COVID-19 in patients with allergic conditions does not seem to take more severe course. The Global Initiative for Asthma recommended that asthmatic patients who are on prescribed inhaled or oral steroids should continue to take them. Contradictions between guidelines in COVID-19 crisis is not uncommon. Use of intranasal steroids and/or saline for anosmia was an area of contention. ARIA and EAACI issued a joint statement on anosmia and allergic rhinitis. A Delphi process was implemented. A questionnaire was submitted to all 509 ARIA members across 84 countries. The main questions asked if intranasal corticosteroids can be continued. After two days, 209 (41%) replies were received from 61 countries. Outcome recommendations were that intranasal steroids can be continued and stopping them is not advised in allergic rhinitis.
It is important to have such statements to guide management for common conditions during COVID-19 crisis.
However, Delphi process is a level V evidence. Additionally, authors did not expand on the details of the process. They also had relatively small response rate which negatively impact its validity. - HM
