Aging and therapy‐related hypogammaglobulinemia causing pneumonia: An overlooked curable entity in the chaotic COVID‐19 pandemic

Zaidi, Syed Ziauddin A.; Zaidi, Fatima Zia; AlShehry, Nawal; Zaidi, Abdul Rehman Zia; Zaidi, Saleha Zia; Abdullah, Syed Maaz

doi:10.1002/jmv.26318

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Despite a relatively low threshold adopted for gamma-globulin and IgG serum levels, we found more than 10% of admitted patients presenting antibody deficiency, of which only one had primary antibody deficiency. This prevalence is apparently high, but possibly related to age and comorbidities ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of Hypogammaglobulinemia on the Course of COVID-19 in a Non-Intensive Care Setting: A Single-Center Retrospective Cohort Study

et al. 2022

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BackgroundSeverity and mortality of COVID-19 largely depends on the ability of the immune system to clear the virus. Among various comorbidities potentially impacting on this process, the weight and the consequences of an antibody deficiency have not yet been clarified.MethodsWe used serum protein electrophoresis to screen for hypogammaglobulinemia in a cohort of consecutive adult patients with COVID-19 pneumonia, hospitalized in non-intensive care setting between December 2020 and January 2021. The disease severity, measured by a validated score and by the need for semi intensive (sICU) or intensive care unit (ICU) admission, and the 30-day mortality was compared between patients presenting hypogammaglobulinemia (HYPO) and without hypogammaglobulinemia (no-HYPO). Demographics, comorbidities, COVID-19 specific treatment during the hospital stay, disease duration, complications and laboratory parameters were also evaluated in both groups.ResultsWe enrolled 374 patients, of which 39 represented the HYPO cohort (10.4%). In 10/39 the condition was previously neglected, while in the other 29/39 hematologic malignancies were common (61.5%); 2/39 were on regular immunoglobulin replacement therapy (IgRT). Patients belonging to the HYPO group more frequently developed a severe COVID-19 and more often required sICU/ICU admission than no-HYPO patients. IgRT were administered in 8/39 during hospitalization; none of them died or needed sICU/ICU. Among HYPO cohort, we observed a significantly higher prevalence of neoplastic affections, of active oncologic treatment and bronchiectasis, together with higher prevalence of viral and bacterial superinfections, mechanical ventilation, convalescent plasma and SARS-CoV-2 monoclonal antibodies administration during hospital stay, and longer disease duration. Multivariate logistic regression analysis and Cox proportional hazard regression confirmed the impact of hypogammaglobulinemia on the COVID-19 severity and the probability of sICU/ICU admission. The analysis of the mortality rate in the whole cohort showed no significant difference between HYPO and no-HYPO.ConclusionsHypogammaglobulinemia, regardless of its cause, in COVID-19 patients hospitalized in a non-intensive care setting was associated to a more severe disease course and more frequent admission to s-ICU/ICU, particularly in absence of IgRT. Our findings emphasize the add-value of routine serum protein electrophoresis evaluation in patients admitted with COVID-19 to support clinicians in patient care and to consider IgRT initiation during hospitalization.

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Section: Discussionmentioning

confidence: 99%

Impact of Hypogammaglobulinemia on the Course of COVID-19 in a Non-Intensive Care Setting: A Single-Center Retrospective Cohort Study

et al. 2022

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Immunoglobulin Levels in Children with COVID-19 and Impact on Hospital Admissions

KASAP,

İNCEALTIN

2023

Uludağ Üniversitesi Tıp Fakültesi Dergisi

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Koronavirüs hastalığı-2019 (COVID-19) salgını tüm dünyada bir sağlık krizine dönüşmüştür. Çocukların da erişkinler kadar Şiddetli Akut Solunum Sendromu Coronavirüs 2 (SARS-CoV-2) ile enfekte olabildikleri belirlenmiştir. Bu çalışmada, COVID-19 saptanan çocuklarda bakılan immunoglobulin seviyelerini ve hastane başvurularındaki etkisini araştırmayı amaçladık. Ocak 2020 ve Aralık 2022 tarihleri arasında hastaneye başvuran COVID-19 saptanan, immunoglobulin seviyeleri bakılan 138 çocuk hastanın; demografik özellikleri, klinik belirtileri ve laboratuvar sonuçları tıbbi kayıtlardan elde edilerek analiz edildi. Olguların %53’ü kız, %47’si erkekti ve yaş ortancaları 9 yıl (0,6–17,8) idi. En sık başvuru semptomları ateş (%52), öksürük (%45) ve gastrointestinal belirtilerdi (%9). IgG %34.5’inde, IgA %14’ünde ve IgM %21.6’sında düşük seviyelerde bulundu. Düşük IgG bulunan hastalarda; IgA, IgM ve IgE seviyelerinde de azalma olduğu saptandı (p0,05). Düşük IgA ve IgM seviyeleri olanlarda anlamlı oranda çocuk yoğun bakım ihtiyacı oldugu saptandı (p=0.049, p=0.011, sırasıyla). Uzayan yatış durumu (>15 gün) ile cinsiyet, IgG, IgA, IgM ve IgE arasında istatistiksel olarak anlamlı ilişki yoktu (p>0,05). Hipogammaglobulinemi olan COVID-19 tanılı çocuk hastalarda, genel popülasyona göre mortalite ve yoğun bakım yatış oranlarının daha yüksek olduğu bilinmektedir. Bulgularımız, COVID-19 ile başvuran, hastane yatış gereksinimi olan çocuk hastaların rutin değerlendirmesinde immunoglobulin seviyelerinin değerlendirilmesinin önemini vurgulamaktadır.

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Aging and therapy‐related hypogammaglobulinemia causing pneumonia: An overlooked curable entity in the chaotic COVID‐19 pandemic

Cited by 2 publications

References 14 publications

Impact of Hypogammaglobulinemia on the Course of COVID-19 in a Non-Intensive Care Setting: A Single-Center Retrospective Cohort Study

Impact of Hypogammaglobulinemia on the Course of COVID-19 in a Non-Intensive Care Setting: A Single-Center Retrospective Cohort Study

Immunoglobulin Levels in Children with COVID-19 and Impact on Hospital Admissions

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