Allergic diseases and COVID-19: experience of a single Italian hospital during the first COVID-19 wave


The aim of this study was to compare the number of the Pediatric Emergency Department (PED) visits for young allergic patients with respiratory or cutaneous symptoms during the first wave of the coronavirus disease 19 (COVID-19) pandemic in 2020 with the same period in 2019, evaluating the percentage of positive cases to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). We carried out a retrospective analysis using data from young patients who visited the PED with cutaneous or respiratory symptoms in the period from 20th February to 12th May of the years 2020 and 2019. Data on allergy and COVID-19 nasal swab were also collected. We observed eleven (28.2%) PED visits for allergic patients with respiratory or cutaneous symptoms for the period from 20th February to 12th May of the year 2020 and ninety-three (31.8%) PED visits for the same time frame of the year 2019 (p=0.645). Only a two-month-old child out of 39 patients with non-allergic respiratory or cutaneous symptoms resulted positive for SARS-CoV-2. Specifically, we found for all the PED visits: 21 (7.2%) in 2019 vs 2 (5.1%) in 2020 for patients with urticaria/angioedema or atopic dermatitis (p=0.634); 3 (1.0%) in 2019 vs 3 (7.7%) in 2020 for patients with anaphylaxis (p=0.003); 19 (6.5%) in 2019 vs 2 (5.1%) in 2020 for those with asthma (p=0.740); 11(3.8%) in 2019 vs 1(2.6%) in 2020 for those with lower respiratory diseases, excluding asthma (p=0.706); 39(13.4%) in 2019 vs 3 (7.7%) in 2020 for those with upper respiratory diseases (URDs) (p=0.318). We also showed a substantial decrease (~80%) in all PED visits compared with the same time frame in 2019 (absolute number 263 vs 1211, respectively). Among all the PED visits a significant reduction was mostly found for URDs [155 (12.8%) in 2019 vs 17 (6.5%) in 2020; p=0.045)]. The total number of PED visits for allergic patients with respiratory or cutaneous symptoms dropped precipitously in 2020. It is very tricky to estimate whether it was a protective action of allergy or the fear of contagion or the lockdown or a reduction in air pollution that kept children with allergy from visiting the PED. Further studies are needed to better understand the impact of underlying allergies on COVID-19 susceptibility and disease severity.



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World Health Organization. Asthma. 2006. Accessed on: 7 March 2007. Available from:

Attanasi M, Pasini S, Caronni A, Pellegrino GM, Faverio P, Di Pillo S, et al. Inpatient care during the COVID-19 pandemic: A survey of Italian physicians. Respiration 2020;99:667-77. DOI:

Shaker MS, Oppenheimer J, Grayson M, Stukus D, Hartog N, Hsieh EWY, et al. COVID-19: pandemic contingency planning for the allergy and immunology clinic. J Allergy Clin Immunol Pract 2020;8:1477-88.e5. DOI:

Centers for Disease Control and Prevention [Internet]. People who are at higher risk for severe illness. Updated July 30, 2020. Available from: conditions.html

Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis 2020;94:91-5. DOI:

Pearce N, Aït-Khaled N, Beasley R, Mallol J, Keil U, Mitchell E, et al. Worldwide trends in the prevalence of asthma symptoms: phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax 2007;62:758-66. DOI:

Angoulvant F, Ouldali N, Yang DD, Filser M, Gaidos V, Rybak A, et al. COVID-19 pandemic: impact caused by school closure and national lockdown on pediatric visits and admissions for viral and non-viral infections, a time series analysis. Clin Infect Dis 2021;72:319-22. DOI:

DeLaroche AM, Rodean J, Aronson PL, Fleegler EW, Florin TA, Goyal M, et al. Pediatric emergency department visits at US children's hospitals during the COVID-19 pandemic. Pediatrics 2021;147:e2020039628. DOI:

Haddadin Z, Blozinski A, Fernandez K, Vittetoe K, Greeno AL, Halasa NB, Lovvorn HN III. Changes in pediatric emergency department visits during the COVID-19 pandemic. Hosp Pediatr 2021;11:e57-e60. DOI:

Licari A, Votto M, Brambilla I, Castagnoli R, Piccotti E, Olcese R, et al. Allergy and asthma in children and adolescents during the COVID outbreak: What we know and how we could prevent allergy and asthma flares. Allergy 2020;75:2402-5. DOI:

