Mortality in Severe Antibody Deficiencies Patients during the First Two Years of the COVID-19 Pandemic: Vaccination and Monoclonal Antibodies Efficacy
Cinzia Milito,
Francesco Cinetto,
Andrea Palladino,
Giulia Garzi,
Alessandra Punziano,
Gianluca Lagnese,
Riccardo Scarpa,
Marcello Rattazzi,
Anna Maria Pesce,
Federica Pulvirenti,
Giulia Di Napoli,
Giuseppe Spadaro,
Rita Carsetti,
Isabella Quinti
Affiliations
Cinzia Milito
Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
Francesco Cinetto
Internal Medicine 1, Ca’ Foncello University Hospital, AULSS2, 31100 Treviso, Italy
Andrea Palladino
Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
Giulia Garzi
Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
Alessandra Punziano
Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
Gianluca Lagnese
Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
Riccardo Scarpa
Internal Medicine 1, Ca’ Foncello University Hospital, AULSS2, 31100 Treviso, Italy
Marcello Rattazzi
Internal Medicine 1, Ca’ Foncello University Hospital, AULSS2, 31100 Treviso, Italy
Anna Maria Pesce
Regional Reference Centre for Primary Immune Deficiencies, Azienda Ospedaliera Universitaria Policlinico Umberto I, 00161 Rome, Italy
Federica Pulvirenti
Regional Reference Centre for Primary Immune Deficiencies, Azienda Ospedaliera Universitaria Policlinico Umberto I, 00161 Rome, Italy
Giulia Di Napoli
Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
Giuseppe Spadaro
Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
Rita Carsetti
Diagnostic Immunology Research Unit, Multimodal Medicine Research Area, Bambino Gesù Children’s Hospital, IRCCS, Viale di San Paolo 15, 00146 Rome, Italy
Isabella Quinti
Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
Patients with severely impaired antibody responses represent a group at-risk in the SARS-CoV-2 pandemic due to the lack of Spike-specific neutralizing antibodies. The main objective of this paper was to assess, by a longitudinal prospective study, COVID-19 infection and mortality rates, and disease severity in the first two years of the pandemic in a cohort of 471 Primary Antibody Defects adult patients. As secondary endpoints, we compared SARS-CoV-2 annual mortality rate to that observed over a 10-year follow-up in the same cohort, and we assessed the impact of interventions done in the second year, vaccination and anti-SARS-CoV-2 monoclonal antibodies administration on the disease outcome. Forty-one and 84 patients were infected during the first and the second year, respectively. Despite a higher infection and reinfection rate, and a higher COVID-19-related mortality rate compared to the Italian population, the pandemic did not modify the annual mortality rate for any cause in our cohort compared to that registered over the last ten years in the same cohort. PADs patients who died from COVID-19 had an underlying end-stage lung disease. We showed a beneficial effect of MoAbs administration on the likelihood of hospitalization and development of severe disease. In conclusion, COVID-19 did not cause excess mortality in Severe Antibody Deficiencies.
