INTRODUCTION:
On March 11, 2020 when the World Health Organization (WHO) declared the
’corona virus disease 2019’ (COVID-19) a pandemic, the first case was
announced by the Ministry of Health in Turkey. COVID-19 pandemic itself
and the social restriction measures applied to control the transmission
of the virus have influenced many areas of medical interventions
including ongoing treatments of chronic diseases all over the world.
Meanwhile statements from specific health organisations have been
announced to warn patients and healthcare professionals about the
importance of maintaining such treatments under many different clinical
conditions. Similarly, a recent Allergic Rhinitis and its Impact on
Asthma (ARIA)-European Academy for Allergy and Clinical Immunology
(EAACI) statement has addressed issues and recommendations on how to
handle allergen immunotherapy (AIT) during the
pandemic1.
AIT, the only disease modifying therapy that confers a long-term
clinical benefit for respiratory, venom and food allergies, has been
used as a treatment modality for more than 100
years2-5. Subcutaneous immunotherapy (SCIT), the
oldest route of administration has disadvantages like necessity of
regular follow-ups and applications in the clinic when compared to other
routes2,3,6. Therefore, it is inevitable that there
could be disruptions in SCIT administrations during the COVID-19
pandemic that has deeply affected the health care system.
The ARIA-EAACI statement document recommended prolonging injection
intervals during SCIT in patients acutely infected by severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) like in other
respiratory infections. However, by taking necessary precautions, the
continuation of SCIT was recommended in asymptomatic patients without
suspicious infection and/or possible contact with SARS-CoV-2 positive
individuals, in patients with negative test results, in those following
an adequate quarantine period and finally in those with high serum IgG
levels to SARS-CoV2 with non-detectable virus specific IgM
levels1. This statement is expected to have an
important influence in guiding daily clinical practice of SCIT in many
countries since treatment disruptions caused by a pandemic is a new
field for the physicians and it is important to prevent any negative
effects on treatment success. Real-life data on SCIT practices during
the pandemic are important to show the implementation and further
improvement of such recommendations. In this real-life multicentre
study, our aim was to investigate adherence to SCIT and influence of
treatment disruptions on short-term clinical outcomes in patients on
maintenance phase of SCIT with aeroallergens during the COVID-19
pandemic.