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GENERAL INFORMATION
Authors: Motohiro Ebisawa, MD, PhD; Bryan Martin, DO;
Sandra González Díaz, MD, PhD; Elham Hossny, MD, PhD;
Michael Levin, MD, PhD; Mário Morais Almeida, MD;
José Antonio Ortega Martell, MD; and Gary WK Wong, MD
Disclaimer: Do not consider this information to be medical advice. Consult your physi-
cian about COVID-19 as well as allergic disease, asthma, or any health matters. This
information is current as of 17 June 2020. Stay updated, because experts are still
learning about SARS-CoV-2 and COVID-19.
Stay updated on accurate medical
information about COVID-19 and
allergy from allergy professionals.
There is agreement in the international medical commu-
nity that we do not yet understand COVID-19 and the
best treatment for those who have become sick during
the pandemic. We are quickly learning more about
this virus, the disease it causes, and the effect it has on
those suffering from other conditions such as diabetes,
hypertension, and asthma. Because of this, information
released to the public may seem to disagree with earlier
information or be incomplete.
Allergic diseases, particularly asthma, may affect
COVID-19 infections as well as be affected by them and
our attempts to limit the spread of the virus. Stay in fre-
quent contact with your physicians, including your aller-
gist. Ask them for up-to-date and clear information about
COVID-19 and the ways it might affect your allergies
or asthma. Likewise, keep them informed of your health
status if anything changes. A pandemic can be a time of
anxiety for everyone, and especially those with allergies
and asthma. Ease your anxieties about your healthcare
by staying in contact with your allergist.
What is COVID-19?
COVID‑19, short for “coronavirus disease 2019”, is a
disease spreading around the world caused by infection
with a new strain of coronavirus (SARS-
CoV-2). Patients with symptoms are
very contagious, but even those
with mild or no symptoms can still
infect others. A vaccine against
COVID‑19 is not yet available.1
There are many different coro-
naviruses, and they can change
over time to become more infec-
tious and spread between peo-
ple such as with SARS-CoV-1 and
MERS-CoV.2
The new virus, SARS-
CoV-2, which causes COVID-19,
mostly spreads from person to person
through droplets suspended in the air
when an infected person coughs or sneez-
es. Because droplets usually fall out of the air
and settle on the ground within a few meters, it may be
less likely to catch the disease if people remain at least
two meters (six feet) apart. Studies continue on how long
droplets of the virus remain in the air.
The diagnosis of COVID-19 is made by finding SARS-
CoV-2 virus in samples taken from swabbing the nose or
throat, or more recently from saliva. Blood tests cannot
show whether someone has infection from SARS CoV-2.
Because of the transmission through droplets, the best
ways to reduce spread is to keep people apart (social
distancing and lockdowns), test widely, and use personal
www.worldallergyweek.org
protective equipment for health care workers and cloth
masks for the public.3
Children are as likely as adults are to get SARS-CoV-2
infection, but they get a much milder disease, in general.
However, children can still pass on infection to others
even when they seem completely well. On the other
hand, the elderly and people of all ages with severe
chronic conditions such as heart disease, lung disease,
obesity, and diabetes, seem to be at higher risk of devel-
oping serious COVID-19.4,5
Always take care of your allergies and
asthma – with or without a pandemic.
Get the care you need while limiting your
exposure to the virus.
As health facilities around the world focus on the pandem-
ic, there may be less focus on other health care issues.
However, that does not mean other health issues have
become less important or that you should reduce or delay
usual care. In fact, controlling your allergies can help pro-
tect you against COVID-19. People with allergies and
asthma should make sure they access regular
care but do so as safely as possible. If you
have ongoing allergy treatment, discuss
with your health care practitioners how
best to continue care while limiting
your exposure to the virus.
Your doctor might offer the option
of a consultation by telephone
or through Internet. Health care
practitioners use telemedicine
and telephone consults for
non-emergencies in many areas
to avoid the risk of infection from
face-to-face medical visits. If you
do need to seek health care in per-
son, remember to maintain social dis-
tance, wear a mask, and wash hands
frequently and thoroughly. Avoid touching
high-use surfaces in public spaces.
