A cross-sectional survey on the experience of people with allergic rhinitis amidst COVID-19 pandemic: The impact of the facemask: A pilot study

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Nadia Al Mazrouei https://orcid.org/0000-0002-1339-9730
Asim Ahmed Elnour https://orcid.org/0000-0002-4143-7810
Abdalla Abou Hajal https://orcid.org/0000-0003-4655-1193
Adel Sadeq https://orcid.org/0000-0001-9529-8898
Al Kubaisi Khalid Awad https://orcid.org/0000-0002-4260-1117
Raneem Hammouri https://orcid.org/0000-0003-2516-8582
Ola Ishbair https://orcid.org/0000-0001-8580-3993
Nour Dabbagh https://orcid.org/0000-0001-7644-6736
Alin Alkwarit https://orcid.org/0000-0001-6991-3228
Maisoun Alkaabi https://orcid.org/0000-0003-3023-5639
Vineetha Menon https://orcid.org/0009-0009-0013-4221
Semira Abdi Beshir https://orcid.org/0000-0003-2516-8582
Mohamed A. Baraka https://orcid.org/0000-0002-7645-2420
Israa Yousif Khidir https://orcid.org/0000-0001-8674-3603
Samah Mohammed Hussein https://orcid.org/0000-0003-3802-8714
Abdulla Al Amoodi https://orcid.org/0000-0001-5248-9598
Sami Fatehi Abdalla https://orcid.org/0000-0002-7396-8376


Allergic rhinitis, COVID-19, Eye symptoms, Facemask, Nasal symptoms


Background: Since outbreak of COVID-19 pandemic, almost whole world asked to wear the facemask especially in the public areas as a precaution to avoid the transmission of the disease, and curbs the pandemic. Looking from another perspective, we need to consider the effect of the facemask in reducing allergic rhinitis symptoms. Objective: The current study objective was to assess the impact of facemasks on the symptoms of allergic rhinitis in subjects who were obligatory using facemask due to the COVID-19 pandemic. Methods: The current study was ethically approved self-administered validated survey (Cronbach Alfa 0.81) comprised of 28-items to assess the impact of wearing the facemask, and whether there was an improvement in symptoms of allergic rhinitis. The outcome measure was the responses to the four domains (knowledge, attitude, symptoms, and help/advice) measured on Likert scale to assess the responses of subjects with allergic rhinitis during the COVID -19 pandemic. Results: 82 respondents (mean age was 22.59 ±2.77 years) have completed the survey, of which 73 females (89%) and (52/82, 63.4%) university students. 29 (35.4%), stated that the fabric facemask is useful in reduction of symptoms. 44 (53.7%) believe that the surgical mask N95 is very beneficial in the reduction of symptoms. There was a significant difference in knowledge levels for both eye and nasal symptoms’ reduction responses (P <0.001). Tukey’s HSD (honestly significant difference) used to determine the specifics of the variances (differences in multiple means) in symptom reduction. For eye symptoms, the analysis revealed that respondents who reported that they had reduced symptoms had higher knowledge scores (6.74±2.7) than those who reported no reduction in allergic symptoms (mean ±SD: 4.96±3.2). The lowest score was associated with respondents that were uncertain regarding their symptom alleviation (mean ±SD: 4.53±3.1). For nasal symptoms, the analysis revealed that respondents who reported that they had reduced symptoms had higher knowledge scores (7.03±2.7) than those who reported no reduction in allergic symptoms (3.94±2.5). Conclusion: Our results reveal that facemask usage may reduce allergic rhinitis symptom severity in chronically affected individuals with intermittent disease. The study supports the hypothesis that facemask may reduce atopic allergic responses

