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Case Report: A Severe Paediatric Presentation of COVID-19 in APDS2 Immunodeficiency

Nuria Sanchez Clemente1,2, Justin Penner1, Judith Breuer3

  • 1Immunology and Infectious Diseases Department, Great Ormond Street Hospital for Children, London, United Kingdom.

Frontiers in Immunology
|June 16, 2022
PubMed

Insights

This case study details a severe COVID-19 infection in an immunocompromised child with activated PI3K delta syndrome type 2 (APDS2). Combination therapy with remdesivir and nitazoxanide may improve viral clearance for SARS-CoV-2.

Area of Science:

  • Immunology
  • Virology
  • Pediatrics

Background:

  • Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections are uncommon in children, with limited data on immunocompromised pediatric populations.
  • Activated PI3K delta syndrome type 2 (APDS2) is a primary immunodeficiency affecting immune cell function.

Observation:

  • A 4-year-old boy with APDS2 presented with a severe and prolonged course of COVID-19, exhibiting significant inflammatory and acute respiratory symptoms.
  • The patient received a multi-drug regimen including remdesivir, nitazoxanide, high-dose corticosteroids, and tocilizumab.

Findings:

  • The child experienced a full recovery following the comprehensive treatment regimen.
  • The combination of remdesivir and nitazoxanide is proposed as a potential strategy to enhance viral clearance and mitigate resistance in SARS-CoV-2 infections.

Implications:

  • This case highlights the potential severity of SARS-CoV-2 in immunocompromised children with specific genetic disorders.
  • The findings suggest a possible therapeutic approach for severe COVID-19 in similar pediatric cases, warranting further investigation.

Keywords:
APDS2COVID-19SARS-CoV-2case reportprimary immunodeficiency

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