Table 5.

EAACI position papers on the management of allergic diseases during COVID-19

Allergic disease or topics	Recommendations	References
Asthma	ICS or OCS should continue. Spacers of large capacity are recommended to replace nebulizer for active infectants	(72)
Intranasal corticosteroids in AR in COVID-19	In COVID-19 patients, intranasal corticosteroids (including spray) can be continued in AR at the recommended dose	(107)
Drug allergy	All available information about drug hypersensitivity reactions due to current and candidate off-label drugs to treat COVID-19	(122)
Severe allergic reactions to COVID- 19 vaccines	Milder and moderate reactions should not be excluded from the vaccination; recognize and treat anaphylaxis, including administering adrenalin properly; at least 15 min observation period following vaccination; AR and asthma are not at higher risk of severe allergic reactions to COVID-19 vaccines	(125)
Handling of AIT during COVID-19	Both SCIT and SLIT can be continued in COVID-19 pandemics in uninfected individuals, in suspected individuals with negative test result (RT-PCR) or after an adequate quarantine, or convalescent patients with detection of serum IgG to SARS-CoV-2 without virus-specific IgM	(129)
Managing childhood allergies during COVID-19	Gain the best control of current allergic symptoms and reduce the risk of COVID-19 infection; reduce stress levels of the children and their parents; be aware of the difference of COVID-19 and seasonal allergy; treat allergies according to usual guidelines; recommend using pMDI but not nebulizer	(130)
Biologicals use during COVID-19	Noninfected patients on biologicals for the treatment of allergic diseases should continue their biologicals targeting type 2 inflammation via self-application. In case of an active SARS-CoV-2 infection, biological treatment needs to be stopped until clinical recovery and SARS-CoV-2 negativity is established and treatment with biologicals should be re-initiated	(131)
Organization of an allergy clinic	Recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients while ensuring the necessary safety measures in the current COVID- 19 pandemic	(132)
Management of chronic rhinosinusitis during COVID-19	Intranasal corticosteroids remain the standard treatment for CRS in COVID-19 patients. Surgery should be reduced to a minimum and preserved for patients with local complications and for those with no other treatment options. Systemic corticosteroids should be avoided. Biologicals can be continued with careful monitoring in noninfected patients and should be temporarily interrupted during COVID-19	(133)