Outcomes following SARS-CoV-2 infection in patients with primary and secondary immunodeficiency in the UK.
Author
Shields, Adrian MAnantharachagan, Ariharan
Arumugakani, Gururaj
Baker, Kenneth
Bahal, Sameer
Baxendale, Helen
Bermingham, William
Bhole, Malini
Boules, Evon
Bright, Philip
Chopra, Charu
Cliffe, Lucy
Cleave, Betsy
Dempster, John
Devlin, Lisa
Dhalla, Fatima
Diwakar, Lavanya
Drewe, Elizabeth
Duncan, Christopher
Dziadzio, Magdalena
Elcombe, Suzanne
Elkhalifa, Shuayb
Gennery, Andrew
Ghanta, Harichandrana
Goddard, Sarah
Grigoriadou, Sofia
Hackett, Scott
Hayman, Grant
Herriot, Richard
Herwadkar, Archana
Huissoon, Aarnoud
Jain, Rashmi
Jolles, Stephen
Johnston, Sarah
Khan, Sujoy
Laffan, James
Lane, Peter
Leeman, Lucy
Lowe, David M
Mahabir, Shanti
Lochlainn, Dylan James Mac
McDermott, Elizabeth
Misbah, Siraj
Moghaddas, Fiona
Morsi, Hadeil
Murng, Sai
Noorani, Sadia
O'Brien, Rachael
Patel, Smita
Price, Arthur
Rahman, Tasneem
Seneviratne, Suranjith
Shrimpton, Anna
Stroud, Catherine
Thomas, Moira
Townsend, Katie
Vaitla, Prashantha
Verma, Nisha
Williams, Anthony
Burns, Siobhan O
Savic, Sinisa
Richter, Alex G
Publication date
2022-09-29Subject
Microbiology. Immunology
Metadata
Show full item recordAbstract
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.Citation
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. Outcomes following SARS-CoV-2 infection in patients with primary and secondary immunodeficiency in the UK. Clin Exp Immunol. 2022 Sep 29;209(3):247-258. doi: 10.1093/cei/uxac008Type
ArticleAdditional Links
https://academic.oup.com/ceihttp://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2249
https://www.ncbi.nlm.nih.gov/pmc/journals/335/
PMID
35641155Publisher
Oxford University Pressae974a485f413a2113503eed53cd6c53
10.1093/cei/uxac008