Introduction
Allergen immunotherapy is an effective and game-changing treatment method for allergic rhinitis, venom anaphylaxis and allergic asthma which can provide immune tolerance for many years. Subcutaneous allergen immunotherapy (SCIT) is the most commonly used administration route, and requires repeated administration of allergen extracts for 3 to 5 years depending on the type of allergen applied.
Compliance is essential for AIT to obtain maximal benefit as it is a long term treatment. However non-compliance rates may be as high as 50% in both adults and children1-3. The major factors associated to noncompliance are long duration of treatment, frequency of injections, high medical cost, improvement of systemic reactions over time, poor perceived efficacy, allergic reactions during vaccinations and travelling, and differ between centres, health system structure and cultures4-6. Most of the studies about compliance come either from adult studies or from study populations involving both adults and children; the ones involving only pediatric age group are very limited3.
The Coronavirus disease 2019 (COVID-19) pandemic not only affected people with COVID-19 infection but also disrupted the treatment of patients with chronic diseases. In this period, some changes in the pattern of hospital admissions was recognized. A study from northern Italy showed a significant decrease in acute coronary syndrome related hospitalization rates across several cardiovascular centers in northern Italy during the early days of the COVID-19 outbreak7. During that period, a significant increase in mortality was reported that was not fully explained by COVID-19 cases alone, and thought to be due to failure to access medical attention. In this period, we also observed a reduction in pediatric outpatient admissions for AIT.
In the present study we aimed to investigate the real life compliance of children with SCIT and tried to document the factors associated with compliance. Additionally we evaluated how the COVID-19 pandemic effected the compliance of our patients and the reasons that caused drop-outs.