학술논문
Impact of vaccination on hospitalization and mortality from COVID-19 in patients with primary and secondary immunodeficiency: The United Kingdom experience
Document Type
article
Author
Adrian M. Shields; Susan Tadros; Adam Al-Hakim; Jeremy M. Nell; Me Me Nay Lin; Michele Chan; Sarah Goddard; John Dempster; Magdalena Dziadzio; Smita Y. Patel; Shuayb Elkalifa; Aarnoud Huissoon; Christopher J. A. Duncan; Archana Herwadkar; Sujoy Khan; Claire Bethune; Suzanne Elcombe; James Thaventhiran; Paul Klenerman; David M. Lowe; Sinisa Savic; Siobhan O. Burns; Alex G. Richter
Source
Frontiers in Immunology, Vol 13 (2022)
Subject
Language
English
ISSN
1664-3224
Abstract
BackgroundIndividuals with primary and secondary immunodeficiency (PID/SID) were shown to be at risk of poor outcomes during the early stages of the SARS-CoV-2 pandemic. SARS-CoV-2 vaccines demonstrate reduced immunogenicity in these patients.ObjectivesTo understand whether the risk of severe COVID-19 in individuals with PID or SID has changed following the deployment of vaccination and therapeutics in the context of the emergence of novel viral variants of concern.MethodsThe outcomes of two cohorts of patients with PID and SID were compared: the first, infected between March and July 2020, prior to vaccination and treatments, the second after these intervention became available between January 2021 and April 2022.Results22.7% of immunodeficient patients have been infected at least once with SARS-CoV-2 since the start of the pandemic, compared to over 70% of the general population. Immunodeficient patients were typically infected later in the pandemic when the B.1.1.529 (Omicron) variant was dominant. This delay was associated with receipt of more vaccine doses and higher pre-infection seroprevalence. Compared to March-July 2020, hospitalization rates (53.3% vs 17.9%, p