COVID-19 in a Child with Pre-Existing Immunodeficiency,
                    Cardiomyopathy, and Chronic Pulmonary Disease

Dinkelbach, Lars; Franzel, Julia; Berghäuser, Martin Andree; Hoehn, Thomas; Ghosh, Sujal; Lee, Unaa; Wulf, Dominik; Schaper, Jörg; Jensen, Björn; Niehues, Tim; Distelmaier, Felix; Neubert, Jennifer

doi:10.1055/a-1210-2639

Cited by 4 publications

(5 citation statements)

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“…The current knowledge about COVID-19 in cases with underlying immunodeficiency is scarce [18][19][20][21][22][23][24]. Comparing to previous data reported mainly primary antibody deficient and male patients with COVID-19 infection (Table S4), we did not observe the dominancy of infected patients in this PID category despite their high frequency among the national registry with no deceased patient.…”

Section: Discussioncontrasting

confidence: 85%

Impact of SARS-CoV-2 Pandemic on Patients with Primary Immunodeficiency

et al. 2020

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Although it is estimated that COVID-19 life-threatening conditions may be diagnosed in less than 1:1000 infected individuals below the age of 50, but the real impact of this pandemic on pediatric patients with different types of primary immunodeficiency (PID) is not elucidated. The current prospective study on a national registry of PID patients showed that with only 1.23 folds higher incidence of infections, these patients present a 10-folds higher mortality rate compared to population mainly in patients with combined immunodeficiency and immune dysregulation. Therefore, further management modalities against COVID-19 should be considered to improve the survival rate in these two PID entities using hematopoietic stem cell transplantation and immunomodulatory agents.

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Section: Discussioncontrasting

confidence: 85%

Impact of SARS-CoV-2 Pandemic on Patients with Primary Immunodeficiency

et al. 2020

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“…In adults, several comorbidities, such as cardiovascular disease, diabetes, obesity, and chronic pulmonary diseases, have been identified as risk factors for a critical course of COVID-19 [ 6 ]. Even though severe disease courses of COVID-19 have been reported in children [ 7 , 8 ], there are yet no established risk factors for hospitalization or mortality related to SARS-CoV-2 in pediatric patients. In a study of PCR-positive pediatric patients, preexisting neurologic, cardiac, and hemato-oncologic conditions were associated with a higher likelihood of hospitalization due to COVID-19 [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

High rate of clinically unrecognized SARS-CoV-2 infections in pediatric palliative care patients

et al. 2021

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Little is known about the frequency and clinical course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in pediatric patients with severe comorbidities. In this prospective cross-sectional trial, the seroprevalence of SARS-CoV-2-IgG in patients with life-limiting conditions being treated by a large specialized pediatric palliative home-care team was determined. In order to gain insight into the infection chain, close contacts of seropositive patients were also included in the study. We analyzed the sera of 39 patients and found a 25.6% seroprevalence for SARS-CoV-2. No SARS-CoV-2 infections were known prior to the study. No significant difference was found in the symptom load between seropositive and seronegative patients during the risk period for SARS-CoV-2 infections. Of the 20 close contacts tested, only one was seropositive for SARS-CoV-2.Conclusions: Our results indicate a substantially high prevalence of silent SARS-CoV-2 infections in pediatric palliative care patients. Surprisingly, no severe outcomes were seen in this fragile patient collective with severe comorbidities. The chain of infection and thus the reason for the high frequency of SARS-CoV-2 infections in pediatric palliative care patients remain unclear. What is Known:•Even though severe disease courses of COVID-19 have been reported in children, there are yet no established risk factors for SARS-CoV-2 in pediatric patients. What is New:•In this cross-sectional seroprevalence study of palliative pediatric patients with severe life-limiting conditions, a high rate of seropositive patients (25.6%) was found.•Surprisingly, all seropositive patients were previously unrecognized, despite the severe comorbidities of our collective.

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“…175 One case report describes a moderately severe case of COVID-19 in a 7-yearold child with a rare folliculin interacting protein 1 (FNIP1) deficiency that leads to cardiomyopathy, chronic lung disease, and a B-cell deficiency with hypogammaglobulinemia necessitating immunoglobulin replacement. 185 This patient required high-flow nasal cannula and developed cardiac dysfunction and renal failure but ultimately clinically improved. 185 In a study of the Mexican Open Registry of patients with COVID-19, immunodeficiencies (3.8%) and asthma (3.8%) were the most commonly found pre-existing conditions in the 21,161 patients younger than 18 years of age.…”

Section: Clinical Manifestations Among Patients With Primary Immunodementioning

confidence: 97%

“…185 This patient required high-flow nasal cannula and developed cardiac dysfunction and renal failure but ultimately clinically improved. 185 In a study of the Mexican Open Registry of patients with COVID-19, immunodeficiencies (3.8%) and asthma (3.8%) were the most commonly found pre-existing conditions in the 21,161 patients younger than 18 years of age. 186 The patients labeled with an immunodeficiency included "transient hypogammaglobulinemia, IgG subclass deficiency, impaired polysaccharide responsiveness, and IgA deficiency."…”

Section: Clinical Manifestations Among Patients With Primary Immunodementioning

confidence: 97%

“…Predominantly antibody deficiencies represent the most common group of primary immunodeficiency diagnoses and reports have shown a wide range of clinical presentations of COVID-19 in these patients but suggest that the adaptive immune system may not be as critical of a defense against SARS-CoV-2 as other aspects of the immune system. 175,177,[182][183][184][185][186][187] Cases of COVID-19 in children with PID are limited. From the international study of patients with PID, 32 of the 94 patients reported were younger than 18 years of age.…”

Section: Clinical Manifestations Among Patients With Primary Immunodementioning

confidence: 99%

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