While remembering to avoid COVID-19,
also remember to avoid your allergens.
You may have started to take measures to reduce your
risk of infection by the coronavirus. While you do that,
keep in mind an important aspect of self-care during the
pandemic: Remember to avoid your allergens while you
are avoiding COVID-19.
Do not stop your prescribed allergy
medications.
The best way of self-care for people with allergies is to
take your prescribed allergy and asthma medications
regularly and with the best possible technique – which
is true even when there is no pandemic. This is particu-
larly important for your inhaled corticosteroids and other
controlled inhaler medication for asthma and your nasal
sprays for allergic rhinitis. Use them the way your physi-
cian taught you, or ask your doctor about the best way
to make them work. Allergen immunotherapy treatment
is not discouraged during the COVID-19 pandemic, but
office visits may be risky. For those who receive immuno-
therapy, it is important to discuss continuing it safely with
your allergist.
For asthma, do not stop your prescribed
medications.
Individuals with asthma might have concerns about taking
their standard treatment due to the pandemic, including
the safety of using inhaled and oral corticosteroids. There
is no evidence that the use of inhaled or nasal steroids
increases one’s risk of contracting COVID-19, and using
them regularly might even help prevent you from getting
the infection or from suffering with more severe symptoms.
Uncontrolled asthma is a possible risk factor for severe
COVID-19. Stopping inhaled corticosteroids can lead to
worsening of asthma, and avoiding oral corticosteroids
during severe asthma attacks may have serious conse-
quences.6-8
Always discuss with your doctor or nurse
before stopping any asthma medication. If your asthma
gets worse, follow the instructions on your asthma action
plan for how to change your asthma medications and
when to seek medical help.9,10
www.worldallergyweek.org
Nebulizers increase the risk of spreading the virus to
others through the air. Many people who carry the virus
may not be aware of it because they might not have
symptoms. For those and other health reasons, your doc-
tor might switch from nebulizer treatment to using asthma
pumps (known as pressurized metered dose inhalers, or
pMDIs) for acute asthma attacks, regardless of whether
or not you have a diagnosis of COVID-19. If you rou-
tinely use a nebulizer as part of your asthma treatment,
it is preferable that you use your pMDI with a spacer
for all but life threatening exacerbations. Spacers allow
effective delivery of inhaled medication to the airways.11
Never share spacers.
Stop smoking, or avoid it until you can quit
for good.
Chronic obstructive pulmonary disease (COPD) and ongo-
ing smoking will not help against COVID-19, and it could
make the disease worse.12
Studies have suggested that
smokers who get SARS CoV-2 are more likely to develop
severe COVID-19 disease compared to non-smokers.12
Smoking impairs lung function, making it harder for
the body to fight off coronaviruses and other disease.
Tobacco is also a major risk factor for non-communicable
diseases like cardiovascular disease, cancer, respiratory
disease, and diabetes, which put people with these con-
ditions at higher risk for developing severe illness when
infected by COVID-19.13,14
Symptom similarity between allergies
and COVID-19 can be confusing.
Your allergist will help identify the
differences.
Spring and early summer in some parts of the world is
a time when people with allergies have an increase in
symptoms due to their allergies and the pollination of
plants. It can be difficult to distinguish allergic symptoms
from symptoms of COVID-19. Allergists can help you
identify the differences. Hay fever (allergic rhinitis), for
example, can be confused with viral illnesses. Sneezing
and itching are common in allergic rhinitis, while fever,
fatigue, and shortness of breath appear in COVID-19.
Poor control of allergic rhinitis worsens asthma, though,
so it is important to control allergic rhinitis.
Again, allergies will not give you a fever, even though
we talk about “hay fever” when we talk about allergies.
If you have a fever, contact your primary care doctor.
This may be a sign of COVID-19.
If infected with COVID-19, your
allergy care might change. Ask your
allergist for an assessment.
