Environmental Exposure Shifts and Their Impact on Allergen-Sensitization Profiles in Allergic Rhinitis: A Retrospective Pre-Post COVID-19 Policy Study in Wuhan, 2020 to 2024.

Ting-ting Cui,Guang Yang,Yue-Bin Yang,Er-Bao Liu,Peng Huang,Bin Ruan,Changliang Yang

Published 2025 in Ear, nose, & throat journal

ABSTRACT

OBJECTIVE To investigate changes in the serum allergen-specific IgE (sIgE) profile in allergic rhinitis (AR) before and after widespread mask usage, home isolation, and reduced outdoor activities. METHODS This retrospective study enrolled 3715 patients with AR in Wuhan (September 2020-October 2024), with a cutoff date of January 8, 2023, when the coronavirus disease-19 control policy transitioned from "category B with class A management" to "category B with class B management." Changes in the allergen profile before and after the implementation of mask wearing, home isolation, and reduced outdoor activities were compared in analyses stratified by age, sex, and season. RESULTS Post-policy adjustment, most allergen sIgE positivity rates declined, and significantly for inhalant allergens (Dermatophagoides farinae, 12.9% vs 9.9%, P = .005; mulberry tree, 12.1% vs 9.5%, P = .012; and cockroach, 9.4% vs 6.3%, P < .001) and food allergens (56.3% vs 39.9%, P < .001), especially for milk, egg white, and crab. Trends remained consistent after adjusting for age and sex through propensity score matching. Individuals aged 18 to 59 showed marked declines, except for D. farinae, cat/dog dander, and short ragweed. In males, most allergens decreased, except cat/dog dander, short ragweed, mixed trees, and mango (P < .05). In the autumn subgroup, allergen positivity rates decreased for most allergens, excluding short ragweed, Dermatophagoides pteronyssinus, cat dander, dog dander, and beef (P < .05). CONCLUSION Policy relaxation was associated with reduced positivity rates for most inhalant and food allergens, particularly among adults, males, and during the autumn. Changes in environmental exposure significantly influenced allergen profiles.

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