Asthma And COVID-19

The aim of this paper is to discuss evidence-based practice in understanding the impact of immunotherapy on children’s asthma during the COVID-19 pandemic. The research question regarding the patients aged 12 to 15 years suffering from asthma symptoms will be discussed through several empirical data to find out whether immunotherapy works better in the management of asthma symptoms.  The literature review will include the points of view of the experts in allergy and immunotherapy and researches collecting data from the hospitals directly.  There are several pieces of evidences from the systematic review on immunotherapy in the present practice of childhood Asthma treatment (Klimek et al., 2020).

According to Ruano et al. (2020), the COVID-19 pandemic has enhanced threats among the children who have asthma, one of the most common chronic diseases among children around the world.  COVID-19 has already affected the countries severely and questioning the health care capacity to overcome the threat even among the healthy adults.   As COVID-19 virus is a respiratory virus therefore it can easily exacerbate asthma. The polymerase chain reaction confirmed cases are common among the children from 0 to 14 years among whom 29% required hospitalization and 4% required intensive care.  The problem is sever because no diagnostic tests could be performed due to various reasons.  Awareness about keeping children safe especially those who have been suffering from asthma is lower in various parts of the world.  This is the reason why COVID-19 has affected the children with asthma intensely. Impact Of Immunotherapy On Children’s Asthma During The COVID-19 Pandemic Essay Paper   During the second wave of COVID-19, Spain has been affected among all the countries with millions of confirmed cases. The study aimed to determine the effect of COVID-19 infection in the second wave and the asthma patient children.  In this research process, the children within 14 years with allergic asthma have been included.  The researchers have analysed the probable cases of COVID-19 among the children as per the recommendations of World Health Organisation guidelines.  The clinical characteristics, democratic data, along with lung function, asthma treatment and asthma examinations had been recorded by the consulting electronic therapeutic records. Here are the clinical characteristics include atopic dermatitis, rhino conjunctivitis, food allergy and aeroallergen sensitization through skin prick test. During the pandemic’s second wave in 2020, two allergists were interviewed regarding the presence of SARS-cov-2 infection and its reaction for the children. The result of this study reveals that the Pollen exposure infection in Association with COVID-19 virus can worsen the symptoms among children and lead them to other allergy comorbidities.

The study by Castro?Rodriguez and Forno (2020) reflects that the severity of COVID-19 has not left the children and youths to suffer  the symptoms despite are mild among the children, but the risk factors of SARS-cov-2 have led the pediatricians to take the situation seriously especially for the children with chronic asthma. This study has followed systematic review of available articles regarding pediatric asthma as comorbidity for the COVID-19 pandemic.  The results reveal that the children with chronic conditions like lung diseases including asthma may sustain worse condition. This study has found the scarcity of medical data available for further understanding the severity among the children who have chronic asthma during the pandemic.

According to Toska et al. (2018), allergen immunotherapy is considered to be the only disease-modifying approach for treatment in the allergic diseases.  There are consolidated evidences of application for both the children as well as adults.  Allergy and immunotherapy effectively determine the clinical improvement of the allergic asthma.  These improvements can be seen through reduced symptoms, improved life quality, and long-lasting impact upon cessation of treatment and medication use. This study has collected numerous clinical data to find evidence whether the impact and safety of allergen immunotherapy in treating allergic asthma follow current guidelines recommended in the sublingual immunotherapy for adults and adolescents.  The data has been collected in order to understand whether the dust mite allergy and allergy rhinitis can be predicted.  The therapy can also reduce the risks of development from the allergic rhinitis towards asthma among the children.  Preventing the onset of sensitization and related criticality can be prevented through this treatment.  The study has reviewed all the updated clinical indications from various sources about allergen immunotherapy and referenced pediatric asthma.  The contrivances of immunological as well as clinical tolerance of allergens along with the potential biomarkers have been explored in terms of clinical responses.

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Allergen Immunotherapy For Treating Allergic Diseases

According to this study, the candidates for or allergy in therapy show uncontrolled symptoms to the medications because they experience various drugs as adverse effects.  Along with this the environmental prevention or dedication to long term treatment may not be found among the patients.  The European Academy of Allergy and Clinical Immunology has recommended guidelines for patients without conjunctivitis to suffer from more clinically relevant allergen and evident sensitization with moderate-to-severe symptoms.  Despite the fact they follow avoidance strategies, the failure during the COVID-19 pandemic can cause harm eventually.  In referring the children allergy immunotherapy targets the lower and upper respiratory allergic symptom through the modulation of IgE mediated responses relating allergen response. These can be lowered during the pendency because the virus involves both children’s adaptive and innate immunity.  Allergy immunotherapy regulators with T and B cells change their antibody isotype and decrease mediator releases.  Thus the therapy can change migration procedure of inflammatory cells to the tissues. The children suffering from AR can be effectively supported by allergy immunotherapy because implementation of vaccination strategies through modified extracts of Recombinant allergen or adjuvant to stimulate the immune system can eventually help. This approach can enhance the medical and immunological tolerance of children regarding allergens and help them survive any situation like the respiratory virus pandemic even.

