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COVID-19 Outcomes in Patients With Immunodeficiency

Adults with primary immunodeficiency (PID) and symptomatic secondary immunodeficiency (SID) are at risk of greater morbidity and mortality from COVID-19 compared with the general population, a new study suggests. The findings were published in the Journal of Allergy and Clinical Immunology. 

Researchers determined outcomes of COVID-19 in individuals with PID or symptomatic SID identified from a registry established by the United Kingdom Primary Immunodeficiency Network. 

Patients with primary immunodeficiency had a hospitalisation rate of 53.3 per cent, an overall infection fatality rate (IFR) of 20.0 per cent, a case fatality rate (CFR) of 31.6 per cent and inpatient mortality of 37.5 per cent. Patients with secondary immunodeficiency fared worse with a hospitalisation rate of 75.8 per cent, an IFR of 33.3 per cent, a CFR of 39.2 per cent and inpatient mortality of 44.0 per cent. 

In comparison, the IFR of the UK general population is estimated to be less than 1 per cent. The CFR was estimated to be 1.5 per cent as of August 2020. A study involving 20,133 UK patients hospitalised with COVID-19 showed an inpatient mortality rate of 26 per cent in a general population cohort with median age 73 years.

"The comparatively high morbidity and mortality in PID and SID should inform public health policy and be communicated to patients so they can take appropriate actions to reduce their exposure to the virus," the authors stated.

Shields AM, Burns SO, Savic S, Richter AG. COVID-19 in patients with primary and secondary immunodeficiency: the United Kingdom experience. J Allergy Clin Immunol. 2020 Dec 15 [Epub ahead of print]. doi: 10.1016/j.jaci.2020.12.620. PMID: 33338534View full text

This article originally appeared on Univadis, part of the Medscape Professional Network.

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