New coronavirus infection SARS-CoV-2 in adult patients with inborn errors of immunity
- 作者: Roppelt A.1,2, Mаrkina U.1, Bobrikova E.1, Кruglova T.1, Мukhina O.1, Lebedkina M.1, Andrenova G.1, Chernov A.1, Alekseeva E.3,4, Karaulov A.3, Lysenko M.1,5, Fomina D.1,3,6
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隶属关系:
- Moscow City Hospital 52
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology
- The First Sechenov Moscow State Medical University (Sechenov University)
- National Medical Research Center for Children's Health
- The Russian National Research Medical University named after N.I. Pirogov
- Astana Medical University
- 期: 卷 21, 编号 2 (2024)
- 页面: 216-229
- 栏目: Original studies
- URL: https://journals.rcsi.science/raj/article/view/260057
- DOI: https://doi.org/10.36691/RJA16521
- ID: 260057
如何引用文章
详细
BACKGROUND: Diagnosis and treatment of COVID-19 in patients with primary immunodeficiency, or inborn errors of immunity, are often challenging.
AIM: Description of the COVID-19 course and therapy of adult patients with primary immunodeficiency treated in medical organizations of Moscow Healthcare Department.
MATERIALS AND METHODS: We analyzed a cohort of 68 patients over 18 years (median ― 35 years) with primary immunodeficiency; 91% of patients have primary immunodeficiency with predominantly antibody deficiencies. Altogether 90 cases of the new СOVID-19 were analyzed: in 68 cases infection occurred for the first time, in 22 cases it recurred. The duration of the disease ranged from 3 to 80 days. Duration of PCR-positivity ranged from 0 to 59 days, median 8 days.
RESULTS: Patients with Wuhan and Delta strains had more severe inflammatory signs according to C-reactive protein and lactate dehydrogenase, in patients with Wuhan lung involvement on CT-scam was larger. In demonstrated group of patients higher C-reactive protein correlated with larger lung involvement, longer duration of the disease and PCR-positivity, significant lymphopenia also correlated with higher C-reactive protein. To our data regularity of intravenous immunoglobulin therapy and IgG trough level didn’t correlate with infection severity and duration of the disease and virus-carriage.
Indirectly, the change in the spectrum of medicine used in patients of the analyzed group coincided with the virus strain evolution. Anti-inflammatory therapy was mainly presented by dexamethasone and antagonists to interleukin 6 or its receptor (anti-IL-6): 55% and 73% for Wuhan, 63% and 50% for Delta, 17% and 39% for Omicron. Then, preference was gradually given to the target anti-cytokine medicine. Etiotropic antiviral therapy was more often used to treat infection caused by Wuhan and Delta strains ― 32% and 38%, respectively (in 17% for Omicron). With shifting toward immunotherapy by specific against COVID-19 immunoglobulins and monoclonal antibody to SARS-CoV-2: 5% and 9% for Wuhan, 0% and 75% for Delta, 48% and 83% for Omicron, respectively. Immune and etiotropic therapy was not carried out in Wuhan in 39%, in Delta in 43%, in Omicron in 41% of cases. The overall mortality rate from COVID-19 in the analyzed group was 3%.
CONCLUSION: Patients with primary immunodeficiency represent a vulnerable group to the SARS-CoV-2 virus with a high risk of not only severe, but also a protracted and undulating course of infection, what must be taken into account for the correct interpretation of the patient's condition and the timely administration of the appropriate therapy.
作者简介
Anna Roppelt
Moscow City Hospital 52; Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology
编辑信件的主要联系方式.
Email: roppelt_anna@mail.ru
ORCID iD: 0000-0001-5132-1267
SPIN 代码: 7249-4423
MD, Cand. Sci. (Med.)
俄罗斯联邦, Moscow; MoscowUlyana Mаrkina
Moscow City Hospital 52
Email: itchermd@gmail.com
ORCID iD: 0000-0002-6646-4233
俄罗斯联邦, Moscow
Elena Bobrikova
Moscow City Hospital 52
Email: elena.bobrikova.69@mail.ru
ORCID iD: 0000-0002-6534-5902
SPIN 代码: 5806-7260
俄罗斯联邦, Moscow
Tatiana Кruglova
Moscow City Hospital 52
Email: surckova.t@yandex.ru
ORCID iD: 0000-0002-4949-9178
SPIN 代码: 2884-5000
俄罗斯联邦, Moscow
Olga Мukhina
Moscow City Hospital 52
Email: mukhina.o.a@gmail.com
ORCID iD: 0000-0002-3794-4991
SPIN 代码: 7721-1941
俄罗斯联邦, Moscow
Marina Lebedkina
Moscow City Hospital 52
Email: marina.ivanova0808@yandex.ru
ORCID iD: 0000-0002-9545-4720
SPIN 代码: 1857-8154
俄罗斯联邦, Moscow
Gerelma Andrenova
Moscow City Hospital 52
Email: Andrenovagv@mail.ru
ORCID iD: 0000-0001-7053-3900
SPIN 代码: 2891-1650
俄罗斯联邦, Moscow
Anton Chernov
Moscow City Hospital 52
Email: sbornaya1med@yandex.ru
ORCID iD: 0000-0001-6209-387X
SPIN 代码: 5893-5394
俄罗斯联邦, Moscow
Ekaterina Alekseeva
The First Sechenov Moscow State Medical University (Sechenov University); National Medical Research Center for Children's Health
Email: alekatya@yandex.ru
ORCID iD: 0000-0002-3874-4721
SPIN 代码: 4713-9943
MD, Dr. Sci. (Med.), Professor, corresponding member of the Russian Academy of Sciences
俄罗斯联邦, Moscow; MoscowAlexander Karaulov
The First Sechenov Moscow State Medical University (Sechenov University)
Email: drkaraulov@mail.ru
ORCID iD: 0000-0002-1930-5424
SPIN 代码: 4122-5565
MD, Dr. Sci. (Med.), Professor, academician of the Russian Academy of Sciences
俄罗斯联邦, MoscowMariana Lysenko
Moscow City Hospital 52; The Russian National Research Medical University named after N.I. Pirogov
Email: gkb52@zdrav.mos.ru
ORCID iD: 0000-0001-6010-7975
SPIN 代码: 3887-6250
MD, Dr. Sci. (Med.), Professor
俄罗斯联邦, Moscow; MoscowDaria Fomina
Moscow City Hospital 52; The First Sechenov Moscow State Medical University (Sechenov University); Astana Medical University
Email: daria_fomina@mail.ru
ORCID iD: 0000-0002-5083-6637
SPIN 代码: 3023-4538
MD, Cand. Sci. (Med.), Assistant Professor
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