He et al. (2019) in “Immunoregulatory Effects of Subcutaneous Immunotherapy on Lymphocyte Subgroups and Cytokines in Children with Asthma”, reveal that bronchial asthma is a common chronic disease of respiration among children.  This contains different inducing as well as complex pathogenesis.  This study mainly focuses on the Healthcare industry in China where Der-f and Der-p are the two most important inhaled allergens that cause paediatric allergic asthma. Subcutaneous immunotherapy has immunologic effects which exert allergic asthma in different ways.  It is the recommended etiological treatment for treating pediatric allergic asthma as it has proved its rapid efficacy to improve symptoms and leaves long-term effects. However the mechanism of subcutaneous immunotherapy has still remained unclear but it is found that type to immunity has been considered as the main immunotype of asthma.  The cytokines type 2 like IL-4, IL-5 and IL-13 cause any airway hyper Responsiveness eosinophil aggregation and mucus secretion. Hence By lymphocyte produces IgE as the medicated reaction for allergy.  The th2 cells are considered to be the main source of type 2 cytokines hence the imbalance of th1 and th2 can lead to grow symptoms for asthma. This study has enrolled 60 children patients aging from five to 10 years with moderate or mild allergic asthma sensitized. This research took place in the respiratory department of the children’s hospital in Nanjing Medical University and maintained all guidelines of the test.  The children were divided into two groups one in SCIT and another non-SCIT. They were properly diagnosed according to the global initiative for asthma and received antiasthmatic drug treatments for long 3 months.  They were tested with positive skin prick test with the main allergen Der-p. As a result is it seems to be in habitant the expression of patients’ peripheral blood ILSC2.  The imbalances in the t-lymphocyte subgroup manifested as the reason for the Th1 and Th2 imbalance and the decrease of Th7 and Treg ratios.
The study by Shaker et al. (2020) focuses upon the global infections pandemic, which needs limited and requires adjustment of the Ambulatory allergic services around the world.  Novel coronavirus has its effect ranging from severe respiratory illness as well as fertility from the complications towards children and the elderly leading to comorbidities.  The asymptomatically spread of this virus among children from person to person presented one of the most vexing problems from the standpoint of Public Health.  Social distancing and telehealth services have reduced allergic rhinitis and asthma, but the unstable condition of the patients with poor perception during the significant exhibition have increased threats from time to time.  Allergic conditions have become severe as children are not getting proper treatment by visiting the hospitals and continuing the previous prescriptions.  Virtual care is not supporting immunotherapy in most of the cases there for the children, and the elderly people are the most dangerous victims of the second wave of the Corona pandemic.

Efficacy And Safety Of Allergen Immunotherapy In Children With Asthma

Paar et al. (2021) in the study named COVID-19 pandemic and allergy immunotherapy, have surveyed to understand many area of the medical treatments and allergy diagnosis specifically. Coronavirus disease 2019 has affected allergen precise immunotherapy which is one of the most important treatments for IgE mediated allergy and examination of responses of immunological impact on the patients. EEACI recommendations related to allergen specific immunotherapy during the pending has been outlined in this particular study.  Such recommendations have supported the allergy and all the physicians performing allergen-specific immunotherapy to be safe from the covid affected patients. The study has undergone systematic reviews as well as meta-analyses which revealed that allergy specific immunotherapy is effective to reduce symptoms of asthma among the patients and rescue the medication for allergic asthma and allergic rhinoconjunctivitis. As COVID-19 is a viral infection therefore can enhance allergic Airway diseases. The study has found out that allergen specific immunotherapy from the clinical perspective show no significant difference in its efficacy for the improvement of symptoms relating allergic asthma patient under a subcutaneous allergen specific immunotherapy with symptomatic influenza. This has also not affected the standard hematology, chemical parameters, or different cytokines.  This one-year follow-up has suggested that SCIT patients will be safe and well tolerated despite their COVID-19 symptoms.

Therefore, all of these studies have seen the COVID-19 pandemic affecting the children suffering from asthma and undergoing immunotherapy from different points of view.  It is true that there are scarcity of clinical data in the COVID-19 pandemic has created are huge upheaval in the medical system around the world.  Under such circumstances collecting data and properly analyzing them have been difficult.  Despite these facts, empirical data used in this analysis are well sourced and relevant for further research.

References:

Castro?Rodriguez, J. A., & Forno, E. (2020). Asthma and COVID?19 in children: a systematic review and call for data. Pediatric pulmonology, 55(9), 2412-2418. DOI: 10.1002/ppul.24909.

He, Y. T., Zhou, Y., Shao, Q., Gan, C., Chen, M., Bao, Y. L., … & Tian, M. (2019). Immunoregulatory effects of subcutaneous immunotherapy on lymphocyte subgroups and cytokines in children with asthma. Journal of immunology research, 2019. https://doi.org/10.1155/2019/7024905

Klimek, L., Jutel, M., Akdis, C., Bousquet, J., Akdis, M., Bachert, C., … & ARIA?MASK study group. (2020). Handling of allergen immunotherapy in the COVID?19 pandemic: An ARIA?EAACI statement. Allergy, 75(7), 1546-1554. doi: 10.1111/all.14336.      Impact Of Immunotherapy On Children’s Asthma During The COVID-19 Pandemic Essay Paper