Pediatric and Adult Inborn Errors of Immunity and COVID-19: A Comparative Study

Area of Science:

• Immunology
• Infectious Diseases
• Genetics

Background:

• Inborn errors of immunity (IEI) are associated with severe clinical outcomes in COVID-19 patients.
• Understanding the specific risks of hospitalization, ICU admission, and mortality in IEI patients is crucial for clinical management.

Purpose of the Study:

• To determine the risk factors for COVID-19-related hospitalization, ICU admission, and mortality in patients with IEI.
• To analyze clinical characteristics and outcomes of COVID-19 in a cohort of IEI patients.

Main Methods:

• Retrospective analysis of 62 COVID-19 patients (29 children, 33 adults) with diagnosed IEI.
• Data collection included demographics, IEI type, clinical presentation, laboratory markers (D-dimer, ferritin), comorbidities, and treatment received.
• Statistical analysis to identify risk factors for hospitalization and ICU admission.

Main Results:

• Hospitalization rates were higher in adults (21/33) than children (11/29).
• Cough, elevated D-dimer, and ferritin levels were associated with hospitalization.
• Immunoglobulin replacement therapy and cough were significant predictors of hospitalization risk.
• Higher ferritin levels correlated with ICU admission.
• Mortality was 6.5% overall, significantly higher than the general population, with no deaths in children.
• Agammaglobulinemia showed a high ICU admission rate, highlighting the role of mucosal IgA in COVID-19 defense.

Conclusions:

• IEI patients, particularly adults, exhibit increased risk for severe COVID-19 outcomes.
• Elevated D-dimer and ferritin levels are indicators of severe disease and hospitalization risk.
• Convalescent plasma therapy may shorten hospitalization duration in specific IEI types like agammaglobulinemia.