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Background. According to available studies during the pandemic, the incidence of COVID-19 among children was significantly lower than among adults. However, it remains unclear whether children with allergies and asthma are at risk for COVID-19 and whether the respiratory morbidity have changed during the pandemic in children with asthma as well as the asthma activity. Aims to determine the respiratory morbidity in children with and without asthma before and during the COVID-19 pandemic, to estimate asthma activity. Methods. The main group was formed of 60 children 617 y.o with confirmed asthma diagnosis, the control group from 30 children aged 617 y.o. without asthma. Data on outcomes in children with asthma and in control group were obtained on the basis of the retrospective collected information from medical records of patients and from questionnaires, filled during telephone call in 2020. Respiratory morbidity was estimated in 2019 and during the COVID-19 pandemic period in 2020 till the end of May. Results. The incidence of upper respiratory tract infections has decreased in 2020 in 72% of children with asthma by an average of 53%; in 86% of children without by an average of 62%. The frequency of lower respiratory tract infections decreased in 37% of children with asthma by an average of 61%, in 20% of children without asthma on 100%. According to the patients parents answers, none of the children were diagnosed with COVID-19. The number of episodes which required additional anti-asthma therapy decreased or didnt change in 77% of patients. According to the results of the Asthma Control Test in 2020 asthma was fully controlled in 82% of patients, 65% of patients had complete adherence to therapy. Conclusions. Children with asthma and allergies, as well as healthy children, do not seem to be at risk of contracting a new coronavirus infection. Lockdown, good adherence to therapy in children with asthma had a positive impact, led to a decrease of respiratory morbidity, exacerbations of asthma, improved disease control. Further monitoring of children with allergies and asthma during the COVID-19 pandemic is required.

In Russia, a universal varicella vaccination (UVV) program has not been implemented, and varicella vaccination coverage is low. We assessed the efficacy, antibody persistence, and safety of one- and two-dose varicella vaccination schedules in Russian children with a ten-year follow-up period, as part of an international phase IIIB, observer-blind, randomized, controlled trial (NCT00226499). Children aged 12-22 months were randomized (3:3:1) to receive two doses of tetravalent measles-mumps-rubella-varicella vaccine (V2 group), one dose trivalent measles-mumps-rubella (MMR) vaccine and one dose of varicella vaccine (V1 group), or two doses of MMR vaccine (V0 [control] group), 42 days apart. Main study outcomes were: vaccine efficacy (VE) against confirmed varicella cases, anti-varicella zoster virus (VZV) seropositivity rates and geometric mean concentrations, and reporting of (serious) adverse events ([S]AEs). The total vaccinated cohort in Russia comprised 1000 children; 900 were followed up until study end (year [Y] 10). VE estimates against confirmed varicella (Y10) were 92.4% in the V2 group and 74.7% in the V1 group. Anti-VZV seropositivity rates remained ≥99.4% in the V2 group and ≥89.7% in the V1 group from day 42 post-vaccination 2 until Y10. Occurrence of (un)solicited AEs and SAEs was similar across groups and confirmed the safety profile of the vaccines. No vaccination-related SAEs or deaths were reported. These results are consistent with the global trial results, i.e., the highest VE estimates observed following the two-dose schedule compared to the one-dose schedule. These data may inform decision-making related to potential implementation of a UVV program.

BACKGROUND: It is unclear whether asthma may affect susceptibility or severity of coronavirus disease 2019 (COVID-19) in children and how pediatric asthma services worldwide have responded to the pandemic. OBJECTIVE: To describe the impact of the COVID-19 pandemic on pediatric asthma services and on disease burden in their patients. METHODS: An online survey was sent to members of the Pediatric Asthma in Real Life think tank and the World Allergy Organization Pediatric Asthma Committee. It included questions on service provision, disease burden, and the clinical course of confirmed cases of COVID-19 infection among children with asthma. RESULTS: Ninety-one respondents, caring for an estimated population of more than 133,000 children with asthma, completed the survey. COVID-19 significantly impacted pediatric asthma services: 39% ceased physical appointments, 47% stopped accepting new patients, and 75% limited patients' visits. Consultations were almost halved to a median of 20 (interquartile range, 10-25) patients per week. Virtual clinics and helplines were launched in most centers. Better than expected disease control was reported in 20% (10%-40%) of patients, whereas control was negatively affected in only 10% (7.5%-12.5%). Adherence also appeared to increase. Only 15 confirmed cases of COVID-19 were reported among the population; the estimated incidence is not apparently different from the reports of general pediatric cohorts. CONCLUSIONS: Children with asthma do not appear to be disproportionately affected by COVID-19. Outcomes may even have improved, possibly through increased adherence and/or reduced exposures. Clinical services have rapidly responded to the pandemic by limiting and replacing physical appointments with virtual encounters. (C) 2020 American Academy of Allergy, Asthma & Immunology.