COVID-19 expression or severity does not seem to
increase in other forms of allergy such as nasal
allergy (hay fever), urticaria, or eczema. If
you have nasal or ocular allergy, you
may continue your usual treatment,
including intra-nasal sprays at the
dose recommended by your
allergist.9
COVID-19 may rarely
affect the eye,15
but its manifes-
tations are quite different from
those of eye allergy. Eye itching
is a characteristic feature of
allergy.
If you have a diagnosis of
COVID-19 infection, do not use a
nebulizer. It may cause droplets of
the virus to persist or linger in aero-
sol form and spread to those nearby.
Talk to your allergist about this.11
A mod-
erate-to-severe COVID-19 infection can cause
difficulty breathing. If you have received a diagnosis
of COVID-19, do not assume that symptoms of shortness
of breath, chest tightness, or difficulty breathing are a
result of your asthma. Contact your physician immediate-
ly to discuss your symptoms. You may need to go to the
emergency room for oxygen therapy or other breathing
assistance. Many viral infections increase severity of asth-
ma. It is important to have professional help to determine
if asthma has caused your shortness of breath, or another
cause.
www.worldallergyweek.org
Controlling your allergy could help
you better defend yourself against the
virus.
Touching your face and eyes due to itching can increase
the risk of infection of SARS-CoV-2, if you have been in
contact with the virus. For atopic eczema/dermatitis,
be sure to continue regular skin care and topical steroid
ointment as recommended by your doctor. If you have
allergic conjunctivitis, continue your anti-histamine and
topic steroid eye drops. Prepare for accidental allergic
reactions with medications such auto-injectable adren-
aline, anti-histamines, and any other medications pre-
scribed by your doctor. Anyone with food allergy should
continue reading food labels carefully while shopping, to
avoid foods that might trigger reactions.
Individuals with uncontrolled or severe asthma may be in
a high-risk group for severe illness from COVID-19.10,13
Most respiratory viruses are common triggers of severe
asthma attacks. The current SARS-CoV-2 pandemic
makes it important to manage asthma as best as possible
in these circumstances. When you have asthma, you
have underlying swelling and inflammation in the lungs
that make it difficult for you to fight off viruses. Taking
your controller therapy every day, whether you have
symptoms or not, helps repair that inflammation and fight
off viruses more efficiently. That is why you should contin-
ue taking your prescribed medications regularly and with
the best possible technique: it might even help prevent
you from getting coronavirus infection or from suffering
with more severe symptoms.16
References
1.	 Apple CDC Screening Tool. About COVID‑19. https://www.
apple.com/covid19. Publication date not available. Accessed
May 19, 2020.
2.	 U.S. Centers for Disease Control and Infection. Coronavirus
Disease 2019 (COVID-19). Frequently Asked Questions.
Updated May 24, 2020. https://www.cdc.gov/coronavi-
rus/2019-ncov/faq.html. Accessed May 29, 2020.
3.	 Gandhi RT, Lynch JB, Del Rio C. Mild or Moderate COVID-19.
N Engl J Med. 2020 Apr 24. doi: 10.1056/NE-
JMcp2009249. Online ahead of print.
4.	 Kam KQ, Yung CF, Cui L, et al. A well infant with coronavirus
disease 2019 (COVID-19) with high viral load. Clin Infect Dis.
2020 Feb 28. doi: 10.1093/cid/ciaa201. Online ahead of
print.
5.	 Hossny E, El-Owaidy R. COVID-19 in children: current data
and future perspectives. Egypt J Pediatr Allergy Immunol. 2020;
18(1):3-9. doi:10.21608/ejpa.2020.81765.
6.	 David MG Halpin, David Singh, Ruth M. Hadfield. Inhaled
Corticosteroids and COVID-19: a systematic review and
clinical perspective. Eur Respir J. 2020 55(5):2001009. doi:
10.1183/13993003.01009-2020.
7.	 Shaker MS, Oppenheimer J, Grayson M, et al. COVID-19:
pandemic contingency planning for the allergy and immunology
clinic. J Allergy Clin Immunol Pract. 2020;8(5):1477-1488e5.
doi: 10.1016/j.jaip.2020.03.012.
8.	 Johnston SL. Asthma and COVID-19: Is asthma a risk factor
for severe outcomes? Allergy. 2020 May 2. doi:10.1111/
all.14348. Online ahead of print.
