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Adverse COVID-19 outcomes in immune deficiencies: Inequality exists between subclasses

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dc.contributor.authorÖZEN, AHMET OĞUZHAN
dc.contributor.authorsAydiner, Elif Karakoc; Eltan, Sevgi Bilgic; Babayeva, Royale; Aydiner, Omer; Kepenekli, Eda; Kolukisa, Burcu; Sefer, Asena Pinar; Gungoren, Ezgi Yalcin; Karabiber, Esra; Yucel, Esra Ozek; Ozdemir, Oner; Kiykim, Ayca; Artac, Hasibe; Yakici, Nalan; Yalcin, Koray; Cokugras, Haluk; Celkan, Tulin Tiraje; Orhan, Fazil; Yesilipek, Mehmet Akif; Baris, Safa; Ozen, Ahmet
dc.date.accessioned2022-03-14T09:57:46Z
dc.date.available2022-03-14T09:57:46Z
dc.date.issued2022-01
dc.description.abstractBackground Genetic deficiencies of immune system, referred to as inborn errors of immunity (IEI), serve as a valuable model to study human immune responses. In a multicenter prospective cohort, we evaluated the outcome of SARS-CoV-2 infection among IEI subjects and analyzed genetic and immune characteristics that determine adverse COVID-19 outcomes. Methods We studied 34 IEI patients (19M/15F, 12 [min: 0.6-max: 43] years) from six centers. We diagnosed COVID-19 infection by finding a positive SARS-CoV-2 PCR test (n = 25) and/or a lung tomography scoring (CORADS) >= 4 (n = 9). We recorded clinical and laboratory findings prospectively, fitted survival curves, and calculated fatality rates for the entire group and each IEI subclass. Results Nineteen patients had combined immune deficiency (CID), six with predominantly antibody deficiency (PAD), six immune dysregulation (ID), two innate immune defects, and one in the autoinflammatory class. Overall, 23.5% of cases died, with disproportionate fatality rates among different IEI categories. PAD group had a relatively favorable outcome at any age, but CIDs and IDs were particularly vulnerable. At admission, presence of dyspnea was an independent risk for COVID-related death (OR: 2.630, 95% CI; 1.198-5.776, p < .001). Concerning predictive roles of laboratory markers at admission, deceased subjects compared to survived had significantly higher CRP, procalcitonin, Troponin-T, ferritin, and total-lung-score (p = .020, p = .003, p = .014, p = .013, p = .020; respectively), and lower absolute lymphocyte count, albumin, and trough IgG (p = .012, p = .022, p = .011; respectively). Conclusion Our data disclose a highly vulnerable IEI subgroup particularly disadvantaged for COVID-19 despite their youth. Future studies should address this vulnerability and consider giving priority to these subjects in SARS-Cov-2 therapy trials.
dc.identifier.doi10.1111/all.15025
dc.identifier.eissn1398-9995
dc.identifier.issn0105-4538
dc.identifier.pubmed34314546
dc.identifier.urihttps://hdl.handle.net/11424/243775
dc.identifier.wosWOS:000683242900001
dc.language.isoeng
dc.publisherWILEY
dc.relation.ispartofALLERGY
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCOVID-19
dc.subjectinborn errors of immunity
dc.subjectoutcome
dc.subjectSARS-Cov-2
dc.titleAdverse COVID-19 outcomes in immune deficiencies: Inequality exists between subclasses
dc.typearticle
dspace.entity.typePublication
local.avesis.id41c83c5f-3d1b-4c7f-b436-87635ef88201
local.import.packageSS16
local.indexed.atWOS
local.indexed.atSCOPUS
local.indexed.atPUBMED
local.journal.numberofpages14
oaire.citation.titleALLERGY
relation.isAuthorOfPublication3e9c297b-e636-4836-8f61-dc9c8b7c29cf
relation.isAuthorOfPublication.latestForDiscovery3e9c297b-e636-4836-8f61-dc9c8b7c29cf

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