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1. Gilles S, Akdis C, Lauener R, et al. The role of environmental factors in allergy: A critical reappraisal. Experimental Dermatology. 2018; 27(11):1193-1200. https://doi.org/10.1111/exd.13769
2. Mahboub B, Al-Hammadi S, Prakash VP, et al. Prevalence and triggers of allergic rhinitis in the United Arab Emirates. World Allergy Organization Journal. 2014;7(1):1-5. https://doi.org/10.1186/1939-4551-7-19
3. Dror AA, Eisenbach N, Marshak T, et al. Reduction of allergic rhinitis symptoms with face mask usage during the COVID-19 pandemic. J Allergy Clin Immunol Pract. 2020;8(10):3590-3593. https://doi.org/10.1016/j.jaip.2020.08.035
4. Mengi E, Kara CO, Alptürk U, et al. The effect of face mask usage on the allergic rhinitis symptoms in patients with pollen allergy during the COVID-19 pandemic. American journal of otolaryngology. 2022;43(1):103206. https://doi.org/10.1016/j.
5. Candevir A, Üngör C, Çizmeci Şenel F, et al. How efficient are facial masks against COVID-19? Evaluating the mask use of various communities one year into the pandemic. Turkish Journal of Medical Sciences. 2021;51(Special Issue 1):3238-3245. https://
6. Gani F, Cottini M, Landi M, et al. Allergic rhinitis and COVID-19: friends or foes? European Annals of Allergy and Clinical Immunology. 2022;54(2):53-59. https://doi.org/10.23822/EurAnnACI.1764-1489.234
7. Thompson AK, Juniper E, Meltzer EO. Quality of life in patients with allergic rhinitis. Annals of Allergy, Asthma & Immunology. 2000;85(5):338-348.
8. Kalmarzi RN, Khazaei Z, Shahsavar J, et al. The impact of allergic rhinitis on quality of life: a study in western Iran. Biomedical Research and Therapy. 2017;4(9):1629-1637. https://doi.org/10.15419/bmrat.v4i9.370
9. Canonica GW, Mullol J, Pradalier A, et al. Patient perceptions of allergic rhinitis and quality of life: findings from a survey conducted in Europe and the United States. World Allergy Organization Journal. 2008;1(9):138-144.
10. Meltzer EO. Quality of life in adults and children with allergic rhinitis. Journal of Allergy and Clinical Immunology. 2001;108(1):S45-S53. https://doi.org/10.1067/mai.2001.115566
11. Camelo-Nunes IC, Solé D. Allergic rhinitis: indicators of quality of life. Jornal Brasileiro de Pneumologia. 2010;36:124-133.
12. Crystal-Peters J, Crown WH, Goetzel RZ, et al. The cost of productivity losses associated with allergic rhinitis. Am J Manag Care. 2000;6(3):373-378.
13. Cockburn IM, Bailit HL, Berndt ER, et al. Loss of work productivity due to illness and medical treatment. Journal of Occupational and Environmental Medicine. 1999;1999:948-953. https://doi.org/10.1097/00043764-199911000-00005
14. Schoenwetter WF, Dupclay L, Appajosyula S, et al. Economic impact and quality-of-life burden of allergic rhinitis. Current Medical Research and Opinion. 2004;20(3):305-317. https://doi.org/10.1185/030079903125003053
15. Al-Rabia MW. Food-induced immunoglobulin E-mediated allergic rhinitis. Journal of Microscopy and Ultrastructure. 2016;4(2):69-75. https://doi.org/10.1016/j.jmau.2015.11.004
16. Anderson J. Adverse reactions to foods. Hyattsville. Maryland. 1984;84-242.
17. Dror AA, Eisenbach N, Marshak T, et al. Reduction of allergic rhinitis symptoms with face mask usage during the COVID-19 pandemic. The Journal of Allergy and Clinical Immunology: In Practice. 2020;8(10):3590-3593. https://doi.org/10.1016/j.
18. Gelardi M, Trecca EM, Fortunato F, et al. COVID‐19: when dust mites and lockdown create the perfect storm. Laryngoscope Investigative Otolaryngology. 2020;5(5):788-790. https://doi.org/10.1002/lio2.439
19. Gallo O, Bruno C, Orlando P, et al. The impact of lockdown on allergic rhinitis: What is good and what is bad? Laryngoscope Investigative Otolaryngology. 2020;5(5):807. https://doi.org/10.1002/lio2.459
20. Dayal AK, Sinha V. Trend of allergic rhinitis post COVID-19 pandemic: a retrospective observational study. Indian Journal of Otolaryngology and Head & Neck Surgery. 2020;1-3. https://doi.org/10.1007/s12070-020-02223-y
21. Dubini M, Robotti C, Benazzo M, et al. Impact of quarantine and face masks on ragweed-induced oculorhinits during the COVID-19 pandemic in Northern Italy. Int Forum Allergy Rhinol. 2021;12(2):220-222. https://doi.org/10.1002/alr.22889
