Risk Factors for Severe COVID-19 and Hospital Admission in Patients With Inborn Errors of Immunity - Results From a Multicenter Nationwide Study

Frontiers in Immunology

Irena Krcmova¹  Pavlina Kralickova¹  Jiri Novak²  Roman Hakl³  Jiri Litzman³  Zita Chovancova³  Dalibor Jilek⁴  Beata Hutyrova⁵  Jana Vydlakova⁶  Ivana Malkusova⁷  Jana Hanzlikova⁷  Vitezslav Novak⁸  Anna Sediva⁹  Marta Sobotkova⁹  Tomas Milota⁹  Jitka Smetanova⁹  Marketa Bloomfield^1,10 

[1] 0Institute of Clinical Immunology and Allergy, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove, Charles University, Hradec Kralove, Czechia;Center for Clinical Immunology, Hospital Ceske Budejovice, Ceske Budejovice, Czechia;Department of Allergology and Clinical Immunology, Faculty of Medicine, Masaryk University and St Anne’s University Hospital in Brno, Brno, Czechia;Department of Allergology and Clinical Immunology, Institute of Health in Usti nad Labem, Usti nad Labem, Czechia;Department of Allergology and Clinical Immunology, University Hospital in Olomouc, Olomouc, Czechia;Department of Clinical and Transplant Immunology, Institute for Clinical and Experimental Medicine, Prague, Czechia;Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czechia;Department of Immunology and Allergy, Institute of Health in Ostrava, Ostrava, Czechia;Department of Immunology, Second Faculty of Medicine Charles University and Motol University Hospital, Prague, Czechia;Department of Paediatrics, First Faculty of Medicine, Charles University in Prague, Prague, Czechia;

关键词: inborn errors of immunity;    COVID-19;    SARS-CoV-2;    risk factors;    mortality;    hospital admission;   

DOI  :  10.3389/fimmu.2022.835770

来源: DOAJ

【 摘 要 】

Despite the progress in the understanding how COVID-19 infection may impact immunocompromised patients, the data on inborn errors of immunity (IEI) remain limited and ambiguous. Therefore, we examined the risk of severe infection course and hospital admission in a large cohort of patients with IEI. In this multicenter nationwide retrospective survey-based trial, the demographic, clinical, and laboratory data were collected by investigating physicians from 8 national referral centers for the diagnosis and treatment of IEI using a COVID-19-IEI clinical questionnaire. In total, 81 patients with IEI (including 16 with hereditary angioedema, HAE) and confirmed SARS-CoV-2 infection were enrolled, and were found to have a 2.3-times increased (95%CI: 1.44–3.53) risk ratio for hospital admission and a higher mortality ratio (2.4% vs. 1.7% in the general population). COVID-19 severity was associated with the presence of clinically relevant comorbidities, lymphopenia, and hypogammaglobulinemia, but not with age or BMI. No individuals with HAE developed severe disease, despite a hypothesized increased risk due to perturbed bradykinin metabolism. We also demonstrated a high seroconversion rate in antibody-deficient patients and the safety of anti-spike SARS CoV-2 monoclonal antibodies and convalescent plasma. Thus, IEI except for HAE, represent significant risk factors for a severe COVID-19. Therefore, apart from general risk factors, immune system dysregulation may also be involved in the poor outcomes of COVID-19. Despite the study limitations, our results support the findings from previously published trials.

【 授权许可】

Unknown