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Outcomes following SARS-CoV-2 infection in patients with primary and secondary immunodeficiency in the UK.

Authors :
Shields AM
Anantharachagan A
Arumugakani G
Baker K
Bahal S
Baxendale H
Bermingham W
Bhole M
Boules E
Bright P
Chopra C
Cliffe L
Cleave B
Dempster J
Devlin L
Dhalla F
Diwakar L
Drewe E
Duncan C
Dziadzio M
Elcombe S
Elkhalifa S
Gennery A
Ghanta H
Goddard S
Grigoriadou S
Hackett S
Hayman G
Herriot R
Herwadkar A
Huissoon A
Jain R
Jolles S
Johnston S
Khan S
Laffan J
Lane P
Leeman L
Lowe DM
Mahabir S
Lochlainn DJM
McDermott E
Misbah S
Moghaddas F
Morsi H
Murng S
Noorani S
O'Brien R
Patel S
Price A
Rahman T
Seneviratne S
Shrimpton A
Stroud C
Thomas M
Townsend K
Vaitla P
Verma N
Williams A
Burns SO
Savic S
Richter AG
Source :
Clinical and experimental immunology [Clin Exp Immunol] 2022 Sep 29; Vol. 209 (3), pp. 247-258.
Publication Year :
2022

Abstract

In March 2020, the United Kingdom Primary Immunodeficiency Network (UKPIN) established a registry of cases to collate the outcomes of individuals with PID and SID following SARS-CoV-2 infection and treatment. A total of 310 cases of SARS-CoV-2 infection in individuals with PID or SID have now been reported in the UK. The overall mortality within the cohort was 17.7% (n = 55/310). Individuals with CVID demonstrated an infection fatality rate (IFR) of 18.3% (n = 17/93), individuals with PID receiving IgRT had an IFR of 16.3% (n = 26/159) and individuals with SID, an IFR of 27.2% (n = 25/92). Individuals with PID and SID had higher inpatient mortality and died at a younger age than the general population. Increasing age, low pre-SARS-CoV-2 infection lymphocyte count and the presence of common co-morbidities increased the risk of mortality in PID. Access to specific COVID-19 treatments in this cohort was limited: only 22.9% (n = 33/144) of patients admitted to the hospital received dexamethasone, remdesivir, an anti-SARS-CoV-2 antibody-based therapeutic (e.g. REGN-COV2 or convalescent plasma) or tocilizumab as a monotherapy or in combination. Dexamethasone, remdesivir, and anti-SARS-CoV-2 antibody-based therapeutics appeared efficacious in PID and SID. Compared to the general population, individuals with PID or SID are at high risk of mortality following SARS-CoV-2 infection. Increasing age, low baseline lymphocyte count, and the presence of co-morbidities are additional risk factors for poor outcome in this cohort.<br /> (© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Immunology.)

Details

Language :
English
ISSN :
1365-2249
Volume :
209
Issue :
3
Database :
MEDLINE
Journal :
Clinical and experimental immunology
Publication Type :
Academic Journal
Accession number :
35641155
Full Text :
https://doi.org/10.1093/cei/uxac008