Jackson DJ, Busse WW, Bacharier LB, Kattan M, O’Connor GT, Wood RA, et al. Association of respiratory allergy, asthma and expression of the SARS-CoV-2 receptor, ACE2. J Allergy Clin Immunol 2020;146:203-6.e3. DOI:

Lindsley AW, Schwartz JT, Rothenberg ME. Eosinophil responses during COVID-19 infections and coronavirus vaccination. J Allergy Clin Immunol 2020;146:1-7. DOI:

Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis 2020;71:762-8. DOI:

Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy 2020;75:1730-41. DOI:

Castro-Rodriguez JA, Forno E. Asthma and COVID-19 in children - a systematic review and call for data. Pediatr Pulmonol 2020;55:2412-2418. DOI:

Boechat JL, Wandalsen GF, Kuschnir FC, Delgado L. COVID-19 and pediatric asthma: Clinical and management challenges. Int J Environ Res Public Health 2021;18:1093. DOI:

Hurst JH, Zhao C, Fitzpatrick NS, Goldstein BA, Lang JE. Reduced pediatric urgent asthma utilization and exacerbations during COVID-19 pandemic. Pediatr Pulmonol 2021. Online ahead of print. DOI:

Guijon OL, Morphew T, Consulting M, Ehwerhemuepha L, Galant SP. Evaluating the impact of COVID-19 on asthma morbidity: a comprehensive analysis of potential influencing factors. Ann Allergy Asthma Immunol 2021;127:91-9. DOI:

Papadopoulos NG, Mathioudakis AG, Custovic A, Deschildre A, Phipatanakul W, Wong G, et al. Childhood asthma outcomes during the COVID- 19 pandemic: findings from the:1765 PeARL multinational cohort. Allergy 2021;76:1765-75. DOI:

Brake SJ, Barnsley K, Lu W, Mc Alinden KD, Eapen MS, Sohal SS. Smoking upregulates angiotensin-converting enzyme-2 receptor: A potential adhesion site for novel Coronavirus SARS-CoV-2 (Covid-19). J Clin Med 2020;9:841. DOI:

Bacharier LB, Beigelman A, Calatroni A, Jackson DJ, Gergen PJ, O'Connor GT, et al. Longitudinal phenotypes of respiratory health in a high-risk urban birth cohort. Am J Respir Crit Care Med 2019;199:71-82. DOI:

Lazzerini M, Barbi E, Apicella A, Marchetti F, Cardinale F, Trobia G. Delayed access or provision of care in Italy resulting from fear of COVID-19 (2020). Lancet Child Adolesc Health 4:e10-1. DOI:

Ciacchini B, Tonioli F, Marciano C, Faticato MG, Borali E, Pini Prato A, et al. Reluctance to seek pediatric care during the COVID-19 pandemic and the risks of delayed diagnosis. Ital J Pediatr 2020;46:87. DOI:

Cozzi G, Zanchi C, Giangreco M, Rabach I, Calligaris L, Giorgi R, et al. The impact of the COVID-19 lockdown in Italy on a pediatric emergency setting. Acta Paediatr 2020;109:2157-9. DOI:

Pines JM, Zocchi MS, Black BS, Carlson JN, Celedon P, Moghtaderi A, et al. Characterizing pediatric emergency department visits during the COVID-19 pandemic. Am J Emerg Med 2021;41:201-4. DOI:

Bao R, Zhang A. Does lockdown reduce air pollution? Evidence from 44 cities in northern China. Sci Total Environ 2020;731:139052. DOI:

Hassoun A, Pugh S, Merced I, Sharma M. The power of social isolation on pediatric emergency visits during COVID-19 lockdown. Acta Paediatr 2020;109:2425-6. DOI:

Dutheil F, Baker JS, Navel V. COVID-19 as a factor influencing air pollution? Environ Pollut 2020;263:114466. DOI:

Letters to the Editor
COVID-19, children, allergic diseases
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How to Cite
Attanasi, M., Porreca, A., Sferrazza Papa, G. F., Di Donato, G., Cauzzo, C., Patacchiola, R., Di Filippo, P., Di Pillo, S., & Chiarelli, F. (2021). Allergic diseases and COVID-19: experience of a single Italian hospital during the first COVID-19 wave. Multidisciplinary Respiratory Medicine, 16.