Background and aim Pollinosis is an allergic disease that manifests during spring or summer with symptoms of allergic rhinitis, conjunctivitis, asthma and atopic dermatitis. In Russia the most common reason for pollinosis is birch and grass pollen. Since pollinosis is a multifactorial disease, the aim of this study was to investigate the association between polymorphic markers of candidate genes and the development of the disease. Methods and patients The genotypes of polymorphic markers of genes-candidates (IL4, IL4R, IL13, IL33, IL6, TLR4, MMP9) were examined by Real-time PCR for a group of 131 children 5–17 y.o. (average age 10.9, 81 boys and 50 girls) with pollinosis and for a control group of 78 healthy children. 86% of children with pollinosis had any family history of allergy, 58% had one allergic parent (33% - allergic mother, 25% - allergic father); 20% had both allergic parents; 51% had some family history of pollinosis. 75% of patients had atopic dermatitis while being toddlers. The average age of pollinosis debut was 4.9±2.8. The diagnosis of pollinosis was confirmed by the positive skin prick tests or by high level of specific IgE to tree or grass pollen in blood serum. Results We reveal a statistically significant association of the rs1805010 of IL4R gene with pollinosis. The children with GG genotype of rs1805010 had increased risk of pollinosis compared with healthy controls (P = 0.010; OR = 3.73; 95% CI, 1.24 – 11.28). Moreover, there was a tendency to increase the allele C frequency of the rs1805015 of the IL4R gene in children with pollinosis (OR=1,81, p=0,040). No significant association was found with other polymorphisms. Conclusion The results of the present study revealed an association of cytokine gene polymorphism IL4R rs1805010 with pollinosis. Our results indicate a high predictive value of this polymorphic marker for the development of pollinosis in Russian pediatric population.

Introduction Smoking is one of the leading causes of death. Smoking also decreases lung efficiency and impairs lung function in children of all ages. Second-hand tobacco smoking increases both the frequency and severity of childhood asthma. However, the role of active tobacco smoking in the manifestation of asthma remains inconclusive. The aim of this article was to describe the current understanding of the prevalence and adverse effects of cigarette smoking and to determine whether there is an association between smoking and the manifestation and progression of asthma among adolescents and high school students in Russia. Objectives This study aimed to determine the true prevalence of bronchial asthma (BA), allergic rhinitis (AR), and atopic dermatitis (AD) in the population of adolescents in the Russian Federation. In the GA2LEN (Global Allergy and Asthma European Network) study, we analyzed participant responses to confirm a connection between smoking and asthma exacerbation or development. This study examined the association between parental smoking and childhood atopic disorders. We sought to determine the effects of exposure to environmental tobacco smoke and childhood cigarette smoking on asthma symptoms among high school and college students in Moscow, Russia. We analyzed the reactions to the present tobacco control policy and evaluated the significance of the success of the policy. A number of methods were used, including questionnaires, surveys, and statistical analysis software. Results Our research indicates a moderate decrease in smoking prevalence among Russian teenagers. From the data and results of our study, 25.3% of the respondents said that they have ever smoked for as long as a year. Among the participants who had ever smoked, most of them started smoking at the age of 16 years while the state-reported average age for a new smoker is 11.4. Fifty percent of the respondents who had shortness of breath had been woken by an attack once a week in the last three months. Only 21.1% of the people with asthma were taking medicines for it. According to our calculations, there is no significant association between smoking status and the prevalence of asthma, hay fever, and sinusitis. More respondents (34.2%) had fathers who regularly smoked during their childhood than mothers who regularly smoked during their childhood or before the children were born (7.9%). There is a statistically significant association between a mother smoking during childhood or before the birth of a child and that child being hospitalized before the age of two years for lung disease. Conclusion The fact that the smoking rates among study participants are relatively low is quite encouraging and anti-smoking campaigns should be intensified to drive the rates lower. The data analyzed do not provide sufficient evidence to show that there is any causative association between smoking status and the development of asthma, hay fever, or sinusitis. Since there is no clear association between smoking status and the development of asthma, hay fever, or allergic sinusitis, it is imperative to say that smoking cessation will have very little effect on allergy prevalence as per the data analyzed. From the conducted analysis, it is evident that there is a clear link between second-hand smoke and asthma in children. According to our results, children whose mothers smoked are especially vulnerable to asthma and other respiratory disorders.

Omalizumab (O) is a targeted therapy with proved efficacy in patients with persistent uncontrolled asthma, incl. children. Asthma can be associated with nasal polyposis, which may add negative effect on quality of life. According to some previous studies O could be effective in adult patients with asthma and nasal polyps. Aim: to observe the impact of Omalizumab in children with uncontrolled allergic persistent severe asthma and concomitant nasal polyposis. Results: 6 children (5 boys) received therapy of O for 23±10 mo in addition to basic therapy and intranasal steroids. All the children had neither NSAIDs nor aspirin intolerance. All the children had positive dynamics in asthma during the therapy with O. The disease control improved: ACTtest before the therapy: 14.17 ± 4.8 points, after: 18.5 ± 6,65 points. The amount of basic therapy has been reduced (before O the average dose in term of fluticasone propionate was 750 ± 306 µg, after 662 ± 375 µg). The number of exacerbations and requirement of quick-relief medications decreased. Involution of nasal polyps was observed in 2 patients received O ≥1.5 y without surgical treatment (confirmed by CT-scan). 4 children had sinusopolypectomy after 1-1,5 y of O therapy start, where 2 children underwent the second polypectomy. The first surgical treatment was provided 2 years before the start of O therapy, however, relapse of nasal polyps occurred by the time they started receiving O. Conclusion: this observation of series cases of severe persistent asthma and concomitant nasal polyps in children, treated with O, showed controversial data about the effect of O on nasal polyposis. Obtained data require further observation

Background in children with severe persistent uncontrolled asthma atopic dermatitis (AD) is often characterized by persistent continually relapsing. According to the approach ICON for children > 6 y o with severe uncontrolled asthma as an additional treatment from 3-4 step of therapy omalizumab (Omab) is recommended for use of. We report on the experience of the use of Omab in children with asthma and AD.