Review
SARS-CoV-2 and allergy – what have we learned after two and a half years?
Knut Brockow, Rosi Wang, Sonja Mathes, Rebekka Bent, Valentina Faihs, Bernadette Eberlein, Ulf Darsow, and Tilo Biedermann
Volume 7 (2023) p. 101 - 112
Abstract
Allergologie select, Vol. 7/2023 (101-112)
SARS-CoV-2 and allergy – what have we learned after two and a half years?
Knut Brockow, Rosi Wang, Sonja Mathes, Rebekka Bent, Valentina Faihs, Bernadette Eberlein, Ulf Darsow, and Tilo Biedermann
Department of Dermatology and Allergy Biederstein, Technical University of Munich, Faculty of Medicine, Munich, Germany
Background: Coronavirus disease-2019 (COVID-19) has significantly hampered the regular workflow for allergists and allergy departments. Materials and methods: The purpose of this review is to highlight our own experiences on SARS-CoV-2 and allergy as well as to discuss findings from the literature. Results: Vaccination against SARS-CoV-2 is needed for protection against severe infection. Skin reactions may arise with SARS-CoV-2 infections. Short-term general immune reactions and skin reactions are also possible upon SARS-CoV-2 vaccination; however, they recur in only a proportion of patients during follow-up vaccinations. Initial reports of anaphylaxis after vaccination fueled public fear. On the other hand, more recent epidemiologic data do not show a substantially increased anaphylaxis risk compared with other vaccines. Fear-related reactions may be essential for many “anaphylaxis” reports. In Germany, the flow chart developed by Paul-Ehrlich-Institut (PEI) and Robert-Koch-Institut (RKI) together with the allergological societies helps to care for patients with suspected “allergy history” safely and effectively. Through this, patients with increased risk of anaphylaxis to SARS-CoV-2 vaccines and their ingredients (e.g., polyethylene glycol (PEG), polysorbate 80) are identified. However, since only small amounts of these excipients are contained in mRNA vaccines, even some PEG-allergic patients can tolerate the vaccination. In Germany, an allergy test-guided procedure is recommended for high-risk patients, including an allergy history, prick tests, intradermal and basophil activation tests, and, if necessary, provocation tests. This also appears effective for anxiety reduction in patients with vaccination skepticism. To date, all of our patients have been able to be vaccinated with SARS-CoV-2 vaccines without the occurrence of significant reactions. Conclusion: Many initial concerns about unexpected side effects of SARS-CoV-2 vaccination have not been confirmed. The flowchart and, in the case of suspicion of hypersensitivity, an allergy test-guided risk assessment helps to reduce patients’ fear of vaccination and enables safe vaccination.Correspondence to:
Knut Brockow, Department of Dermatology and Allergy Biederstein, Technical University of Munich, Faculty of Medicine, Biedersteiner Straße 29, 80802 Munich, Germany
Email: [email protected]
Review
AI – one size fits all?
Stephan Traidl, Sonja Mathes, and Sebastian Seurig
Volume 9 (2025) p. 75 - 79
Abstract
Allergologie select, Vol. 9/2025 (75-79)
AI – one size fits all?
Stephan Traidl1, Sonja Mathes2, and Sebastian Seurig3
1Department of Dermatology and Allergy, Hannover Medical School, Hanover, 2Department of Dermatology and Allergy, School of Medicine and Health, Technical University of Munich, Munich, and 3Department of Respiratory Medicine, Allergology and Sleep Medicine, General Hospital Nuremberg, Campus North, Paracelsus Medical University, Nuremberg, Germany
The use of artificial intelligence (AI) in medicine requires a careful selection of suitable models, as there is no universal “one size fits all” method. While linear regression is convincing due to its simplicity and interpretability, it is limited due to the assumption of linearity and susceptibility to multicollinearity and outliers. More complex approaches such as neural networks show their strengths in the detection of non-linear patterns and automatic feature extraction but require large amounts of data, high computing capacity, and suffer from limited explainability. Principal component analysis (PCA) offers an efficient reduction of dimensionality. Ultimately, the choice of model depends on the balance between accuracy, interpretability, and data availability. A selection of machine learning models is presented in this article.Correspondence to:
PD Dr. med. Stephan Traidl, MSc, Department of Dermatology and Allergy, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hanover, Germany
Email: [email protected]
Review
Ethical aspects of the application of artificial intelligence in allergology
Sonja Mathes, Sebastian Seurig, Stephan Traidl, Valentina Faihs, Marta Dechant, Knut Brockow, and Ulf Darsow
Volume 9 (2025) p. 86 - 92
Abstract
Allergologie select, Vol. 9/2025 (86-92)
Ethical aspects of the application of artificial intelligence in allergology
Sonja Mathes1, Sebastian Seurig2, Stephan Traidl3, Valentina Faihs1, Marta Dechant1, Knut Brockow1, and Ulf Darsow1
1Department of Dermatology and Allergy, School of Medicine and Health, Technische Universität München, Munich, 2Department of Respiratory Medicine, Allergology and Sleep Medicine, General Hospital Nuremberg, Campus North, Paracelsus Medical University, Nuremberg, and 3Department of Dermatology and Allergy, Hannover Medical School, Hanover, Germany
Background: Artificial intelligence (AI) offers a wide range of applications in allergology, including diagnostics and disease course prediction, consultations, real-time monitoring of allergic reactions, and support for decentralized clinical studies. Materials and methods: This review aims to highlight not only the potential applications but also the ethical aspects of using AI in allergology. Results: Initial studies demonstrate potential applications of AI in predicting provocation tests and antibiotic delabeling. However, these models from research and development have not yet been established in clinical practice, partly because ethical considerations, alongside technical challenges, and data quality issues, must be addressed. Key ethical dilemmas include bias and fairness, the principle of nonmaleficence, data protection and autonomy, transparency of AI models, and questions of accountability. AI applications must be robust and reliable to prevent harm caused by erroneous recommendations. Conclusion: The use of AI in allergology requires clear guidelines based on principles such as autonomy, justice, and non-maleficence. General bioethical principles must be complemented by specific regulations for AI.Correspondence to:
Dr. med. Sonja Mathes, Klinik und Poliklinik für Dermatologie und Allergologie, Biedersteiner Straße 29, 80802 Munich, Germany
Email: [email protected]
Position Paper
Artificial intelligence in allergology: A Position Paper of the German Society of Allergology and Clinical Immunology (DGAKI), Ärzteverband Deutscher Allergologen (AeDA) and German Society of Pediatric Allergology and Environmental Medicine (GPA): P1
Oliver Pfaar, Stephan Traidl, Friederike Bärhold, Sven Becker, Christoph Bergmann, Jeroen Buters, Stephanie Dramburg, Wojciech Francuzik, Michael Gerstlauer, Eckard Hamelmann, Camilo José Hernandez Toro, Ludger Klimek, Lars Lange, Paolo M. Matricardi, Laura Pfeffer, Mariel Suarez-Suarez, Philipp Utz, Martin Wagenmann, Margitta Worm, Mehrak Yoosefi, Sonja Mathes, and Sebastian Seurig
Volume 10 (2026) p. 303 - 322
Abstract
Allergologie select, Vol. 10/2026 (303-322)
Artificial intelligence in allergology: A Position Paper of the German Society of Allergology and Clinical Immunology (DGAKI), Ärzteverband Deutscher Allergologen (AeDA) and German Society of Pediatric Allergology and Environmental Medicine (GPA): P1
Oliver Pfaar1, Stephan Traidl2, Friederike Bärhold3, Sven Becker4, Christoph Bergmann5, Jeroen Buters6, Stephanie Dramburg7, Wojciech Francuzik8, Michael Gerstlauer9, Eckard Hamelmann10, Camilo José Hernandez Toro7,11, Ludger Klimek3, Lars Lange12, Paolo M. Matricardi7,13,14, Laura Pfeffer15, Mariel Suarez-Suarez6, Philipp Utz16, Martin Wagenmann17, Margitta Worm8, Mehrak Yoosefi18, Sonja Mathes19, and Sebastian Seurig20
1Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, 2Department of Dermatology and Allergy, Medizinische Hochschule Hannover, Hanover, 3Center for Rhinology and Allergology, Wiesbaden, 4Department of Otorhinolaryngology, Head and Neck Surgery, University of Tübingen, 5Hals-Nasen-Ohrenheilkunde, interdisziplinäre Facharztklinik, Düsseldorf, 6Center of Allergy & Environment (ZAUM), Member of the German Center for Lung Research (DZL), Technical University and Helmholtz Center, Munich, 7Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 8Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin, Berlin, 9Pediatric Pulmonology and Allergology, University Hospital Augsburg, Augsburg, 10Children‘s Center Bethel, University Hospital OWL, University Bielefeld, Bielefeld, 11Institute of Biometry and Clinical Epidemiology, Charité – Universitätsmedizin Berlin, Berlin, 12Department of Pediatrics, GFO-Kliniken Bonn, St. Marien-Hospital, Bonn, 13Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 14Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, 15Pediatric Dermatology and Allergology, Kinder- und Jugendkrankenhaus AUF DER BULT, Hannover, 16Kinderarztpraxis Hirschberg, Hirschberg, 17Department of Otorhinolaryngology, Düsseldorf University Hospital, Düsseldorf, 18Kinderarztpraxis Dr. med. Mehrak Yoosefi, Berlin, 19Department of Dermatology and Allergology, TUM Clinic Rechts der Isar, School of Medicine and Health, Technical University of Munich, Munich, and 20Department of Respiratory Medicine, Allergology and Sleep Medicine, General Hospital Nuremberg, Campus North, Paracelsus Medical University, Nuremberg, Germany
Background: Artificial intelligence (AI) is rapidly advancing in medicine, yet its translation into clinical and research practice in allergology remains limited. Given the heterogeneity of allergic diseases and the complexity of integrating clinical, environmental, and molecular data, a structured assessment is required. This first part of a joint position paper, developed by German allergology societies and associations under the leadership of the DGAKI, aims to establish a conceptual and clinical foundation for AI in allergology. Materials and methods: The Position Paper is based on a targeted narrative literature review and structured expert consensus. Development was informed by AGREE II principles. Part I comprises Chapters 1 – 4, covering introduction, methodology, AI taxonomy, and selected early application domains. Results: AI is conceptualized as an augmentative tool supporting clinical reasoning and individualized decision-making. The paper distinguishes classical statistical approaches from machine learning, deep learning, vision models, and large language models, emphasizing their complementary roles. Key applications include environmental analytics (e.g., automated pollen monitoring and forecasting), image-based classification systems, clinical decision support for diagnostics and therapy, and emerging patient-facing tools. Across these domains, AI may improve diagnostic precision and enable integration of heterogeneous data. Limitations include restricted generalizability, bias, limited explainability, and regulatory and data protection challenges. Conclusion: The role of AI in allergology is defined, its methodological basis is outlined, and initial application domains are highlighted. Together, these elements provide a framework for evidence-based and patient-oriented integration, requiring human oversight, robust scientific validation, and regulatory alignment.Correspondence to:
Prof. Dr. Oliver Pfaar, Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Germany, or Dr. med. Sonja Mathes, Department of Dermatology and Allergology, TUM Clinic Rechts der Isar, School of Medicine and Health, Technical University of Munich, Munich, Germany
Email: [email protected]