9.	 Bousquet J, Akdis C, Jutel M, et al. Intranasal corticosteroids in
allergic rhinitis in COVID-19 infected patients: An ARIA-EAACI
statement. Allergy. 2020 Mar 31. doi: 10.1111/all.14302.
Online ahead of print.
10.	Global Initiative for Asthma (GINA). Global Strategy for Asthma
Management and Prevention. Updated 2020. Interim guid-
ance on asthma management during the COVID-19 pandemic.
https://ginasthma.org/gina-reports/. Accessed May 29,
2020.
11.	Levin M, Morais-Almeida M, Ansotegui IJ, et al. Acute asthma
management during SARS-CoV2-pandemic 2020. World
Allergy Organ J. 2020;13(5):100125. doi:10.1016/j.wao-
jou.2020.100125
12.	Zhao Q, Meng M, Kumar R, et al. The impact of COPD and
smoking history on the severity of COVID-19: A systemic review
and meta-analysis. J Med Virol. 2020 Apr 15. doi: 10.1002/
jmv.25889. Online ahead of print.
13.	World Health Organization (WHO). Clinical management of
COVID-19: interim guidance. Geneva: World Health Orga-
nization. Updated May 27, 2020. https://www.who.int/
publications-detail/clinical-management-of-severe-acute-respi-
ratory-infection-when-novel-coronavirus-(ncov)-infection-is-sus-
pected. WHO Reference Number: WHO/2019-nCoV/clini-
cal/2020.5. Accessed May 29, 2020.
14.	World Health Organization (WHO). WHO statement: Tobacco
use and COVID-19. May 11, 2020. https://www.who.int/
news-room/detail/11-05-2020-who-statement-tobacco-use-
and-covid-19. Accessed May 20, 2020.
15.	Chen L, Liu M, Zhang Z, et al. Ocular manifestations of a hospi-
talized patient with confirmed 2019 novel coronavirus disease.
Br J Ophthalmol 2020;104(6):748-751. doi: 10.1136/bjoph-
thalmol-2020-316304.
16.	Kumar K, Hinks TS, Singanayagam A. Treatment of COVID-19
exacerbated asthma: Should systemic corticosteroids be
used? Am J Physiol Lung Cell Mol Physiol. 2020 May 13.
doi:10.1152/ajplung.00144.2020. Online ahead of print.
www.worldallergyweek.org
WAO-0620-156

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World Allergy Week 2020 General Information

  • 1. GENERAL INFORMATION Authors: Motohiro Ebisawa, MD, PhD; Bryan Martin, DO; Sandra González Díaz, MD, PhD; Elham Hossny, MD, PhD; Michael Levin, MD, PhD; Mário Morais Almeida, MD; José Antonio Ortega Martell, MD; and Gary WK Wong, MD Disclaimer: Do not consider this information to be medical advice. Consult your physi- cian about COVID-19 as well as allergic disease, asthma, or any health matters. This information is current as of 17 June 2020. Stay updated, because experts are still learning about SARS-CoV-2 and COVID-19. Stay updated on accurate medical information about COVID-19 and allergy from allergy professionals. There is agreement in the international medical commu- nity that we do not yet understand COVID-19 and the best treatment for those who have become sick during the pandemic. We are quickly learning more about this virus, the disease it causes, and the effect it has on those suffering from other conditions such as diabetes, hypertension, and asthma. Because of this, information released to the public may seem to disagree with earlier information or be incomplete. Allergic diseases, particularly asthma, may affect COVID-19 infections as well as be affected by them and our attempts to limit the spread of the virus. Stay in fre- quent contact with your physicians, including your aller- gist. Ask them for up-to-date and clear information about COVID-19 and the ways it might affect your allergies or asthma. Likewise, keep them informed of your health status if anything changes. A pandemic can be a time of anxiety for everyone, and especially those with allergies and asthma. Ease your anxieties about your healthcare by staying in contact with your allergist. What is COVID-19? COVID‑19, short for “coronavirus disease 2019”, is a disease spreading around the world caused by infection with a new strain of coronavirus (SARS- CoV-2). Patients with symptoms are very contagious, but even those with mild or no symptoms can still infect others. A vaccine against COVID‑19 is not yet available.1 There are many different coro- naviruses, and they can change over time to become more infec- tious and spread between peo- ple such as with SARS-CoV-1 and MERS-CoV.2 The new virus, SARS- CoV-2, which causes COVID-19, mostly spreads from person to person through