2020年COVID-19封锁期间出生的CORAL队列5年时的特应性结局
Atopic outcomes at 5 years in the CORAL cohort born during the 2020 COVID-19 lockdown.
文献信息
| PMID | 42748042 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Anitha Sokay |
| 作者单位 | Paediatrics and Child Health, Royal College of Surgeons, Dublin, Ireland. |
| 期刊 | Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology |
| SCI 分区 | Q1 |
| IF | 4.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 2020年爱尔兰的SARS-CoV-2封锁是欧洲最严格的封锁之一。CORAL（冠状病毒大流行对封锁期间出生婴儿过敏性和自身免疫失调的影响）研究旨在调查改变环境中的生命早期过敏结局。在2岁时，我们发现食物过敏率较低，而特应性皮炎发生率较高。本报告对同一队列在5岁时重新评估，以评价早期大流行相关趋势是暂时性的，还是代表了儿童过敏的持久改变。
方法： 这项纵向观察性研究评估了5岁时的结局。临床评估包括特应性皮炎评估、食物和吸入性变应原皮肤点刺试验，以及粪便和血液样本采集。家长填写的问卷收集了环境和家庭暴露、过敏和呼吸系统结局以及医疗保健使用情况的数据。
结果： 吸入性变应原致敏率从2岁时的8.9%上升至5岁时的24%（p < .001）。致敏强烈预测过敏性鼻炎症状（OR 5.68，p < .001）。家长报告的喘息在2岁（23.8%）和5岁（22.1%）之间无变化，并与哮喘诊断密切相关（χ2 = 33.0，p < .001）。喘息主要发生在近期感染的儿童中。大多数特应性皮炎已缓解，5岁时食物过敏仍不常见。
结论： 本研究首次对儿童大流行相关的生命早期暴露和特应性结局进行了纵向评估。我们的发现提示，大流行相关的生命早期环境变化可能选择性地改变了食物过敏风险，而过敏性疾病总体模式仍与公认的过敏性疾病演变过程大致一致。
英文摘要
BACKGROUND: The 2020 SARS-CoV-2 lockdown in Ireland was among the most stringent in Europe. The CORAL (Impact of Coronavirus Pandemic on Allergic and Autoimmune Dysregulation in Infants Born during Lockdown) study was developed to investigate early-life allergic outcomes in an altered environment. At 2 years we showed lower food allergy and higher atopic dermatitis rates. The current report reassesses this same cohort at 5 years to evaluate whether early pandemic-related trends were transient or represented enduring alterations in childhood allergy.
METHODS: This longitudinal observational study assessed outcomes at 5 years. Clinical assessments included evaluation of atopic dermatitis, skin prick testing for food and aeroallergens, and collection of stool and blood samples. Parent-completed questionnaires collected data on environmental and household exposures, allergic and respiratory outcomes, and healthcare use.
RESULTS: Aeroallergen sensitisation increased from 8.9% at 2 years to 24% at 5 years (p < .001). Sensitisation strongly predicted allergic rhinitis symptoms (OR 5.68, p < .001). Parent-reported wheeze was unchanged between 2 years (23.8%) and 5 years (22.1%) and strongly associated with asthma diagnosis (χ2 = 33.0, p < .001). Wheeze occurred predominantly in children with a recent infection. Most atopic dermatitis had resolved and food allergy remained uncommon at 5 years of age.
CONCLUSION: This study provides the first longitudinal evaluation of pandemic-associated early-life exposures and atopic outcomes in children. Our findings suggest that pandemic-associated early-life environmental changes may have selectively modified food allergy risk, while the overall pattern of allergic disease remained broadly consistent with the accepted evolution of allergic conditions.