ALERGOLOGÍA PARA MÉDICOS Y PACIENTES 2021

Risk and Management of Patients with Mastocytosis and MCAS in the SARS-CoV-2 (COVID-19) Pandemic: Expert Opinions  Authors: PeterValentM.D.1CemAkinM.D., Ph.D.2PatriziaBonadonnaM.D.3KnutBrockowM.D.4MarekNiedoszytkoM.D., Ph.D.5BoguslawNedoszytkoPh.D.6Joseph H.ButterfieldM.D.7IvanAlvarez-TwoseM.D., Ph.D.8KarlSotlarM.D.9JulianaSchwaabM.D.10MohamadJawharM.D.10AndreasReiterM.D.10MarianaCastellsM.D., Ph.D.11Wolfgang R.SperrM.D.1Hanneke C.Kluin-NelemansM.D., Ph.D.12OlivierHermineM.D., Ph.D.13JasonGotlibM.D., M.S.14RobertaZanottiM.D. Abstract The COVID-19 (SARS-CoV-2) pandemic has massively distorted our health care systems and caused catastrophic consequences in our affected communities. The number of victims continues to increase and patients at risk can only be protected to a degree, since the virulent state may be asymptomatic. Risk factors concerning COVID-19-induced morbidity and mortality include advanced age, an impaired immune system, cardiovascular or pulmonary diseases, obe...

Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis Authors: Derek K Chu, Elie A Akl, Stephanie Duda, Karla Solo, Sally Yaacoub, Holger J Schünemann, on behalf of the COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors* Summary Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person- to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings. Methods We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to- person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. We obtained data for SARS-CoV-2 and the betacoronaviruses that cause severe acute respirato...

Clinical Characteristics of 182 Pediatric COVID-19 Patients With Different Severities and Allergic Status Authors; Hui Du 1, Xiang Dong 2, Jin-Jin Zhang 2, Yi-Yuan Cao 3, Mubeccel Akdis 4, Pei-Qi Huang 1, Hong-Wei Chen 1, Ying Li 1, Guang-Hui Liu 2, Cezmi A Akdis 4, Xiao-Xia Lu 1, Ya-Dong Gao 2 Abstract Background: The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has made widespread impact recently. We aim to investigate the clinical characteristics of COVID-19 children with different severities and allergic status. Methods: Data extracted from the electronical medical records, including demographics, clinical manifestations, comorbidities, laboratory and immunological results and radiological images of 182 hospitalized COVID-19 children were summarized and analyzed. Results: The median age was 6 years old, ranging from 3 days to 15 years, and there were more boys (male-female ratio about 2:...

Immune responses in COVID-19 and potential vaccines: Lessons learned from SARS and MERS epidemic Authors: Eakachai Prompetchara,1,2,3 Chutitorn Ketloy,1,2 Tanapat Palaga4,5  From: 1 Center of Excellence in Vaccine Research and Development (Chula Vaccine Research Center Chula VRC), Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand 2 Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand 3 Vaccines and Therapeutic Proteins Research Group, the Special Task Force for Activating Research (STAR), Chulalongkorn University, Bangkok 10330, Thailand 4 Department of Microbiology, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand 5 Center of Excellence in Immunology and Immune-mediated Diseases, Chulalongkorn University, Bangkok 10330, Thailand Abstract As the world is witnessing the epidemic of COVID-19, a disease caused by a novel coronavirus, SARS-CoV-2, emerging genetics and clinical...

COVID-19 and allergen immunotherapy: theoretical benefits invite to adjustments in practice recommendations Authors: Désirée Larenas-Linnemann, MD,∗ Noel Rodríguez-Pérez, MD, Jose Antonio Ortega-Martell, MD, Virginia Blandon Vijil, MD, Jorge A. Luna-Pech, MD, PhD, and Mexican Immunotherapy Working Group Abstract  Introduction During the pandemic of COVID-19 the world is facing at this moment, professional groups have made specialty-specific recommendations. Thus, suggestions on how to manage allergen immunotherapy (AIT) have been published by several workgroups,(1, 2, 3) that are timely and adequate for the present situation. However, none of the manuscripts reviews the immune effects of AIT in the light of the immunological changes brought about by coronavirus, and more specifically SARS-CoV-2. Taking a closer look at what is known in this field at present, one could conclude there might be a theoretical advantage for allergic patients to receive sublingual or subcutaneo...

