Psychological impact of the COVID-19 pandemic on patients with allergic diseases

https://doi.org/10.1016/j.waojou.2021.100510Get rights and content
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Abstract

Background

On March 2020, World Health Organization (WHO) declared COVID-19 to be a pandemic disease. Interactions between allergy-related inflammatory and psychiatric disorders including depression, anxiety, and post-traumatic stress disorder (PTSD) have been documented. Therefore, those who have pre-existing allergic conditions may have an increased psychiatric reaction to the stresses of the COVID-19 pandemic.

Objective

Identify the psychological impact of COVID-19 in patients with allergic diseases and determine if these individuals have a greater risk of presenting with post-traumatic stress disorder (PTSD).

Methods

It is a cross-sectional, survey-based study designed to assess the degree of symptoms of depression and the risk of PTSD using the Patient Health Questionnaire (PHQ-9) and the Impact of Event Scale–Revised (IES-R), respectively, in allergic patients.

Results

A total of 4106 surveys were evaluated; 1656 (40.3%) were patients with allergic disease, and 2450 (59.7%) were non-allergic (control) individuals. Of those with allergies, 76.6% had respiratory allergic disease including asthma and allergic rhinitis. Individuals with allergic disease reported higher scores regarding symptoms of PTSD on the IES-R scale (p = 0.052, OR 1.24 CI 0.99–1.55) as well as a higher depression risk score in the PHQ-9 questionnaire (mean 6.82 vs. 5.28) p = 0.000 z = −8.76.

The allergy group presented a higher score in the IES-R questionnaire (mean 25.42 vs. 20.59), being more susceptible to presenting PTSD (p = 0.000, z = −7.774).

The individuals with allergic conditions were further divided into subgroups of those with respiratory allergies such as allergic rhinitis and asthma vs those with non-respiratory allergies such as drug and food allergy, urticaria and atopic dermatitis. This subgroup analysis compares respiratory versus non-respiratory allergic patients, with similar results on the IES-R (mean 25.87 vs 23.9) p = 0.0124, z = −1.539. There was no significant difference on intrusion (p = 0.061, z = −1.873) and avoidance (p = 0.767, z = −0.297), but in the hyperarousal subscale, patients with respiratory allergy had higher scores (mean 1.15 vs. 0.99) p = 0.013 z = −2.486.

Conclusions

Psychological consequences such as depression and reported PTSD are present during the COVID-19 pandemic causing an impact particularly in individuals with allergic diseases. If we acknowledge the impact and how it is affecting our patients, we are able to implement interventions, follow up, and contribute to their overall well-being.

Keywords

Allergic
COVID-19
Psychologic
Impact

Abbreviations

COVID 19
coronavirus disease 2019
CoV-2
coronavirus 2
DSM-IV
Diagnostic and Statistical Manual of Mental Disorders, fourth edition
IFN-g
interferon gamma
IL-1
interleukin 1
IL-4
interleukin 4
IL-6
interleukin 6
NK cells
natural killer cells
OR
odds ratio
SARS
severe acute respiratory syndrome
TNF- α
tumoral necrosis factor alfa

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