Covid complications more likely in children with primary immunodeficiency

Children with certain immunodeficiency disorders have abnormalities in genes that regulate the body’s immune system against viral infections, putting them at an increased risk of dying from COVID-19, according to a new study.

This study was published in the Journal of Allergy and Clinical Immunology.

Most children infected with SARS-CoV-2 coronavirus develop a mild illness or show no symptoms at all. However, in a small percentage of cases, serious complications can occur.

“Mortality in children with primary immunodeficiency diseases infected with SARS-CoV-2 is much higher. Our results suggest that children with severe COVID-19 or multiple inflammatory syndrome (MIS-C) It shows that basic immunological testing and genetic analysis should be performed so clinicians can help these children with more precise treatments based on their genetic alterations. Probably,” said Chan Pan Hammerström, professor of biological sciences and nutrition at the Karolinska Institutet, who led the study.

How infections affect patients with primary immunodeficiency diseases, i.e., hereditary and congenital disorders of the immune system, remains controversial. Some of these patients also suffer from severe her COVID-19, while others have mild or no symptoms.

To investigate this more closely and try to find a genetic explanation for severe forms of COVID-19, researchers at the Karolinska Institutet studied primary immunodeficiency diseases that developed severe or severe SARS-CoV. (Inborn Immunodeficiency, also known as IEI) was studied in young patients. -2 infection. Genetic and immunological analyzes were performed.

“Our results reveal the molecular mechanisms underlying these immune disorders and open the possibility of developing more targeted therapies. It also allows us to develop better strategies for the treatment and prevention of patients,” said Qiang Pan-Hammarstrom.

The study included 31 children aged 5 months to 19 years. All children had some form of primary immunodeficiency disease with no molecular diagnosis and suffered from severe or severe her COVID-19. Participants were recruited in Iran from August to September 2020. No children were vaccinated against COVID-19.

More than a third of 11 children died from complications of infection. Five children (16%) met criteria for polyinflammatory syndrome (MIS-C). Some children lacked antibodies to coronavirus.

“This suggests that many children with this type of immune disease are unable to produce antiviral antibodies and therefore do not fully benefit from vaccination,” said the Karolinska Institutet in Biological Sciences and Nutrition. Hassan Abolhasani, assistant professor in the department and first author of the study, said. .

Genetic analysis showed that more than 90% of the participants (28 children) had mutations in genes important for immune defense, which could explain their immune deficiencies. A key mechanism was mutations affecting proteins that regulate the immune system during viral infection, known as interferons.

Analysis of the patient’s immune response showed that children with MIS-C had an immunological profile that differed from that of children with primary immunodeficiency who did not have MIS-C.

The study also included a literature review, and researchers found reports of approximately 1,210 primary immunodeficiency diseases and COVID-19 patients worldwide. About 30% of them were children. Mortality in children with primary immunodeficiency diseases and COVID-19 was over 8%, compared to approximately 0.01% in children in the general population.

The study is limited to severe cases of COVID-19 infected with the original strain of the virus, and to unvaccinated children. Further studies are needed to assess the importance of different viral variants and vaccines in this patient group.

The study was conducted within the research consortium ATAC, funded by the European Commission and coordinated by the Karolinska Institutet in response to the COVID-19 pandemic. Collaboration with Uppsala University, Tehran Medical University (Iran), Iran Medical University, Ahwaz Jundishapur Medical University (Iran), North Khorasan Medical University (Iran), Howard Hughes Medical Institute (USA), Rockefeller University ( USA) and the Necker Hospital for Sick Children (France) also played an important role in conducting the study.

This research has also been funded by the Swedish Research Council and the Knut and Alice Wallenberg Foundation.

(Only the headlines and photos in this report may have been modified by Business Standard staff. The rest of the content is auto-generated from syndicated feeds.)