Intranasal corticosteroids in allergic rhinitis in COVID‐19 infected patients: An ARIA‐EAACI statement

A novel strain of human coronaviruses, named by the International Committee on Taxonomy of Viruses (ICTV) 1 as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged and caused an infectious disease. This disease has recently been referred to by the World Health Organisation (WHO) as the "coronavirus disease 2019" (COVID-19). Since the first report of this disease in December 2019 in Wuhan, China, 2,3 COVID-19 has aggressively spread across the globe. WHO declared it a pandemic on March 11. COVID-19 presents with many different clinical manifestations, ranging from asymptomatic cases to mild and severe disease, with or without pneumonia. 4 Patients with common allergic conditions do not develop additional distinct symptoms and do not seem to be at an increased risk of severe disease. Allergic children show a mild course, like other children. 5 COVID-19 cases with pre-existing COPD, or complicated by secondary bacterial pneumonia, are more severe, and this may be due to a complex immune pathogenesis. Whether systemic corticosteroids have a deleterious effect on COVID-19 infection is still a matter of discussion. Clinical evidence does not support corticosteroid treatment for SARS-CoV-2 pneumonia. 6 Moreover, corticosteroid therapy in patients with MERS (Middle East respiratory syndrome) was not associated with a difference in mortality after adjustment for time-varying confounders but was associated with delayed MERS coronavirus RNA clearance. 7