22. Bergmann KC, Kugler S, Zuberbier T, et al. Face masks suitable for preventing COVID-19 and pollen allergy. A study in the exposure chamber. Allergo Journal International. 2021;30(5):176-182. https://doi.org/10.1007/s40629-021-00180-8
23. Choi HG, Kong IG. Asthma, allergic rhinitis, and atopic dermatitis incidence in Korean adolescents before and after COVID-19. Journal of Clinical Medicine. 2021;10(15):3446. https://doi.org/10.3390/jcm10153446
24. Çelik FÇ, Soyöz Ö, Sancaklı Ö, et al. The effect of the COVID-19 pandemic lockdown on symptom severity in school children with house dust mite-sensitized allergic rhinitis. Revue Française d’Allergologie. 2022;62(8):678-683. https://doi.org/10.1016/j.
25. Brindisi G, De Vittori V, De Nola R, et al. Updates on children with allergic rhinitis and asthma during the COVID-19 outbreak. Journal of Clinical Medicine. 2021;10(11):2278. https://doi.org/10.3390/jcm10112278
26. Choi HG, Kim JH, An YH, et al. Changes in the Mean and Variance of the Numbers of Medical Visits for Allergic Diseases before and during the COVID-19 Pandemic in Korea. Journal of Clinical Medicine. 2022;11(15):4266. https://doi.org/10.3390/
27. Sözener ZÇ, Öztürk BÖ, Aydın Ö, et al. Coincidence of pollen season and coronavirus disease 2019 pandemic: less time outdoorslesser allergy symptoms in 2020. Asia Pacific Allergy. 2021;11(2):e16. https://doi.org/10.5415/apallergy.2021.11.e16
28. Mun SK, Yang BR, Chang M. Changes in respiratory diseases in South Korea during the COVID-19 pandemic: an interrupted time series study. BMJ global health. 2021;6(12):e006912. https://doi.org/10.1136/bmjgh-2021-006912
29. Gotoh M, Okubo K, Okuda M. Inhibitory effects of facemasks and eyeglasses on invasion of pollen particles in the nose and eye: a clinical study. Rhinology. 2005;43(4):266.
30. Grinshpun SA, Haruta H, Eninger RM, et al. Performance of an N95 filtering facepiece particulate respirator and a surgical mask during human breathing: two pathways for particle penetration. Journal of occupational and environmental hygiene. 
2009;6(10):593-603. https://doi.org/10.1080/15459620903120086
31. Lee SA, Grinshpun SA, Reponen T. Respiratory performance offered by N95 respirators and surgical masks: human subject evaluation with NaCl aerosol representing bacterial and viral particle size range. Annals of Occupational Hygiene. 
2008;52(3):177-185. https://doi.org/10.1093/annhyg/men005
32. Portnoy J, Barnes C. Clinical relevance of spore and pollen counts. Immunology and Allergy Clinics. 2003;23(3):389-410. https://doi.org/10.1016/s0889-8561(03)00028-6
33. Tovey ER, Chapman MD, Platts-Mills TA. Mite faeces are a major source of house dust allergens. Nature. 1981 Feb;289(5798):592-593. https://doi.org/10.1038/289592a0
34. Sharma SK, Mishra M, Mudgal SK. Efficacy of cloth face mask in prevention of novel coronavirus infection transmission: A systematic review and meta-analysis. Journal of education and health promotion. 2020;9(1):192. https://doi.org/10.4103/
35. Van Bever HP, Chng SY, Goh DY. Childhood severe acute respiratory syndrome, coronavirus infections and asthma. Pediatric Allergy and Immunology. 2004;15(3):206-209. https://doi.org/10.1111/j.1399-3038.2004.00137.x
36. Zheng XY, Xu YJ, Guan WJ, et al. Regional, age and respiratory-secretion-specific prevalence of respiratory viruses associated with asthma exacerbation: a literature review. Archives of virology. 2018;163(4):845-53. https://doi.org/10.1007/s00705-017-
37. Greenberg SB. Update on human rhinovirus and coronavirus infections. Seminars in Respiratory and Critical Care Medicine.2016;37(4):555-557. https://doi.org/10.1055/s-0036-1584797
38. Lee JH, Lee Y, Lee SY, et al. Management of allergic patients during the COVID-19 pandemic in Asia. Allergy, Asthma & Immunology Research. 2020;12(5):783. https://doi.org/10.4168/aair.2020.12.5.783
39. Szymona-Pałkowska K, Janowski K, Pedrycz A, et al. Knowledge of the disease, perceived social support, and cognitive appraisals in women with urinary incontinence. BioMed Research International. 2016;2016:1-7. https://doi.org/10.1155/2016/3694792

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