How kids born during COVID-19 quarantines may be affected by allergies
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Spring is springing across metro Phoenix, which means some beautiful flowers and the smell of orange blossoms in some parts of town. But, it also means more sneezing, coughing and itchy eyes for allergy sufferers.
There’s also a growing body of research looking into how kids born during COVID-19 quarantines may be affected by allergies going forward.
The Show spoke with Dr. Cindy Bauer, an allergist and immunologist at Phoenix Children’s Hospital. She’s been there for more than a decade and says she is seeing an increase in seasonal allergies right about now.
Bauer talked about what she is seeing specifically in pediatric cases, since there’s been some research suggesting that allergies may be changed based on when kids were born and if they were in pandemic quarantine or not.
Full interview
DR. CINDY BAUER: So the development of allergic conditions in children is a stepwise process for many, not all. So we often can see allergic eczema or a food allergy in early years. But the development of the environmental allergy and asthma can sometimes take time. So for the children affected by the quarantine during the COVID-19 pandemic, it's still a little bit to be determined as to how that's going to affect the more chronic allergic conditions such as asthma. Since many of those infants were, you know, in 2020-21, they're still in that 3 to 4 year range, where much is being, much is still being learned of them.
MARK BRODIE: Right. I'm wondering if there's a sense that how families and maybe the kids specifically handle the lockdown might affect what kind of allergies they have later on, in terms of like if the family has pets, for example, or if the family had to stay in the house as opposed to being able to go out in the backyard or go to a park or something where, where the kids would be exposed to those allergens, even though they were technically on lockdown?
BAUER: Correct. So the microbial diversity that we develop is affected by so many environmental factors. Some are protective and some are harmful. So it honestly depends upon the home to which the child perhaps was quarantined into. A protective home could be one that had a dog, believe it or not. And in the Tucson children's respiratory study, indoor dog exposure at birth was associated with lower incidence of wheezing later on. So that could be helpful that they stayed in that home. Whereas if you were in a home with a wood-burning stove, which is still used in homes, that or a, a smoker in the home is obviously not going to be a good exposure and would increase the child's risk of developing asthma.
BRODIE: Right. So, it really depends on what specifically a child was exposed, to be it, you know, pet dander or pollen or grass or trees or whatever. Versus as you say, some kind of smoke, one might be better than the other.
BAUER: Correct. And from an infectious standpoint, taking it one step further, we do know that during the pandemic, there was a significant decline in other viral infections as well as bacterial infections, which was shown in a decrease in antibiotic prescriptions for other infectious etiologies in children, which was wonderful if you had a pandemic child because they were not sick as much, they weren't in daycare. Again, they weren't exposed. So, was that decrease in infection for those children helpful or harmful? And again, I think many factors need to be looked at, and in time studies will hopefully reveal that information.
BRODIE: Well, it's interesting because, you know, sort of going into the immunology side of, of what you do, there was sort of a conventional wisdom during the pandemic, and I'm sure you heard it that, you know, yes, while it's kind of a pain in the neck for your kid to go to daycare or preschool and come home sick, it's actually helpful for them in the long run to sort of get exposed to all that and start building up immunity. Do you think that maybe some of those kids who didn't go to, you know, preschool or, you know, kindergarten, first, second grade, are those children perhaps more susceptible to infection later on because they haven't been able to build up that immunity?
BAUER: Possibly. Possibly. And again, I think we're going to have to see if the lack of those exposures, knowing that daycare does increase your microbial exposure. And and you know, potentially positively influence the microbiome. If that was decreased, do the children make up for it later? And are they going to get all the infections now just a little bit later. Or is it not something that they recover, and it is a detrimental effect to their microbiome and risk of allergy, because agreed, daycares were closed, the children were at home and largely healthy because of that.
BRODIE: So what kinds of things do you think will be the most important to be looking out for in, you know, in the months and years to come as more and more research, especially on this group of children, continues?
BAUER: Yeah, I think, you know, close care with health-care providers will be important for the children that were born during the pandemic, to monitor them. There, there are studies that were ongoing during the pandemic, one in which Phoenix Children's participates. And that study will be very well poised to, in a secondary aspect, look at how those children did during during that period of time and who does go on to develop asthma and compare that to rates, that we would have otherwise seen.
BRODIE: Sure. So when you talk about seeing, you know, more people with environmental allergies, do you think that that is more related to us or is that more related to changes in the environment?
BAUER: So the increase in allergic conditions is multifactorial. Certainly, genetics may play a role and do. But probably the environmental exposures are even more robust and there's a myriad of environmental exposures that have affected that increase ranging from just modern living. We're not all farmers and able to have those actually healthy exposures, we use antibiotics, we overuse even antibiotics. And antibiotics, they're sort of like the atomic bomb for the microbiome. They, they destroy all that is, is being built. Birth and feeding practices are different in, in some and, and that can affect the microbiome. And other cleaning and practices that we have in our home and workplaces certainly affect the microbial diversity that we're developing. And that is a large factor contributing to the development of allergic conditions.
BRODIE: That must make it really hard to try to narrow down what's going on when there's so many variables out there.
BAUER: Most certainly. So in research, and Phoenix Children's is participating in two such research studies, the hope is to find ways to get past those uncontrollable factors. Again, we cannot go be farmers, we live in a modern world. But could we recreate some of those healthy exposures or is there pharmacotherapy that could help decrease the risk of allergy? How can we work to combat those risks and prevent the development of asthma and potentially other allergic conditions? But yeah, it's a, it's a very complex interplay of genetics and many, many factors in one's environment.
