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Article ; Online: SARS-CoV-2 vaccination in primary antibody deficiencies: an overview on efficacy, immunogenicity, durability of immune response and safety.

Cusa, Gabriella / Sardella, Germano / Garzi, Giulia / Firinu, Davide / Milito, Cinzia

Current opinion in allergy and clinical immunology

2023 Volume 24, Issue 1, Page(s) 37–43

Abstract: Purpose of review: This review aims to summarize the current best knowledge on the efficacy of COVID-19 vaccination in vulnerable patients affected by primary antibody deficiencies (PADs), both in patients previously infected and vaccine-immunized, ... ...

Abstract	Purpose of review: This review aims to summarize the current best knowledge on the efficacy of COVID-19 vaccination in vulnerable patients affected by primary antibody deficiencies (PADs), both in patients previously infected and vaccine-immunized, focusing also on the durability, on the need for multiple booster doses and on the safety of anti-SARS-CoV-2 vaccines. Recent findings: Patients vaccinated for SARS-CoV2 have variable humoral response, still showing a tendency towards an increase in antibody titers, with factors such as booster doses, previous infections, age and specific genetic mutations influencing the outcome. Long-lasting cellular responses to SARS-CoV-2 vaccination instead, mostly of the T-cell type, have been observed. Overall, the duration of protection given by vaccinations is sufficient and increased upon further simulations. Furthermore, the safety profile in PID patients is excellent, with most adverse events being transient and mild and no major adverse event reported. Summary: Several studies have emphasized the benefit of vaccinating patients with PADs against the SARS-CoV-2 virus and the necessity of administering booster doses. This review, by gathering the most recent and significant data from the scientific literature, could be helpful in clinical practice in the management of disease prevention in patients affected by primary immunodeficiency and also serve as inspiration for further in-depth clinical research.
MeSH term(s)	Humans ; COVID-19/prevention & control ; COVID-19 Vaccines/immunology ; Immunity ; Primary Immunodeficiency Diseases ; RNA, Viral ; SARS-CoV-2 ; Vaccination
Chemical Substances	COVID-19 Vaccines ; RNA, Viral
Language	English
Publishing date	2023-11-14
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	2088710-3
ISSN	1473-6322 ; 1528-4050
ISSN (online)	1473-6322
ISSN	1528-4050
DOI	10.1097/ACI.0000000000000955
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Article ; Online: High Prevalence of Long COVID in Common Variable Immunodeficiency: An Italian Multicentric Study.

Villa, Annalisa / Milito, Cinzia / Deiana, Carla Maria / Gambier, Renato Finco / Punziano, Alessandra / Buso, Helena / Bez, Patrick / Lagnese, Gianluca / Garzi, Giulia / Costanzo, Giulia / Giannuzzi, Gloria / Pagnozzi, Chiara / Dalm, Virgil A S H / Spadaro, Giuseppe / Rattazzi, Marcello / Cinetto, Francesco / Firinu, Davide

Journal of clinical immunology

2024 Volume 44, Issue 2, Page(s) 59

Abstract: The long-term effects of SARS-CoV-2 infection represent a relevant global health problem. Long COVID (LC) is defined as a complex of signs and symptoms developed during or after SARS-CoV-2 infection and lasting > 12 weeks. In common variable ... ...

Abstract	The long-term effects of SARS-CoV-2 infection represent a relevant global health problem. Long COVID (LC) is defined as a complex of signs and symptoms developed during or after SARS-CoV-2 infection and lasting > 12 weeks. In common variable immunodeficiency (CVID) patients, we previously reported higher risk of hospitalization and death during SARS-CoV-2 infection, as well as prolonged swab positivity and frequent reinfections. The aim of the present study was to assess the risk of LC in an Italian cohort of CVID patients. We used a translated version of the survey proposed by Centers for Disease Control and Prevention (CDC) to collect data on LC. In the enrolled cohort of 175 CVID patients, we found a high prevalence of LC (65.7%). The most frequent LC symptoms were fatigue (75.7%), arthralgia/myalgia (48.7%), and dyspnea (41.7%). The majority of patients (60%) experienced prolonged symptoms, for at least 6 months after infection. In a multivariate analysis, the presence of complicated phenotype (OR 2.44, 95% CI 1.88-5.03; p = 0.015), obesity (OR 11.17, 95% CI 1.37-90.95; p = 0.024), and female sex (OR 2.06, 95% CI 1.09-3.89; p = 0.024) significantly correlated with the development of LC. In conclusion, in this multicenter observational cohort study, we demonstrated that CVID patients present an increased prevalence of LC when compared to the general population. Improved awareness on the risk of LC in CVID patients could optimize management of this new and alarming complication of SARS-CoV-2 infection.
MeSH term(s)	United States ; Humans ; Female ; Post-Acute COVID-19 Syndrome ; COVID-19/epidemiology ; Common Variable Immunodeficiency/epidemiology ; Prevalence ; SARS-CoV-2 ; Italy/epidemiology
Language	English
Publishing date	2024-02-06
Publishing country	Netherlands
Document type	Multicenter Study ; Observational Study ; Journal Article
ZDB-ID	779361-3
ISSN	1573-2592 ; 0271-9142
ISSN (online)	1573-2592
ISSN	0271-9142
DOI	10.1007/s10875-024-01656-2
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Article: Struggling with COVID-19 in Adult Inborn Errors of Immunity Patients: A Case Series of Combination Therapy and Multiple Lines of Therapy for Selected Patients.

