Obična varijabilna imunodeficijencija: čimbenik koji pogoduje ili štiti od teških komplikacija COVID-19?

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The usual presentation of the disease is a common cold-like illness but it can present with more severe and sometimes fatal manifestations. Immunocompromised patients such as those with common variable immunodeficiency (CVID) also are among the infected population. A limited number of reports have been published concerning CVID patients with COVID-19. The main reported symptoms were fever, cough, dyspnea and fatigue while the median duration of illness was 19 (interquartile range 14-26.5) days. Total recovery rate was 88.4%. It is still unknown whether primary immunodeficiency interacts as a predisposing or protective factor against the severe forms of COVID-19. Substitute immunoglobulin (IG) therapy is the only treatment option for CVID. Some reports suggest that early administration of intravenous IGs or convalescent plasma infusion may positively influence the outcome of COVID-19 in these patients.Koronavirusna bolest (COVID-19) novonastala je zarazna bolest koju uzrokuje SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Uglavnom se očituje blagim simptomima nalik na običnu prehladu, ali može izazvati i teške, a katkada i smrtonosne komplikacije. Imunokompromitirani bolesnici poput onih s dijagnozom obične varijabilne imunodeficijencije (common variable immunodeficiency, CVID) također su dio zaražene populacije. Malo je objavljenih izvještaja o COVID-19 u bolesnika s CVID-om. Najčešće zabilježeni simptomi bili su vrućica, kašalj, dispneja i umor, dok je medijan trajanja bolesti iznosio 19 (interkvartilni raspon 14-26,5) dana. Ukupna stopa ozdravljenja iznosila je 88,4%. Još je uvijek nepoznanica djeluje li primarna imunodeficijencija kao predisponirajući ili zaštitni čimbenik protiv teških oblika COVID-19. Nadomjesna terapija imunoglobulinima (IG) jedina je opcija liječenja za bolesnike s CVID-om. Najnovija istraživanja ukazuju na to da bi u takvih bolesnika rana primjena intravenskih oblika IG ili konvalescentne plazme mogla povoljno utjecati na ishod bolesti COVID-19