在1095名过敏患者中，空气过敏原免疫疗法与降低严重COVID-19风险相关。

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核心技术专利：CN118964589B侵权必究

Suppr 超能文献

核心技术专利：CN118964589B侵权必究

Larenas-Linnemann Désirée, Morfin-Maciel Blanca María, Bedolla-Barajas Martín, López-Bago Ana, Navarrete Rodríguez Elsy Maureen, Mogica-Martínez María Dolores, Gereda José E, Sarrazola Sanjuan Mauricio, Cano Pedroza Rosa Yazmín, Cavallo María Cecilia, Romero Tapia Sergio de Jesús, Jossen Roberto A, Fuentes Pérez José Miguel, Del Rio Navarro Blanca E, Rodríguez Zagal Erendira, Piraino Sosa Pedro A, Huerta Villalobos Yunuen Rocío, Chavez-Vereau Pierre, García Imperial Daniel Alberto, Olivares Gómez Margarita, Valle Rodríguez Francisco, Zuñiga Reyes Carlos Omar, Rodríguez-González Mónica, Gallego Corella Claudia Ivonne, Ivancevich Juan Carlos, García Cruz María de la Luz Hortencia, Repka-Ramirez María Susana, Flores Morales Mauricio Ernesto, Fernández De Córdova Aguirre Juan Carlos, Luna-Pech Jorge A, Rivero Yeverino Daniela, Martínez Guzmán Edgar, Pérez Ortiz Cinthia Elizabeth, Villa Médica Leonor

Médica Sur Fundación y Hospital, Centro de Excelencia en Asma y Alergia, Mexico City, Mexico.

Hospital San Angel Inn Chapultepec, Mexico City, Mexico.

World Allergy Organ J. 2023 May;16(5):100779. doi: 10.1016/j.waojou.2023.100779. Epub 2023 May 3.

INTRODUCTION: Allergen immunotherapy (AIT) brings along changes in the immune system, restoring dendritic cell function, reducing T2 inflammation and augmenting the regulatory cell activation. Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, interferes with the immune system causing immune suppression during the first phase and over-activation in more advanced disease. We decided to explore the interaction of both in a real-world observational trial. METHODS: We registered COVID-19 outcomes in patients with allergic disorders in Latin America, treated with and without AIT. The registry was conducted during the first 1.3 years of the pandemic, with most of the data collected before COVID-19 vaccination was concluded in most countries. Data collection was anonymous via a web-based instrument. Ten countries participated. RESULTS: 630/1095 (57.6%) of the included patients received AIT. Compared to patients without AIT, those treated with AIT had a reduced risk ratio (RR) for COVID-19 lower respiratory symptoms (RR 0.78, 95% CI: 0.6703-0.9024; p = 0.001662) and need for oxygen therapy (RR 0.65, 95% CI: 0.4217-0.9992; p = 0.048). In adherent patients on maintenance sublingual immunotherapy/subcutaneous immunotherapy (SLIT/SCIT) the RR reduction was larger [RR = 0.6136 (95% CI 0.4623-0.8143; p < 0.001) and RR: 0.3495 (95% CI 0.1822-0.6701; p < 0.005), respectively]. SLIT was slightly more effective (NS). We excluded age, comorbidities, level of health care attendance, and type of allergic disorder as confounders, although asthma was related to a higher frequency of severe disease. When analyzing patients with allergic asthma (n = 503) the RR reduction favoring AIT was more pronounced with 30% for lower respiratory symptoms or worse (RR 0.6914, 95% CI 0.5264 to 0.9081, p = 0.0087) and 51% for need of oxygen therapy or worse (RR 0.4868, 95% CI 0.2829-0.8376, p = 0.0082). Among severe allergic patients treated with biologics (n = 24) only 2/24 needed oxygen therapy. There were no critical cases among them. CONCLUSION: In our registry AIT was associated with reduced COVID-19 severity.

引言：变应原免疫疗法（AIT）会带来免疫系统的变化，恢复树突状细胞功能，减轻2型炎症并增强调节性细胞的激活。由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染引起的冠状病毒病（COVID-19）会干扰免疫系统，在第一阶段导致免疫抑制，在病情更严重时导致过度激活。我们决定在一项真实世界观察性试验中探究两者之间的相互作用。方法：我们记录了拉丁美洲患有过敏性疾病且接受或未接受AIT治疗的患者的COVID-19结局。该登记在大流行的前1.3年进行，大多数数据是在大多数国家完成COVID-19疫苗接种之前收集的。通过基于网络的工具进行匿名数据收集。有10个国家参与。结果：纳入的患者中有630/1095（57.6%）接受了AIT。与未接受AIT的患者相比，接受AIT治疗的患者出现COVID-19下呼吸道症状的风险比（RR）降低（RR 0.78，95%置信区间：0.6703 - 0.9024；p = 0.001662），且需要氧疗的风险比降低（RR 0.65，95%置信区间：0.4217 - 0.9992；p = 0.048）。在坚持维持性舌下免疫疗法/皮下免疫疗法（SLIT/SCIT）的患者中，RR降低幅度更大[RR分别为0.6136（95%置信区间0.4623 - 0.8143；p < 0.001）和RR：0.3495（95%置信区间0.1822 - 0.6701；p < 0.005）]。SLIT的效果稍好（无统计学差异）。我们排除了年龄、合并症、医疗保健就诊水平和过敏性疾病类型作为混杂因素，尽管哮喘与严重疾病的更高发生率相关。在分析过敏性哮喘患者（n = 503）时，支持AIT的RR降低在出现下呼吸道症状或更严重症状时更为明显，降低了30%（RR 0.6914，95%置信区间0.5264至0.9081，p = 0.0087），在需要氧疗或更严重情况时降低了51%（RR 0.4868，95%置信区间0.2829 - 0.8376，p = 0.0082）。在接受生物制剂治疗的重度过敏患者（n = 24）中，只有2/24需要氧疗。其中没有危重症病例。结论：在我们的登记研究中，AIT与降低COVID-19严重程度相关。