10.5826/dpc.1401a78
text/xml
2160-9381
3840
en
Öner Özdemir
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Long-Term Omalizumab Use, Chronic Spontaneous Urticaria and COVID-19: Omalizumab, Urticaria, COVID-19
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Letter to the Editor
2024-01-31
2023-09-09
2024-01-31
2024-02-21
e2024078
Dermatol Pract Concept
Öner Özdemir
2024/01/31
10.5826/dpc.1401a78
e2024078
Division of Allergy and Immunology, Department of Pediatrics, Research and Training Hospital of Sakarya University Medical Faculty, Adapazarı, Sakarya, Türkiye
2160-9381
en
e2024078
Ashraf UM, Abokor AA, Edwards JM, et al. SARS-CoV-2, ACE2 expression, and systemic organ invasion. Physiol Genomics. 2021;53(2):51-60. DOI: 10.1152/physiolgenomics.00087.2020. PMID: 33275540. PMCID: PMC7900915.
Long-Term Omalizumab Use, Chronic Spontaneous Urticaria and COVID-19: Omalizumab, Urticaria, COVID-19
https://dpcj.org/index.php/dpc/article/download/3840/2550
                   Long-Term Omalizumab Use, Chronic
                   Spontaneous Urticaria and COVID-19
                                                          Öner Özdemir


Division of Allergy and Immunology, Department of Pediatrics, Research and Training Hospital of Sakarya University Medical Faculty,
Adapazarı, Sakarya, Türkiye



Citation: Özdemir Ö. Long-Term Omalizumab Use, Chronic Spontaneous Urticaria and COVID-19. Dermatol Pract Concept.
2024;14(1):e2024078. DOI: https://doi.org/10.5826/dpc.1401a78
Accepted: September 24, 2023; Published: January 2024
Copyright: ©2024 Özdemir. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Corresponding Author: Öner Özdemir, MD, Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Sakarya
University, Research and Training Hospital of Sakarya University, Adnan Menderes Cad., Sağlık Sok., No: 195, Adapazarı, Sakarya, Turkey.
Tel: + 90–(264) -444 54 00 Fax: +90–(264) -275 91 92 E-mail: ozdemir_oner@hotmail.com




Dear Editor,                                                           incidence by facilitating intracellular entry through increased
                                                                       ACE-2 expression [1]. But would not greater ACE-2 expres-
    I have read the article titled ‘Long-term omalizumab               sion also increase the severity? [5] COVID-19 cases had a
therapy in patients with chronic spontaneous urticaria: Does           mild course and did not cause exacerbation in CSU. It may
it increase the risk of COVID-19?’ by Kaya et al with great            also not be a correct approach to attribute the return of in-
interest [1]. However, there are a few points raised in my             terrupted OMZ treatment in risky groups to the return of
mind about the study. These are as follows:                            eosinophil count to pretreatment values [1]. Because it is not
    Although this article mentions the results of its study, it        known whether the decrease in eosinophil count in patients
is a major deficiency that its results are not discussed in the        on OMZ is due to COVID-19 or OMZ.
light of the recent literature. For instance: COVID-19 can                 Although it is said that ‘none of the other 56 patients had
rarely exacerbate CSU, even if it was not seen in this study.          a history of COVID-19 before or during OMZ ­treatment.’,
Omalizumab (OMZ) is generally accepted as safe in adult                how long were they followed up after OMZ stopped? Because
chronic spontaneous urticaria (CSU) and can be continued               OMZ treatment was longer in those who had COVID-19
without interruption [2]. Most studies have not found an               than in those who did not [1]. Might OMZ treatment predis-
association between OMZ and COVID-19 [3]. Therefore it                 pose to SARS-CoV-2 infection, especially even after the end
is impossible to follow the recommendations proposed in the            of long-term use? Therefore, it may be important to answer
conclusion. Also, 4/51 patients (1 inactive, 3 mRNA) expe-             this question.
rienced a CSU flare after vaccination. However, the authors                There are errors in some expressions such as COVID-19
did not discuss why exacerbations occurred after the first             infection. COVID-19 is the name of the disease. The state-
dose and why they were more common with mRNA vac-                      ment of ‘the second pulmonary phase’ is wrong. Pulmonary
cines [4].                                                             phase is the second phase of COVID-19. In Table 1, after
    There are some contradictory explanations and com-                 ‘Number of patients’, N is not meaningless there. N should
ments [1]. After mentioning that OMZ is an antiviral, it               have been used always as a capital letter, not lowercase (n).
is supposed that it increases the SARS-CoV-2 infection


Letter to Editor | Dermatol Pract Concept. 2024;14(1):e2024078                                                                        1
References                                                               omalizumab and antihistamines: A cross-sectional, compara-
                                                                         tive study. J Cosmet Dermatol. 2021;20(11):3369-3375. DOI:
1. Kaya Ö, Keskinkaya Z, Işık Mermutlu S, Oğuz Kılıç S, ­Öztürk S.       10.1111/jocd.14484. PMID: 34599630. PMCID: PMC8661558.
   Long-Term Omalizumab Therapy in Patients with Chronic              4. Özdemir Ö. Might chronic spontaneous urticaria develop af-
   Spontaneous Urticaria: Does it Increase the Risk of COVID-19?         ter SARS-CoV-2 vaccinations? Eur J Clin Pharmacol. 2023;
   Dermatol Pract Concept. 2023;13(3):e2023145. DOI: 10.5826             79(9):1279-1280. DOI: 10.1007/s00228-023-03532-1. PMID:
   /dpc.1303a145. PMID: 37557113. PMCID: PMC10412006.                    37393210.
2. Özdemir Ö. Omalizumab’s efficacy and safety against chronic        5. Ashraf UM, Abokor AA, Edwards JM, et al. SARS-CoV-2, ACE2
   spontaneous urticaria. World Allergy Organ J. 2023;16(8):100808.      expression, and systemic organ invasion. Physiol Genomics.
   DOI: 10.1016/j.waojou.2023.100808. PMID: 37638362. PMCID:             2021;53(2):51-60. DOI: 10.1152/physiolgenomics.00087.2020.
   PMC10458888.                                                          PMID: 33275540. PMCID: PMC7900915.
3. Bostan E, Zaid F, Karaduman A, et al. The effect of COVID-19
   on patients with chronic spontaneous urticaria treated with




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