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Multicenter Study
. 2023 Feb 8:14:1093385.
doi: 10.3389/fimmu.2023.1093385. eCollection 2023.

A beacon in the dark: COVID-19 course in CVID patients from two European countries: Different approaches, similar outcomes

Cinzia Milito  1 , Davide Firinu  2 , Patrick Bez  3 , Annalisa Villa  1 , Alessandra Punziano  4 , Gianluca Lagnese  4 , Giulia Costanzo  2 , Leanne P M van Leeuwen  5 , Beatrice Piazza  3 , Carla Maria Deiana  2 , Giancarlo d'Ippolito  1 , Stefano Renato Del Giacco  2 , Marcello Rattazzi  3 , Giuseppe Spadaro  4 , Isabella Quinti  1 , Riccardo Scarpa  3 , Virgil A S H Dalm  6 , Francesco Cinetto  3
Affiliations
Multicenter Study

A beacon in the dark: COVID-19 course in CVID patients from two European countries: Different approaches, similar outcomes

Cinzia Milito et al. Front Immunol. .

Abstract

Background: CVID patients present an increased risk of prolonged SARS-CoV-2 infection and re-infection and a higher COVID-19-related morbidity and mortality compared to the general population. Since 2021, different therapeutic and prophylactic strategies have been employed in vulnerable groups (vaccination, SARS-CoV-2 monoclonal antibodies and antivirals). The impact of treatments over the last 2 years has not been explored in international studies considering the emergence of viral variants and different management between countries.

Methods: A multicenter retrospective/prospective real-life study comparing the prevalence and outcomes of SARS-CoV-2 infection between a CVID cohort from four Italian Centers (IT-C) and one cohort from the Netherlands (NL-C), recruiting 773 patients.

Results: 329 of 773 CVID patients were found positive for SARS-CoV-2 infection between March 1st, 2020 and September 1st 2022. The proportion of CVID patients infected was comparable in both national sub-cohorts. During all waves, chronic lung disease, "complicated" phenotype, chronic immunosuppressive treatment and cardiovascular comorbidities impacted on hospitalization, whereas risk factors for mortality were older age, chronic lung disease, and bacterial superinfections. IT-C patients were significantly more often treated, both with antivirals and mAbs, than NL-C patients. Outpatient treatment, available only in Italy, started from the Delta wave. Despite this, no significant difference was found for COVID-19 severity between the two cohorts. However, pooling together specific SARS-CoV-2 outpatient treatments (mAbs and antivirals), we found a significant effect on the risk of hospitalization starting from Delta wave. Vaccination with ≥ 3 doses shortened RT-PCR positivity, with an additional effect only in patients receiving antivirals.

Conclusions: The two sub-cohorts had similar COVID-19 outcomes despite different treatment approaches. This points out that specific treatment should now be reserved for selected subgroups of CVID patients, based on pre-existing conditions.

Keywords: COVID-19; Common Variable Immunodeficiency (CVID); SARS-CoV-2; outpatient; precision medicine; risk factors.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study design.
Figure 2
Figure 2
Factors influencing hospitalization and mortality in CVID patients with Sars-CoV-2 during the entire period of observation (OR adjusted for sex and age).
See this image and copyright information in PMC

References

    1. World Health Organization . Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio....
    1. Merad M, Blish CA, Sallusto F, Iwasaki A. The immunology and immunopathology of covid-19. Science (2022) 375(6585):1122–7. doi: 10.1126/science.abm8108 - DOI - PubMed
    1. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. . Prevalence of comorbidities and its effects in patients infected with sars-Cov-2: A systematic review and meta-analysis. Int J Infect Dis (2020) 94:91–5. doi: 10.1016/j.ijid.2020.03.017 - DOI - PMC - PubMed
    1. Booth A, Reed AB, Ponzo S, Yassaee A, Aral M, Plans D, et al. . Population risk factors for severe disease and mortality in covid-19: A global systematic review and meta-analysis. PloS One (2021) 16(3):e0247461. doi: 10.1371/journal.pone.0247461 - DOI - PMC - PubMed
    1. Rosero PA, Realpe JS, Farinango CD, Restrepo DS, Salazar-Cabrera R, Lopez DM. Risk factors for covid-19: A systematic mapping study. Stud Health Technol Inform (2022) 299:63–74. doi: 10.3233/SHTI220964 - DOI - PubMed

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