Allergy and COVID-19

Main Article Content

Maria De Filippo
Martina Votto
Ilaria Brambilla
Riccardo Castagnoli
Lorenza Montagna
Carlo Caffarelli
Fabio Cardinale
Michele Miraglia Del Giudice
Mariangela Tosca
Silvia Caimmi
Amelia Licari
Gian Luigi Marseglia


COVID-19, SARS-CoV-2, allergy, allergic asthma, phenotype, eosinophil, children, adolescents


The first cases of as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported in Wuhan, China in December 2019. The World Health Organization declared the global pandemic in March 2020. Coronavirus disease 2019 (COVID-19) showed high rates of mortality in the adult population, whereas a mild course was observed in childhood. Allergic diseases, characterized by a type-2 polarization of the immune system, were considered one of the major risk factor of severe COVID-19. Large amounts of clinical data and expert opinions have been collected since the pandemic outbreak. This review summarizes the latest insights on COVID-19 and allergy.


Download data is not yet available.
Abstract 449 | PDF Downloads 206


1. World health Organization. WHO Coronavirus (COVID-19) Dashboard. Available online at: Accessed on 30 May 2021.
2. Novelli V, Cutti S, Muzzi A, et al. Timely adaptation of a Pediatric Unit to COVID-19 emergency in Northern Italy: the experience of Fondazione IRCCS Policlinico San Matteo in Pavia. Acta Biomed 2020;91:e2020004.
3. Cegolon L, Pichierri J, Mastrangelo G et al. Hypothesis to explain the severe form of COVID-19 in Northern Italy. BMJ Glob Health 2020;5:e002564.
4. Sartor G, Del Riccio M, Dal Poz I et al. COVID-19 in Italy: Considerations on official data. Int J Infect Dis 2020;98:188-190.
5. Talarico V, Pinto L, Marseglia GL et al. Impact of novel coronavirus Disease-19 (COVID-19) pandemic in Italian pediatric emergency departments: a national survey. Ital J Pediatr 2021;47:47.
6. Votto M, De Filippo M; Pediatric residents of the University of Pavia, Italy. How pediatric resident's life has changed during the COVID-19 pandemic. Ital J Pediatr 2020;46:156.
7. Castagnoli R, Votto M, Licari A et al. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in children and adolescents: A systematic review. JAMA Pediatr 2020;174:882-889.
8. Graff K, Smith C, Silveira L et al. Risk factors for severe COVID-19 in children. Pediatr Infect Dis J 2021;40:e137-e145.
9. Preston LE, Chevinsky JR, Kompaniyets L et al. Characteristics and disease severity of US children and adolescents diagnosed with COVID-19. JAMA Netw Open 2021;4:e215298.
10. Brambilla I, Tosca MA, De Filippo M et al. Special issues for Coronavirus disease 2019 in children and adolescents. Obesity 2020;28:1369.
11. Babu KS, Arshad SH. The role of allergy in the development of airway inflammation in children. Paediatr Respir Rev 2003;4:40-6.
12. Edwards MR, Strong K, Cameron A et al. Viral infections in allergy and immunology: How allergic inflammation influences viral infections and illness. J Allergy Clin Immunol 2017;140:909-920.
13. Skoner DP. Viral infection and allergy: lower airway. Allergy Asthma Proc 2002;23:229-32.
14. Chan JFW, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020;395:514-523.
15. Docherty AB, Harrison EM, Green CA et al Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO clinical characterisation protocol: prospective observational cohort study. BMJ 2020 22;369:m1985
16. Lazzerini M, Sforzi I, Trapani S et al. Characteristics and risk factors for SARS-CoV-2 in children tested in the early phase of the pandemic: a cross-sectional study, Italy, 23 February to 24 May 2020. Euro Surveill 2021;26:2001248.
17. Garazzino S, Lo Vecchio A, Pierantoni L, et al. Epidemiology, clinical features and prognostic factors of pediatric SARS-CoV-2 infection: results from an italian multicenter study. Front Pediatr 2021;9:649358.
18. Qiu H, Wu J, Hong L, Luo Y et al. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis 2020;20:689–96
