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A Case of Autosomal Recessive Interferon Alpha/Beta Receptor Alpha Chain (Ifnar1) Deficiency With Severe Covid-19 Publisher Pubmed



Khanmohammadi S1, 2 ; Rezaei N1, 2, 3 ; Khazaei M4 ; Shirkani A5
Authors
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Authors Affiliations
  1. 1. Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  3. 3. Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Radiology Department, School of Medicine, Bushehr University of Medical Science, Bushehr, Iran
  5. 5. Allergy and Clinical Immunology Department, School of Medicine, Bushehr University of Medical Science, Moallem St., Bushehr, Iran

Source: Journal of Clinical Immunology Published:2022


Abstract

Background: Interferons (IFNs) play a crucial role in antiviral immunity. Genetic defects in interferon receptors, IFNs, and auto-antibodies against IFNs can lead to the development of life-threatening forms of infectious diseases like a severe form of COVID-19. Case Presentation: A 13-year-old boy with a previously reported homozygous loss-of-function mutation in interferon alpha/beta receptor subunit 1 (IFNAR1) (c.674-2A > G) was diagnosed with severe COVID-19. He had cold symptoms and a high-grade fever at the time of admission. He was admitted to the pediatric intensive care unit after showing no response to favipiravir and being hypoxemic. High-resolution computed tomography (HRCT) scanning revealed lung involvement of 70% with extensive areas of consolidation in both lungs. Antibiotics, interferon gamma (IFN-γ), remdesivir, methylprednisolone pulse, and other medications were started in the patient. However, remdesivir and methylprednisolone pulse were discontinued because of their adverse side effects in the patient. His general condition improved, and a few days later was discharged from the hospital. Conclusion: We reported a patient with severe COVID-19 who had a mutation in IFNAR1. Our finding suggests that patients with IFNAR1 deficiency are prone to severe forms of COVID-19. Besides, IFN-γ therapy may be a potential drug to treat patients with defects in IFN-α/β signaling pathways which needs further investigations. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.