SARS-CoV-2 Antibody Testing – Questions to be asked Authors:  K.ÖzçürümezMD1AndreasAmbroschMD2∗OliverFreyMD34∗VerenaHaselmannMD5∗StefanHoldenriederMD6∗MichaelKiehntopfMD7∗MichaelNeumaierMD5∗MichaelWalterMD89∗FolkerWenzelMD10∗RomanWölfelMD1112∗HaraldRenzMD13∗ COVID-19 Task Force of theGerman Society for Clinical Chemistry and Laboratory Medicine (DGKL) Abstract  SARS-CoV-2 infection and development of COVID-19 disease presents a major healthcare challenge of global dimensions. Laboratory diagnostics of infected patients, and the assessment of immunity against the SARS-CoV-2 virus presents a major cornerstone in handling the pandemic. Currently there is an increase in demand of antibody testing and a large number of tests are already marketed or in the late stage of development. However, the interpretation of test results depends on many variables and factors, including sensitivity, specificity, potential cross-reactivity and cross-protectivity; the diagnostic value of a...

Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages Authors: Miriam Merad & Jerome C. Martin  Abstract The COVID-19 pandemic caused by infection with SARS-CoV-2 has led to more than 200,000 deaths worldwide. Several studies have now established that the hyperinflammatory response induced by SARS-CoV-2 is a major cause of disease severity and death in infected patients. Macrophages are a population of innate immune cells that sense and respond to microbial threats by producing inflammatory molecules that eliminate pathogens and promote tissue repair. However, a dysregulated macrophage response can be damaging to the host, as is seen in the macrophage activation syndrome induced by severe infections, including in infections with the related virus SARS-CoV. Here we describe the potentially pathological roles of macrophages during SARS-CoV-2 infection and discuss ongoing and prospective therapeutic strategies to modulate macroph...

Hydroxychloroquine or Chloroquine With or Without a Macrolide for Treatment of COVID-19: A Multinational Registry Analysis Authors: Mandeep R Mehra 1, Sapan S Desai 2, Frank Ruschitzka 3, Amit N Patel 4 Affiliations expand Abstract Background: Hydroxychloroquine or chloroquine, often in combination with a second-generation macrolide, are being widely used for treatment of COVID-19, despite no conclusive evidence of their benefit. Although generally safe when used for approved indications such as autoimmune disease or malaria, the safety and benefit of these treatment regimens are poorly evaluated in COVID-19. Methods: We did a multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19. The registry comprised data from 671 hospitals in six continents. We included patients hospitalised between Dec 20, 2019, and April 14, 2020, with a positive laboratory finding for SARS-CoV-2. Patients who received one of...

Eleven Faces of Coronavirus Disease 2019 Authors: Xiang Dong  1 , Yi-Yuan Cao  2 , Xiao-Xia Lu  3 , Jin-Jin Zhang  1 , Hui Du  3 , You-Qin Yan  4 , Cezmi A Akdis  5 , Ya-Dong Gao  1 Abstract Background and aims: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has recently spread worldwide and been declared a pandemic. We aim to describe here the various clinical presentations of this disease by examining eleven cases. Methods: Electronic medical records of 11 patients with COVID-19 were collected, and demographics, clinical manifestations, outcomes, key laboratory results, and radiological images are discussed. Results: The clinical course of the eleven cases demonstrated the complexity of the COVID-19 profile with different clinical presentations. Clinical manifestations range from asymptomatic cases to patients with mild and severe symptoms, with or wi...

