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The US Centers for Disease Control and Prevention lists asthma as a risk factor for severe COVID-19 illness, which is logical given that many respiratory viruses have been well established to cause more serious illnesses in those with chronic airway diseases such as asthma. However, asthma and respiratory allergy have not been identified as significant risk factors for severe COVID-19 illness in case series from China. These preliminary reports led us to question whether we could identify features of allergy and/or asthma that could be associated with potential for reduced severity of COVID-19 illness.
In the event of a global infectious pandemic, drastic measures may be needed that limit or require adjustment of ambulatory allergy services. However, no rationale for how to prioritize service shut down and patient care exists. A consensus-based ad-hoc expert panel of allergy/immunology specialists from the United States and Canada developed a service and patient prioritization schematic to temporarily triage allergy/immunology services.
Coronavirus disease 2019 (COVID-19) is caused by a novel zoonotic coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been identified as a pandemic by the World Health Organization. Several risk factors have been identified for severe COVID-19–associated pneumonia including increased age and the presence of comorbidities, in particular diabetes, cardiovascular disease, and tobacco smoking. However, a number of reports have failed to identify excess risk in patients with respiratory airway diseases such as asthma.
With rates of new infections and fatalities potentially reaching a plateau and/or declining, restrictions on provision of routine ambulatory care are lifting, and there is a need to help guide the allergy/immunology clinician on how to reinitiate services. Given the fact that coronavirus disease 2019 will circulate within our communities for months or longer, we present a flexible, algorithmic best-practices planning approach on how to prioritize services, in 4 stratified phases of reopening according to community risk level, as well as highlight key considerations for how to safely do so.