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Therapeutic approach for severe COVID-19 and immunocompromised patients. A case series

BACKGROUND: COVID-19 is a potentially critical infectious disease. Inflammatory response and disease severity may vary according to immune system status. The aim of this case series is to investigate different presentation of COVID-19 in immunocompromised patients. METHODS: this is a single centre c...

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Autores principales: Simioli, Francesca, Martino, Maria, Annunziata, Anna, Carannante, Novella, Fiorentino, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987579/
https://www.ncbi.nlm.nih.gov/pubmed/33777690
http://dx.doi.org/10.1016/j.rmcr.2021.101397
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author Simioli, Francesca
Martino, Maria
Annunziata, Anna
Carannante, Novella
Fiorentino, Giuseppe
author_facet Simioli, Francesca
Martino, Maria
Annunziata, Anna
Carannante, Novella
Fiorentino, Giuseppe
author_sort Simioli, Francesca
collection PubMed
description BACKGROUND: COVID-19 is a potentially critical infectious disease. Inflammatory response and disease severity may vary according to immune system status. The aim of this case series is to investigate different presentation of COVID-19 in immunocompromised patients. METHODS: this is a single centre case series about 17 immunocompromised patients admitted to our respiratory department during the recent COVID-19 pandemic. White blood cell count, C reactive protein, interleukin 6, lymphocytic subpopulation count (CD4(+), CD8(+), CD20(+)) and immunoglobulin count (IgG, IgM, IgA) were measured at hospitalization. RESULTS: the most common causes of immunosuppression observed in our severe COVID-19 population are hematological malignancies, immunosuppressant drugs for transplant, primary immunodeficiency and inflammatory bowel disease. Onset symptoms were fever (88%), cough (53%), dyspnoea (24%), asthenia (35%), anosmia and/or ageusia (17%), expectoration (12%). Compared to benign conditions, patients with malignancies show a lower lymphocytic count (490 vs 1100 cells/uL) and higher interleukin 6 (33 vs 13 pg/mL). CONCLUSIONS: immunocompromised patients are at risk of adverse outcome from COVID-19. Hematological malignancies and anti-CD20 therapies induce a high risk. Primary immunodeficiency and classical immunosuppressant such as calcineurin inhibitors and antimetabolites share an intermediate risk.
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spelling pubmed-79875792021-03-24 Therapeutic approach for severe COVID-19 and immunocompromised patients. A case series Simioli, Francesca Martino, Maria Annunziata, Anna Carannante, Novella Fiorentino, Giuseppe Respir Med Case Rep Case Report BACKGROUND: COVID-19 is a potentially critical infectious disease. Inflammatory response and disease severity may vary according to immune system status. The aim of this case series is to investigate different presentation of COVID-19 in immunocompromised patients. METHODS: this is a single centre case series about 17 immunocompromised patients admitted to our respiratory department during the recent COVID-19 pandemic. White blood cell count, C reactive protein, interleukin 6, lymphocytic subpopulation count (CD4(+), CD8(+), CD20(+)) and immunoglobulin count (IgG, IgM, IgA) were measured at hospitalization. RESULTS: the most common causes of immunosuppression observed in our severe COVID-19 population are hematological malignancies, immunosuppressant drugs for transplant, primary immunodeficiency and inflammatory bowel disease. Onset symptoms were fever (88%), cough (53%), dyspnoea (24%), asthenia (35%), anosmia and/or ageusia (17%), expectoration (12%). Compared to benign conditions, patients with malignancies show a lower lymphocytic count (490 vs 1100 cells/uL) and higher interleukin 6 (33 vs 13 pg/mL). CONCLUSIONS: immunocompromised patients are at risk of adverse outcome from COVID-19. Hematological malignancies and anti-CD20 therapies induce a high risk. Primary immunodeficiency and classical immunosuppressant such as calcineurin inhibitors and antimetabolites share an intermediate risk. Elsevier 2021-03-24 /pmc/articles/PMC7987579/ /pubmed/33777690 http://dx.doi.org/10.1016/j.rmcr.2021.101397 Text en © 2021 The Authors. Published by Elsevier Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Simioli, Francesca
Martino, Maria
Annunziata, Anna
Carannante, Novella
Fiorentino, Giuseppe
Therapeutic approach for severe COVID-19 and immunocompromised patients. A case series
title Therapeutic approach for severe COVID-19 and immunocompromised patients. A case series
title_full Therapeutic approach for severe COVID-19 and immunocompromised patients. A case series
title_fullStr Therapeutic approach for severe COVID-19 and immunocompromised patients. A case series
title_full_unstemmed Therapeutic approach for severe COVID-19 and immunocompromised patients. A case series
title_short Therapeutic approach for severe COVID-19 and immunocompromised patients. A case series
title_sort therapeutic approach for severe covid-19 and immunocompromised patients. a case series
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987579/
https://www.ncbi.nlm.nih.gov/pubmed/33777690
http://dx.doi.org/10.1016/j.rmcr.2021.101397
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