Differentiation of COVID-19 signs and symptoms from allergic rhinitis and common cold: An ARIA-EAACI-GA2LEN consensus

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  • Jan Hagemann
  • Gabrielle L. Onorato
  • Marek Jutel
  • Cezmi A. Akdis
  • Ioana Agache
  • Torsten Zuberbier
  • Wienczyslawa Czarlewski
  • Joaquim Mullol
  • Anna Bedbrook
  • Claus Bachert
  • Kazi S. Bennoor
  • Karl Christian Bergmann
  • Fulvio Braido
  • Paulo Camargos
  • Luis Caraballo
  • Victoria Cardona
  • Thomas Casale
  • Lorenzo Cecchi
  • Tomas Chivato
  • Derek K. Chu
  • Cemal Cingi
  • Jaime Correia-de-Sousa
  • Stefano del Giacco
  • Dejan Dokic
  • Mark Dykewicz
  • Motohiro Ebisawa
  • Yehia El-Gamal✝
  • Regina Emuzyte
  • Jean Luc Fauquert
  • Alessandro Fiocchi
  • Wytske J. Fokkens
  • Joao A. Fonseca
  • Bilun Gemicioglu
  • René Maximiliano Gomez
  • Maia Gotua
  • Tari Haahtela
  • Eckard Hamelmann
  • Tomohisa Iinuma
  • Juan Carlos Ivancevich
  • Ewa Jassem
  • Omer Kalayci
  • Przemyslaw Kardas
  • Musa Khaitov
  • Piotr Kuna
  • Violeta Kvedariene
  • Desiree E. Larenas-Linnemann
  • Brian Lipworth
  • Michael Makris
  • Jorge F. Maspero
  • Neven Miculinic
  • Florin Mihaltan
  • Yousser Mohammad
  • Stephen Montefort
  • Mario Morais-Almeida
  • Ralph Mösges
  • Robert Naclerio
  • Hugo Neffen
  • Marek Niedoszytko
  • Robyn E. O’Hehir
  • Ken Ohta
  • Yoshitaka Okamoto
  • Kimi Okubo
  • Petr Panzner
  • Nikolaos G. Papadopoulos
  • Giovanni Passalacqua
  • Vincenzo Patella
  • Ana Pereira
  • Oliver Pfaar
  • Davor Plavec
  • Todor A. Popov
  • Emmanuel P. Prokopakis
  • Francesca Puggioni
  • Filip Raciborski
  • Jere Reijula
  • Frederico S. Regateiro
  • Sietze Reitsma
  • Antonino Romano
  • Nelson Rosario
  • Menachem Rottem
  • Dermot Ryan
  • Boleslaw Samolinski
  • Joaquin Sastre
  • Dirceu Solé
  • Milan Sova
  • Cristiana Stellato
  • Ioanna Tsiligianni
  • Antonio Valero
  • Arunas Valiulis
  • Erkka Valovirta
  • Tuula Vasankari
  • Maria Teresa Ventura
  • Dana Wallace
  • De Yun Wang
  • Siân Williams
  • Arzu Yorgancioglu
  • Osman M. Yusuf
  • Mario Zernotti
  • Jean Bousquet
  • Ludger Klimek

Background: Although there are many asymptomatic patients, one of the problems of COVID-19 is early recognition of the disease. COVID-19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID-19 symptoms may be mistaken with the common cold or allergic rhinitis. An ARIA-EAACI study group attempted to differentiate upper respiratory symptoms between the three diseases. Methods: A modified Delphi process was used. The ARIA members who were seeing COVID-19 patients were asked to fill in a questionnaire on the upper airway symptoms of COVID-19, common cold and allergic rhinitis. Results: Among the 192 ARIA members who were invited to respond to the questionnaire, 89 responded and 87 questionnaires were analysed. The consensus was then reported. A two-way ANOVA revealed significant differences in the symptom intensity between the three diseases (p <.001). Conclusions: This modified Delphi approach enabled the differentiation of upper respiratory symptoms between COVID-19, the common cold and allergic rhinitis. An electronic algorithm will be devised using the questionnaire.

