The following is a summary of “Rethinking Immunological Risk: A Retrospective Cohort Study of Severe SARS-Cov-2 Infections in Individuals With Congenital Immunodeficiencies,” published in the November 2023 issue of Allergy and Clinical Immunology by Nguyen et al.
During the coronavirus disease 2019 (COVID-19) pandemic, arguments about dividing medical resources showed that researchers needed a better grasp on immune risk. Studies showed that people with problems in both their adaptive and innate immune systems had different clinical results after getting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Other factors may be playing a role. It’s important to note that none of these studies considered factors related to social drivers of health. For a study, they sought to find out how health-related factors affected the chance of going to the hospital with SARS-CoV-2 infection in people born with immune system problems.
It was a retrospective, single-center cohort study of 166 people with inborn errors of immunity who got SARS-CoV-2 infections between March 1, 2020, and March 31, 2022. The people were between the ages of 2 months and 69 years. A mixed logistic regression analysis was used to examine the risks of being hospitalized. The odds of being hospitalized because of SARS-CoV-2 were higher for people from racial and ethnic groups that aren’t well represented (OR 4.50; 95% CI 1.57–13.4), for people with any genetically defined immunodeficiency (OR 3.32; 95% CI 1.24–9.43), for people who are overweight (OR 4.24; 95% CI 1.38–13.3), and for people with neurological diseases (OR 4.47; 95% CI 1.44–14.3). The COVID-19 vaccine was linked to a lower chance of hospitalization (OR = 0.52; 95% CI = 0.31–0.81).
After considering other factors, problems with T cells and the natural immune system, organs affected by the immune system not working right, and social vulnerability were not linked to a higher chance of hospitalization. The links between race, culture, and fat and a higher chance of hospitalization for SARS-CoV-2 infection showed how important social determinants of health are as immunological risk factors for people who are born with immune system problems.
Source: sciencedirect.com/science/article/abs/pii/S2213219823008152