Pediatric allergies in Japan: Coronavirus disease pandemic-related risk factors

Yuri Takaoka; Akihiro Maeta; Atsuko Nakano; Masaaki Hamada; Yukiko Hiraguchi; Tomoko Kawakami; Ikuo Okafuji; Yutaka Takemura; Makoto Kameda; Kyoko Takahashi; Shohei Akagawa; Kaori Anzai; Shinichi Sumimoto; Kenji Bando; Masaaki Doi; Masahiro Enomoto; Shiori Fujikawa; Akiko Ikeda; Megumi Nagai; Atsuko Nishiyama; Keita Otsuka; Satoko Shimizu; Yukiko Sugimoto; Yukiko Tanaka; Yuko Tanaka; Yuya Tanaka; Ryohei Wakahara; Koji Yamasaki

doi:10.5415/apallergy.0000000000000116

Pediatric allergies in Japan: Coronavirus disease pandemic-related risk factors

Asia Pac Allergy. 2023 Sep;13(3):114-120. doi: 10.5415/apallergy.0000000000000116. Epub 2023 Sep 7.

Authors

Yuri Takaoka¹, Akihiro Maeta², Atsuko Nakano³, Masaaki Hamada⁴, Yukiko Hiraguchi⁵, Tomoko Kawakami⁶, Ikuo Okafuji⁷, Yutaka Takemura⁸, Makoto Kameda¹, Kyoko Takahashi², Shohei Akagawa⁹, Kaori Anzai¹⁰, Shinichi Sumimoto¹⁰, Kenji Bando¹¹, Masaaki Doi¹², Masahiro Enomoto¹³, Shiori Fujikawa¹⁴, Akiko Ikeda¹⁵, Megumi Nagai⁸, Atsuko Nishiyama¹⁶, Keita Otsuka¹⁷, Satoko Shimizu^{18

19}, Yukiko Sugimoto²⁰, Yukiko Tanaka²¹, Yuko Tanaka²², Yuya Tanaka²³, Ryohei Wakahara²⁴, Koji Yamasaki²⁵

Affiliations

¹ Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino, Osaka, Japan.
² Department of Food Science and Nutrition, School of Food Science and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan.
³ Department of Pediatrics, Kokuho Chuo Hospital, Shiki, Nara, Japan.
⁴ Department of Pediatrics, Yao Municipal Hospital, Yao, Osaka, Japan.
⁵ Department of Pediatrics, Osaka Saiseikai Nakatsu Hospital, Osaka, Osaka, Japan.
⁶ Department of Pediatrics, Sumitomo Hospital, Osaka, Osaka, Japan.
⁷ Department of Pediatrics, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
⁸ Department of Pediatrics, Kindai University Hospital, Osakasayama, Osaka, Japan.
⁹ Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan.
¹⁰ Department of Pediatrics, Japanese Osaka Red Cross Hospital, Osaka, Osaka, Japan.
¹¹ Department of Pediatrics, Izumi City General Hospital, Izumi, Osaka, Japan.
¹² Department of Pediatrics, Higashiosaka City Medical Center, Higashiosaka, Osaka, Japan.
¹³ Department of Pediatrics, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
¹⁴ Department of Pediatrics, Abeno Medical Clinic, Osaka, Osaka, Japan.
¹⁵ Department of Pediatrics, Yamatotakada Municipal Hospital, Yamatotakada, Nara, Japan.
¹⁶ Department of Pediatrics, Nara Prefecture General Medical Center, Nara, Nara, Japan.
¹⁷ Department of Pediatrics, Nara City Hospital, Nara, Nara, Japan.
¹⁸ Department of Pediatrics, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan.
¹⁹ Department of Pediatrics, Shimizu Family Clinic, Moriguchi, Osaka, Japan.
²⁰ Department of Pediatrics, Hoshigaoka Medical Center, Hirakata, Osaka, Japan.
²¹ Department of Pediatrics, Kobe City Medical Center West Hospital, Kobe, Hyogo, Japan.
²² Department of Pediatrics, Osaka Police Hospital, Osaka, Osaka, Japan.
²³ Department of Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan.
²⁴ Department of Pediatrics, PL Hospital, Tondabayashi, Osaka, Japan.
²⁵ Department of Pediatrics, Kaizuka City Hospital, Kaizuka, Osaka, Japan.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic impacted various parts of society, including Japanese children with allergies.

Objective: This study investigated risk factors for pediatric allergic diseases associated with the state of emergency owing to the COVID-19 pandemic in Japan, including during school closures.

Methods: Parents of pediatric patients (0-15 years) with allergies were enrolled and queried regarding the impact of school closure on pediatric allergies compared to that before the COVID-19 pandemic.

Results: A valid response was obtained from 2302 parents; 1740 of them had children with food allergies. Approximately 4% (62/1740) of the parents reported accidental food allergen ingestion was increased compared to that before the COVID-19 pandemic. Accidental ingestion during school closures was associated with increased contact with meals containing allergens meant for siblings or other members of the family at home. The exacerbation rate during the pandemic was highest for atopic dermatitis at 13% (127/976), followed by allergic rhinitis at 8% (58/697), and bronchial asthma at 4% (27/757). The main risk factors for worsening atopic dermatitis, allergic rhinitis, and bronchial asthma were contact dermatitis of the mask area (34/120 total comments); home allergens, such as mites, dogs, and cats (15/51 total comments); and seasonal changes (6/25 total comments), respectively.

Conclusion: The main factors affecting allergic diseases were likely related to increased time at home, preventive measures against COVID-19, and refraining from doctor visits. Children with allergies were affected by changes in social conditions; however, some factors, such as preventing accidental ingestion and the management of allergens at home, were similar to those before the COVID-19 pandemic. Patients who had received instructions on allergen avoidance at home before the pandemic were able to manage their disease better even when their social conditions changed.

Keywords: Allergic rhinitis; atopic dermatitis; bronchial asthma; coronavirus disease 2019; food allergy; risk factors.