Equipo de protección personal y COVID-19. New England Journal of Medicine 

COVID-19: risk for cytokine targeting in chronic inflammatory diseases? Authors: Schett G1,2, Sticherling M3,4, Neurath MF3,5. Abstract COVID-19, caused by the SARS-CoV-2 virus, has become pandemic. With sharply rising infection rates, patient groups characterized by an enhanced infection risk will be challenged by the virus. In this context, patients with chronic immune-mediated inflammatory diseases are of particular interest, as these diseases are characterized by an intrinsic immune dysfunction leading to inflammation that may enhance risk for severe infection. DOI:   10.1038/s41577-020-0312-7

Two X‐linked agammaglobulinemia patients develop pneumonia as COVID‐19 manifestation but recover Authors: Annarosa Soresina  Daniele Moratto  Marco Chiarini  Ciro Paolillo  Giulia Baresi  Emanuele Focà  Michela Bezzi  Barbara Baronio  Mauro Giacomelli  Raffaele Badolato First published:22 April 2020 Abstract Background The recent SARS‐Cov2 pandemic, which has recently affected Italy since February 21, constitutes a threat for normal subjects, as the Coronavirus Disease 19 (COVID19) can manifest with a broad spectrum of clinical phenotypes ranging from asymptomatic cases to pneumonia or even death. There is evidence that older age and several comorbidities can affect the risk to develop severe pneumonia and possibly the need of mechanic ventilation in subjects infected with SARS‐Cov2. Therefore, we evaluated the outcome of SARS‐Cov2 infection in patients with inborn errors of immunity (IEI) such as X linked agammaglobulinemia (XLA). ...

Antimaláricos y COVID-19, revisión de la literatura a 15 de abril de 2020 Autor: Dr. Steven Fuentes  La infección por SARS-CoV-2 representa un reto actual para la humanidad, no únicamente por el hecho de su comportamiento como pandemia, si no al no haber disponibilidad de un tratamiento especifico contra el microrganismo en cuestión. En los medios de difusión se ha informado de la posibilidad del uso de antimaláricos como un tratamiento efectivo para el COVID-19, sin embargo, a la luz de la literatura científica actualmente publicada, ¿qué tan respaldada esta dicha propuesta? El presente documento es una revisión personal de la literatura con el fin de contestar este interrogante. El COVID-19 como enfermedad emergente propone un reto sanitario como informa Zunyo et al1, ya que el 81 % de los casos tiene un comportamiento leve, 14 % grave y 5% critico con requerimiento de manejo en unidad de cuidados intensivos; es con esta evidencia que se hace imperante la búsqueda de a...

Handling of allergen immunotherapy in the COVID‐19 pandemic: An ARIA‐EAACI statement Authors:  Ludger Klimek  Marek Jutel  Cezmi Akdis  Jean Bousquet  Mübeccel Akdis  Claus Bachert  Ioana Agache  Ignacio Ansotegui  Anna Bedbrook  Sinthia Bosnic‐Anticevich  Giorgio W Canonica  Tomas Chivato  Alvaro A Cruz  Wiencyslawa Czarlewski  Stefano Del Giacco  Hui Du  Joao A Fonseca  Yadong Gao  Tari Haahtela  Karin Hoffmann‐Sommergruber  Juan‐Carlos Ivancevich  Nikolai Khaltaev  Edward F Knol  Piotr Kuna  Desiree Larenas‐Linnemann  Erik Melen  Joaquim Mullol  Robert Naclerio  Ken Ohta Yoshitaka Okamoto  Liam O’Mahony  Gabrielle L Onorato  Nikos G Papadopoulos  Ruby Pawankar Oliver Pfaar  Boleslaw Samolinski  Jurgen Schwarze  Sanna Toppila‐Salmi  Mohamed H. Shamji  Maria Teresa Ventura  Arunas Valiulis...

