1. COVID-19 in patients with primary and secondary immunodeficiency: The United Kingdom experience
- Author
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Philip D Bright, Betsy Cleave, Lisa Devlin, Prashantha M. Vaitla, Rachael O’Brien, John Dempster, Sai Murng, Gururaj Arumugakani, Smita Patel, Dylan MacLochlainn, Magdalena Dziadzio, Richter Ag, Hadeil Morsi, Kenneth F Baker, William H. Bermingham, Siobhan O. Burns, Sinisa Savic, Christopher J A Duncan, Malini Bhole, Anna Shrimpton, Elizabeth Drewe, Evon Boules, Sarah Johnston, Andrew R. Gennery, Ariharan Anantharachagan, Sadia Noorani, Aarnoud Huissoon, Adrian Shields, Grant Hayman, Sameer Bahal, Shuayb Elkhalifa, Fatima Dhalla, Alex G. Richter, Sofia Grigoriadou, Catherine Stroud, Rashmi Jain, Lucy Leeman, A Herwadkar, Nisha Verma, Sarah Goddard, Elizabeth McDermott, Suranjith L. Seneviratne, Siraj A. Misbah, Arthur Price, Stephen Jolles, Adrian M Shields, and Shanti Mahabir
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Male ,0301 basic medicine ,Pediatrics ,BMI, Body-mass index ,IgRT, Immunoglobulin replacement therapy ,UKPIN, United Kingdom Primary Immunodeficiency Network ,0302 clinical medicine ,Risk Factors ,PID, Primary immunodeficiency ,XLA, X-linked agammaglobulinaemia ,Pandemic ,Case fatality rate ,IFR, Infection fatality ratio ,Immunology and Allergy ,Registries ,Aged, 80 and over ,COVID-19, Coronavirus disease 2019 ,education.field_of_study ,Middle Aged ,030220 oncology & carcinogenesis ,Female ,Adult ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Primary Immunodeficiency Diseases ,Immunology ,Population ,BAME, Black, Asian and Minority Ethnic ,primary immunodeficiency ,Article ,Secondary immunodeficiency ,03 medical and health sciences ,CFR, Case fatality ratio ,CVID, Common variable immunodeficiency ,medicine ,Humans ,education ,Aged ,SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 ,SARS-CoV-2 ,business.industry ,Common variable immunodeficiency ,Public health ,COVID-19 ,SID, Secondary immunodeficiency ,medicine.disease ,United Kingdom ,030104 developmental biology ,Primary immunodeficiency ,secondary immunodeficiency ,PCR, Polymerase chain reaction ,business - Abstract
Background As of November 2020, SARS-CoV-2 has resulted in 55 million infections worldwide and over 1.3 million deaths from COVID-19. Outcomes following SARS-CoV-2 infection in individuals with primary immunodeficiency or symptomatic secondary immunodeficiency remain uncertain. Objectives To document the outcomes of individuals with primary or symptomatic secondary immunodeficiency following COVID-19 in the United Kingdom. Methods At the start of the COVID-19 pandemic, the United Kingdom Primary Immunodeficiency Network (UK PIN) 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 100 patients had been enrolled by 1st July 2020, 60 with primary immunodeficiency (PID), 7 with other inborn errors of immunity including autoinflammatory diseases and C1 inhibitor deficiency and 33 with symptomatic secondary immunodeficiency (SID). In individuals with PID, 53.3% (n=32/60) were hospitalized, the infection fatality rate (IFR) was 20.0% (n=12/60), the case fatality rate (CFR) was 31.6% (n=12/38) and the inpatient mortality 37.5% (n=12/32). Individuals with SID had worse outcomes than those with PID. 75.8% (n=25/33) were hospitalized, the IFR was 33.3% (n=11/33), the CFR was 39.2% (n=11/28), and inpatient mortality 44.0% (n=11/25). 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., Capsule summary: This large case series of outcomes following COVID-19 demonstrates that, in comparison to the general population, adults with primary and secondary immunodeficiencies are at increased risk of morbidity and mortality following SARS-CoV-2 infection.
- Published
- 2021
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