Inborn errors of immunity are associated with increased COVID-19-related hospitalization and intensive care compared to the general population.

Cohort study Covid-19 Hospitalization Inborn errors of immunity Intensive Care Population controls

Journal

The Journal of allergy and clinical immunology
ISSN: 1097-6825
Titre abrégé: J Allergy Clin Immunol
Pays: United States
ID NLM: 1275002

Informations de publication

Date de publication:
22 Oct 2024
Historique:
received: 18 07 2024
revised: 14 09 2024
accepted: 08 10 2024
medline: 25 10 2024
pubmed: 25 10 2024
entrez: 24 10 2024
Statut: aheadofprint

Résumé

It is thought that patients with inborn errors of immunity (IEI) are more susceptible to severe Covid-19 than the general population, but a quantification of this potential risk is largely missing. To assess the impact of Covid-19 on patients with IEI. A nationwide cohort study was performed to estimate the relative risk (RR) for hospitalization, intensive care, and death within 30 days after a positive SARS-CoV-2 test in an IEI population (n=2392) compared to the general population (n=8,270,705) using data from Swedish national registries. Three time-periods were studied: Pre-vaccination, Alpha/Delta, and Omicron. Adjustment was made for demographics, income, comorbidities, and vaccination status. During the Pre-vaccination period 25.2% of the IEI population were hospitalized, compared to 17.5% and 5.2% during the Alpha/Delta and Omicron periods, respectively. For the three time periods the adjusted RR for hospitalization in the IEI population compared to the general population was 3.1 [95% CI 2.1-4.2], 3.5 [2.4-4.8], and 4.3 [2.5-6.7], respectively. The adjusted RR for intensive care after Covid-19 were 5.6 [2.6-10.8], 4.7 [1.7-10.1], and 4.7 [1.7-10.1] for the three periods. Five patients (0.6%) in the IEI population died within 30 days of a positive PCR test compared to 18,773 (0.2%) in the general population during the three study periods. Patients with IEI had 3-4 times higher risk for hospitalization and 5 times higher risk for intensive care during Covid-19, compared to the general population.

Sections du résumé

BACKGROUND BACKGROUND
It is thought that patients with inborn errors of immunity (IEI) are more susceptible to severe Covid-19 than the general population, but a quantification of this potential risk is largely missing.
OBJECTIVE OBJECTIVE
To assess the impact of Covid-19 on patients with IEI.
METHODS METHODS
A nationwide cohort study was performed to estimate the relative risk (RR) for hospitalization, intensive care, and death within 30 days after a positive SARS-CoV-2 test in an IEI population (n=2392) compared to the general population (n=8,270,705) using data from Swedish national registries. Three time-periods were studied: Pre-vaccination, Alpha/Delta, and Omicron. Adjustment was made for demographics, income, comorbidities, and vaccination status.
RESULTS RESULTS
During the Pre-vaccination period 25.2% of the IEI population were hospitalized, compared to 17.5% and 5.2% during the Alpha/Delta and Omicron periods, respectively. For the three time periods the adjusted RR for hospitalization in the IEI population compared to the general population was 3.1 [95% CI 2.1-4.2], 3.5 [2.4-4.8], and 4.3 [2.5-6.7], respectively. The adjusted RR for intensive care after Covid-19 were 5.6 [2.6-10.8], 4.7 [1.7-10.1], and 4.7 [1.7-10.1] for the three periods. Five patients (0.6%) in the IEI population died within 30 days of a positive PCR test compared to 18,773 (0.2%) in the general population during the three study periods.
CONCLUSION CONCLUSIONS
Patients with IEI had 3-4 times higher risk for hospitalization and 5 times higher risk for intensive care during Covid-19, compared to the general population.

Identifiants

pubmed: 39447887
pii: S0091-6749(24)01125-4
doi: 10.1016/j.jaci.2024.10.013
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Hannes Lindahl (H)

Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Fredrik Kahn (F)

Department of Clinical Sciences Lund, Section for Infection Medicine, Lund University, Lund, Sweden; Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden.

Åsa Nilsdotter-Augustinsson (Å)

Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Mats Fredrikson (M)

Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University.

Pontus Hedberg (P)

Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.

Isabela Killander Möller (IK)

Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.

Lotta Hansson (L)

Department of Hematology, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.

Lisa Blixt (L)

Department of Hematology, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.

Sandra Eketorp Sylvan (SE)

Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.

Anders Österborg (A)

Department of Hematology, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.

Soo Aleman (S)

Division of Infectious Diseases and Dermatology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.

Christina Carlander (C)

Division of Infectious Diseases and Dermatology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Sofia Nyström (S)

Department of Clinical Immunology and Transfusion Medicine, Linköping University, Linköping, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Peter Bergman (P)

Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: peter.bergman@ki.se.

Classifications MeSH