新型冠状病毒肺炎对儿童皮下特异性免疫治疗不良反应的影响：一项回顾性队列研究

Impact of COVID-19 on adverse reactions to subcutaneous specific immunotherapy in children:a retrospective cohort study.

作者信息

Li Jingjing, Chen Yanling, Ye Hong, Tang Qiuyu, Wang Chengyi, Zhou Qing, Lin Ling, Jiang Liyuan, Peng Xiuling, Zhang Huimin, Li Haibo, Chen Lumin

机构信息

Fujian Branch of Shanghai Children's Medical Center, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Children's Hospital, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350001, China.

College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350001, China.

出版信息

BMC Infect Dis. 2024 Aug 7;24(1):794. doi: 10.1186/s12879-024-09702-5.

DOI:10.1186/s12879-024-09702-5

PMID:39112970

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11305062/

Abstract

BACKGROUND

COVID-19 is a new infectious disease. To investigate whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increases the adverse reactions of subcutaneous specific immunotherapy (SCIT) in children.

METHODS

This study was conducted by collecting relevant data from children who underwent house dust mite SCIT from April 3, 2021, to March 18, 2023, including information on the time of COVID-19 infection, symptoms, and adverse reactions after each allergen injection. A mixed effects model was used to analyze the changes in adverse reactions before and after the COVID-19 infection.

RESULTS

Among the records of adverse reactions from 2658 injections in 123 children who underwent SCIT, the overall adverse reaction rate before COVID-19 infection was 39.8% and 30.0% after COVID-19 infection. Compared with pre-infection with COVID-19, the risks of overall adverse reactions, local adverse reactions, and systemic adverse reactions of immunotherapy after COVID-19 infection were reduced (odds ratio [OR] = 0.24, 0.31, and 0.28, all P < 0.05). Among the local adverse reactions, the incidence of the unvaccinated group was the highest (15.3% vs. 7.1%). The incidence of overall and local adverse reactions to SCIT decreased in 2-vaccinated COVID-19 recipients (OR = 0.29-0.31, P < 0.05).

CONCLUSIONS

In children, SARS-CoV-2 infection does not increase the incidence of adverse reactions to SCIT. This finding can provide a basis for the implementation of allergen-specific immunotherapy (AIT) during the COVID-19 pandemic.

摘要

背景

新型冠状病毒肺炎（COVID-19）是一种新型传染病。旨在调查严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染是否会增加儿童皮下特异性免疫治疗（SCIT）的不良反应。

方法

本研究通过收集2021年4月3日至2023年3月18日接受屋尘螨SCIT治疗的儿童的相关数据进行，包括COVID-19感染时间、症状以及每次注射过敏原后的不良反应信息。采用混合效应模型分析COVID-19感染前后不良反应的变化。

结果

在123例接受SCIT治疗的儿童的2658次注射不良反应记录中，COVID-19感染前的总体不良反应发生率为39.8%，感染后为30.0%。与COVID-19感染前相比，COVID-19感染后免疫治疗的总体不良反应、局部不良反应和全身不良反应风险均降低（优势比[OR]=0.24、0.31和0.28，均P<0.05）。在局部不良反应中，未接种疫苗组的发生率最高（15.3%对7.1%）。在接种2剂COVID-19疫苗的儿童中，SCIT的总体和局部不良反应发生率降低（OR=0.29-0.31，P<0.05）。