{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:06:39Z","timestamp":1791489999427,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The CORAL study is a cohort of infants born during the first weeks of the first SARS\u2010CoV\u20102 (COVID\u201019) lockdown. This cohort has had lower antibiotic exposure, higher breastfeeding rates and lower infection rates, especially in the first year of life. We hypothesized that the altered early\u2010life environment of infants born during lockdown would change the incidence of allergic conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This longitudinal, observational study followed 365 infants born between March and May 2020 from enrolment to the age of 2\u2009years. Infants attended three research appointments at 6\u2010, 12\u2010, and 24\u2010months and completed detailed questionnaires. At research appointments, children had skin prick testing, and atopic dermatitis (AD) assessment. Statistical analysis focused on changes within the group at different time points, the influence of specific environmental factors on allergic risk and compared the incidence of atopic conditions with a pre\u2010pandemic Irish infant cohort, BASELINE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>AD was more common in CORAL group at both 12 (26.5% vs. 15.5%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and 24\u2009months (21.3% vs. 15.9%; <jats:italic>p<\/jats:italic>\u2009=\u2009.02) compared with pre\u2010pandemic BASELINE cohort. Within the CORAL group, those with AD at both 12\u2010 and 24\u2010month appointments had a more severe AD phenotype associated with a higher risk of allergic sensitization. There was less milk (0% vs. 1%; <jats:italic>p<\/jats:italic>\u2009=\u2009.09), peanut (0.6% vs. 1.8%; <jats:italic>p<\/jats:italic>\u2009=\u2009.3), and egg allergy (0% vs. 2.9%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) in the CORAL group at 24\u2009months compared with the BASELINE cohort. Aeroallergen sensitization increased between 12 and 24\u2009months in the CORAL cohort (1.5% vs. 8.9%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), as did parent\u2010reported wheezing episodes (9% vs. 24%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite higher AD incidence in the CORAL cohort, the incidence of food sensitization and allergy are lower than expected pre\u2010pandemic rates possibly reflecting the early introduction and maintenance of dietary allergens enhanced by changes in infant infections, antibiotic use, and breastfeeding in the first 2\u2009years of life in the group. These beneficial effects of the lockdown could be outweighing the expected risk of less early\u2010life microbial encounters outlined by the hygiene hypothesis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pai.14013","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T07:29:41Z","timestamp":1693553381000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Atopic outcomes at 2\u2009years in the <scp>CORAL<\/scp> cohort, born in <scp>COVID<\/scp>\u201019 lockdown"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2456-9328","authenticated-orcid":false,"given":"Sadhbh","family":"Hurley","sequence":"first","affiliation":[{"name":"Paediatrics and Child Health Royal College of Surgeons  Dublin Ireland"},{"name":"Children's Health Ireland  Dublin 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