Consideraciones para la post-cuarentena Autores: Juan M. Cordovez , Mauricio Santos , Carlos Bravo, Jaime Cascante Universidad de los Andes. 8 de Abril, 2020 Resultados de investigación: Modelación COVID-19 - Bogotá ¿Es la prolongación de la cuarentena la solución al problema? Introducción El objetivo de este modelo es establecer el efecto que pueden tener las medidas de mitigación de la propagación del COVID-19 en Bogotá . Para esto se construyó un modelo matemático para estudiar la dinámica de contagio en un ambiente urbano realista. Enlace:   https://uniandes.edu.co/sites/default/files/asset/document/modelo_matematico.pdf

Trained Immunity-Based Vaccines: A New Paradigm for the Development of Broad-Spectrum Anti-infectious Formulations Authors:  Silvia Sánchez-Ramón1,2*, Laura Conejero3, Mihai G. Netea4,5, David Sancho6, Óscar Palomares7 and José Luis Subiza3 1Department of Clinical Immunology and IdISSC, Hospital Clínico San Carlos, Madrid, Spain 2Department of Immunology, ENT and Ophthalmology, Complutense University School of Medicine, Madrid, Spain 3Inmunotek, Alcalá de Henares, Spain 4Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands 5Department for Genomics and Immunoregulation, Life and Medical Sciences Institute, University of Bonn, Bonn, Germany 6Immunobiology Laboratory, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain 7Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain Abstract Challenge with specific microbia...

Hydroxychloroquine in patients with COVID-19: an open-label, randomized, controlled trial Authors: Wei Tang, Zhujun Cao, Mingfeng Han, Zhengyan Wang, Junwen Chen, Wenjin Sun, Yaojie Wu, Wei Xiao, Shengyong Liu, Erzhen Chen, Wei Chen, Xiongbiao Wang, Jiuyong Yang, Jun Lin, Qingxia Zhao, Youqin Yan, Zhibin Xie, Dan Li, Yaofeng Yang, Leshan Liu, Jieming Qu, Guang Ning, Guochao Shi, Qing Xie Abstract Abstract Objectives To assess the efficacy and safety of hydroxychloroquine (HCQ) plus standard-of-care (SOC) compared with SOC alone in adult patients with COVID-19. Design Multicenter, open-label, randomized controlled trial. Setting 16 government-designated COVID-19 treatment centers in China through 11 to 29 in February 2020. Participants 150 patients hospitalized with COVID-19. 75 patients were assigned to HCQ plus SOC and 75 were assigned to SOC alone (control group). Interventions HCQ was administrated with a loading dose of 1, 200 mg daily for three days followed by a maintained...

Antimaláricos en COVID-19 Dr. Stiven Fuentes 

COVID-19: A Lesson in Humility and An Opportunity for Sagacity and Hope Authors: Valentin Fuster and Justine Varieur Turco Abstract “Even great men bow before the Sun; it melts hubris into humility.” ― Dejan Stojanovic The outbreak of COVID-19 has caused all of us to feel like as if we are swimming in turbulent waters, struggling to reach the shore. Many of us are frightened by the rapid, infectious nature of an unknown virus. It is understandable to be frightened, as most of us were not trained in battlefield medicine. DOI:   10.1016/j.jacc.2020.04.008

Rationale for Prolonged Corticosteroid Treatment in the Acute Respiratory Distress Syndrome Caused by Coronavirus Disease 2019 Authors: Villar, Jesús MD, PhD1–3; Confalonieri, Marco MD4; Pastores, Stephen M. MD, MACP, FCCP, FCCM5; Meduri, G. Umberto MD6,,7 Abstract  In December 2019, pneumonia associated with the novel coronavirus disease 2019 (COVID-19) emerged in Wuhan, China. On March 14, 2020, the World Health Organization (WHO) declared the coronavirus outbreak a pandemic with confirmed cases in 127 countries. This unprecedented load on healthcare institutions is particularly overwhelming for ICUs and medical personnel treating mechanically ventilated patients. The occurrence rate of acute respiratory distress syndrome (ARDS) with COVID-19 infection varied between 17% and 41% (1–3). ARDS may require weeks of mechanical ventilation (MV) and is associated with an unacceptably high mortality rate. Worldwide, thousands of patients are denied life-saving support for lack of ...