tetano
Editor, Senior Moderator
J Allergy Clin Immunol
. 2020 Dec 15;147(3):870-875.e1.
doi: 10.1016/j.jaci.2020.12.620. Online ahead of print.
COVID-19 in patients with primary and secondary immunodeficiency: The United Kingdom experience
Adrian M Shields[SUP] 1 [/SUP], Siobhan O Burns[SUP] 2 [/SUP], Sinisa Savic[SUP] 3 [/SUP], Alex G Richter[SUP] 4 [/SUP], UK PIN COVID-19 Consortium
Collaborators, Affiliations
Abstract
Background: As of November 2020, severe acute respiratory syndrome coronavirus 2 has resulted in 55 million infections worldwide and more than 1.3 million deaths from coronavirus disease 2019 (COVID-19). Outcomes following severe acute respiratory syndrome coronavirus 2 infection in individuals with primary immunodeficiency (PID) or symptomatic secondary immunodeficiency (SID) remain uncertain.
Objectives: We sought to document the outcomes of individuals with PID or symptomatic SID following COVID-19 in the United Kingdom.
Methods: At the start of the COVID-19 pandemic, the United Kingdom Primary Immunodeficiency Network established a registry of cases to collate the nationwide outcomes of COVID-19 in individuals with PID or symptomatic SID and determine risk factors associated with morbidity and mortality from COVID-19 in these patient groups.
Results: A total of 100 patients had been enrolled by July 1, 2020, 60 with PID, 7 with other inborn errors of immunity including autoinflammatory diseases and C1 inhibitor deficiency, and 33 with symptomatic SID. In individuals with PID, 53.3% (32 of 60) were hospitalized, the infection-fatality ratio was 20.0% (12 of 60), the case-fatality ratio was 31.6% (12 of 38), and the inpatient mortality was 37.5% (12 of 32). Individuals with SID had worse outcomes than those with PID; 75.8% (25 of 33) were hospitalized, the infection-fatality ratio was 33.3% (11 of 33), the case-fatality ratio was 39.2% (11 of 28), and inpatient mortality was 44.0% (11 of 25).
Conclusions: In comparison to the general population, adult patients with PID and symptomatic SID display greater morbidity and mortality from COVID-19. This increased risk must be reflected in public health guidelines to adequately protect vulnerable patients from exposure to the virus.
Keywords: COVID-19; SARS-CoV-2; primary immunodeficiency; secondary immunodeficiency.
. 2020 Dec 15;147(3):870-875.e1.
doi: 10.1016/j.jaci.2020.12.620. Online ahead of print.
COVID-19 in patients with primary and secondary immunodeficiency: The United Kingdom experience
Adrian M Shields[SUP] 1 [/SUP], Siobhan O Burns[SUP] 2 [/SUP], Sinisa Savic[SUP] 3 [/SUP], Alex G Richter[SUP] 4 [/SUP], UK PIN COVID-19 Consortium
Collaborators, Affiliations
- PMID: 33338534
- PMCID: PMC7737531
- DOI: 10.1016/j.jaci.2020.12.620
Abstract
Background: As of November 2020, severe acute respiratory syndrome coronavirus 2 has resulted in 55 million infections worldwide and more than 1.3 million deaths from coronavirus disease 2019 (COVID-19). Outcomes following severe acute respiratory syndrome coronavirus 2 infection in individuals with primary immunodeficiency (PID) or symptomatic secondary immunodeficiency (SID) remain uncertain.
Objectives: We sought to document the outcomes of individuals with PID or symptomatic SID following COVID-19 in the United Kingdom.
Methods: At the start of the COVID-19 pandemic, the United Kingdom Primary Immunodeficiency Network established a registry of cases to collate the nationwide outcomes of COVID-19 in individuals with PID or symptomatic SID and determine risk factors associated with morbidity and mortality from COVID-19 in these patient groups.
Results: A total of 100 patients had been enrolled by July 1, 2020, 60 with PID, 7 with other inborn errors of immunity including autoinflammatory diseases and C1 inhibitor deficiency, and 33 with symptomatic SID. In individuals with PID, 53.3% (32 of 60) were hospitalized, the infection-fatality ratio was 20.0% (12 of 60), the case-fatality ratio was 31.6% (12 of 38), and the inpatient mortality was 37.5% (12 of 32). Individuals with SID had worse outcomes than those with PID; 75.8% (25 of 33) were hospitalized, the infection-fatality ratio was 33.3% (11 of 33), the case-fatality ratio was 39.2% (11 of 28), and inpatient mortality was 44.0% (11 of 25).
Conclusions: In comparison to the general population, adult patients with PID and symptomatic SID display greater morbidity and mortality from COVID-19. This increased risk must be reflected in public health guidelines to adequately protect vulnerable patients from exposure to the virus.
Keywords: COVID-19; SARS-CoV-2; primary immunodeficiency; secondary immunodeficiency.