droplets suspended in the air when an infected person coughs or sneez- es. Because droplets usually fall out of the air and settle on the ground within a few meters, it may be less likely to catch the disease if people remain at least two meters (six feet) apart. Studies continue on how long droplets of the virus remain in the air. The diagnosis of COVID-19 is made by finding SARS- CoV-2 virus in samples taken from swabbing the nose or throat, or more recently from saliva. Blood tests cannot show whether someone has infection from SARS CoV-2. Because of the transmission through droplets, the best ways to reduce spread is to keep people apart (social distancing and lockdowns), test widely, and use personal www.worldallergyweek.org
  • 2. protective equipment for health care workers and cloth masks for the public.3 Children are as likely as adults are to get SARS-CoV-2 infection, but they get a much milder disease, in general. However, children can still pass on infection to others even when they seem completely well. On the other hand, the elderly and people of all ages with severe chronic conditions such as heart disease, lung disease, obesity, and diabetes, seem to be at higher risk of devel- oping serious COVID-19.4,5 Always take care of your allergies and asthma – with or without a pandemic. Get the care you need while limiting your exposure to the virus. As health facilities around the world focus on the pandem- ic, there may be less focus on other health care issues. However, that does not mean other health issues have become less important or that you should reduce or delay usual care. In fact, controlling your allergies can help pro- tect you against COVID-19. People with allergies and asthma should make sure they access regular care but do so as safely as possible. If you have ongoing allergy treatment, discuss with your health care practitioners how best to continue care while limiting your exposure to the virus. Your doctor might offer the option of a consultation by telephone or through Internet. Health care practitioners use telemedicine and telephone consults for non-emergencies in many areas to avoid the risk of infection from face-to-face medical visits. If you do need to seek health care in per- son, remember to maintain social dis- tance, wear a mask, and wash hands frequently and thoroughly. Avoid touching high-use surfaces in public spaces. While remembering to avoid COVID-19, also remember to avoid your allergens. You may have started to take measures to reduce your risk of infection by the coronavirus. While you do that, keep in mind an important aspect of self-care during the pandemic: Remember to avoid your allergens while you are avoiding COVID-19. Do not stop your prescribed allergy medications. The best way of self-care for people with allergies is to take your prescribed allergy and asthma medications regularly and with the best possible technique – which is true even when there is no pandemic. This is particu- larly important for your inhaled corticosteroids and other controlled inhaler medication for asthma and your nasal sprays for allergic rhinitis. Use them the way your physi- cian taught you, or ask your doctor about the best way to make them work. Allergen immunotherapy treatment is not discouraged during the COVID-19 pandemic, but office visits may be risky. For those who receive immuno- therapy, it is important to discuss continuing it safely with your allergist. For asthma, do not stop your prescribed medications. Individuals with asthma might have concerns about taking their standard treatment due to the pandemic, including the safety of using inhaled and oral corticosteroids. There is no evidence that the use of inhaled or nasal steroids increases one’s risk of contracting COVID-19, and using them regularly might even help prevent you from getting the infection or from suffering with more severe symptoms. Uncontrolled asthma is a possible risk factor for severe COVID-19. Stopping inhaled corticosteroids can lead to worsening of asthma, and avoiding oral corticosteroids during severe asthma attacks may have serious conse- quences.6-8 Always discuss with your doctor or nurse before stopping any asthma medication. If your asthma gets worse, follow the instructions on your asthma action plan for how to change your asthma medications and when to seek medical help.9,10 www.worldallergyweek.org
