The impact of COVID-19 pandemic on adult and pediatric allergy & immunology services in the UK National Health Service
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
BACKGROUND: The COVID-19 pandemic imposed multiple restrictions on healthcare services. OBJECTIVE: To investigate the impact of the pandemic on Allergy & Immunology (A&I) services in the UK. METHODS: National survey of all A&I services registered with the Royal College of Physicians and/or British Society for Allergy and Clinical Immunology. The survey covered staffing, facilities, personal protective equipment, appointments & patient review, investigations, treatments and research activity. Weeks commencing 03 Feb'20 (pre-COVID), 06 April'20 and 08'May'20 were used as reference points for the dataset. RESULTS: 99 services participated. There was a reduction in nursing, medical, administrative and allied health professional staff during pandemic; 86% and 92% of A&I services continued to accept non-urgent and urgent referrals respectively during the pandemic. There were changes in immunoglobulin (Ig) dose and infusion regimen in 67% and 14% of adult and pediatric services respectively; 30% discontinued immunoglobulin replacement in some patients. There was a significant (all variables, p≤0.0001) reduction in the following: face-to-face consultations (increase in telephone consultations), initiation of venom immunotherapy, sublingual and subcutaneous injection immunotherapy, anesthetic allergy testing and hospital procedures (food challenges, immunoglobulin and omalizumab, administration); and a significant increase (p≤0.0001) in home therapy for immunoglobulin and omalizumab. Adverse clinical outcomes were reported, but none were serious. CONCLUSION: The pandemic had significant impact on A&I services leading to multiple unplanned pragmatic amendments in service delivery. There is an urgent need for prospective audits and strategic planning in the medium and long term to achieve equitable, safe and standardised healthcare.
Date Issued
2021-02
Date Acceptance
2020-11-14
Citation
Journal of Allergy and Clinical Immunology: In Practice, 2021, 9 (2), pp.709-722.e2
ISSN
2213-2198
Publisher
Elsevier
Start Page
709
End Page
722.e2
Journal / Book Title
Journal of Allergy and Clinical Immunology: In Practice
Volume
9
Issue
2
Copyright Statement
© 2020 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33271350
PII: S2213-2198(20)31260-5
Subjects
Allergy
COVID-19
Immunology
human immunoglobulin
immunodeficiency
impact
service
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2020-11-30