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June 2020

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Allergic Respiratory Disease Care in the COVID-19 Era: A EUFOREA Statement

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Glenis K S, Peter W H, Claus B, et al.

World Allergy Organ J. 2020 May 16;100124. doi: 10.1016/j.waojou.2020.100124. Online ahead of print.

Acute COVID-19 infection and onset of seasonal allergic rhinitis share some features, which may be confusing, especially in those new to such symptoms. Cough and fever are the most prominent symptoms of COVID-19, while conjunctivitis and itching are allergic rhinitis symptoms. Sudden and complete anosmia may be an early sign of COVID-19 infection, differentiating it from allergic rhinitis. The EUFOREA expert teams makes an overview of recommendations for people with seasonal allergic rhinitis.

Given that 44 % of all COVID-19 transmission occurs from asymptomatic people, it is important to keep seasonal allergic rhinitis under the best possible control in order to diminish symptoms, such as sneezing, rhinorrhoea and coughing, which may be responsible for viral spread to others via aerosol formation in those who do not realise that they also have COVID-19.

They recommend that seasonal allergic rhinitis treatment to be started early and used regularly in the pollen season. Systemic corticosteroids should be avoided as they may suppress the immune system. There is no contraindication to the use of intranasal corticosteroids, as they do not reduce immunity and normalize the structure and function of the nasal mucosa. Asthma inhalers should be continued as before and taken regularly to maintain control in the pollen season. Inhaled corticosteroids and inhaled corticosteroids combinations with bronchodilators, long acting beta agonists protect against virally induced asthma exacerbations and may be beneficial in COVID-19. Also, treatment with biologicals for people with more severe asthma and severe chronic rhinosinusitis with nasal polyps should be continued to avoid aggravation of these diseases. Ongoing allergen-specific immunotherapy (AIT) should be continued, if feasible within the health care system, as long as no COVID-19 infection has been diagnosed. New AIT treatments are not advised, except for sublingual immunotherapy, which requires only one does under supervision.

In case of COVID-19 infection, oral corticosteroids may be needed in asthma patients for severe virus-evoked exacerbations. NSAIDs, which were suggested to be avoided for all possible patients, are vital in NSAID-sensitive asthma.

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Share with us a real clinical case and win a free registration for EAACI 2021!

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With the enthusiastic collaboration of renowned KOLs in the jury, we are eager to receive your clinical experiences!

Join us at and you will get to know all the details on how to participate in Bilastine EAACI 2020 Real World Clinical Case Challenge


Multidisciplinary Real World Allergic patients that require antihistamine (AH) use.


Multidisciplinary Real-World cases that require AH use. Cases should be coupled with evidence from the literature.  Any discussion concerning off-label use should be considered an expert opinion only. The target audience for this contest are physicians who treat patients with conditions requiring AHs.

The cases presented should be focused on the use of antihistamines in conditions such as allergic rhinitis or rhinoconjunctivitis and urticaria, as well as less common but challenging conditions such as urticarial vasculitis and pruritus skin conditions.

Jury panel of the contest:

The members of the jury will be: Prof I. Ansotegui, Prof M. Church., Dr P. Rodriguez del Rio.

The panel members will make sure that cases include some of the following questions:

  • What are the case and the impact of the condition?
  • What are the treatment options, and what treatment(s) were previously used?
  • Why might antihistamines work in this case, and what were the results of use?
  • Did any adverse events occur? If yes, describe.
  • What (if any) are the special circumstances related to this particular case and what lessons are learned?

The panel will discuss the information presented and the use of AHs. During a one-day panel meeting each member of the panel will present 3 selected cases, followed by a group discussion, after which a final consensus vote on the cases will be conducted to select 3 cases as winners of the free EAACI 2021 Registrations.  The panel will also review other cases and select an additional X cases for inclusion in a publication.

The decision will be published in this website.

Participants in the contest will be included as authors of this publication and give up their copyrights for this purpose. The final publication will be published for free download in this website.

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