Immunology & Allergy referral patterns in Hong Kong following the COVID-19 pandemic: A 8-year longitudinal analysis

•Hong Kong’s first public adult clinical Immunology & Allergy service was founded in 2018 to address a critical shortage of expertise in this area.•There was a shift in referral trends following the COVID-19 outbreak, with allergy referrals significantly increasing, particularly for suspected drug allergies.•This underscores the need for novel strategies to manage the increasing and evolving need for Immunology & Allergy services. In 2018, Hong Kong established its first public adult clinical immunology and allergy (IA) team. The COVID-19 outbreak in early 2020 disrupted services for IA patients. This study aims to assess case burden among non-COVID-19-related referrals at our center before and after the COVID-19 pandemic and identify changing service needs. The study included the first 1000 adult patients seen at our clinic, divided into “pre-COVID-19” (Jan 2018–Dec 2019) and “post-COVID-19” (Jan 2020–Dec 2022) groups. Clinical data were compared between these cohorts. Of the first 1000 cases, allergy and immunology cases were equally represented. There was a significant increase in allergy referrals in the post-COVID19 cohort, particularly a 7 % rise in drug allergy cases. Conversely, immunology referrals decreased significantly. Referral trends shifted towards allergy cases, especially drug allergies, after COVID-19. It is essential to implement effective protocols to manage the increased allergy burden and enable primary care providers to handle low-risk cases.