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2019年冠状病毒病大流行对特应性皮炎和食物过敏的成人及儿童的影响:系统评价

Impact of COVID-19 pandemic on adults and children with atopic dermatitis and food allergy: Systematic review.

作者信息

Ne Colver Ken Howe, Suaini Noor Hidayatul Aini, Aung Win Thu, Ong Kevin Gheng Seong, Samuel Miny, Tham Elizabeth Huiwen

机构信息

University of Cambridge, Cambridge, United Kingdom.

Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore.

出版信息

J Allergy Clin Immunol Glob. 2023 Oct 18;3(1):100181. doi: 10.1016/j.jacig.2023.100181. eCollection 2024 Feb.

Abstract

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic caused significant disruptions to health care services and health impacts on patients with atopic dermatitis (AD) and/or food allergy (FA).

OBJECTIVE

We evaluated the impact of the COVID-19 pandemic and disease on AD/FA patients.

METHODS

A comprehensive systematic literature search was conducted from December 2019 to 2022. Screening and data extraction were done following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, and the Mixed Methods Appraisal Tool, or MMAT, was used to assess risk of bias.

RESULTS

In total, 159 studies were included. Five of 7 studies reported no significant changes in overall incidence or prevalence of AD during the pandemic, although some studies noted an increase in the elderly and infants. Telehealth served as an effective alternative to face-to-face consultations, with mixed levels of patient and provider satisfaction. Dissatisfaction was most marked in patients with more severe disease, who thought that their disease was inadequately managed through telemedicine. Higher levels of general anxiety were recorded in both AD/FA patients and caregivers, and it was more pronounced in patients with severe disease. Most studies reported no significant differences in postvaccination adverse effects in AD patients; however, results were more varied in FA patients.

CONCLUSION

Our review identified the impact of COVID-19 pandemic- and disease-driven changes on AD/FA patients. Telemedicine is uniquely suited to manage atopic diseases, and hybrid care may be a suitable approach even in the postpandemic era. COVID-19 vaccines and biologics can be safely administered to patients with atopic diseases, with appropriate patient education to ensure continued care for high-risk patients.

摘要

背景

2019年冠状病毒病(COVID-19)大流行对医疗服务造成了重大干扰,并对特应性皮炎(AD)和/或食物过敏(FA)患者的健康产生了影响。

目的

我们评估了COVID-19大流行及疾病对AD/FA患者的影响。

方法

于2019年12月至2022年进行了全面的系统文献检索。筛选和数据提取按照系统评价和Meta分析的首选报告项目(PRISMA)指南进行,并使用混合方法评估工具(MMAT)来评估偏倚风险。

结果

共纳入159项研究。7项研究中的5项报告称,大流行期间AD的总体发病率或患病率无显著变化,不过一些研究指出老年人和婴儿的发病率有所增加。远程医疗是面对面咨询的有效替代方式,患者和提供者的满意度参差不齐。病情较重的患者不满情绪最为明显,他们认为通过远程医疗对其疾病的管理不够充分。AD/FA患者及其照顾者的总体焦虑水平均有所升高,且在重症患者中更为明显。大多数研究报告称AD患者接种疫苗后的不良反应无显著差异;然而,FA患者的结果差异更大。

结论

我们的综述确定了COVID-19大流行和疾病驱动的变化对AD/FA患者的影响。远程医疗特别适合管理特应性疾病,即使在大流行后时代,混合护理也可能是一种合适的方法。COVID-19疫苗和生物制剂可以安全地施用于特应性疾病患者,并进行适当的患者教育,以确保对高危患者的持续护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da77/10665685/34be9a8a7dee/gr1.jpg

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