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Genetic and Immunologic Evaluation of Children With Inborn Errors of Immunity and Severe or Critical Covid-19 Publisher Pubmed



Abolhassani H1, 3 ; Delavari S3 ; Landegren N2, 6 ; Shokri S7 ; Bastard P8, 9, 10 ; Du L1 ; Zuo F1 ; Hajebi R4 ; Abolnezhadian F11 ; Iranparast S12 ; Modaresi M5 ; Vosughimotlagh A13 ; Salami F3 ; Arandaguillen M2 Show All Authors
Authors
  1. Abolhassani H1, 3
  2. Delavari S3
  3. Landegren N2, 6
  4. Shokri S7
  5. Bastard P8, 9, 10
  6. Du L1
  7. Zuo F1
  8. Hajebi R4
  9. Abolnezhadian F11
  10. Iranparast S12
  11. Modaresi M5
  12. Vosughimotlagh A13
  13. Salami F3
  14. Arandaguillen M2
  15. Cobat A9, 10
  16. Marcotte H1
  17. Zhang SY8, 9, 10
  18. Zhang Q8, 9
  19. Rezaei N3
  20. Casanova JL8, 9, 10, 14
  21. Kampe O2, 15
  22. Hammarstrom L1
  23. Panhammarstrom Q1
Show Affiliations
Authors Affiliations
  1. 1. Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden
  2. 2. Centre for Molecular Medicine, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
  3. 3. Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of General Surgery, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Division of Pediatrics Pulmonary Disease, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
  7. 7. Department of Pediatrics, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
  8. 8. St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
  9. 9. Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Sante et de la Recherche Medicale U1163, Necker Hospital for Sick Children, Paris, France
  10. 10. University of Paris, Imagine Institute, Paris, France
  11. 11. Department of Pediatrics, Abuzar Children's Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  12. 12. Department of Immunology, Faculty of Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  13. 13. Department of Pediatrics, North Khorasan University of Medical Sciences, Bojnurd, Iran
  14. 14. Howard Hughes Medical Institute, New York, NY
  15. 15. Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden

Source: Journal of Allergy and Clinical Immunology Published:2022


Abstract

Background: Most severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected individuals are asymptomatic or only exhibit mild disease. In about 10% of cases, the infection leads to hypoxemic pneumonia, although it is much more rare in children. Objective: We evaluated 31 young patients aged 0.5 to 19 years who had preexisting inborn errors of immunity (IEI) but lacked a molecular diagnosis and were later diagnosed with coronavirus disease 2019 (COVID-19) complications. Methods: Genetic evaluation by whole-exome sequencing was performed in all patients. SARS-CoV-2–specific antibodies, autoantibodies against type I IFN (IFN-I), and inflammatory factors in plasma were measured. We also reviewed COVID-19 disease severity/outcome in reported IEI patients. Results: A potential genetic cause of the IEI was identified in 28 patients (90.3%), including mutations that may affect IFN signaling, T- and B-cell function, the inflammasome, and the complement system. From tested patients 65.5% had detectable virus-specific antibodies, and 6.8% had autoantibodies neutralizing IFN-I. Five patients (16.1%) fulfilled the diagnostic criteria of multisystem inflammatory syndrome in children. Eleven patients (35.4%) died of COVID-19 complications. All together, at least 381 IEI children with COVID-19 have been reported in the literature to date. Although many patients with asymptomatic or mild disease may not have been reported, severe presentation of COVID-19 was observed in 23.6% of the published cases, and the mortality rate was 8.7%. Conclusions: Young patients with preexisting IEI may have higher mortality than children without IEI when infected with SARS-CoV-2. Elucidating the genetic basis of IEI patients with severe/critical COVID-19 may help to develop better strategies for prevention and treatment of severe COVID-19 disease and complications in pediatric patients. © 2022 The Authors
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