Rev Fr Allergol (2009) . The Effect Of COVID-19 On Patients Recieving Omalizumab Treatment

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Rev Fr Allergol (2009)


. 2023 Jan 5.
doi: 10.1016/j.reval.2023.103281. Online ahead of print.
The Effect Of COVID-19 On Patients Recieving Omalizumab Treatment


Nurhan Sayaca ¹ , Kübra Aşık Cansiz ¹ , Eylem Yildirim ¹ , Beyhan Öztürk ² , Cengiz Kirmaz ¹



Affiliations

• PMID: 36624750
• PMCID: PMC9812821
• DOI: 10.1016/j.reval.2023.103281

Abstract

Background and aim: Although, exposure during drug administration and susceptibility to coronavirus disease-19 (COVID-19) infection secondary to immunomodulatory effects are potential risks for patients with chronic spontaneous urticaria (CSU) or asthma on omalizumab (OMZ), there is a risk of loss of response following OMZ discontinuation. There are limited studies presenting the clinical course of COVID-19 in patients receiving OMZ.
Materials and methods: A total of 103 patients using OMZ were included in the study between February 2021 and January 2022.
Results: Fourteen (13.6%) of the patients participating in the study had SARS-CoV-2 infection, of which 3 (21.4%) needed hospitalization and 11 (78.6%) were treated in outpatient clinic. During the pandemic, 17 (16.5%) of the patients interrupted their OMZ treatment. Patients using OMZ for six months or less had a lower rate of interruption (2.5%) than patients using OMZ for more than 6 months (25.4%). Patients interrupted treatment because, 3 (17.6%) had COVID-19, 10 (58.9%) did not attend to the hospital due to concern of contaminating with SARS-CoV-2, and 4 (23.5%) thought that OMZ treatment would facilitate contaminating with SARS-CoV-2. After interrupting OMZ, 3 (25%) of the females and 5 (100%) of the males did not have increase in their symptoms. Three (13%) of the patients using OMZ for asthma and 11 (13.8%) of the patients using OMZ for urticaria had COVID-19 infection. Patients suffering from CSU and severe asthma are completely different, with different potential consequences of an interruption of OMZ. Nine (52.9%) patients had aggravated symptoms when interrupted OMZ treatment. Three of them described an increasing of asthma symptoms and a need to increment their maintenance therapy as asthma exacerbation after nearly three weeks of interruption, and 6 of them had hives and pruritus as urticaria exacerbation after nearly four weeks of interruption OMZ treatment. Asthmatic patients did not stop other treatment, including inhaled corticosteroids.
Conclusion: The use of OMZ does not increase the risk of SARS-CoV-2 infection, COVID-19-related pneumonia and COVID-19-related hospitalizations. We advise patients not to interrupt treatment of OMZ during the COVID-19 pandemic unless the doctors recommend, and we recommend that they receive education for self-administration of OMZ to avoid visiting to hospitals in the event of a pandemic.

Keywords: Asthma; COVID-19; Omalizumab; Urticaria.