原发性免疫缺陷病患者的 SARS-CoV-2 感染和对 COVID-19 疫苗接种的反应。
SARS-CoV-2 Infection and Response to COVID-19 Vaccination in Patients With Primary Immunodeficiencies.
机构信息
Moderna, Inc., Cambridge, Massachusetts, USA.
Department of Medicine, Infectious Diseases, University of Maryland School of Medicine, Baltimore, Maryland, USA.
出版信息
J Infect Dis. 2023 Aug 4;228(Suppl 1):S24-S33. doi: 10.1093/infdis/jiad145.
Primary immunodeficiencies (PIDs) are heterogeneous, rare disorders that increase susceptibility to infection and/or immune dysregulation. Individuals with certain PIDs are at high risk of severe or fatal outcomes from SARS-CoV-2 infections (the causative agent of COVID-19), either due to the underlying PID and/or due to the presence of comorbidities such as severe lung and liver disease. Vaccination remains the primary strategy to protect individuals with PID from COVID-19. However, populations with PID exhibit variable vaccine seroresponse rates, antibody titers, and neutralization activity depending on the type of PID and/or COVID-19 vaccine, and consequently, are at an elevated risk of severe disease. In this article, we review the COVID-19 burden in patients with PIDs and focus in-depth on findings from patients with predominantly antibody deficiencies or combined immunodeficiencies. We conclude by providing COVID-19 vaccination recommendations for this population.
原发性免疫缺陷病（PIDs）是一组异质性罕见疾病，可导致机体易感性增加，从而发生感染和/或免疫失调。某些 PID 患者由于基础 PID 和/或严重肺部和肝脏疾病等合并症的存在，发生 SARS-CoV-2 感染（COVID-19 的病原体）后，严重或致命结局的风险较高。疫苗接种仍然是保护 PID 患者免受 COVID-19 感染的主要策略。然而，PID 患者的疫苗血清反应率、抗体滴度和中和活性存在差异，具体取决于 PID 类型和/或 COVID-19 疫苗类型，因此，这些患者发生严重疾病的风险较高。本文综述了 PID 患者的 COVID-19 负担，并重点关注了以抗体缺陷或联合免疫缺陷为主的患者的研究结果。最后，我们为这一人群提供了 COVID-19 疫苗接种建议。
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