Mij
Senior Member (Voting Rights)
Abstract
BackgroundSARS-CoV-2 offers a new context to examine the relationship between viral infection and allergic disease. A biologically plausible mechanism exists for post-infectious Th2-skewed responses, among other forms of immune dysregulation, and early studies suggest increases in asthma and other allergic or atopy-associated diagnoses following infection.
Objective
To investigate whether COVID-19 infection predisposes individuals to developing allergic conditions.
Methods
We conducted a 1:2 propensity-matched retrospective cohort study of individuals 1 to 64 years evaluating the association of COVID-19 exposure and development of incident allergic conditions (atopic dermatitis, asthma, food allergies, rhinoconjunctivitis, medication allergies, or urticaria) within a follow-up period of 18 months. We calculated hazard ratios for the incident outcomes of interest amongst the entire cohort as well as sub-analyses in children and active-duty service members.
Results
COVID-19 infection was associated with significantly increased hazard ratios for all six allergic conditions in the full cohort. Among the active-duty subset, asthma and rhinoconjunctivitis were significantly associated with infection. In children, all conditions except food allergies were significantly associated with infection. Higher sponsor rank, evaluated as a potential surrogate for socioeconomic status, showed a slight protective effect against the development of asthma.
Conclusion
This study adds to the growing body of evidence illustrating the risk for development of allergic conditions after COVID-19 infection in both children and adults. Our findings highlight the potential public health burden of these conditions, emphasize the importance of monitoring for allergic diseases after COVID-19 infection to enable prompt intervention, and suggest a mechanistic link between COVID-19 infection and type 2 inflammation.
Study