Frontiers in Immunology (Jan 2021)

Minor Clinical Impact of COVID-19 Pandemic on Patients With Primary Immunodeficiency in Israel

  • Nufar Marcus,
  • Nufar Marcus,
  • Nufar Marcus,
  • Shirly Frizinsky,
  • Shirly Frizinsky,
  • Shirly Frizinsky,
  • Shirly Frizinsky,
  • Shirly Frizinsky,
  • David Hagin,
  • David Hagin,
  • David Hagin,
  • Adi Ovadia,
  • Adi Ovadia,
  • Adi Ovadia,
  • Suhair Hanna,
  • Suhair Hanna,
  • Michael Farkash,
  • Michael Farkash,
  • Michael Farkash,
  • Ramit Maoz-Segal,
  • Ramit Maoz-Segal,
  • Ramit Maoz-Segal,
  • Nancy Agmon-Levin,
  • Nancy Agmon-Levin,
  • Nancy Agmon-Levin,
  • Arnon Broides,
  • Arnon Broides,
  • Amit Nahum,
  • Amit Nahum,
  • Elli Rosenberg,
  • Elli Rosenberg,
  • Amir Asher Kuperman,
  • Amir Asher Kuperman,
  • Yael Dinur-Schejter,
  • Yael Dinur-Schejter,
  • Yackov Berkun,
  • Yackov Berkun,
  • Ori Toker,
  • Ori Toker,
  • Ori Toker,
  • Shmuel Goldberg,
  • Shmuel Goldberg,
  • Ronit Confino-Cohen,
  • Ronit Confino-Cohen,
  • Oded Scheuerman,
  • Basel Badarneh,
  • Basel Badarneh,
  • Na‘ama Epstein-Rigbi,
  • Amos Etzioni,
  • Amos Etzioni,
  • Ilan Dalal,
  • Ilan Dalal,
  • Ilan Dalal,
  • Ilan Dalal,
  • Raz Somech,
  • Raz Somech

DOI
https://doi.org/10.3389/fimmu.2020.614086
Journal volume & issue
Vol. 11

Abstract

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In the last few months the world has witnessed a global pandemic due to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection causing coronavirus disease 2019 (COVID-19). Obviously, this pandemic affected individuals differently, with a significant impact on populations considered to be at high-risk. One such population, was assumed to be patients with primary genetic defect involving components or pathways of the immune system. While human immunity against COVID-19 is not fully understood, it is, so far, well documented, that both adaptive and innate cells have a critical role in protection against SARS-CoV-2. Here, we aimed to summarize the clinical and laboratory data on primary immunodeficiency (PID) patients in Israel, who were tested positive for SARS-CoV-2, in order to estimate the impact of COVID-19 on such patients. Data was collected from mid-February to end-September. During this time Israel experienced two “waves” of COVID-19 diseases; the first, from mid-February to mid-May and the second from mid-June and still ongoing at the end of data collection. A total of 20 PID patients, aged 4 months to 60 years, were tested positive for SARS-CoV-2, all but one, were detected during the second wave. Fourteen of the patients were on routine monthly IVIG replacement therapy at the time of virus detection. None of the patients displayed severe illness and none required hospitalization; moreover, 7/20 patients were completely asymptomatic. Possible explanations for the minimal clinical impact of COVID-19 pandemic observed in our PID patients include high level of awareness, extra-precautions, and even self-isolation. It is also possible that only specific immune pathways (e.g. type I interferon signaling), may increase the risk for a more severe course of disease and these are not affected in many of the PID patients. In some cases, lack of an immune response actually may be a protective measure against the development of COVID-19 sequelae.

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