Rethinking Immunological Risk: A Retrospective Cohort Study of Severe SARS-Cov-2 Infections in Individuals With
Alan A Nguyen1, Saddiq B Habiballah1, Brenna LaBere1
1Division of Immunology, Boston Children's Hospital and Harvard Medical School, Boston, Mass.
Social determinants like race, ethnicity, and obesity increase hospitalization risk for individuals with inborn errors of immunity during COVID-19. Vaccination reduces this risk, highlighting health disparities in immunological risk.
Area of Science:
- Immunology
- Public Health
- Genetics
Background:
- COVID-19 pandemic highlighted the need to understand immunological risk.
- Variable outcomes in immunocompromised individuals suggest factors beyond adaptive/innate immunity.
- Previous studies overlooked social determinants of health.
Purpose of the Study:
- To investigate the impact of social determinants of health on COVID-19 hospitalization risk.
- To assess hospitalization risks for individuals with inborn errors of immunity (IEI).
Main Methods:
- Retrospective cohort study of 166 individuals with IEI.
- Analysis of SARS-CoV-2 infection hospitalization risks from March 2020 to March 2022.
- Multivariable logistic regression to control for covariates.
Main Results:
- Underrepresented race/ethnicity, IEI diagnosis, obesity, and neurological disease increased hospitalization risk.
- COVID-19 vaccination was associated with reduced hospitalization risk.
- Immune function defects and social vulnerability were not significant risk factors after covariate adjustment.
Conclusions:
- Race, ethnicity, and obesity are critical immunological risk factors for individuals with IEI.
- Social determinants of health significantly influence COVID-19 outcomes in immunocompromised populations.
- Addressing health disparities is crucial for managing immunological risk in IEI.
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