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ALLERGIC rhinitis influences COVID 19 symptom patterns, with new data showing both protective and risk associations, while sublingual immunotherapy further modifies respiratory and febrile outcomes.
Allergic Rhinitis and COVID 19 Symptom Profile
The study evaluated 1,368 participants within 1 month of adjustments to COVID 19 response measures in China, including 746 individuals with allergic rhinitis and 622 controls without allergic diseases. Among infected participants with allergic rhinitis, 122 received sublingual immunotherapy and 483 did not. Outcomes were compared after propensity score matching.
Data were analysed to determine the impact of allergic rhinitis on COVID 19 manifestations. Allergic rhinitis demonstrated a dual effect. Compared with non-allergic individuals, patients with allergic rhinitis had a lower likelihood of respiratory symptoms, suggesting a protective association. However, allergic rhinitis was also linked to a higher risk of olfactory and gustatory dysfunctions as well as fever. These findings indicate that allergic rhinitis may modulate immune responses in complex ways during acute viral infection.
Impact of Sublingual Immunotherapy in Allergic Rhinitis
Among patients with allergic rhinitis, sublingual immunotherapy was associated with distinct differences in COVID 19 presentation. Those receiving sublingual immunotherapy had a higher risk of respiratory symptoms compared with those not treated with immunotherapy. In contrast, the risk of fever was lower in the sublingual immunotherapy group. The therapy did not significantly influence the occurrence of olfactory or gustatory dysfunctions.
These data suggest that immunomodulatory treatment may alter specific inflammatory pathways relevant to respiratory and systemic manifestations of COVID 19.
Clinical Considerations for Allergic Rhinitis Management
The findings highlight important considerations for clinicians managing allergic rhinitis during periods of high COVID 19 transmission. Respiratory symptoms should be carefully evaluated when deciding whether to continue or initiate sublingual immunotherapy in patients with concurrent infection. In addition, the altered risk of fever warrants attention with regard to monitoring and clinical assessment. Further research may help clarify the mechanisms underlying these associations and inform personalised treatment strategies.
Reference
Zhang Y-Y et al. A retrospective cohort study on the association between allergic rhinitis, sublingual immunotherapy, and COVID-19 symptomatology. Scientific Reports. 2026;16:2159.