19. Lu X, Zhang L, Du H et al. SARS-CoV-2 infection in children. N Engl J Med 2020;382:1663–5
20. Fischer A. Resistance of children to Covid-19. How? Mucosal Immunol 2020;13:563-565.
21. Istituto Sueriore di Sanità. Epidemia COVID-19. Available online at: Accessed on 16 June 2021.
22. Xu H, Zhong L, Deng J et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci 2020;12:8.
23. Patel AB, Verma A. Nasal ACE2 levels and COVID-19 in children. JAMA 2020;323:2386-2387.
24. Jackson DJ, Busse WW, Bacharier LB, et al. Association of respiratory allergy, asthma, and expression of the SARS-CoV-2 receptor ACE2. J Allergy Clin Immunol 2020;146:203-206.e3.
25. Amat F, Delaisi B, Labbé JP, Leonardi J, Houdouin V. Asthma may not be a risk factor for severe COVID-19 in children. J Allergy Clin Immunol Pract 2021;9:2478-2479.
26. Kimura H, Francisco D, Conway M et al. Type 2 inflammation modulates ACE2 and TMPRSS2 in airway epithelial cells. J Allergy Clin Immunol 2020;146:80-88.e8.
27. Graham Roberts et al. EAACI Guidelines on the effective transition of adolescents and young adults with allergy and asthma. Allergy 2020;75:2734-2752.
28. Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol 2020;146:110–118.
29. Skevaki C, Karsonova A, Karaulov A, Xie M, Renz H. Asthma-associated risk for COVID-19 development. J Allergy Clin Immunol 2020;146:1295-1301.
30. Izquierdo JL, Almonacid C, González Y et al. The impact of COVID-19 on patients with asthma. Eur Respir J 2021;57:2003142.
31. De Filippo M, Votto M, Licari A et al. Novel therapeutic approaches targeting endotypes of severe airway disease. Expert Rev Respir Med 2021:1-14. Online ahead of print.
32. Williamson EJ, Walker AJ, Bhaskaran K et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature 2020;584:430-436
33. Eggert LE, He Z, Collins W et al. Asthma phenotypes, associated comorbidities, and long-term symptoms in COVID-19. Allergy 2021. Online ahead of print.
34. Tosca MA, Licari A, Marseglia GL et al. COVID-19 in Italian children and adolescents: The role of allergy and asthma. Allergy Asthma Proc 2021;42:e101-e102
35. Boechat JL, Wandalsen GF, Kuschnir FC et al. COVID-19 and pediatric asthma: clinical and management challenges. Int J Environ Res Public Health 2021;18:1093.
36. Moeller A, Thanikkel L, Duijts L, et al. COVID-19 in children with underlying chronic respiratory diseases: survey results from 174 centres. ERJ Open Res 2020;6:00409-2020.
37. Perlini S, Ciprandi G, Castagnoli R et al. Eosinopenia could be a relevant prognostic biomarker in patients with coronavirus disease 2019. Allergy Asthma Proc 2020;41:e80-e82.
38. Licari A, Votto M, Brambilla I et al. Allergy and asthma in children and adolescents during the COVID outbreak: What we know and how we could prevent allergy and asthma flares. Allergy 2020;75:2402-2405.
39. Zhang JJ, Dong X, Cao YY et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy 2020;75:1730-1741.
40. Du Y, Tu L, Zhu P et al. Clinical features of 85 fatal cases of COVID-19 from Wuhan. A retrospective observational study. Am J Respir Crit Care Med 2020;201:1372-1379.
41. Lindsley AW, Schwartz JT, Rothenberg ME. Eosinophil responses during COVID-19 infections and coronavirus vaccination. J Allergy Clin Immunol 2020;146:1-7.
42. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention 2021. Available at: Accessed on August 4, 2021.
43. Cardinale F, Ciprandi G, Barberi S et al. Consensus statement of the Italian society of pediatric allergy and immunology for the pragmatic management of children and adolescents with allergic or immunological diseases during the COVID-19 pandemic. Ital J Pediatr 2020;46:84.
44. Liotti L, Bianchi A, Bottau P, et al. COVID-19 vaccines in children with cow’s milk and food allergies. Nutrients 2021;13:2637.
45. Hanon S, Brusselle G, Deschampheleire M et al COVID-19 and biologics in severe asthma: data from the belgian severe asthma registry. Eur Respir J 2020;56:2002857.

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 > >>