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. 2024 Dec 16:5:1512182.
doi: 10.3389/falgy.2024.1512182. eCollection 2024.

Infants born during COVID-19 pandemic experience increased susceptibility to airway hyperresponsiveness

Idit Lachover-Roth  1   2 , Anat Cohen-Engler  1 , Yael Furman  2   3 , Yossi Rosman  1   2 , Keren Meir-Shafrir  1 , Michal Mozer-Mandel  3 , Sivan Farladansky-Gershnabel  2   3 , Tal Biron-Shental  2   3 , Ronit Confino-Cohen  1   2
Affiliations

Infants born during COVID-19 pandemic experience increased susceptibility to airway hyperresponsiveness

Idit Lachover-Roth et al. Front Allergy. .

Abstract

Background: Asthma, allergic rhinitis, atopic dermatitis, and food allergy are type 2 inflammation diseases. Since the 1960s, the prevalence of those diseases has steadily increased, presumably due to the "Hygiene hypothesis" which suggests that early exposure of infants to pathogens, siblings, and environmental dust, has a protective effect against the development of allergic diseases. The COVID-19 pandemic increased environmental hygiene due to lockdowns, masks, and social distancing.

Objective: To compare the prevalence of allergic diseases among children born before and during the pandemic.

Methods: The Cow's Milk Early Exposure Trial prospectively followed newborns until 12-months of age using monthly survey and examined milk allergy development. Some were born before the first COVID-19 lockdown in Israel (April 2018-March 2020), and some were born during the pandemic (March 2020-May 2021). The monthly surveys included questions regarding atopic comorbidities.

Results: A total of 1,989 infants completed 12-months of follow-up. Among them, 1,086(54.5%) were diagnosed with at least one atopic disease. Among 235 infants born after the last lockdown, 162 were diagnosed with airway hyperresponsiveness (AHR)(68.9%), significantly more than in any other group. No other significant differences were found between the study groups.

Conclusions: There was no significant difference in the development of atopic comorbidities between infants born before and during the pandemic. Significantly more infants who were born after restrictions were eased were diagnosed AHR. A longer follow-up period is needed to obtain a better understanding of the influence of the COVID-19 restrictions on the development of atopic comorbidities.

Clinical trial registry: NIH Clinical Trials Registry: NCT02785679.

Keywords: COVID-19; airway hyper responsiveness; allergy; atopic comorbidities; hygiene hypothesis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Distribution of the study groups. Study groups were formed according to the pandemic periods and are not equal. Excluded infants: 263 infants were excluded because they did not complete 12 months of follow-up: 100 were lost to follow-up, 158 consent withdrawn, and 5 developed serious medical problems. Details are presented in Supplementary Table S1.
Figure 2
Figure 2
Seasonal inhalation uses during the study. (A) Inhalation use distribution along the year. Light purple line includes sub-group A1. The dark purple line includes sub-groups A1 and A2. Light-blue line includes sub-groups A2 and B1. The blue line includes sub-groups B1 and B2, and the dark blue line includes sub-group B2. *p < 0.001 March 2021-February 2022 (blue line) and March 2019-February 2020 (dark purple line). (B) Inhalation use in the sub-groups. The Gray bars represent the lockdowns in Israel. Each line represents a separate sub-group.
See this image and copyright information in PMC

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