The global impact of the COVID-19 pandemic on the management and course of chronic urticaria

Emek Kocatürk*, Andaç Salman, Ivan Cherrez-Ojeda, Paulo Ricardo Criado, Jonny Peter, Elif Comert-Ozer, Mohamed Abuzakouk, Rosana Câmara Agondi, Mona Al-Ahmad, Sabine Altrichter, Rand Arnaout, Luisa Karla Arruda, Riccardo Asero, Andrea Bauer, Moshe Ben-Shoshan, Jonathan A. Bernstein, Mojca Bizjak, Isabelle Boccon-Gibod, Hanna Bonnekoh, Laurence BouilletZenon Brzoza, Paula Busse, Regis A. Campos, Emily Carne, Niall Conlon, Roberta F. Criado, Eduardo M. de Souza Lima, Semra Demir, Joachim Dissemond, Sibel Doğan Günaydın, Irina Dorofeeva, Luis Felipe Ensina, Ragıp Ertaş, Silvia Mariel Ferrucci, Ignasi Figueras-Nart, Daria Fomina, Sylvie M. Franken, Atsushi Fukunaga, Ana M. Giménez-Arnau, Kiran Godse, Margarida Gonçalo, Maia Gotua, Clive Grattan, Carole Guillet, Naoko Inomata, Thilo Jakob, Gul Karakaya, Alicja Kasperska-Zając, Constance H. Katelaris, Mitja Košnik, Dorota Krasowska, Kanokvalai Kulthanan, M. Sendhil Kumaran, Claudia Lang, José Ignacio Larco-Sousa, Elisavet Lazaridou, Tabi Anika Leslie, Undine Lippert, Oscar Calderón llosa, Michael Makris, Alexander Marsland, Iris V. Medina, Raisa Meshkova, Esther Bastos Palitot, Claudio A.S. Parisi, Julia Pickert, German D. Ramon, Mónica Rodríguez-Gonzalez, Nelson Rosario, Michael Rudenko, Krzysztof Rutkowski, Jorge Sánchez, Sibylle Schliemann, Bulent Enis Sekerel, Faradiba S. Serpa, Esther Serra-Baldrich, Zhiqiang Song, Angèle Soria, Maria Staevska, Petra Staubach, Anna Tagka, Shunsuke Takahagi, Simon Francis Thomsen, Regina Treudler, Zahava Vadasz, Solange Oliveira Rodrigues Valle, Martijn B.A. Van Doorn, Christian Vestergaard, Nicola Wagner, Dahu Wang, Liangchun Wang, Bettina Wedi, Paraskevi Xepapadaki, Esra Yücel, Anna Zalewska-Janowska, Zuotao Zhao, Torsten Zuberbier, Marcus Maurer*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Introduction: The COVID-19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. Aim: To understand how CU patients are affected by the COVID-19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID-19. Materials and Methods: Our cross-sectional, international, questionnaire-based, multicenter UCARE COVID-CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. Results: The COVID-19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID-19 patient care, which negatively impacted on the care of urticaria patients. The rate of face-to-face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID-19, but COVID-19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID-19. Conclusions: The COVID-19 pandemic brings major changes and challenges for CU patients and their physicians. The long-term consequences of these changes, especially the increased use of remote consultations, require careful evaluation.

Original languageEnglish
Pages (from-to)816-830
Number of pages15
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume76
Issue number3
Early online date7 Dec 2020
DOIs
Publication statusPublished - Mar 2021

