Mild to moderate clinical course of COVID-19 infection in patients with common variable immune deficiency

Spaska Lesichkova; Snezhina Mihailova; Elisaveta Naumova; Petya Yankova; Yana Krasteva; Ralitsa Marinova

doi:10.5114/ceji.2022.124079

eISSN: 1644-4124
ISSN: 1426-3912

Central European Journal of Immunology

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4/2022
vol. 47

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abstract:

Letter to the Editor

Mild to moderate clinical course of COVID-19 infection in patients with common variable immune deficiency

Spaska Lesichkova

^{1, 2, 3}

,

Snezhina Mihailova

^{1, 2, 3}

,

Elisaveta Naumova

^{1, 2, 3}

,

Petya Yankova

^{1, 2, 3}

,

Yana Krasteva

¹

,

Ralitsa Marinova

⁴

Clinic of Clinical Immunology and Stem Cell Bank, University Hospital Alexandrovska, Sofia, Bulgaria
Expert Center for Rare Diseases-PID, University Hospital Alexandrovska, Sofia, Bulgaria
Department of Clinical Immunology, Medical Faculty, Medical University, Sofia, Bulgaria
Department of Anesthesiology and Intensive Care, University Hospital Alexandrovska, Sofia, Bulgaria

Cent Eur J Immunol 2022; 47 (4): 357-361

DOI: https://doi.org/10.5114/ceji.2022.124079

Online publish date: 2023/01/31

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The association of immunocompromised patients and severity of COVID-19 infection is not well established. According to the Centers for Disease Control and Prevention (CDC), primary immune deficiencies (PIDs) are among the conditions that can predispose to a more severe course of COVID-19. We report the clinical course and immunological evaluation of five patients with common variable immune deficiency (CVID) who have experienced SARS-CoV-2 virus. Here we assess the severity of the infection, the immunophenotypic profile of the major lymphocyte subgroups, the nonspecific T-cell functional capacity and the SARS-CoV-2 specific effector T-cell immune response. Our results showed that the course of COVID-19 infection in CVID patients was mild to moderate and none of them developed a critical form of the disease. All patients developed a specific SARS-CoV-2 T cell immune response. Lymphopenia as well as impaired T-cell response prior to COVID-19 appeared to be related to a more severe course of the infection. Data on a good specific T cell response against SARS-CoV-2 in CVID patients will help to make the right vaccination decision and establish its efficacy. Clinical outcome even in these individual cases was in agreement with the therapeutic recommendations underlining that regular maintenance with subcutaneous immunoglobulins can be beneficial against immune system overreaction and a severe disease course and convalescent plasma is a treatment option in patients with CVID and COVID-19.

keywords:

Mild to moderate clinical course of COVID-19 infection in patients with common variable immune deficiency

Spaska Lesichkova 1, 2, 3 , Snezhina Mihailova 1, 2, 3 , Elisaveta Naumova 1, 2, 3 , Petya Yankova 1, 2, 3 , Yana Krasteva 1 , Ralitsa Marinova 4

COVID-19 infection, common variable immune deficiency, T cell immune response

Spaska Lesichkova

^{1, 2, 3}

,

Snezhina Mihailova

^{1, 2, 3}

,

Elisaveta Naumova

^{1, 2, 3}

,

Petya Yankova

^{1, 2, 3}

,

Yana Krasteva

¹

,

Ralitsa Marinova

⁴