van Leeuwen Leanne P M, Van Coillie Samya, Prévot Johan, Drabwell Jose, Mahlaoui Nizar, Sánchez-Ramón Silvia, Poli M Cecilia, Meyts Isabelle, Ali Adli, Lowe David M, Dalm Virgil A S H, Pergent Martine
Department of Viroscience, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
International Patient Organization for Primary Immunodeficiencies, Brussels, Belgium.
J Allergy Clin Immunol. 2025 Apr 30. doi: 10.1016/j.jaci.2025.04.023.
During the coronavirus disease 2019 (COVID-19) pandemic, many individuals developed persistent symptoms after COVID-19. The data on these long-term effects in the primary immunodeficiency (PID) community are limited.
This study aimed to understand long-term symptoms after COVID-19 in patients with PID, focusing on prevalence, risk factors, viral persistence, and the impact of COVID-19 on their health-related quality of life (HR-QoL).
A global, multilingual web-based survey was conducted by the International Patient Organization for Primary Immunodeficiencies between July and October 2023. Self-reported data on demographics, PID diagnosis, comorbidities, COVID-19, and HR-QoL were collected using the EuroQol 5-Dimensions 5-Level (EQ-5D-5L) survey and analyzed.
Of the 1160 respondents, 25% reported persistent symptoms after COVID-19. Common symptoms included fatigue, headache, and nasal symptoms. Compared with those respondents without persistent symptoms, those with persistent symptoms after COVID-19 reported a significantly higher prevalence of symptoms across all categories-systemic, pain, cardiopulmonary, gastrointestinal, neurologic, psychological, neurocognitive, and others-except for upper respiratory tract symptoms. Independent risk factors for development of persistent symptoms included female sex, asthma, neurologic diseases, and predominantly antibody deficiency other than common variable immunodeficiency or agammaglobulinemia. In 30% of patients with persistent symptoms, viral clearance was not achieved within 1 month. During the pandemic, HR-QoL declined across all PID categories-even in those without COVID-19, but especially in those with a symptom duration of more than 6 months.
Persistent symptoms after COVID-19 are prevalent among patients with PID, with various risk factors identified. The COVID-19 pandemic had a considerable impact on the HR-QoL of patients with PID regardless of COVID-19 status.
在2019年冠状病毒病（COVID-19）大流行期间，许多人在感染COVID-19后出现了持续症状。关于原发性免疫缺陷（PID）群体中这些长期影响的数据有限。
本研究旨在了解PID患者感染COVID-19后的长期症状，重点关注患病率、危险因素、病毒持续存在情况以及COVID-19对其健康相关生活质量（HR-QoL）的影响。
国际原发性免疫缺陷患者组织于2023年7月至10月进行了一项全球性、多语言的基于网络的调查。使用欧洲五维健康量表（EQ-5D-5L）收集关于人口统计学、PID诊断、合并症、COVID-19和HR-QoL的自我报告数据并进行分析。
在1160名受访者中，25%报告在感染COVID-19后出现持续症状。常见症状包括疲劳、头痛和鼻部症状。与没有持续症状的受访者相比，感染COVID-19后有持续症状的受访者在所有类别（全身、疼痛、心肺、胃肠道、神经、心理、神经认知及其他）的症状患病率显著更高，但上呼吸道症状除外。出现持续症状的独立危险因素包括女性、哮喘、神经系统疾病以及除常见变异型免疫缺陷或无丙种球蛋白血症外的主要抗体缺陷。在30%有持续症状的患者中，1个月内未实现病毒清除。在大流行期间，所有PID类别的HR-QoL均有所下降，即使是那些未感染COVID-19的患者，但症状持续时间超过6个月的患者下降尤为明显。
COVID-19后持续症状在PID患者中很普遍，已确定了多种危险因素。无论COVID-19感染状况如何，COVID-19大流行对PID患者的HR-QoL都有相当大的影响。
