Outcomes following SARS-CoV-2 infection in patients with primary and secondary immunodeficiency in the UK.
Outcomes following SARS-CoV-2 infection in patients with primary and secondary immunodeficiency in the UK.
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DOI：
10.1093/cei/uxac008
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发表时间：
2022-09-29
影响因子：
4.6
通讯作者：
Richter AG
中科院分区：
文献类型：
--
作者：
Shields AM;Anantharachagan A;Arumugakani G;Baker K;Bahal S;Baxendale H;Bermingham W;Bhole M;Boules E;Bright P;Chopra C;Cliffe L;Cleave B;Dempster J;Devlin L;Dhalla F;Diwakar L;Drewe E;Duncan C;Dziadzio M;Elcombe S;Elkhalifa S;Gennery A;Ghanta H;Goddard S;Grigoriadou S;Hackett S;Hayman G;Herriot R;Herwadkar A;Huissoon A;Jain R;Jolles S;Johnston S;Khan S;Laffan J;Lane P;Leeman L;Lowe DM;Mahabir S;Lochlainn DJM;McDermott E;Misbah S;Moghaddas F;Morsi H;Murng S;Noorani S;O'Brien R;Patel S;Price A;Rahman T;Seneviratne S;Shrimpton A;Stroud C;Thomas M;Townsend K;Vaitla P;Verma N;Williams A;Burns SO;Savic S;Richter AG
2020年3月，英国原发性免疫缺陷网络（UKPIN）建立了病例登记册，以整理SARS-CoV-2感染和治疗后患有PID和SID的个体的结果。目前，英国共报告了310例PID或SID患者感染SARS-CoV-2病例。该队列的总死亡率为17.7% （n = 55/310）。CVID患者感染病死率（IFR）为18.3% (n = 17/93)，接受IgRT的PID患者感染病死率为16.3% (n = 26/159)， SID患者感染病死率为27.2% （n = 25/92）。与一般人群相比，患有PID和SID的个体住院死亡率更高，死亡年龄更小。年龄增加、低sars - cov -2前感染淋巴细胞计数和常见合并症的存在增加了PID的死亡风险。在该队列中，获得特异性COVID-19治疗的机会有限：入院患者中只有22.9% （n = 33/144）接受了地塞米松、瑞德西韦、一种基于抗sars - cov -2抗体的治疗药物（例如REGN-COV2或恢复期血浆）或托珠单抗作为单一疗法或联合疗法。地塞米松、瑞德西韦和以抗sars - cov -2抗体为基础的治疗方法对PID和SID有效。与一般人群相比，患有PID或SID的个体在SARS-CoV-2感染后死亡的风险很高。年龄增加、基线淋巴细胞计数低和合并症的存在是该队列预后不良的额外危险因素。具有免疫缺陷的个体严重感染的风险增加。本研究观察了英国310例原发性或继发性免疫缺陷患者感染SARS-CoV-2后的结果，发现与普通人群相比，这两组患者的死亡率均显著升高。在该队列中，年龄增加、既往淋巴细胞减少和其他合并症被确定为COVID-19死亡的其他危险因素。
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. Individuals with immunodeficiency are at increased risk of severe infection. This study looks at outcomes following SARS-CoV-2 infection in 310 patients with primary or secondary immunodeficiency in the United Kingdom and finds significantly elevated mortality in both cohorts compared to the general population. Increasing age, pre-existing lymphopenia and other co-morbidities are identified as additional risk factors for death from COVID-19 in this cohort.
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影响因子：
9.1
作者：
Goudouris ES;Pinto-Mariz F;Mendonça LO;Aranda CS;Guimarães RR;Kokron C;Barros MT;Anísio F;Alonso MLO;Marcelino F;Valle SOR;Junior SD;Barreto IDP;Ferreira JFS;Roxo-Junior P;do Rego Silva AM;Campinhos FL;Bonfim C;Loth G;Fernandes JF;Garcia JL;Capelo A;Takano OA;Nadaf MIV;Toledo EC;Cunha LAO;Di Gesu RSW;Schidlowski L;Fillipo P;Bichuetti-Silva DC;Soldateli G;Ferraroni NR;de Oliveira Dantas E;Pestana S;Mansour E;Ulaf RG;Prando C;Condino-Neto A;Grumach AS
通讯作者：
Grumach AS
影响因子：
9.1
作者：
Delavari S;Abolhassani H;Abolnezhadian F;Babaha F;Iranparast S;Ahanchian H;Moazzen N;Nabavi M;Arshi S;Fallahpour M;Bemanian MH;Shokri S;Momen T;Sadeghi-Shabestari M;Molatefi R;Shirkani A;Vosughimotlagh A;Safarirad M;Sharifzadeh M;Pashangzadeh S;Salami F;Shirmast P;Rezaei A;Moeini Shad T;Mohraz M;Rezaei N;Hammarström L;Yazdani R;Aghamohamamdi A
通讯作者：
Aghamohamamdi A
DOI：
10.1056/nejmoa2029849
发表时间：
2021-01-21
期刊：
The New England journal of medicine
影响因子：
--
作者：
Chen P;Nirula A;Heller B;Gottlieb RL;Boscia J;Morris J;Huhn G;Cardona J;Mocherla B;Stosor V;Shawa I;Adams AC;Van Naarden J;Custer KL;Shen L;Durante M;Oakley G;Schade AE;Sabo J;Patel DR;Klekotka P;Skovronsky DM;BLAZE-1 Investigators
通讯作者：
BLAZE-1 Investigators
影响因子：
12.4
作者：
Adamo S;Chevrier S;Cervia C;Zurbuchen Y;Raeber ME;Yang L;Sivapatham S;Jacobs A;Baechli E;Rudiger A;Stüssi-Helbling M;Huber LC;Schaer DJ;Bodenmiller B;Boyman O;Nilsson J
通讯作者：
Nilsson J
DOI：
10.3399/bjgp20x713981
发表时间：
2021
期刊：
The British journal of general practice : the journal of the Royal College of General Practitioners
影响因子：
--
作者：
Hamilton F;Arnold D;Payne R
通讯作者：
Payne R