Acute Urticaria Incidence Declined During COVID-19
A population-based analysis of more than 26 million patient-years has identified a significant association between non–COVID-19 viral respiratory infections (NCVRIs) and the annual incidence of acute urticaria (AU).
Using longitudinal data from Kaiser Permanente Southern California between 2017 and 2022, researchers tracked annual rates of AU, chronic urticaria (CU), and NCVRI-related health care visits across 3 pandemic-related timeframes: pre-COVID-19, the early COVID-19 era (without vaccines), and the COVID-19 vaccination era.
The annual incidence of AU dropped significantly during the first year of the pandemic, from 1586 per 100,000 patient-years in 2019 to 1194 in 2020, before partially rebounding to 1434 in 2022. In contrast, CU incidence remained relatively stable throughout the study period, ranging from 95 to 129 per 100,000 patient-years.
Health care utilization for NCVRIs also declined sharply during the early pandemic period, with visit rates decreasing from 14,843 per 100,000 patient-years in 2019 to 8671 in 2020 and 6507 in 2021, before increasing again in 2022.
“There was a significant correlation between NCVRIs and AU (r = 0.82, P = .05),” the authors reported, suggesting that AU incidence may be influenced by fluctuations in circulating viral respiratory pathogens. No such correlation was observed for CU (r = 0.10, P = .86).
The analysis included 7,404,343 individuals enrolled in the health plan during the study period. According to the authors, “AU may be associated with NCVRIs,” and the decline in AU incidence during the COVID-19 era may reflect the reduced transmission of respiratory viruses due to widespread public health measures.
These findings may inform clinicians’ understanding of AU pathogenesis and guide seasonal or outbreak-related clinical expectations.
Reference
Jean T, Yim HJ, Chu V, et al. Population-based incidence of acute and chronic urticaria in southern California: 2017-2022. Perm J. Published online November 26, 2025. doi:10.7812/TPP/25.135
