ABSTRACT
In the era of COVID-19, understanding how our immune system responds to viral infections is more pertinent than ever. Immunodeficiencies with very low or absent B cells offer a valuable model to study the role of humoral immunity against these types of infection. This review looks at the available evidence on viral infections in patients with B cell alymphocytosis, in particular those with X-linked agammaglobulinemia (XLA), Good's syndrome, post monoclonal-antibody therapy and certain patients with Common Variable Immune Deficiency (CVID). Viral infections are not as infrequent as previously thought in these conditions and individuals with very low circulating B cells seem to be predisposed to an adverse outcome. Particularly in the case of SARS-CoV2 infection, mounting evidence suggests that peripheral B cell alymphocytosis is linked to a poor prognosis.
Subject(s)
Agammaglobulinemia/immunology , B-Lymphocytes/immunology , COVID-19/pathology , Common Variable Immunodeficiency/immunology , Genetic Diseases, X-Linked/immunology , Severe Combined Immunodeficiency/immunology , Thymoma/immunology , B-Lymphocytes/cytology , COVID-19/immunology , Humans , Lymphocyte Count , SARS-CoV-2/immunology , Thymoma/therapyABSTRACT
We describe the unique disease course and cure of SARS-CoV-2 infection in a patient with SCID and graft failure. In absence of a humoral immune response, viral clearance was only achieved after transfusion of convalescent plasma. This observation underscores the necessity of the humoral immune response for SARS-CoV-2 clearance.