Bronchiectasis, Low IgG Levels and Lack of Vaccination are Risk Factors for Covid-19 Hospitalization in X-linked Agammaglobulinemia - A Retrospective Multicenter Study

• Autoři: STENLANDER Caroline; LINDAHL Hannes; WAHREN-BORGSTROM Emelie; GEIER Christoph B; SEDIVA Anna; FEVANG Borre; MILITO Cinzia; VARANDAS Claudia; ROCA-OPORTO Cristina; PULVIRENTI Federica; HODL Isabel; MALKUSOVA Ivana; RIVIERE Jacques G; LITZMAN Jiří; WALTER Jolan E; HANITSCH Leif G; NETH Olaf; KRALICKOVA Pavlina; MILLER Rahim; SHAFFREN Serena; SILVA Susana L; KATZENSTEIN Terese; MARTELIUS Timi; STEINER Urs C; SMITH C I Edvard; WARNATZ Klaus; BERGMAN Peter
• Rok publikování: 2025
• Druh: Článek v odborném periodiku
• Časopis / Zdroj: Journal of Clinical Immunology
• Fakulta / Pracoviště MU: Lékařská fakulta
• www: https://link.springer.com/article/10.1007/s10875-025-01962-3?utm_source=getftr&utm_medium=getftr&utm_campaign=getftr_pilot&getft_integrator=clarivate
• Doi: https://doi.org/10.1007/s10875-025-01962-3
• Klíčová slova: X-linked agammaglobulinemia; SARS CoV-2; Covid-19; Bronchiectasis; Vaccination; IgG trough levels
• Popis: X-linked agammaglobulinemia (XLA) is caused by loss-of-function variants in Bruton's tyrosine kinase, leading to absence of circulating B lymphocytes and inability to produce antibodies. Despite the fear that patients with XLA would be at high risk for severe infection when the novel virus SARS-CoV-2 emerged in the society with low pre-existing immunity, most patients with XLA did not suffer from severe disease. However, some patients were critically affected. Factors associated with hospitalization in patients with XLA remain poorly described. Thus, we designed a study to determine risk factors associated with hospitalization due to Covid-19 in patients with XLA. Data was collected from 17 sites in Europe and the US, comprising n = 81 patients, with hospitalization due to SARS-CoV-2 infection in 14 patients. Nearly 17% of patients with XLA required hospitalization due to Covid-19, but only 3 patients had ventilatory support. After correcting for the effect of the date of infection during the early pandemic, univariate and multiple logistic regression analysis showed that preexisting bronchiectasis and lower IgG serum trough levels (< 8 g/L) before infection were associated with an increased risk for hospitalization, with a high rate of superinfection. The lack of vaccination seemed to contribute to this risk, and ambulatory patients had higher amounts of CD4(+) T cells before infection compared to hospitalized patients. Thus, our data suggests a need for IgG trough levels above 8 g/L, especially in patients with bronchiectasis, to protect patients with XLA during viral infections such as Covid-19 and reduce morbidity due to superinfections.