Bibliographical note

Funding Information:
Dr. Kocaturk received personal fees from Novartis, Sanofi and Menarini. Dr. Salman reports personal fees from Novartis and İbrahim Etem‐Menarini, outside the submitted work. Dr. Cherrez‐Ojeda reports grants from Universidad Espiritu Santo, outside the submitted work. Dr. Criado reports personal fees from Novartis and Takeda, during the conduct of the study; personal fees from Novartis and Takeda, outside the submitted work. Dr. Peter has nothing to disclose. Dr. Cömert Özer has nothing to disclose. Dr. Abuzakouk has nothing to disclose. Dr. Agondi reports other from Novartis, outside the submitted work. Dr. Al‐Ahmad has nothing to disclose. Dr. Altrichter reports grants and personal fees from Allakos, grants and personal fees from AstraZeneca, non‐financial support from Moxie, grants from Sanofi, CSL Behring, and Novartis, outside the submitted work. Dr. ARNAOUT has nothing to disclose. Dr. Asero received honoria (speaker) from Novartis. Dr. Bauer reports grants, personal fees, and other from Novartis, and personal fees and other from Sanofi, during the conduct of the study. Dr. Ben‐Shoshan received honoraria from Novartis. Dr. Bernstein reports grants and personal fees from Novartis, Genentech, AstraZeneca, Sanofi Regeneron, and from Allakos, outside the submitted work. He is a UCARE member site and a member of the JTF practice parameter committee. Dr. Bizjak reports personal fees from Novartis, outside the submitted work. Dr. BOCCON‐GIBOD has nothing to disclose. Dr. Bonnekoh received honoria (advisory board, speaker) from Novartis. Dr. Bouillet reports grants and non‐financial support from Novartis, grants, personal fees, and non‐financial support from Takeda, grants and non‐financial support from Behring, and non‐financial support from Pharming and GSK, outside the submitted work. Dr. Brzoza has nothing to disclose. Dr. Busse reports grants and personal fees from CSL Behring, Shire/Takada, Pharming, BioCryst, Novartis, and ResTORbio, personal fees from Pearl Therapeutics, CVS Health, Law offices of Levin, Riback, Adelman, Flangel, AstraZeneca, GSK, Vedder Price, and Fresenius, and non‐financial support from Hereditary Angioedema Association, American Academy of Allergy, Asthma, and Immunology, outside the submitted work. Dr. Campos has nothing to disclose. Dr. Carne has nothing to disclose. Dr. Conlon reports grants from Novartis and grants from Takeda, outside the submitted work. Dr. Criado reports personal fees from Takeda and Novartis, during the conduct of the study; and personal fees from Takeda and Novartis, outside the submitted work. Dr. Demir has nothing to disclose. Dr. Dissemond reports personal fees and other from Novartis, during the conduct of the study. Dr. Dogan Gunaydin has nothing to disclose. Dr. Dorofeeva has nothing to disclose. Dr. ENSINA reports personal fees from Novartis, and personal fees and non‐financial support from SANOFI, outside the submitted work. Dr. Ertaş has nothing to disclose. Dr. Ferrucci has nothing to disclose. Dr. FIGUERAS NART has nothing to disclose. Dr. Fomina has nothing to disclose. Dr. Franken has nothing to disclose. Dr. Fukunaga reports grants and honoraria as a speaker from Novartis, Taiho, and honoraria as a speaker from Sanofi, Kyowa Kirin, Tanabe, Korin and Takeda, outside the submitted work. Dr. Giménez‐Arnau reports grants and personal fees from Uriach Pharma, grants, personal fees and other from Novartis Pharma, personal fees and other from Sanofi, grants from GSK, grants from Instituto Carlos III FEDER, personal fees from Menarini, personal fees from Amgen, personal fees from Thermo Fisher, and personal fees from Avene, outside the submitted work. Dr. Godse has nothing to disclose. Dr. Gonçalo reports personal fees from Novartis Pharma and Sanofi Genzyme, outside the submitted work. Dr. Gotua has nothing to disclose. Dr. Grattan has nothing to disclose. Dr. Guillet has nothing to disclose. Dr. Inomata has nothing to disclose. Dr. Jakob reports grants, personal fees, and non‐financial support from Novartis, during the conduct of the study; grants, personal fees, and non‐financial support from ALK‐Abello, personal fees from Bencard/Allergy Therapeutics, Thermo Fisher, Celgene, and Allergopharma, outside the submitted work. Dr. Karakaya has nothing to disclose. Dr. Kasperska‐Zając has nothing to disclose. Dr. Katelaris has nothing to disclose. Dr. Košnik has nothing to disclose. Dr. Krasowska has nothing to disclose. Dr. Kulthanan has nothing to disclose. Dr. KUMARAN has nothing to disclose. Dr. Lang has nothing to disclose. Dr. Larco reports personal fees from Novartis, Sanofi, and Faes Farma, outside