  • 3. Nebulizers increase the risk of spreading the virus to others through the air. Many people who carry the virus may not be aware of it because they might not have symptoms. For those and other health reasons, your doc- tor might switch from nebulizer treatment to using asthma pumps (known as pressurized metered dose inhalers, or pMDIs) for acute asthma attacks, regardless of whether or not you have a diagnosis of COVID-19. If you rou- tinely use a nebulizer as part of your asthma treatment, it is preferable that you use your pMDI with a spacer for all but life threatening exacerbations. Spacers allow effective delivery of inhaled medication to the airways.11 Never share spacers. Stop smoking, or avoid it until you can quit for good. Chronic obstructive pulmonary disease (COPD) and ongo- ing smoking will not help against COVID-19, and it could make the disease worse.12 Studies have suggested that smokers who get SARS CoV-2 are more likely to develop severe COVID-19 disease compared to non-smokers.12 Smoking impairs lung function, making it harder for the body to fight off coronaviruses and other disease. Tobacco is also a major risk factor for non-communicable diseases like cardiovascular disease, cancer, respiratory disease, and diabetes, which put people with these con- ditions at higher risk for developing severe illness when infected by COVID-19.13,14 Symptom similarity between allergies and COVID-19 can be confusing. Your allergist will help identify the differences. Spring and early summer in some parts of the world is a time when people with allergies have an increase in symptoms due to their allergies and the pollination of plants. It can be difficult to distinguish allergic symptoms from symptoms of COVID-19. Allergists can help you identify the differences. Hay fever (allergic rhinitis), for example, can be confused with viral illnesses. Sneezing and itching are common in allergic rhinitis, while fever, fatigue, and shortness of breath appear in COVID-19. Poor control of allergic rhinitis worsens asthma, though, so it is important to control allergic rhinitis. Again, allergies will not give you a fever, even though we talk about “hay fever” when we talk about allergies. If you have a fever, contact your primary care doctor. This may be a sign of COVID-19. If infected with COVID-19, your allergy care might change. Ask your allergist for an assessment. COVID-19 expression or severity does not seem to increase in other forms of allergy such as nasal allergy (hay fever), urticaria, or eczema. If you have nasal or ocular allergy, you may continue your usual treatment, including intra-nasal sprays at the dose recommended by your allergist.9 COVID-19 may rarely affect the eye,15 but its manifes- tations are quite different from those of eye allergy. Eye itching is a characteristic feature of allergy. If you have a diagnosis of COVID-19 infection, do not use a nebulizer. It may cause droplets of the virus to persist or linger in aero- sol form and spread to those nearby. Talk to your allergist about this.11 A mod- erate-to-severe COVID-19 infection can cause difficulty breathing. If you have received a diagnosis of COVID-19, do not assume that symptoms of shortness of breath, chest tightness, or difficulty breathing are a result of your asthma. Contact your physician immediate- ly to discuss your symptoms. You may need to go to the emergency room for oxygen therapy or other breathing assistance. Many viral infections increase severity of asth- ma. It is important to have professional help to determine if asthma has caused your shortness of breath, or another cause. www.worldallergyweek.org
