RESULTS
The details of the systematic search performed are shown in Fig. 1. In total, our search yielded 9870 after duplicates removal. We excluded 2767 due to time of publication and type of article, then 7103 were finally screened. This resulted in 30 publications of which the full texts were assessed and included in a qualitative analysis. We summarized in tables the included studies per each phenotype classifying evidence using GRADE methodology. No studies were included in a quantitative synthesis (meta-analysis).
Allergy and acute rhinosinusitis in children.
According to the EPOS2020 guidelines(7), acute rhinosinusitis in children (ARS) is defined as a sudden onset of two or more of the following symptoms: nasal blockage/obstruction/congestion, discoloured nasal discharge and cough (daytime and night-time) for<12 weeks. ARS in children can theoretically be divided into viral acute rhinosinusitis (i.e. common cold), post-viral rhinosinusitis, acute bacterial rhinosinusitis (ABRS). Acute viral rhinosinusitis has usually a duration of symptoms of <10 days. Post-viral one is defined if symptoms increase after five days, or are persistent for more than 10 days, with less than 12 weeks duration; only a small subgroup of these are of bacterial origin. Discolored mucous, severe pain, fever >38, “double sickening” lead to the suspicious of bacterial supra infection. Recurrent ARS(RARS) is defined as ≥4 episodes of rhinosinusitis per year with symptom-free intervals.
Allergy and acute viral rhinosinusitis in children (i.e common cold) including viral upper respiratory tract infections (URTIs).
Viral acute rhinosinusitis (i.e common cold) may be induced in children by a wide variety of viruses, such rhinoviruses (RV) and coronaviruses (CorV), as well as respiratory syncytial virus (RSV), parainfluenza viruses and adenoviruses. The common cold is the most frequent upper respiratory tract infection (URTI), which are the most commonly treated acute problems in primary pediatric care(8). URTI are caused mainly by viruses and may involve not only nose and sinuses but also pharynx, larynx, and large airways. Clinical expression of URTIs is variable and it is influenced by the nature of the infecting virus, by the age and by physiological state and immunological experience of the host. Sino nasal clinical features of common cold or URTI commonly overlap and are characterized by self-limiting irritation of the upper airways with associated cough with no proof of pneumonia(9). Based on our review of the literature we observed that authors for research purpose include common colds in URTI; for this reason, we included both papers about allergy and common cold or URTI.