Suchergebnisse

Climate could influence the COVID-19 pandemic, but while no evidence has been advanced on the influence of colder climates, some studies have provided data to support a possible heat-related protective factor. The objective is to verify whether areas with a Cold Temperate Climate (TC) have a higher Case Fatality Ratio (CFR) for COVID-19 than areas with a Cold Climate (CC) or with a Mediterranean Climate (MC) in the European Union and the Enlarged European Region. Countries or regions were subdivided into 3 groups according to the Köppen climate classification system: TC (Cfa, Cfb and Cfc in the Köppen system); MC (Csa, Csb); CC (D and E in the Köppen system). The total number of cases and the total number of deaths were detected on 13 August 2020 on the COVID-19 Map-Johns Hopkins Coronavirus Resource Center-the CFR was thus calculated by area. Living in TC areas is strongly associated with risk of a high Case Fatality Ratio for COVID-19, OR for MC =0.42, IC 95% 0.41-0.43; OR for CC=0.33, IC 95% 0.33-0.35. The results are confirmed in the EU, OR per MC=0.85, CI 95% 0.84-0.87; OR per CC=0.63, IC 95% 0.61-0.65.The study found that the IC in a humid temperate climate is associated with higher CFR with respect to the coldest and warmest temperate climates in Europe. This does not appear to be the only determinant of the pandemic.

The first approved COVID-19 vaccines include Pfizer/BioNTech BNT162B2, Moderna mRNA-1273 and AstraZeneca recombinant adenoviral ChAdOx1-S. Soon after approval, severe allergic reactions to the mRNA-based vaccines that resolved after treatment were reported. Regulatory agencies from the European Union, Unites States and the United Kingdom agree that vaccinations are contraindicated only when there is an allergy to one of the vaccine components or if there was a severe allergic reaction to the first dose. This position paper of the European Academy of Allergy and Clinical Immunology (EAACI) agrees with these recommendations and clarifies that there is no contraindication to administer these vaccines to allergic patients who do not have a history of an allergic reaction to any of the vaccine components. Importantly, as is the case for any medication, anaphylaxis may occur after vaccination in the absence of a history of allergic disease. Therefore, we provide a simplified algorithm of prevention, diagnosis and treatment of severe allergic reactions and a list of recommended medications and equipment for vaccine centres. We also describe potentially allergenic/immunogenic components of the approved vaccines and propose a workup to identify the responsible allergen. Close collaboration between academia, regulatory agencies and vaccine producers will facilitate approaches for patients at risks, such as incremental dosing of the second injection or desensitization. Finally, we identify unmet research needs and propose a concerted international roadmap towards precision diagnosis and management to minimize the risk of allergic reactions to COVID-19 vaccines and to facilitate their broader and safer use.

To address uncertainties in the prevention and management of influenza in people with asthma, we performed a scoping review of the published literature on influenza burden; current vaccine recommendations; vaccination coverage; immunogenicity, efficacy, effectiveness and safety of influenza vaccines; and the benefits of antiviral drugs in people with asthma. We found significant variation in the reported rates of influenza detection in individuals with acute asthma exacerbations making it unclear to what degree influenza causes exacerbations of underlying asthma. The strongest evidence of an association was seen in studies of children. Countries in the European Union currently recommend influenza vaccination of adults with asthma; however, coverage varied between regions. Coverage was lower among children with asthma. Limited data suggest that good seroprotection and seroconversion can be achieved in both children and adults with asthma and that vaccination confers a degree of protection against influenza illness and asthma related morbidity to children with asthma. There were insufficient data to determine efficacy in adults. Overall, influenza vaccines appeared to be safe for people with asthma. We identify knowledge gaps and make recommendations on future research needs in relation to influenza in patients with asthma.