Risk and protective factors for coronavirus disease 2019 (COVID-19) in allergic rhinitis patients: a national survey in China

Xiaozhe Yang; Yutong Sima; Jinming Zhao; Jing Zhang; Xiangdong Wang; Luo Zhang

doi:10.3389/falgy.2024.1479493

Risk and protective factors for coronavirus disease 2019 (COVID-19) in allergic rhinitis patients: a national survey in China

Front Allergy. 2024 Dec 10:5:1479493. doi: 10.3389/falgy.2024.1479493. eCollection 2024.

Authors

Xiaozhe Yang^#^{1

2

3}, Yutong Sima^#^{1

2

3}, Jinming Zhao^{1

2

3}, Jing Zhang^{1

2

3}, Xiangdong Wang^{1

2

3}, Luo Zhang^{1

2

3

4}

Affiliations

¹ Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
² Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
³ Beijing Laboratory of Allergic Diseases, Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
⁴ Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China.

^# Contributed equally.

Abstract

Background: Several epidemiological studies have shown that allergic rhinitis (AR) patients are more susceptible to coronavirus disease 2019 (COVID-19).

Objective: We aim to investigate the risk factors for COVID-19 in AR patients.

Methods: A retrospective nationwide cohort study was conducted based on a questionnaire survey in China. The baseline characteristics, region of residence, smoking and drinking status, comorbidities, vaccination status and previous infection information were obtained. Allergen test results, the SARS-CoV-2 nucleic acid test, and antigen detection results were collected. Information on AR and comorbid medication use pre-SARS-CoV-2 infection was also collected. Binary logistic regression and analysis of covariance (different adjusted models) were conducted.

Results: In all, 830 AR patients were included; 627 patients (75.54%) were infected with SARS-CoV-2. AR comorbid with allergic conjunctivitis (AC) was a protective factor [OR: 0.525 (95% CI = 0.296-0.929), P = 0.027] against SARS-CoV-2 infection, while AR comorbid with food allergy was a risk factor [OR: 6.404 (95% CI = 1.349-30.402), P = 0.0195]. Although fewer patients received four doses of the vaccine, the results showed a significant protective effect against SARS-CoV-2 infection in AR patients [OR: 0.093 (95% CI = 0.025-0.348), P = 0.0004]. Underweight was a protective factor against COVID-19 [OR: 0.287 (95% CI = 0.147-0.562), P = 0.0003] after full multivariable adjustment. Overweight was associated with a 2.071-fold higher risk for COVID-19 compared with normal weight [(95% CI = 1.045-4.105), P = 0.0370]. Additionally, house dust mite (HDM)-specific allergies were also protective against COVID-19 [OR: 0.537 (95% CI = 0.290-0.996), P = 0.0484].

Conclusions: This study revealed underlying protective and risk factors, which might be used to improve the management of AR and COVID-19.

Keywords: COVID-19; allergic rhinitis; infection; protective factor; risk factor.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Key R&D Program of China (2022YFC2504100), the program for the Changjiang Scholars and Innovative Research Team (IRT13082), the National Natural Science Foundation of China (82171110), the CAMS Innovation Fund for Medical Sciences (2019-I2M-5-022), Special Funds for the Construction of High-level Public Health Technical Talents (Lingjunrencai-01-08, Lingjunrencai-02-09), Beijing Municipal Science & Technology Commission (Z211100002921057), the Capital's Funds for Health Improvement and Research (CFH 2022-1-1091, CFH 2024-4-1093), the Beijing Natural Science Foundation (7222024), the Beijing New-star Plan of Science and Technology (20220484226), Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes (JYY2021-2), Beijing Hospitals Authority Innovation Studio of Young Staff Funding Support (202306).