Intranasal corticosteroids in allergic rhinitis in COVID‐19 infected patients: An ARIA‐EAACI statement
Jean Bousquet, Cezmi A. Akdiş, Marek Jutel, Claus Bachert, Ludger Klimek, Ioana Agache, Ignacio J. Ansotegui, Anna Bedbrook, Sinthia Bosnic‐Anticevich, Giorgio Walter Canonica, Tomás Chivato, Álvaro A. Cruz, Wienczyslawa Czarlewski, Stefano Del Giacco, Hui Du, João Fonseca, Yadong Gao, Tari Haahtela, Karin Hoffmann‐Sommergruber, Juan Carlos Ivancevich, Nikolaï Khaltaev, Edward F. Knol, Piotr Kuna, Désirée Larenas‐Linnemann, Joaquim Mullol, Robert M. Naclerio, Ken Ohta, Yoshitaka Okamoto, Liam O’Mahony, Gabrielle L. Onorato, Nikolaos G. Papadopoulos, Oliver Pfaar, Bolesław Samoliński, Jürgen Schwarze, Sanna Toppila‐Salmi, Maria Teresa Ventura, Arūnas Valiulis, Arzu Yorgancıoğlu, Torsten Zuberbier, Ruby Pawankar, the ARIA‐MASK Study Group
Abstract
A novel strain of human coronaviruses, named by the International Committee on Taxonomy of Viruses (ICTV) 1 as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged and caused an infectious disease. This disease has recently been referred to by the World Health Organisation (WHO) as the "coronavirus disease 2019" (COVID-19). Since the first report of this disease in December 2019 in Wuhan, China, 2,3 COVID-19 has aggressively spread across the globe. WHO declared it a pandemic on March 11. COVID-19 presents with many different clinical manifestations, ranging from asymptomatic cases to mild and severe disease, with or without pneumonia. 4 Patients with common allergic conditions do not develop additional distinct symptoms and do not seem to be at an increased risk of severe disease. Allergic children show a mild course, like other children. 5 COVID-19 cases with pre-existing COPD, or complicated by secondary bacterial pneumonia, are more severe, and this may be due to a complex immune pathogenesis. Whether systemic corticosteroids have a deleterious effect on COVID-19 infection is still a matter of discussion. Clinical evidence does not support corticosteroid treatment for SARS-CoV-2 pneumonia. 6 Moreover, corticosteroid therapy in patients with MERS (Middle East respiratory syndrome) was not associated with a difference in mortality after adjustment for time-varying confounders but was associated with delayed MERS coronavirus RNA clearance. 7