Introduction
Allergen immunotherapy is an effective and game-changing treatment
method for allergic rhinitis, venom anaphylaxis and allergic asthma
which can provide immune tolerance for many years. Subcutaneous allergen
immunotherapy (SCIT) is the most commonly used administration route, and
requires repeated administration of allergen extracts for 3 to 5 years
depending on the type of allergen applied.
Compliance is essential for AIT to obtain maximal benefit as it is a
long term treatment. However non-compliance rates may be as high as 50%
in both adults and
children1-3. The major
factors associated to noncompliance are long duration of treatment,
frequency of injections, high medical cost, improvement of systemic
reactions over time, poor perceived efficacy, allergic reactions during
vaccinations and travelling, and differ between centres, health system
structure and
cultures4-6. Most of the
studies about compliance come either from adult studies or from study
populations involving both adults and children; the ones involving only
pediatric age group are very
limited3.
The Coronavirus disease 2019 (COVID-19) pandemic not only affected
people with COVID-19 infection but also disrupted the treatment of
patients with chronic diseases. In this period, some changes in the
pattern of hospital admissions was recognized. A study from northern
Italy showed a significant decrease in acute coronary syndrome related
hospitalization rates across several cardiovascular centers in northern
Italy during the early days of the COVID-19
outbreak7. During that
period, a significant increase in mortality was reported that was not
fully explained by COVID-19 cases alone, and thought to be due to
failure to access medical attention. In this period, we also observed a
reduction in pediatric outpatient admissions for AIT.
In the present study we aimed to investigate the real life compliance of
children with SCIT and tried to document the factors associated with
compliance. Additionally we evaluated how the COVID-19 pandemic effected
the compliance of our patients and the reasons that caused drop-outs.