Minor Clinical Impact of COVID-19 Pandemic on Patients With Primary Immunodeficiency in Israel

author.DisplayName ¹ author.DisplayName ² author.DisplayName ³ author.DisplayName ⁴ author.DisplayName ⁵ author.DisplayName ¹ author.DisplayName ⁶ author.DisplayName ⁶ author.DisplayName ⁷ author.DisplayName ⁷ author.DisplayName ⁷ author.DisplayName ⁸ author.DisplayName ⁹ author.DisplayName ⁹ author.DisplayName ¹⁰ author.DisplayName ¹⁰ author.DisplayName ¹¹ author.DisplayName ¹ author.DisplayName ^1,12 author.DisplayName ¹³ author.DisplayName ⁵ author.DisplayName ⁴ author.DisplayName ²

¹Allergy and Immunology Unit and Pediatrics B Unit, Schneider Children's Medical Center of Israel
²Pediatric Department a and the Immunology Service, , Jeffrey Modell Foundation Center, “Edmond and Lily Safra” Children‘s Hospital, Sheba Medical Center,
³Department of Medicine, Allergy and Clinical Immunology Unit, , Tel Aviv Sourasky Medical Center, Tel Aviv, Israel,
⁴Pediatric Allergy Unit, Pediatric Department, E, E. Wolfson Medical Center, Holon, Israel,
⁵Ruth Children Hospital,, Ruth Children Hospital, Rappaport Faculty of Medicine, Technion, Haifa, Israel
⁶Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, , Sheba Medical Center, Tel Hashomer, Israe
⁷Immunology Clinic, , Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
⁸Blood Coagulation Service and Pediatric Hematology Clinic,, Galilee Medical Center, Nahariya, Israel,
⁹Department of Pediatrics, Bone Marrow Transplantation Department, , Hadassah-Hebrew University Medical Center, Jerusalem, Israel, Mount Scopus Hadassah-Hebrew University Medical Center, Jerusalem, Israel,
¹⁰Allergy and Clinical Immunology Clinic and Pulmonolgy Clinic, , Shaare Zedek Medical Center, Hadassah-Hebrew University Medical School, Jerusalem, Israel
¹¹Allergy and Clinical Immunology Unit,, Meir Medical Center, Kfar-Saba, Israel
¹²Pediatric Department, Allergy and Immunology Clinic,, Carmel Medical Center, Haifa, Israel,
¹³nstitute of Allergy, Immunology and Pediatric Pulmonology,, Shamir (Former Assaf Harofeh) Medical Center, Zerifin, Israel

In the last few months, the world has witnessed a global pandemic due to SARS-CoV-2 infection causing coronavirus disease 2019 (COVID-19). This pandemic affected individuals differently, with a significant impact on populations considered to be at high-risk. One such population, was assumed to be patients with primary genetic defect involving components or pathways of the immune system. Here, we aimed to summarize the clinical and laboratory data on primary immunodeficiency (PID) patients in Israel, who were tested positive for SARS-CoV-2, in order to estimate the impact of COVID-19 on such patients.

Data was collected from mid-February to end-September. During this time Israel experienced two “waves” of COVID-19 diseases. A total of 20 PID patients, aged 4 months to 60 years, were tested positive for SARS-CoV-2, all but one, were detected during the second wave. Fourteen of the patients were on routine monthly IVIG replacement therapy at the time of virus detection. None of the patients displayed severe illness and none required hospitalization; moreover, 7/20 patients were completely asymptomatic. Possible explanations for the minimal clinical impact of COVID-19 pandemic observed in our PID patients include high level of awareness, extra precautions, and even self-isolation. It is also possible that only specific immune pathways (e.g. type I interferon signaling), may increase the risk for a more severe course of disease and these are not affected in many of the PID patients. In some cases, lack of an immune response actually may be a protective measure against the development of COVID-19 sequelae.