OriginalsprogEngelsk
TidsskriftAllergy: European Journal of Allergy and Clinical Immunology
Vol/bind76
Udgave nummer8
Sider (fra-til)2354-2366
ISSN0105-4538
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
CA reports grants from Allergopharma, Idorsia, Swiss National Science Foundation, Christine Kühne‐Center for Allergy Research and Education, European Commission's Horison's 2020 Framework Programme, Cure, Novartis Research Institutes, Astra Zeneca, Scibase, advisory role in Sanofi/Regeneron, grants from Glakso Smith‐Kline, advisory role in Scibase. JB reports personal fees from Chiesi, Cipla, Hikma, Menarini, Mundipharma, Mylan, Novartis, Purina, Sanofi‐Aventis, Takeda, Teva, Uriach, other from KYomed‐Innov. VC reports personal fees from ALK, Allergy Therapeutics, LETI, Thermofisher, Merck, Astrazeneca, GSK. JCS reports Advisory Board from Boheringer Ingelheim, personal fees and Advisory Board from GSK, Bial, grants, personal fees and Advisory Board from AstraZeneca, non‐financial support from Mundipharma, personal fees from Sanofi, Advisory Board from Novartis. JCI reports personal fees from Faes Farma, Abbott Ecuador, Laboratorios Casasco, Laboratorios Bago Bolivia, Eurofarma Argentina, Sanofi. PK reports personal fees from Adamed, AstraZeneca, Berlin Chemie Menarini, Boehringer Ingelheim, Hal Allergy, Lekam, Mylan, Novartis, Polpharma, Sanofi, Teva, Chiesi, USP Pharmacia. VK reports personal fees from GSK, non‐financial support from AstraZeneca, DIMUNA, DLL reports personal fees from Allakos, Amstrong, Astrazeneca, Boehringer Ingelheim, Chiesi, DBV Technologies, Grunenthal, GSK, MEDA, Menarini, MSD, Novartis, Pfizer, Novartis, Sanofi, Siegfried, UCB, Alakos, Gossamer, grants from Sanofi, Astrazeneca, Novartis, UCB, GSK, TEVA, Boehringer Ingelheim, Chiesi, Purina institute. BL reports grants and personal fees from Mylan, Glenmark. JM reports personal fees and other from SANOFI‐GENZYME & REGENERON, NOVARTIS, ALLAKOS, grants and personal fees from MYLAN‐MEDA Pharma, URIACH Group, personal fees from MITSUBISHI‐TANABE, MENARINI, UCB, ASTRAZENECA, personal fees from GSK, MSD. NP reports personal fees from Novartis, Nutricia, HAL, MENARINI/FAES FARMA, SANOFI, MYLAN/MEDA, BIOMAY, AstraZeneca, GSK, MSD, ASIT BIOTECH, Boehringer Ingelheim, grants from Gerolymatos International SA, Capricare. OP reports grants and personal fees from ALK‐Abelló, Allergopharma, Stallergenes Greer, HAL Allergy Holding B.V./HAL Allergie GmbH, Bencard Allergie GmbH/Allergy Therapeutics, Lofarma, ASIT Biotech Tools S.A., Laboratorios LETI/LETI Pharma, Anergis S.A., Glaxo Smith Kline, personal fees Astellas Pharma Global, EUFOREA, ROXALL Medizin, Novartis, Sanofi‐Aventis and Sanofi‐Genzyme, Med Update Europe GmbH, streamedup! GmbH, grants from Pohl‐Boskamp, Inmunotek S.L.,personal fees from John Wiley and Sons, AS, personal fees from MEDA Pharma/MYLAN, Mobile Chamber Experts (a GALEN Partner), Indoor Biotechnologies. DP reports grants and personal fees from GlaxoSmithKline, personal fees from Menarini, Pliva, Belupo, AbbVie, Novartis, MSD, Chiesi, Revenio, AbbVie, Novartis, MSD, Chiesi, Revenio, non‐financial support from Philips, personal fees and non‐financial support from Boehringer Ingelheim, FP reports personal fees from SANOFI, ASTRAZENECA, NOVARTIS, GLAXO SMITHKLINE, STALLERGENES, ALLERGY THERAPEUTICS, HAL ALLERGY, MENARINI, MALESCI, GUIDOTTI, VALEAS, BOEHRINGER INGELHEIM, ALMIRALL, MUNDIPHARMA. NR reports and Advisory Board: Sanofi, Mylan, AstraZeneca, Speaker: Sanofi, Mylan, Chiesi. JS reports grants and personal fees from SANOFI, personal fees from GSK, NOVARTIS, ASTRA ZENECA, MUNDIPHARMA, FAES FARMA. Dr. Tsiligianni reports grants from GSK Hellas, ELPEN, Astra Zeneca Hellas, personal fees from GSK, Boehringer Ingelheim, Novartis, Astra Zeneca. DW reports personal fees from Optinose, ALK, Sanofi, and was co‐chair of Joint Task Force on Practice Parameters until July 2020. author of Rhinitis GRADE document (2017) and Rhinitis practice parameter update (2020). TZ reports personal fees from Bayer Health Care, FAES, Novartis, Henkel, AstraZeneca, AbbVie, ALK, Almirall, Astellas, Bayer Health Care, Bencard, Berlin Chemie, HAL, Leti, Meda, Menarini, Merck, MSD, Novartis, Pfizer, Sanofi, Stallergenes, Takeda, Teva, UCB, Kryolan L'Oréal. 2

Publisher Copyright:
© 2021 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

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