The impact of COVID-19 infection in pediatric and adult patients with primary immunodeficiency: a single center analysis

Publication: LymphoSign Journal
11 January 2024

Abstract

Background: The global impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been profound, with over 760 million confirmed infections and almost 7 million deaths from coronavirus disease 2019 (COVID-19). The pandemic, officially declared in March 2020, has caused significant and irreversible changes in society. COVID-19 continues to pose a serious threat, ranging from asymptomatic cases to severe outcomes such as acute respiratory distress syndrome and organ failure, putting immense pressure on healthcare systems worldwide. The effects of SARS-CoV-2 infection on individuals with primary immunodeficiency (PID) are not yet fully understood. To date, the available research remains scarce, and the results do not yet provide conclusive evidence of a definitive link between PID and severe SARS-CoV-2 infection. In this study we present the clinical course and outcome of COVID-19 in individuals with PID.
Methods: This study is a retrospective analysis involving 65 patients, comprising both pediatric and adult individuals diagnosed with PID, who exhibited symptoms of SARS-CoV-2 infection and tested positive at The Hospital for Sick Children in Toronto, Ontario, Canada. The data was collected from October 2020 to December 2022.
Results: Sixty-five patients (36 children and 29 adults) were enrolled in our study. Our patients were diagnosed with primary immunodeficiency, and categorized as combined immunodeficiency, antibody deficiency, immune dysregulation disorder, phagocyte defect, intrinsic and innate immunity, or autoinflammatory disorder. Each of our patients had their COVID-19 infection confirmed through serology, rapid antigen test, and/or PCR. Among the study participants, 24 individuals had pre-existing lung conditions. At the time of contracting the infection, 42 patients had been vaccinated against SARS-CoV-2. The majority of patients in the study experienced mild to moderate symptoms of COVID-19.
Conclusion: Our patients with PID exhibited mild to moderate symptoms of COVID-19, and all made a full recovery without any complications.
Statement of Novelty: This study sheds light on impact of COVID-19 in individuals with primary immunodeficiency, revealing a noteworthy observation that patients exhibited mild to moderate symptoms, and remarkably, all experienced a complete recovery devoid of complications.

Get full access to this article

View all available purchase options and get full access to this article.