  • 4. Controlling your allergy could help you better defend yourself against the virus. Touching your face and eyes due to itching can increase the risk of infection of SARS-CoV-2, if you have been in contact with the virus. For atopic eczema/dermatitis, be sure to continue regular skin care and topical steroid ointment as recommended by your doctor. If you have allergic conjunctivitis, continue your anti-histamine and topic steroid eye drops. Prepare for accidental allergic reactions with medications such auto-injectable adren- aline, anti-histamines, and any other medications pre- scribed by your doctor. Anyone with food allergy should continue reading food labels carefully while shopping, to avoid foods that might trigger reactions. Individuals with uncontrolled or severe asthma may be in a high-risk group for severe illness from COVID-19.10,13 Most respiratory viruses are common triggers of severe asthma attacks. The current SARS-CoV-2 pandemic makes it important to manage asthma as best as possible in these circumstances. When you have asthma, you have underlying swelling and inflammation in the lungs that make it difficult for you to fight off viruses. Taking your controller therapy every day, whether you have symptoms or not, helps repair that inflammation and fight off viruses more efficiently. That is why you should contin- ue taking your prescribed medications regularly and with the best possible technique: it might even help prevent you from getting coronavirus infection or from suffering with more severe symptoms.16 References 1. Apple CDC Screening Tool. About COVID‑19. https://www. apple.com/covid19. Publication date not available. Accessed May 19, 2020. 2. U.S. Centers for Disease Control and Infection. Coronavirus Disease 2019 (COVID-19). Frequently Asked Questions. Updated May 24, 2020. https://www.cdc.gov/coronavi- rus/2019-ncov/faq.html. Accessed May 29, 2020. 3. Gandhi RT, Lynch JB, Del Rio C. Mild or Moderate COVID-19. N Engl J Med. 2020 Apr 24. doi: 10.1056/NE- JMcp2009249. Online ahead of print. 4. Kam KQ, Yung CF, Cui L, et al. A well infant with coronavirus disease 2019 (COVID-19) with high viral load. Clin Infect Dis. 2020 Feb 28. doi: 10.1093/cid/ciaa201. Online ahead of print. 5. Hossny E, El-Owaidy R. COVID-19 in children: current data and future perspectives. Egypt J Pediatr Allergy Immunol. 2020; 18(1):3-9. doi:10.21608/ejpa.2020.81765. 6. David MG Halpin, David Singh, Ruth M. Hadfield. Inhaled Corticosteroids and COVID-19: a systematic review and clinical perspective. Eur Respir J. 2020 55(5):2001009. doi: 10.1183/13993003.01009-2020. 7. Shaker MS, Oppenheimer J, Grayson M, et al. COVID-19: pandemic contingency planning for the allergy and immunology clinic. J Allergy Clin Immunol Pract. 2020;8(5):1477-1488e5. doi: 10.1016/j.jaip.2020.03.012. 8. Johnston SL. Asthma and COVID-19: Is asthma a risk factor for severe outcomes? Allergy. 2020 May 2. doi:10.1111/ all.14348. Online ahead of print. 9. Bousquet J, Akdis C, Jutel M, et al. Intranasal corticosteroids in allergic rhinitis in COVID-19 infected patients: An ARIA-EAACI statement. Allergy. 2020 Mar 31. doi: 10.1111/all.14302. Online ahead of print. 10. Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. Updated 2020. Interim guid- ance on asthma management during the COVID-19 pandemic. https://ginasthma.org/gina-reports/. Accessed May 29, 2020. 11. Levin M, Morais-Almeida M, Ansotegui IJ, et al. Acute asthma management during SARS-CoV2-pandemic 2020. World Allergy Organ J. 2020;13(5):100125. doi:10.1016/j.wao- jou.2020.100125 12. Zhao Q, Meng M, Kumar R, et al. The impact of COPD and smoking history on the severity of COVID-19: A systemic review and meta-analysis. J Med Virol. 2020 Apr 15. doi: 10.1002/ jmv.25889. Online ahead of print. 13. World Health Organization (WHO). Clinical management of COVID-19: interim guidance. Geneva: World Health Orga- nization. Updated May 27, 2020. https://www.who.int/ publications-detail/clinical-management-of-severe-acute-respi- ratory-infection-when-novel-coronavirus-(ncov)-infection-is-sus- pected. WHO Reference Number: WHO/2019-nCoV/clini- cal/2020.5. Accessed May 29, 2020. 14. World Health Organization (WHO). WHO statement: Tobacco use and COVID-19. May 11, 2020. https://www.who.int/ news-room/detail/11-05-2020-who-statement-tobacco-use- and-covid-19. Accessed May 20, 2020. 15. Chen L, Liu M, Zhang Z, et al. Ocular manifestations of a hospi- talized patient with confirmed 2019 novel coronavirus disease. Br J Ophthalmol 2020;104(6):748-751. doi: 10.1136/bjoph- thalmol-2020-316304. 16. Kumar K, Hinks TS, Singanayagam A. Treatment of COVID-19 exacerbated asthma: Should systemic corticosteroids be used? Am J Physiol Lung Cell Mol Physiol. 2020 May 13. doi:10.1152/ajplung.00144.2020. Online ahead of print. www.worldallergyweek.org WAO-0620-156