Temporal trends in anaphylaxis ED visits over the last decade and the effect of COVID-19 pandemic on these trends

Adnan Al Ali¹, Sofianne Gabrielli¹, Luca Delli Colli¹, Marina Delli Colli¹, Christine McCusker¹, Ann E Clarke², Judy Morris³, Jocelyn Gravel⁴, Rodrick Lim⁵, Edmond S Chan⁶, Ran D Goldman⁷, Andrew O'Keefe⁸, Jennifer Gerdts⁹, Derek K Chu¹⁰, Julia Upton¹¹, Elana Hochstadter¹², Jocelyn Moisan¹³, Adam Bretholz¹⁴, Xun Zhang¹⁵, Jennifer Lp Protudjer¹⁶, Elissa M Abrams¹⁷, Elinor Simons¹⁷, Moshe Ben-Shoshan¹

Affiliations

¹ Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada.
² Division of Rheumatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
³ Department of Emergency Medicine, Sacré-Coeur Hôpital, Montreal, Quebec, Canada.
⁴ Department of Pediatric Emergency Medicine, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada.
⁵ Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital at London Health Science Centre, London, Ontario, Canada.
⁶ Division of Allergy and Immunology, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
⁷ Division of Clinical Pharmacology and Emergency Medicine, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
⁸ Department of Pediatrics, Faculty of Medicine, Memorial University, St. John's, Newfoundland & Labrador, St. John's, Newfoundland and Labrador, Canada.
⁹ Executive Director, Food Allergy Canada, Toronto, Ontario, Canada.
¹⁰ Division of Clinical Immunology & Allergy, Department of Medicine, and Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.
¹¹ Division of Immunology and Allergy, Department of Pediatrics, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
¹² Department of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
¹³ Department of Emergency Medicine, Regional Medical Director of Emergency Medical Services of Outaouais, Outaouais, Quebec, Canada.
¹⁴ Division of Pediatric Emergency Medicine, Department of Pediatrics, Montreal Children's Hospital, Montreal, QC, Canada.
¹⁵ Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada.
¹⁶ Department of Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.
¹⁷ Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.

PMID: 36620923
DOI: 10.1080/1744666X.2023.2166934

Temporal trends in anaphylaxis ED visits over the last decade and the effect of COVID-19 pandemic on these trends

Adnan Al Ali et al. Expert Rev Clin Immunol. 2023 Mar.

. 2023 Mar;19(3):341-348.

doi: 10.1080/1744666X.2023.2166934. Epub 2023 Jan 31.

Authors

Affiliations

¹ Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada.
² Division of Rheumatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
³ Department of Emergency Medicine, Sacré-Coeur Hôpital, Montreal, Quebec, Canada.
⁴ Department of Pediatric Emergency Medicine, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada.
⁵ Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital at London Health Science Centre, London, Ontario, Canada.
⁶ Division of Allergy and Immunology, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
⁷ Division of Clinical Pharmacology and Emergency Medicine, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
⁸ Department of Pediatrics, Faculty of Medicine, Memorial University, St. John's, Newfoundland & Labrador, St. John's, Newfoundland and Labrador, Canada.
⁹ Executive Director, Food Allergy Canada, Toronto, Ontario, Canada.
¹⁰ Division of Clinical Immunology & Allergy, Department of Medicine, and Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.
¹¹ Division of Immunology and Allergy, Department of Pediatrics, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
¹² Department of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
¹³ Department of Emergency Medicine, Regional Medical Director of Emergency Medical Services of Outaouais, Outaouais, Quebec, Canada.
¹⁴ Division of Pediatric Emergency Medicine, Department of Pediatrics, Montreal Children's Hospital, Montreal, QC, Canada.
¹⁵ Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada.
¹⁶ Department of Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.
¹⁷ Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.

PMID: 36620923
DOI: 10.1080/1744666X.2023.2166934

Abstract

Background: Anaphylaxis is an acute systemic and potentially fatal allergic reaction. We evaluated trends in yearly rates of anaphylaxis in a pediatric Emergency Department (ED) in Montreal, Canada.

Methods: A prospective and retrospective recruitment process was used to find families of children who had presented with anaphylaxis at the Montreal Children's Hospital between April 2011 and April 2021. Using a uniform recruitment form, data were collected. Anaphylaxis patterns were compared to clinical triggers using descriptive analysis.

Results: Among 830,382 ED visits during the study period, 2726 (26% recruited prospectively) presented with anaphylaxis. The median age was 6 years (IQR: 0.2, 12.00), and 58.7% were males. The relative frequency of anaphylaxis cases doubled between 2011-2015, from 0.22% (95% CI, 0.19, 0.26) to 0.42 March 2020, the total absolute number of anaphylaxis cases and relative frequency declined by 24 cases per month (p < 0.05) and by 0.5% of ED visits (p < 0.05).

Conclusions: The rate of anaphylaxis has changed over the years, representing modifications in food introduction strategies or lifestyle changes. The decrease in the frequency of anaphylaxis presenting to the ED during the COVID pandemic may reflect decreased accidental exposures with reduced social gatherings, closed school, and reluctance to present to ED.

Keywords: Allergy; anaphylaxis; children; epinephrine; food induced; pandemic.

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Temporal trends in anaphylaxis ED visits over the last decade and the effect of COVID-19 pandemic on these trends

Affiliations

Temporal trends in anaphylaxis ED visits over the last decade and the effect of COVID-19 pandemic on these trends

Authors

Affiliations

Abstract

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LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

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