Background

Oral immunotherapy (OIT) is effective in desensitizing patients with food allergy but adverse reactions limit its use.

Objective

To study the effect of the coronavirus disease 2019 lockdown in Israel between March 15, 2020, and April 30, 2020, on the incidence of home epinephrine-treated reactions.

Methods

All patients who were in the up-dosing phase of OIT for greater than or equal to 1 month during the lockdown, or a respective period in years 2015 to 2019, were studied. The incidence of home-epinephrine treated reactions during the 2020 lockdown was compared with that in the respective period in 2015 to 2019 and to periods before and after the lockdown.

Results

A total of 1163 OIT treatments were analyzed. Two epinephrine injections occurred during 2020 (0.7%) compared with 29 injections (3.28%) during 2015 to 2019 (P = .03). Patients treated in 2020 were older (8.1 vs 7 years, P < .01) and had a significantly lower single highest tolerated dose (12 vs 20 mg protein, P < .01). The rate of milk-OIT was lower (P = .01), but the total number of milk treatments was higher (99 vs 71 to 82) in 2020 compared with 2015 to 2019. On multivariate analysis, treatments during the 2020 lockdown were performed in older patients (P = .001), primarily for nonmilk (P = .03), began with a lower single highest tolerated dose (P = .006), and were associated with significantly less home epinephrine-treated reactions (P = .05) compared with those in 2015 to 2019. Patients treated in 2020 experienced more epinephrine-treated reactions in adjacent periods before (n = 8) and after (n = 6) the lockdown.

Conclusion

The lower rate of home epinephrine-treated reactions during the coronavirus disease 2019 lockdown in Israel suggests that potentially avoidable triggers contribute significantly to the rate of adverse reactions during OIT.

中文翻译：

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食物过敏口服免疫治疗中的家庭肾上腺素治疗反应

背景

口服免疫疗法 (OIT) 对食物过敏患者脱敏有效，但不良反应限制了其使用。

客观的

研究 2020 年 3 月 15 日至 2020 年 4 月 30 日期间以色列的 2019 年冠状病毒病封锁对家庭肾上腺素治疗反应发生率的影响。

方法

研究了在锁定期间或 2015 年至 2019 年的相应期间处于 OIT 剂量增加阶段大于或等于 1 个月的所有患者。将 2020 年封锁期间家庭肾上腺素治疗反应的发生率与 2015 年至 2019 年相应时期以及封锁前后期间的发生率进行了比较。

结果

共分析了 1163 个 OIT 治疗。2020 年发生了两次肾上腺素注射（0.7%），而 2015 年至 2019 年发生了 29 次注射（3.28%）（P  = .03）。2020 年接受治疗的患者年龄较大（8.1 岁对 7 岁，P < .01），单次最高耐受剂量显着降低（12 对 20 mg 蛋白质，P < .01）。与 2015 年至 2019 年相比，2020 年牛奶 OIT 发生率较低（P  = .01），但牛奶处理的总数较高（99 比 71 至 82）。在多变量分析中，进行了 2020 年封锁期间的处理在老年患者（P  = .001）中，主要是非牛奶（P  = .03），从较低的单次最高耐受剂量开始（P = .006)，并且与 2015 年至 2019 年相比，家庭肾上腺素治疗反应显着减少 ( P  = .05)。2020 年治疗的患者在之前的相邻时期经历了更多的肾上腺素治疗反应 (n = 8) 和在（n = 6）锁定之后。

结论

在以色列 2019 年冠状病毒病封锁期间，家庭肾上腺素治疗反应的发生率较低，这表明可能避免的触发因素对 OIT 期间的不良反应发生率有显着影响。