TY - JOUR
T1 - Outcomes following SARS-CoV-2 infection in patients with primary and secondary immunodeficiency in the UK
AU - Outcomes following SARS-CoV-2 infection in patients with primary and secondary immunodeficiency in the UK group
AU - Shields, Adrian M
AU - Anantharachagan, Ariharan
AU - Arumugakani, Gururaj
AU - Baker, Kenneth
AU - Bahal, Sameer
AU - Baxendale, Helen
AU - Bermingham, William
AU - Bhole, Malini
AU - Boules, Evon
AU - Bright, Philip
AU - Chopra, Charu
AU - Cliffe, Lucy
AU - Cleave, Betsy
AU - Dempster, John
AU - Devlin, Lisa
AU - Dhalla, Fatima
AU - Diwakar, Lavanya
AU - Drewe, Elizabeth
AU - Duncan, Christopher
AU - Dziadzio, Magdalena
AU - Elcombe, Suzanne
AU - Elkhalifa, Shuayb
AU - Gennery, Andrew
AU - Ghanta, Harichandrana
AU - Goddard, Sarah
AU - Grigoriadou, Sofia
AU - Hackett, Scott
AU - Hayman, Grant
AU - Herriot, Richard
AU - Herwadkar, Archana
AU - Huissoon, Aarnoud
AU - Jain, Rashmi
AU - Jolles, Stephen
AU - Johnston, Sarah
AU - Khan, Sujoy
AU - Laffan, James
AU - Lane, Peter
AU - Leeman, Lucy
AU - Lowe, David M
AU - Mahabir, Shanti
AU - Lochlainn, Dylan James Mac
AU - McDermott, Elizabeth
AU - Misbah, Siraj
AU - Moghaddas, Fiona
AU - Morsi, Hadeil
AU - Murng, Sai
AU - Noorani, Sadia
AU - O'Brien, Rachael
AU - Patel, Smita
AU - Richter, Alex G
N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Immunology.
PY - 2022/1/28
Y1 - 2022/1/28
N2 - 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.
AB - 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.
KW - Antibodies, Monoclonal, Humanized
KW - Antibodies, Neutralizing
KW - Antibodies, Viral
KW - COVID-19/drug therapy
KW - Dexamethasone
KW - Drug Combinations
KW - Humans
KW - Immunization, Passive
KW - Immunologic Deficiency Syndromes
KW - SARS-CoV-2
KW - Sudden Infant Death
KW - United Kingdom/epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85139378485&partnerID=8YFLogxK
U2 - 10.1093/cei/uxac008
DO - 10.1093/cei/uxac008
M3 - Article
C2 - 35641155
SN - 0009-9104
VL - 209
SP - 247
EP - 258
JO - Clinical and Experimental Immunology
JF - Clinical and Experimental Immunology
IS - 3
M1 - uxac008
ER -