations: there has not been and adjustment for, i.e. COPD patients or other patients with a known increased risk of severe COVID-19 disease. Furthermore, there hasn’t been a detailed sub analysis of which inhibitors are more or less effective at potentially preventing severe COVID-19. It is important to acknowledge that psoriatic patients on biologicals do show an increased risk of contracting mild-to-moderate COVID-19
Questions for further research include the role of the blocked interleukins in COVID-19. Does a similar pattern occur in i.e. asthma patients on asthma biologicals?"

This article was selected by FJS van der Velden, MD (resident paeds) & G. Tramper, PhD, MD (paediatrician, paediatric infectiologist)

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22 April 2020
Association of Respiratory Allergy, Asthma and Expression of the SARS-CoV-2 Receptor, ACE2

"Asthma and respiratory allergies have not been identified as risk factor for severe Covid-19 disease in case series till now. This paper describes features that could be associated with this diminished risk. In 3 different asthma/allergy cohorts, it was examined whether ACE2 (the receptor for SARS-Cov-2 entry) expression on airway cells was reduced. Allergen sensitisation and allergen exposure was strongly associated with reduced ACE2 expression in all cohorts. This might be mediated by type 2 inflammation, as IL-13 reduced ACE2 in bronchial and nasal epithelium; non-atopic asthma was not associated with this reduction. The role of biological treatment for allergic or type 2 high asthma and SARS-Cov-2 susceptibility is yet unknown. The relation between type 2 inflammatory processes and SARS-Cov-2 disease severity could identify novel therapeutic strategies.

This article was selected by FJS van der Velden, MD (resident paeds) & G. Tramper, PhD, MD (paediatrician, paediatric infectiologist)

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26 March 2020
COVID-19: Pandemic Contingency Planning for the Allergy and Immunology Clinic

"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."


24 March 2020
World Allergy Organization (WAO): Preparing your office for the COVID-19 Pandemic

"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."


16 March 2020
DGAKI statement on asthma and COVID-19

"AIT and COVID-19
March 18, 2020
Dear colleagues,

In the past few days, we have received more and more inquiries regarding the administration of allergen immunotherapy (AIT, also hyposensitization or specific immunotherapy) in times of the COVID-19 pandemic.
If possible, AIT treatments should continue. We would like to make the following recommendations:

When carrying out AIT, the product information for the AIT products must be observed and followed.
AIT in the form of subcutaneous injections (SCIT) or in the form of (sublingual) drops or tablets (SLIT) can be continued in symptom-free and healthy patients and the therapy regimen should not be interrupted.

If signs of infection such as fever, unclear cough or reduced general condition occur, AIT should be stopped and continued at a later (symptom-free) time-point . If SCIT is interrupted, the dose has to be adjusted by the treating doctor and according to the recommendations of the manufacturer. The resumption of SLIT should be carried out under medical supervision.

Prof. Dr. med. O. Pfaar, board member of DGAKI
Prof. Dr. me. Margitta Worm, President of the DGAKI"


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Last updated 26 October 2021
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