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Subcutaneous Allergen Immunotherapy in Children: Real Life Compliance and Effect of COVID-19 Pandemic on Compliance
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  • Elif Soyak Aytekin,
  • Ozge Soyer,
  • Bulent Sekerel,
  • Umit Sahiner
Elif Soyak Aytekin
Hacettepe University
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Ozge Soyer
Hacettepe University Faculty of Medicine
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Bulent Sekerel
Hacettepe University Faculty of Medicine
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Umit Sahiner
Hacettepe University Faculty of Medicine
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Abstract

Background: Allergen immunotherapy(AIT) is an effective treatment for allergic rhinitis, asthma and venom allergy. Compliance is essential for AIT to obtain maximal benefit as it is a long term treatment. Objective: We aimed to evaluate the real life compliance of children with subcutaneous immunotherapy(SCIT) and tried to document the factors associated. Additionally how COVID-19 pandemic effected the compliance of the patients and the reasons of drop-outs were also evaluated. Method: Patients diagnosed with allergic rhinitis, allergic asthma or venom allergy and treated with SCIT between 2012 September, 2020 July were analyzed. Results: The study population comprised of 201 children (66,7% male) with a median (interquartile range) age of 12,8(9,4-15,2) years during the first injection of SCIT. The overall compliance rate before COVID-19 pandemic was 86,1%. Short AIT follow up time and venom allergy were found to be risk factors for drop out. The leading causes of drop outs were moving to another city/country(32,1%), improvement of symptoms(17,8%), ineffectiveness(14,2%) and adverse reactions(14,2%). During COVID-19 pandemic, among 108 patients receiving AIT, 31(28,7%) dropped out the therapy. The most frequent reasons for drop-outs were fear of being infected with COVID-19(35,4%) and thinking that the AIT practise stopped due to COVID-19 pandemic(29%). Male gender and older age were found to be the independent risk factors for drop out. Conclusion: The real life compliance in children was higher than in adults. Nearly one third of children dropped out during COVID-19 pandemic. Male gender and older age are associated with AIT drop out during COVID-19 pandemic.