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Outcomes following SARS-CoV-2 infection in patients with primary and secondary immunodeficiency in the UK.
Shields, Adrian M; Anantharachagan, 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.
  • Shields AM; Clinical Immunology Service, Institute of Immunology and Immunotherapy, University of Birmingham, UK.
  • Anantharachagan A; Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK.
  • Arumugakani G; Department of Clinical Immunology and Allergy, St James University Hospital, Leeds Teaching Hospital NHS Trust, Leeds, UK.
  • Baker K; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
  • Bahal S; Department of Immunology, Royal Free London NHS Foundation Trust, London, UK.
  • Baxendale H; Royal Papworth NHS Foundation Trust, Cambridge, UK.
  • Bermingham W; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Bhole M; The Dudley Group NHS Foundation Trust, Birmingham, UK.
  • Boules E; Clinical Immunology and Allergy Department, Sheffield Teaching Hospitals NHS Foundation Trust, UK.
  • Bright P; Clinical Immunology, North Bristol NHS Trust, Bristol, UK.
  • Chopra C; Department of Haematology & Immunology, Royal Infirmary of Edinburgh, NHS Lothian, UK.
  • Cliffe L; Clinical Immunology and Allergy Department, Nottingham University Hospital NHS Trust, Nottingham, UK.
  • Cleave B; Clinical Immunology and Allergy Department, Nottingham University Hospital NHS Trust, Nottingham, UK.
  • Dempster J; Specialist Allergy and Clinical Immunology, University College London Hospitals, London, UK.
  • Devlin L; Regional Immunology Service, The Royal Hospitals, Belfast, UK.
  • Dhalla F; Department of Clinical Immunology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Diwakar L; Department of Immunology, Royal Stoke Hospital, Stoke-on-Trent, UK.
  • Drewe E; Clinical Immunology and Allergy Department, Nottingham University Hospital NHS Trust, Nottingham, UK.
  • Duncan C; Translational and Clinical Research Institute, Immunity and Inflammation Theme, Newcastle University, Newcastle upon Tyne, UK.
  • Dziadzio M; Ear Institute, University College London, London, UK.
  • Elcombe S; Regional Department of Clinical Immunology & Allergy, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK.
  • Elkhalifa S; Immunology Department, Salford Royal NHS Foundation Trust, Manchester, UK.
  • Gennery A; Translational and Clinical Research Institute, Newcastle University, and Paediatric Stem Cell Transplant Unit, Great North Children's Hospital, Newcastle upon Tyne, UK.
  • Ghanta H; Department of Allergy and Clinical Immunology, University Hospital Southampton NHS Trust, University of Southampton, Southampton, UK.
  • Goddard S; Department of Immunology, Royal Stoke Hospital, Stoke-on-Trent, UK.
  • Grigoriadou S; Immunology Department, Royal London Hospital, Barts Health NHS Trust, London, UK.
  • Hackett S; Paediatric Immunology Department, University Hospitals of Birmingham, Birmingham, UK.
  • Hayman G; Clinical Immunology Service, South West London Immunodeficiency Centre, Epsom and St Helier University Hospital NHS Trust, London, UK.
  • Herriot R; Immunology Department, Aberdeen Royal Infirmary, Aberdeen, UK.
  • Herwadkar A; Immunology Department, Salford Royal NHS Foundation Trust, Manchester, UK.
  • Huissoon A; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Jain R; Department of Clinical Immunology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Jolles S; Immunodeficiency Centre for Wales, University Hospital of Wales, Heath Park, Cardiff, UK.
  • Johnston S; Clinical Immunology, North Bristol NHS Trust, Bristol, UK.
  • Khan S; Hull University Teaching Hospitals NHS Trust, Hull, UK.
  • Laffan J; Clinical Immunology Service, South West London Immunodeficiency Centre, Epsom and St Helier University Hospital NHS Trust, London, UK.
  • Lane P; Clinical Immunology Service, Institute of Immunology and Immunotherapy, University of Birmingham, UK.
  • Leeman L; University Hospitals Plymouth NHS Trust, Plymouth, UK.
  • Lowe DM; Institute of Immunity and Transplantation, University College London, London, UK.
  • Mahabir S; Department of Immunology, Royal Free London NHS Foundation Trust, London, UK.
  • Lochlainn DJM; Clinical Immunology and Allergy Department, Leicester Royal Infirmary, Leicester, UK.
  • McDermott E; Department of Clinical Immunology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Misbah S; Clinical Immunology and Allergy Department, Nottingham University Hospital NHS Trust, Nottingham, UK.
  • Moghaddas F; Department of Clinical Immunology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Morsi H; Clinical Immunology, North Bristol NHS Trust, Bristol, UK.
  • Murng S; Department of Clinical Immunology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Noorani S; Clinical Immunology Service, South West London Immunodeficiency Centre, Epsom and St Helier University Hospital NHS Trust, London, UK.
  • O'Brien R; Clinical Immunology Department, Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK.
  • Patel S; Department of Clinical Immunology, Frimley Park Hospital, Frimley, Surrey, UK.
  • Price A; Department of Clinical Immunology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Clin Exp Immunol ; 209(3): 247-258, 2022 09 29.
Article in English | MEDLINE | ID: covidwho-1740820
ABSTRACT
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sudden Infant Death / COVID-19 / COVID-19 Drug Treatment / Immunologic Deficiency Syndromes Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Country/Region as subject: Europa Language: English Journal: Clin Exp Immunol Year: 2022 Document Type: Article Affiliation country: Cei

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sudden Infant Death / COVID-19 / COVID-19 Drug Treatment / Immunologic Deficiency Syndromes Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Country/Region as subject: Europa Language: English Journal: Clin Exp Immunol Year: 2022 Document Type: Article Affiliation country: Cei