the submitted work. Dr. Lazaridou has received grants, or honoraria as a speaker or participant in advisory boards from AbbVie, Novartis, Janssen, Leo Pharma, Lilly, Sanofi, Roche, Genesis, UCB, and Pfizer. Dr. Leslie reports personal fees from Novartis and Menlo Therapeutics, outside the submitted work. Dr. Lippert reports grants, personal fees, non‐financial support, and other from Novartis Pharma GmbH, during the conduct of the study; personal fees, non‐financial support, and other from Sanofi Genzyme; personal fees and non‐financial support from Takeda Pharma GmbH, outside the submitted work. Dr. Calderon has nothing to disclose. Dr. Makris reports personal fees from Novartis, outside the submitted work. Dr. Marsland reports grants and personal fees from Novartis; personal fees from Roche and Almirall; and personal fees and non‐financial support from Sanofi and Galderma, outside the submitted work. Dr. Palitot has nothing to disclose. Dr. Parisi has nothing to disclose. Dr. Pickert has nothing to disclose. Dr. Ramon has nothing to disclose. Dr. Rodriguez‐Gonzalez has nothing to declare. Dr. Rosario has nothing to declare. Dr. Rudenko has nothing to disclose. Dr. Rutkowski has nothing to disclose. Dr. SANCHEZ has nothing to disclose. Dr. Schliemann reports grants and personal fees from Novartis Pharma GmbH, outside the submitted work. Dr. Sekerel has nothing to disclose. Dr. Serpa has nothing to disclose. Dr. Serra‐Baldrich has nothing to disclose. Dr. Soria has nothing to disclose. Dr. Staevska has nothing to disclose. Dr. Staubach reports grants, personal fees, non‐financial support, and other from AbbVie, Allergika, Almirall‐Hermal, Amgen, Beiersdorf, Biocryst, Biogen Idec, BMS, Boehringer‐Ingelheim, Celgene, CSL‐Behring, Eli‐Lilly, Galderma, Hexal, Janssen, Klosterfrau, LEO‐Pharma, LETI‐Pharma, L´Oreal, Medice, Novartis, Octapharma, Pfizer, Pflüger, Pharming, Regeneron, Shire, Takeda, Regeneron, Sanofi‐Genzyme, and UCB Pharma. Dr. Tagka has nothing to disclose. Dr. Takahagi reports personal fees from Novartis Pharma, outside the submitted work. Dr. Thomsen reports grants and other from Novartis, during the conduct of the study. Dr. Treudler reports grants and personal fees from Sanofi Genzyme, personal fees from ALK‐Abello, Takeda, Novartis, and AbbVie, other from Fraunhofer‐IZI Leipzig, and grants from Hautnetz Leipzig/Westsachsen e.V., outside the submitted work. Dr. Vadasz has nothing to disclose. Dr. Valle has nothing to disclose. Dr. van Doorn reports grants and personal fees from Novartis, and personal fees from LEO Pharma, AbbVie, BMS, Celgene, Lilly, MSD, Pfizer, Sanofi Genzyme, Janssen Cilag, outside the submitted work. Dr. Vestergaard reports grants and personal fees from Novartis, and grants and personal fees from Sanofi, outside the submitted work. Dr. Wagner received a grant from Novartis Pharma GmbH and honoraria for lectures or Advisory boards from Novartis Pharma GmbH, ALK‐Abello, Allergopharma, Takeda, and AbbVie. Dr. Wang has nothing to disclose. Dr. Wedi reports grants, personal fees, non‐financial support, and other from Novartis, grants, personal fees, and non‐financial support from Shire, and personal fees from ALK‐Abéllo, HAL‐Allergy, Bencard, CSL Behring, and Leo Pharma, outside the submitted work. Dr. Xepapadaki reports personal fees from Uriach, Novartis, Nestle, and Nutricia, outside the submitted work. Dr. Yucel has nothing to disclose. Dr. Zalewska‐Janowska has nothing to disclose. Dr.Zhao has nothing to disclose. R. Dr. Zuberbier reports personal fees from Bayer Health Care, FAES, Novartis, Henkel, null, null, Novartis, Henkel, AstraZeneca Fee for talk, AbbVie Fee for talk, ALK Fee for talk, Almirall Fee for talk, Astellas Fee for talk, Bayer Health Care Fee for talk, Bencard Fee for talk, Berlin Chemie Fee for talk, FAES Fee for talk, HAL Fee for talk, Leti Fee for talk, Meda Fee for talk, Menarini Fee for talk, Merck Fee for talk, MSD Fee for talk, Novartis Fee for talk, Pfizer Fee for talk, Sanofi Fee for talk, Stallergenes Fee for talk, Takeda Fee for Teva Fee for talk, UCB Fee for talk, Henkel Fee for talk, Kryolan Fee for talk, and L'Oréal Fee for talk outside the submitted work. Dr. Mauer reports grants and personal fees from Allakos, argenx, CSL Behring, FAES, Genentech Menarini, Moxie, Novartis, Sanofi/Regeneron, UCB, GI innovation, and Uriach, personal fees from Aralez and Celldex, grants from AstraZeneca, personal fees from, Amgen, Innate Pharma, Kyowa Kirin, Leo Pharma, Lilly, and Roche, outside the submitted work.

Publisher Copyright:
© 2020 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd

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