COVID-19 in children with inborn errors of immunity: clinical scenarios

The new emerging virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a huge burden of morbidity and mortality worldwide. One of the predisposing factors which might increase the infection susceptibility and its complications can be the Inborn Errors of Immunity (IEI). One hundred and seventeen primary immunodeficient (PID) pediatric patients were monitored from March to December 2020 for any signs and symptoms of SARS-CoV-2 infection. Among them twenty-eight children were symptomatic and nineteen out of the twenty-eight patients took the coronavirus PCR test. Out of them, the PCR test results of 9 patients were positive. Herein, we report the nine cases of pediatric patients with IEI who were also infected with SARS-CoV-2 with a positive PCR test. We observed a variation in clinical manifestations, clinical courses, and outcomes among IEI pediatric patients affected with COVID-19. In our survey, prompt diagnosis and appropriate monitoring for possible complications were shown to be effective in reducing the mortality rate of the SARS-CoV-2 affected patients with IEI. Although there is no approved treatment for SARS-CoV-2 infection, supportive treatment might reduce the complications and lead to better outcomes. This study received approval from the Research Ethics Committee of Mashhad University of Medical Science with the ethics code of IR.MUMS.REC.1399.155. (https://ethics.research.ac.ir/EthicsProposalViewEn.php?id=129963).