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COVID-19 in patients with primary and secondary immunodeficiency: The United Kingdom experience

Lookup NU author(s): Dr Ken BakerORCiD, Professor Andrew GenneryORCiD, Dr Shanti Mahabir, Dr Catherine Stroud


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© 2020 American Academy of Allergy, Asthma & ImmunologyBackground: As of November 2020, severe acute respiratory syndrome coronavirus 2 has resulted in 55 million infections worldwide and more than 1.3 million deaths from coronavirus disease 2019 (COVID-19). Outcomes following severe acute respiratory syndrome coronavirus 2 infection in individuals with primary immunodeficiency (PID) or symptomatic secondary immunodeficiency (SID) remain uncertain. Objectives: We sought to document the outcomes of individuals with PID or symptomatic SID following COVID-19 in the United Kingdom. Methods: At the start of the COVID-19 pandemic, the United Kingdom Primary Immunodeficiency Network established a registry of cases to collate the nationwide outcomes of COVID-19 in individuals with PID or symptomatic SID and determine risk factors associated with morbidity and mortality from COVID-19 in these patient groups. Results: A total of 100 patients had been enrolled by July 1, 2020, 60 with PID, 7 with other inborn errors of immunity including autoinflammatory diseases and C1 inhibitor deficiency, and 33 with symptomatic SID. In individuals with PID, 53.3% (32 of 60) were hospitalized, the infection-fatality ratio was 20.0% (12 of 60), the case-fatality ratio was 31.6% (12 of 38), and the inpatient mortality was 37.5% (12 of 32). Individuals with SID had worse outcomes than those with PID; 75.8% (25 of 33) were hospitalized, the infection-fatality ratio was 33.3% (11 of 33), the case-fatality ratio was 39.2% (11 of 28), and inpatient mortality was 44.0% (11 of 25). Conclusions: In comparison to the general population, adult patients with PID and symptomatic SID display greater morbidity and mortality from COVID-19. This increased risk must be reflected in public health guidelines to adequately protect vulnerable patients from exposure to the virus.

Publication metadata

Author(s): Shields AM, Burns SO, Savic S, Richter AG, Anantharachagan A, Arumugakani G, Baker K, Bahal S, Bermingham W, Bhole M, Boules E, Bright P, Burns S, Cleave B, Dempster J, Devlin L, Dhalla F, Drewe E, Duncan C, Dziadzio M, Elkhalifa S, Gennery A, Goddard S, Grigoriadou S, Hayman G, Herwadkar A, Huissoon A, Jain R, Jolles S, Johnston S, Leeman L, Mahabir S, MacLochlainn D, McDermott E, Misbah S, Morsi H, Murng S, Noorani S, O'Brien R, Patel S, Price A, Richter A, Seneviratne S, Shields A, Shrimpton A, Stroud C, Vaitla P, Verma N

Publication type: Article

Publication status: Published

Journal: Journal of Allergy and Clinical Immunology

Year: 2021

Volume: 147

Issue: 3

Pages: 870-875

Print publication date: 01/03/2021

Online publication date: 14/12/2020

Acceptance date: 02/12/2020

ISSN (print): 0091-6749

ISSN (electronic): 1097-6825

Publisher: Mosby Inc.


DOI: 10.1016/j.jaci.2020.12.620

PubMed id: 33338534


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