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Inborn errors of immunity are associated with increased COVID-19–related hospitalization and intensive care compared to the general population

Lindahl, Hannes ; Kahn, Fredrik LU ; Nilsdotter-Augustinsson, Åsa ; Fredrikson, Mats ; Hedberg, Pontus ; Killander Möller, Isabela ; Hansson, Lotta ; Blixt, Lisa ; Eketorp Sylvan, Sandra and Österborg, Anders , et al. (2024) In Journal of Allergy and Clinical Immunology
Abstract

Background: It is thought that patients with inborn errors of immunity (IEI) are more susceptible to severe coronavirus disease 2019 (COVID-19) than the general population, but a quantification of this potential risk is largely missing. Objective: We assessed the impact of COVID-19 on patients with IEI. Methods: A nationwide cohort study was performed to estimate the relative risk (RR) for hospitalization, intensive care, and death within 30 days after a positive severe acute respiratory syndrome coronavirus 2 test result in an IEI population (n = 2392) compared to the general population (n = 8,270,705) using data from Swedish national registries. Three time periods were studied: the prevaccination period, and the Alpha/Delta and... (More)

Background: It is thought that patients with inborn errors of immunity (IEI) are more susceptible to severe coronavirus disease 2019 (COVID-19) than the general population, but a quantification of this potential risk is largely missing. Objective: We assessed the impact of COVID-19 on patients with IEI. Methods: A nationwide cohort study was performed to estimate the relative risk (RR) for hospitalization, intensive care, and death within 30 days after a positive severe acute respiratory syndrome coronavirus 2 test result in an IEI population (n = 2392) compared to the general population (n = 8,270,705) using data from Swedish national registries. Three time periods were studied: the prevaccination period, and the Alpha/Delta and Omicron periods. Adjustment was made for demographics, income, comorbidities, and vaccination status. Results: During the prevaccination period, 25.2% of the IEI population was hospitalized, compared to 17.5% and 5.2% during the Alpha/Delta and Omicron periods, respectively. For the 3 time periods, the adjusted RR [95% confidence interval] for hospitalization in the IEI population compared to the general population was 3.1 [2.1-4.2], 3.5 [2.4-4.8], and 4.3 [2.5-6.7], respectively. The respective values for intensive care after COVID-19 were 5.6 [2.6-10.8], 4.7 [1.7-10.1], and 4.7 [1.7-10.1] for the 3 periods. Five patients (0.6%) in the IEI population died within 30 days of a positive PCR test result compared to 18,773 (0.2%) in the general population during the 3 study periods. Conclusion: Patients with IEI had a 3 to 4 times higher risk for hospitalization and a 5 times higher risk for intensive care during COVID-19 compared to the general population.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
cohort study, COVID-19, hospitalization, Inborn errors of immunity, intensive care, population controls
in
Journal of Allergy and Clinical Immunology
publisher
Elsevier
external identifiers
  • pmid:39447887
  • scopus:85209149506
ISSN
0091-6749
DOI
10.1016/j.jaci.2024.10.013
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2024 The Authors
id
6cb674a7-37c4-4b17-ab7b-619e442f195d
date added to LUP
2025-01-23 13:19:52
date last changed
2025-06-27 02:32:23
@article{6cb674a7-37c4-4b17-ab7b-619e442f195d,
  abstract     = {{<p>Background: It is thought that patients with inborn errors of immunity (IEI) are more susceptible to severe coronavirus disease 2019 (COVID-19) than the general population, but a quantification of this potential risk is largely missing. Objective: We assessed the impact of COVID-19 on patients with IEI. Methods: A nationwide cohort study was performed to estimate the relative risk (RR) for hospitalization, intensive care, and death within 30 days after a positive severe acute respiratory syndrome coronavirus 2 test result in an IEI population (n = 2392) compared to the general population (n = 8,270,705) using data from Swedish national registries. Three time periods were studied: the prevaccination period, and the Alpha/Delta and Omicron periods. Adjustment was made for demographics, income, comorbidities, and vaccination status. Results: During the prevaccination period, 25.2% of the IEI population was hospitalized, compared to 17.5% and 5.2% during the Alpha/Delta and Omicron periods, respectively. For the 3 time periods, the adjusted RR [95% confidence interval] for hospitalization in the IEI population compared to the general population was 3.1 [2.1-4.2], 3.5 [2.4-4.8], and 4.3 [2.5-6.7], respectively. The respective values for intensive care after COVID-19 were 5.6 [2.6-10.8], 4.7 [1.7-10.1], and 4.7 [1.7-10.1] for the 3 periods. Five patients (0.6%) in the IEI population died within 30 days of a positive PCR test result compared to 18,773 (0.2%) in the general population during the 3 study periods. Conclusion: Patients with IEI had a 3 to 4 times higher risk for hospitalization and a 5 times higher risk for intensive care during COVID-19 compared to the general population.</p>}},
  author       = {{Lindahl, Hannes and Kahn, Fredrik and Nilsdotter-Augustinsson, Åsa and Fredrikson, Mats and Hedberg, Pontus and Killander Möller, Isabela and Hansson, Lotta and Blixt, Lisa and Eketorp Sylvan, Sandra and Österborg, Anders and Aleman, Soo and Carlander, Christina and Nyström, Sofia and Bergman, Peter}},
  issn         = {{0091-6749}},
  keywords     = {{cohort study; COVID-19; hospitalization; Inborn errors of immunity; intensive care; population controls}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Allergy and Clinical Immunology}},
  title        = {{Inborn errors of immunity are associated with increased COVID-19–related hospitalization and intensive care compared to the general population}},
  url          = {{http://dx.doi.org/10.1016/j.jaci.2024.10.013}},
  doi          = {{10.1016/j.jaci.2024.10.013}},
  year         = {{2024}},
}