Allergic diseases as risk factors for Long‐COVID symptoms: Systematic review of prospective cohort studies

Author:

Wolff Doreen1ORCID,Drewitz Karl Philipp1ORCID,Ulrich Angela1ORCID,Siegels Doreen2ORCID,Deckert Stefanie2ORCID,Sprenger Antonia Anabella1ORCID,Kuper Paula Ricarda1ORCID,Schmitt Jochen2ORCID,Munblit Daniel3ORCID,Apfelbacher Christian14ORCID

Affiliation:

1. Institute of Social Medicine and Health Systems Research University of Magdeburg Magdeburg Germany

2. Center for Evidence‐Based Healthcare University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden Dresden Germany

3. Care for Long Term Conditions Division King's College London London UK

4. Family Medicine and Primary Care, Lee Kong Chian School of Medicine Nanyang Technological University Singapore Singapore City Singapore

Abstract

AbstractObjectiveThe role of allergy as a risk factor for Long‐COVID (LC) is unclear and has not been thoroughly examined yet. We aimed to systematically review and appraise the epidemiological evidence on allergic diseases as risk factors for LC.DesignThis is an initial systematic review. Two reviewers independently performed the study selection and data extraction using Covidence. Risk of bias (RoB) and certainty of evidence (GRADE) were assessed. Random effects meta‐analyses were used to pool unadjusted ORs within homogeneous data subsets.Data SourcesWe retrieved articles published between January 1st, 2020 and January 19th, 2023 from MEDLINE via PubMed, Scopus, the WHO‐COVID‐19 database and the LOVE platform (Epistemonikos Foundation). In addition, citations and reference lists were searched.Eligibility CriteriaWe included prospective cohort studies recruiting individuals of all ages with confirmed SARS‐CoV‐2 infection that were followed up for at least 12 months for LC symptoms where information on pre‐existing allergic diseases was available. We excluded all study designs that were not prospective cohort studies and all publication types that were not original articles.ResultsWe identified 13 studies (9967 participants, range 39–1950 per study), all assessed as high RoB, due to population selection and methods used to ascertain the exposures and the outcome. Four studies did not provide sufficient data to calculate Odds Ratios. The evidence supported a possible relationship between LC and allergy, but was very uncertain. For example, pre‐existing asthma measured in hospital‐based populations (6 studies, 4019 participants) may be associated with increased risk of LC (Odds Ratio 1.94, 95% CI 1.08, 3.50) and findings were similar for pre‐existing rhinitis (3 studies, 1141 participants; Odds Ratio 1.96, 95% CI 1.61, 2.39), both very low certainty evidence.ConclusionsPre‐existing asthma or rhinitis may increase the risk of LC.

Funder

Bundesministerium für Bildung und Forschung

Publisher

Wiley

Subject

Immunology,Immunology and Allergy

Reference61 articles.

1. How and why patients made Long Covid

2. Emergency use ICD codes for COVID‐19.Disease outbreak.2021https://www.who.int/standards/classifications/classification‐of‐diseases/emergency‐use‐icd‐codes‐for‐covid‐19‐disease‐outbreak. [Accessed April 20 2023].

3. S1-Leitlinie Post-COVID/Long-COVID

4. Risk Factors Associated With Post−COVID-19 Condition

5. National Institute for Health and Care Excellence.Overview|COVID‐19 rapid guideline: managing the long‐term effects of COVID‐19|Guidance|NICE. NICE.2021.https://www.nice.org.uk/guidance/ng188. [Accessed April 20 2023.]

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