REFERENCES

Al-Musa A., LaBere B., Habiballah S., Nguyen A.A., and Chou J. 2022. Advances in clinical outcomes: what we have learned during the COVID-19 pandemic. J. Allergy Clin. Immunol. 149(2): 569–578.
Delavari S., Abolhassani H., Abolnezhadian F., Babaha F., Iranparast S., Ahanchian H., Moazzen N., Nabavi M., Arshi S., Fallahpour M., Bemanian M.H., Shokri S., Momen T., Sadeghi-Shabestari M., Molatefi R., Shirkani A., Vosughimotlagh A., Safarirad M., Sharifzadeh M., Pashangzadeh S., Salami F., Shirmast P., Rezaei A., Shad T.M., Mohraz M., Rezaei N., Hammarström L., Yazdani R., and Aghamohamamdi A. 2021. Impact of SARS-CoV-2 pandemic on patients with primary immunodeficiency. J. Clin. Immunol. 41(2): 345–355.
Esenboga S., Ocak M., Akarsu A., Bildik H.N., Cagdas D., Iskit A.T., and Tezcan I. 2021. COVID-19 in patients with primary immunodeficiency. J. Clin. Immunol. 41(7): 1515–1522.
Fan Y., Li X., Zhang L., Wan S., Zhang L., and Zhou F. 2022. SARS-CoV-2 Omicron variant: recent progress and future perspectives. Signal Transduct Target Ther, 7(1): 141.
Guisado Hernández P., Blanco Lobo P., Villaoslada I., De Felipe B., Lucena J.M., Martín Gutierrez G., Castro M.J., Gutiérrez Valencia A., Sánchez Codez M.I., Gaboli M., Neth O., and Olbrich P. 2021. SARS-CoV-2 infection in a pediatrics STAT1 GOF patient under Ruxolitinib therapy-a matter of balance? J. Clin. Immun. 41(7): 1502–1506.
Jalil M., Pietras J., Ahmed S.N., Daniels P., and Hostoffer R. 2022. COVID-19 infection in patients with humoral immunodeficiency: a case series and literature review. Allergy Rhinol (Providence), 13: 215265752210960.
Marcus N., Frizinsky S., Hagin D., Ovadia A., Hanna S., Farkash M., Maoz-Segal R., Agmon-Levin N., Broides A., Nahum A., Rosenberg E., Kuperman A.A., Dinur-Schejter Y., Berkun Y., Toker O., Goldberg S., Confino-Cohen R., Scheuerman O., Badarneh B., Epstein-Rigbi N., Etzioni A., Dalal I., and Somech R. 2021. Minor clinical impact of COVID-19 pandemic on patients with primary immunodeficiency in Israel. Front Immunol, 11: 614086.
Meyts I.Bucciol G.Quinti I.Neven B.Fischer A.Seoane E.Lopez-Granados E.Gianelli C.Robles-Marhuenda A.Jeandel P.-Y.Paillard C.Sankaran V.G.Demirdag Y.Y.Lougaris V.Aiuti A.Plebani A.Milito C.Dalm V.A.Guevara-Hoyer K.Sánchez-Ramón S.Bezrodnik L.Barzaghi F.Gonzalez-Granado L.I.Hayman G.R., Uzel G.Mendonça L.O.Agostini C.Spadaro G.Badolato R.Soresina A.Vermeulen F.Bosteels C.Lambrecht B.N.Keller M.Mustillo P.J.Abraham R.S.Gupta S.Ozen A.Karakoc-Aydiner E.Baris S.Freeman A.F.Yamazaki-Nakashimada M.Scheffler-Mendoza S.Espinosa-Padilla S.Gennery A.R.Jolles S.Espinosa Y.Poli M.C.Fieschi C.Hauck F.Cunningham-Rundles C.Mahlaoui N.IUIS Committee of Inborn Errors of Immunity,Warnatz K., Sullivan K.E., and Tangye S.G. (2021). Coronavirus disease 2019 in patients with inborn errors of immunity: an international study. J. Allergy Clin. Immunol. 147(2): 520–531.
Shields A.M., Burns S.O., Savic S., Richter A.G., Anantharachagan A., Arumugakani G., Baker K., Bahal S., Bermingham W., Bhole M., Boules E., Bright P., Burns S., Cleave B., Dempster J., Devlin L., Dhalla F., Drewe E., Duncan C., and Verma N. (2021). COVID-19 in patients with primary and secondary immunodeficiency: the United Kingdom experience. J. Allergy Clin. Immunol. 147(3): 870–875.e1.
Shields A.M., Tadros S., Al-Hakim A., Nell J.M., Lin M.M.N., Chan M., Goddard S., Dempster J., Dziadzio M., Patel S.Y., Elkalifa S., Huissoon A., Duncan C.J.A., Herwadkar A., Khan S., Bethune C., Elcombe S., Thaventhiran J., Klenerman P., Lowe D.M., Savic S., Burns S.O., and Richter A.G. (2022). Impact of vaccination on hospitalization and mortality from COVID-19 in patients with primary and secondary immunodeficiency: the United Kingdom experience. Front Immunol, 13: 984376.
Volk A., Covini-Souris C., Kuehnel D., De Mey C., Römisch J., and Schmidt T. (2022). SARS-CoV-2 neutralization in convalescent plasma and commercial lots of plasma-derived immunoglobulin. BioDrugs, 36(1): 41–53.
WHO Coronavirus (COVID-19) dashboard. [online]. Available from https://covid19.who.int. [accessed 30 July 2023]

Information & Authors

Information

Published In

cover image LymphoSign Journal
LymphoSign Journal
Volume 10Number 4December 2023
Pages: 71 - 76

History

Received: 1 November 2023
Accepted: 27 November 2023
Accepted manuscript online: 1 December 2023
Version of record online: 11 January 2024

Authors

Affiliations

Azhar Al Shaqaq
Division of Immunology & Allergy, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON
Marina Sham
Division of Immunology & Allergy, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON
Laura Abrego Fuentes
Division of Immunology & Allergy, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON
Jenny Garkaby
McMaster University, McMaster Children’s Hospital, Department of Pediatrics, Division of Rheumatology, Immunology and Allergy, Hamilton, ON
Jessica Willett Pachul
Division of Immunology & Allergy, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON
Linda Vong
Division of Immunology & Allergy, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON
Julia Upton
Division of Immunology & Allergy, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON
Vy Kim
Division of Immunology & Allergy, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON
Chaim M. Roifman [email protected]
Division of Immunology & Allergy, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON

Metrics & Citations

Metrics

Other Metrics

Citations

Cite As

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

Cited by

1. Impact of the COVID-19 pandemic on patients with primary immunodeficiency

View Options

Get Access

Login options

Check if you access through your login credentials or your institution to get full access on this article.

Subscribe

Click on the button below to subscribe to LymphoSign Journal

Purchase options

Purchase this article to get full access to it.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF

View PDF

Full Text

View Full Text

Media

Media

Other

Tables

Share Options

Share

Share the article link

Share on social media