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

被引：25

作者：

Shields, Adrian M. ^{[1
]}

Anantharachagan, Ariharan ^{[2
]}

Arumugakani, Gururaj ^{[3
]}

Baker, Kenneth ^{[4
,5
]}

Bahal, Sameer ^{[6
]}

Baxendale, Helen ^{[7
]}

Bermingham, William ^{[8
]}

Bhole, Malini ^{[9
]}

Boules, Evon ^{[10
]}

Bright, Philip ^{[11
]}

Chopra, Charu ^{[12
]}

Cliffe, Lucy ^{[13
]}

Cleave, Betsy ^{[13
]}

Dempster, John ^{[14
]}

Devlin, Lisa ^{[15
]}

Dhalla, Fatima ^{[16
]}

Diwakar, Lavanya ^{[17
]}

Drewe, Elizabeth ^{[13
]}

Duncan, Christopher ^{[18
]}

Dziadzio, Magdalena ^{[19
]}

Elcombe, Suzanne ^{[20
]}

Elkhalifa, Shuayb ^{[21
]}

Gennery, Andrew ^{[22
,23
]}

Ghanta, Harichandrana ^{[24
]}

Goddard, Sarah ^{[17
]}

Grigoriadou, Sofia ^{[25
]}

Hackett, Scott ^{[26
]}

Hayman, Grant ^{[27
]}

Herriot, Richard ^{[28
]}

Herwadkar, Archana ^{[21
]}

Huissoon, Aarnoud ^{[8
]}

Jain, Rashmi ^{[16
]}

Jolles, Stephen ^{[29
]}

Johnston, Sarah ^{[11
]}

Khan, Sujoy ^{[30
]}

Laffan, James ^{[27
]}

Lane, Peter ^{[1
]}

Leeman, Lucy ^{[31
]}

Lowe, David M. ^{[6
,32
]}

Mahabir, Shanti ^{[33
]}

Mac Lochlainn, Dylan James ^{[16
]}

McDermott, Elizabeth ^{[13
]}

Misbah, Siraj ^{[16
]}

Moghaddas, Fiona ^{[11
]}

Morsi, Hadeil ^{[16
]}

Murng, Sai ^{[27
]}

Noorani, Sadia ^{[34
]}

O'Brien, Rachael ^{[35
]}

Patel, Smita ^{[16
]}

Price, Arthur ^{[33
]}

机构：

[1] Univ Birmingham, Inst Immunol & Immunotherapy, Clin Immunol Serv, Birmingham, W Midlands, England

[2] Lancashire Teaching Hosp NHS Fdn Trust, Preston, Lancs, England

[3] Leeds Teaching Hosp NHS Trust, Dept Clin Immunol & Allergy, St James Univ Hosp, Leeds, W Yorkshire, England

[4] Newcastle Univ, NIHR Newcastle Biomed Res Ctr, Newcastle Upon Tyne, Tyne & Wear, England

[5] Newcastle Upon Tyne Hosp NHS Fdn Trust, Newcastle Upon Tyne, Tyne & Wear, England

[6] Royal Free London NHS Fdn Trust, Dept Immunol, London, England

[7] Royal Papworth NHS Fdn Trust, Cambridge, England

[8] Univ Hosp Birmingham NHS Fdn Trust, Birmingham, W Midlands, England

[9] Dudley Grp NHS Fdn Trust, Birmingham, W Midlands, England

[10] Sheffield Teaching Hosp NHS Fdn Trust, Clin Immunol & Allergy Dept, Sheffield, S Yorkshire, England

[11] North Bristol NHS Trust, Clin Immunol, Bristol, Avon, England

[12] Royal Infirm Edinburgh NHS Trust, Dept Haematol & Immunol, NHS Lothian, Edinburgh, Midlothian, Scotland

[13] Nottingham Univ Hosp NHS Trust, Clin Immunol & Allergy Dept, Nottingham, England

[14] Univ Coll London Hosp, Specialist Allergy & Clin Immunol, London, England

[15] Royal Hosp, Reg Immunol Serv, Belfast, Antrim, North Ireland

[16] Oxford Univ Hosp NHS Fdn Trust, Dept Clin Immunol, Oxford, England

[17] Royal Stoke Hosp, Dept Immunol, Stoke On Trent, Staffs, England

[18] Newcastle Univ, Translat & Clin Res Inst, Immun & Inflammat Theme, Newcastle Upon Tyne, Tyne & Wear, England

[19] UCL, Ear Inst, London, England

[20] Newcastle Upon Tyne Hosp NHS Fdn Trust, Royal Victoria Infirm, Reg Dept Clin Immunol & Allergy, Newcastle Upon Tyne, Tyne & Wear, England

[21] Salford Royal NHS Fdn Trust, Immunol Dept, Manchester, Lancs, England

[22] Newcastle Univ, Translat & Clin Res Inst, Newcastle Upon Tyne, Tyne & Wear, England

[23] Great North Children S Hosp, Paediat Stem Cell Transplant Unit, Newcastle Upon Tyne, Tyne & Wear, England

[24] Univ Southampton, Univ Hosp Southampton NHS Trust, Dept Allergy & Clin Immunol, Southampton, Hants, England

[25] Barts Hlth NHS Trust, Immunol Dept, Royal London Hosp, London, England

[26] Univ Hosp Birmingham, Paediat Immunol Dept, Birmingham, W Midlands, England

[27] Epsom & St Helier Univ Hosp NHS Trust, Clin Immunol Serv, South West London Immunodeficiency Ctr, London, England

[28] Aberdeen Royal Infirm, Immunol Dept, Aberdeen, Scotland

[29] Univ Hosp Wales, Immunodeficiency Ctr Wales, Heath Pk, Cardiff, Wales

[30] Hull Univ Teaching Hosp NHS Trust, Kingston Upon Hull, N Humberside, England

[31] Univ Hosp Plymouth NHS Trust, Plymouth, Devon, England

[32] UCL, Inst Immun & Transplantat, London, England

[33] Leicester Royal Infirm, Clin Immunol & Allergy Dept, Leicester, Leics, England

[34] Sandwell & West Birmingham Hosp NHS Trust, Clin Immunol Dept, Birmingham, W Midlands, England

[35] Frimley Pk Hosp, Dept Clin Immunol, Frimley, Surrey, England

[36] NHS Greater Glasgow & Clyde, Clin Immunol Serv, Glasgow, Lanark, Scotland

来源：

CLINICAL AND EXPERIMENTAL IMMUNOLOGY | 2022年 / 209卷 / 03期

关键词：

COVID-19; SARS-CoV-2; hypogammaglobulinemia; inborn errors of immunity; primary immunodeficiencies; secondary immunodeficiencies; lymphopenia; COVID-19; IMMUNITY;

D O I：

10.1093/cei/uxac008

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

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. Individuals with immunodeficiency are at increased risk of severe infection. This study looks at outcomes following SARS-CoV-2 infection in 310 patients with primary or secondary immunodeficiency in the United Kingdom and finds significantly elevated mortality in both cohorts compared to the general population. Increasing age, pre-existing lymphopenia and other co-morbidities are identified as additional risk factors for death from COVID-19 in this cohort.

引用

页码：247 / 258

页数：12

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