López Ana Laura, Torre María Gabriela, Paolini María Virginia, Juri María Cecilia, Fernández Romero Diego S
Unidad de Inmunología e Histocompatibilidad, Hospital Dr. Carlos G. Durand, Buenos Aires, Argentina. E-mail:
Servicio de Alergia e Inmunología, Hospital Británico de Buenos Aires, Argentina.
Medicina (B Aires). 2021;81(3):478-481.
COVID-19, caused by SARS-CoV-2, emerged in late 2019 in Wuhan, China. Its clinical course is variable, as well as the mortality rate, which is higher among people over 65 years of age and persons with underlying conditions. Immunodeficiencies are potential risk factors for severe forms of COVID-19. Furthermore, patients with immunodeficiencies often undergo non-infectious complications, which could bear additional risk. So far, few reports of patients with COVID-19 and humoral immunodeficiencies have been published. Considering the importance of the study of this new viral disease and its potential health impact on patients with immunodeficiency disorders, we present six cases of COVID-19 in patients with impaired humoral immunity. Three were women and three were men. The average age was 48.5 years (range 20-67). Four had been diagnosed with primary antibody deficiency: three had common variable immunodeficiency and one had X-linked agammaglobulinemia. The other two patients had secondary hypogammaglobulinemia, one was associated with thymoma (Good's syndrome), and the other was associated with rituximab treatment. The evolution was favorable in all except the patient with Good's syndrome, who presented a marked decline in clinical status before contracting COVID-19.
由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的新型冠状病毒肺炎(COVID-19)于2019年末在中国武汉出现。其临床病程各异,死亡率也有所不同,65岁以上人群和有基础疾病者的死亡率更高。免疫缺陷是COVID-19重症形式的潜在风险因素。此外,免疫缺陷患者常出现非感染性并发症,这可能带来额外风险。到目前为止,关于COVID-19患者合并体液免疫缺陷的报道较少。考虑到研究这种新型病毒性疾病的重要性及其对免疫缺陷疾病患者潜在的健康影响,我们报告6例体液免疫受损的COVID-19患者。其中3例为女性,3例为男性。平均年龄为48.5岁(范围20 - 67岁)。4例被诊断为原发性抗体缺陷:3例患有常见变异型免疫缺陷,1例患有X连锁无丙种球蛋白血症。另外2例患者患有继发性低丙种球蛋白血症,1例与胸腺瘤相关(古德综合征),另1例与利妥昔单抗治疗相关。除古德综合征患者外,所有患者病情均呈好转趋势,该患者在感染COVID-19之前临床状态就已显著下降。