key: cord-0917105-z4t3bp6r authors: Pfaar, Oliver; Torres, Maria J.; Akdis, Cezmi A. title: COVID‐19: A series of important recent clinical and laboratory reports in immunology and pathogenesis of SARS‐CoV‐2 infection and care of allergy patients date: 2020-06-26 journal: Allergy DOI: 10.1111/all.14472 sha: a8fb63d60d3e3215404e2eb12ab4baa59b432614 doc_id: 917105 cord_uid: z4t3bp6r The “coronavirus disease 2019 (COVID‐19)” outbreak was first reported in December 2019 (China). Since then, this disease has rapidly spread across the globe and in March 2020 the World Health Organization (WHO) declared the COVID‐19 pandemic.(1) Since the outbreak was first announced, our journal has extensively focused on the clinical features, outcomes, diagnosis, immunology, and pathogenesis of COVID‐19 and its infectious agent severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). symptoms, with or without pneumonia as well as with only diarrhea. 5 Patients with common allergic diseases did not develop distinct symptoms and severe courses. Cases with pre-existing chronic obstructive pulmonary disease or complicated with a secondary bacterial pneumonia were severe. Another article, timely appearing in our journal, alerted the scientific community that even in experienced hands there was a 14.1% false negative polymerase chain reaction (PCR) diagnosis in COVID-19 cases and were later diagnosed positive after repeated tests. 6 A pediatric article was also published extensively analyzing 182 cases and it was reported that children with COVID-19 showed a mild clinical course. 7 Patients with pneumonia had a higher proportion of fever and cough and increased inflammatory biomarkers compared to those without pneumonia. There were 43 allergic patients in this series and there was no significant difference between allergic and non-allergic COVID-19 children in disease incidence, clinical features, laboratory, and immunological findings. Allergy was not a risk factor for disease and severity of SARS-CoV-2 infection and did not significantly influence the disease course of COVID-19 in children. 7 The immunology of COVID-19 was extensively reviewed in two articles from leading experts with a comprehensive discussion of the tip of the iceberg in COVID-19 epidemiology, anti-viral response, antibody response to SARS-CoV-2, acute phase reactants, cytokine storm, and pathogenesis of tissue injury and severity. 8, 9 Two studies timely reported the role of possible trained immunity in countries with a Bacillus Calmette-Guérin (BCG) vaccination programme and a relatively low COVID-19 prevalence and mortality rate. 10, 11 In an extensive RNA sequencing analyses of SARS-CoV-2 receptor and their molecular partners revealed that ACE2 and TMPRSS2 were coexpressed at the epithelial sites of the lung and skin, whereas CD147 (BSG), cyclophilins (PPIA and PPIB), CD26 (DPP4) and related molecules were expressed in both, epithelium and in immune cells. 12 Allergists, respiratory physicians, pediatricians, and other health care providers treating patients with allergic diseases are frequently in contact with patients potentially infected with SARS-CoV-2. Practical considerations and recommendations given by experts in the field of allergic diseases can provide useful recommendations for clinical daily work. Since the beginning This article is protected by copyright. All rights reserved of this current pandemic, our journal has disseminated clinical reports, 2,3,5,6,13 statements on the urgent need for accuracy in designing and reporting clinical trials in COVID-19, 14 preventive measures, 10, 11, 15 and Position Statements elaborated by experts in the field in close collaboration with the European Academy of Allergy and Clinical Immunology (EAACI) and its task force "Allergy and Its Impact on Asthma (ARIA)". [16] [17] [18] [19] [20] [21] [22] [23] [24] [25] [26] [27] [28] (keynote information in table 1). A compendium answering 150 frequently encountered questions regarding COVID-19 and allergic diseases has been recently published by experts in their respective area (Figure 1) . 29 In addition, readers can put further questions regarding this "living" compendium electronically to the authors and their answers will be available through a new category in the journal's webpage. 30 Besides, EAACI in collaboration with ARIA, has provided recommendations on operational plans and practical procedures for ensuring optimal standards in the daily clinical care of patients with allergic diseases, whilst ensuring the safety of patients and healthcare workers. 23 This article is protected by copyright. All rights reserved This article is protected by copyright. All rights reserved COVID-19 pandemic should be followed. COVID-2019) situation reports Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan COVID-19, chronic inflammatory respiratory diseases and eosinophils -Observationsfrom reported clinical case series The role of peripheral blood eosinophil counts in COVID-19 patients Accepted Article 5 Eleven faces of coronavirus disease 2019 Distinct characteristics of COVID-19 patients with initial rRT-PCR-positive and rRT-PCR-negative results for SARS-CoV-2. Allergy Clinical characteristics of 182 pediatric COVID-19 patients with different severities and allergic status Immune response in Covid-19: mechanisms, clinical outcome, diagnostics and perspectives -an EAACI report Immune response to SARS-CoV-2 and mechanisms of immunopathological changes in COVID-19 Is global BCG vaccination-induced trained immunity relevant to the progression of SARS-CoV-2 pandemic? Allergy Is BCG vaccination affecting the spread and severity of COVID-19? Allergy Distribution of ACE2, CD147, CD26 and other SARS-CoV-2 associated molecules in tissues and immune cells in health and in asthma, COPD, obesity, hypertension, and COVID-19 risk factors COVID-19 in a designated infectious diseases hospital outside Hubei Province COVID-19Clinical trials: quality matters more than quantity Advanced forecasting of SARS-CoV-2-related deaths in Italy ARIA-EAACI statement on Asthma and COVID-19 Is asthma protective against COVID-19? Allergy Asthma and COVID-19: is asthma a risk factor for severe outcomes? Managing ocular allergy in the time of COVID-19. Allergy. 2020. Accepted Article This article is protected by copyright Allergy and asthma in children and adolescents during the COVID outbreak: What we know and how we could prevent allergy and asthma flares Intranasal corticosteroids in allergic rhinitis in COVID-19 infected patients: An ARIA-EAACI statement Handling of allergen immunotherapy in the COVID-19 pandemic: An ARIA-EAACI statement COVID-19 pandemic: Practical considerations on the organization of an allergy clinic -an EAACI/ARIA Position Paper Treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) in the COVID-19 pandemic -An EAACI Position Paper Managing childhood allergies and immunodeficiencies during respiratory virus epidemics -The 2020 COVID-19 pandemic: A statement from the EAACI-section on pediatrics Immunology of COVID-19: mechanisms, clinical outcome, diagnostics and perspectives -a report of the European Academy of Allergy and Clinical Immunology (EAACI) Diagnosis and management of the drug hypersensitivity reactions in Coronavirus disease 19 Considerations on Biologicals for Patients with allergic disease in times of the COVID-19 pandemic: an EAACI Statement A compendium answering 150 questions on COVID-19 and SARS-CoV-2. Allergy. 2020. 30. Allergy homepage