Bez, Patrick / D'ippolito, Giancarlo / Deiana, Carla Maria / Finco Gambier, Renato / Pica, Andrea / Costanzo, Giulia / Garzi, Giulia / Scarpa, Riccardo / Landini, Nicholas / Cinetto, Francesco / Firinu, Davide / Milito, Cinzia

Life (Basel, Switzerland)

2023 Volume 13, Issue 7

Abstract: Background: The SARS-CoV-2 infection is now a part of the everyday lives of immunocompromised patients, but the choice of treatment and the time of viral clearance can often be complex, exposing patients to possible complications. The role of the ... ...

Abstract	Background: The SARS-CoV-2 infection is now a part of the everyday lives of immunocompromised patients, but the choice of treatment and the time of viral clearance can often be complex, exposing patients to possible complications. The role of the available antiviral and monoclonal therapies is a matter of debate, as are their effectiveness and potential related adverse effects. To date, in the literature, the amount of data on the use of combination therapies and on the multiple lines of anti-SARS-CoV-2 therapy available to the general population and especially to inborn error of immunity (IEI) patients is small. Methods: Here, we report a case series of five adult IEI patients managed as inpatients at three Italian IEI referral centers (Rome, Treviso, and Cagliari) treated with combination therapy or multiple therapeutic lines for SARS-CoV-2 infection, such as monoclonal antibodies (mAbs), antivirals, convalescent plasma (CP), mAbs plus antiviral, and CP combined with antiviral. Results: This study may support the use of combination therapy against SARS-CoV-2 in complicated IEI patients with predominant antibody deficiency and impaired vaccine response.
Language	English
Publishing date	2023-07-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life13071530
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Article ; Online: SARS-CoV-2 pre-exposure prophylaxis with tixagevimab/cilgavimab (AZD7442) provides protection in inborn errors of immunity with antibody defects: a real-world experience.

Pulvirenti, Federica / Garzi, Giulia / Milito, Cinzia / Sculco, Eleonora / Sciannamea, Maddalena / Napoli, Anna / Cinti, Lilia / Roberto, Piergiorgio / Punziano, Alessandra / Carrabba, Maria / Piano Mortari, Eva / Carsetti, Rita / Antonelli, Guido / Quinti, Isabella

Frontiers in immunology

2023 Volume 14, Page(s) 1249462

Abstract: Background: Preventive strategies against severe COVID-19 in Inborn Errors of Immunity (IEI) include bivalent vaccines, treatment with SARS-CoV-2 monoclonal antibodies (mAbs), early antiviral therapies, and pre-exposure prophylaxis (PrEP).: Objective!# ...

Abstract	Background: Preventive strategies against severe COVID-19 in Inborn Errors of Immunity (IEI) include bivalent vaccines, treatment with SARS-CoV-2 monoclonal antibodies (mAbs), early antiviral therapies, and pre-exposure prophylaxis (PrEP). Objective: To assess the effectiveness of the PrEP with tixagevimab/cilgavimab (AZD7442) in IEI with primary antibody defects during the COVID-19 Omicron wave. Methods: A six-month prospective study evaluated the SARS-CoV-2 infection rate and the COVID-19 severity in the AZD7442 group, in the no-AZD7442 group, and in a group of patients with a recent SARS-CoV-2 infection (< three months). Spike-specific IgG levels were measured at regular intervals. Results: Six out of thirty-three patients (18%) and 54/170 patients (32%) became infected in the AZD7442 group and in the no-AZD7442 group, respectively. Within 90 days post-administration, the AZD7442 group was 85% less likely to be infected and 82% less likely to have a symptomatic disease than the no-AZD7442 group. This effect was lost thereafter. In the entire cohort, no mortality/hospitalisation was observed. The control group of 35 recently infected patients was 88% and 92% less likely to be infected than the AZD7442 and no-AZD7442 groups. Serum anti-Spike IgG reached the highest peak seven days post-AZD7442 PrEP then decreased, remaining over 1000 BAU/mL 180 days thereafter. Conclusion: In patients with IEI and antibody defects, AZD7442 prophylaxis had a transient protective effect, possibly lost possibly because of the appearance of new variants. However, PrEP with newer mAbs might still represent a feasible preventive strategy in the future in this population.
MeSH term(s)	Humans ; SARS-CoV-2 ; Pre-Exposure Prophylaxis ; Prospective Studies ; COVID-19 ; Antibodies, Monoclonal ; Antibodies, Viral ; Immunoglobulin G
Chemical Substances	tixagevimab ; cilgavimab and tixagevimab drug combination ; cilgavimab (1KUR4BN70F) ; Antibodies, Monoclonal ; Antibodies, Viral ; Immunoglobulin G
Language	English
Publishing date	2023-10-26
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2023.1249462
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Article ; Online: Decline of gastric cancer mortality in common variable immunodeficiency in the years 2018-2022.

Milito, Cinzia / Pulvirenti, Federica / Garzi, Giulia / Sculco, Eleonora / Cinetto, Francesco / Firinu, Davide / Lagnese, Gianluca / Punziano, Alessandra / Discardi, Claudia / Costanzo, Giulia / Felice, Carla / Spadaro, Giuseppe / Ferrari, Simona / Quinti, Isabella

Frontiers in immunology

2023 Volume 14, Page(s) 1231242

Abstract: Introduction: In patients with Common Variable Immunodeficiency, malignancy has been reported as the leading cause of death in adults, with a high risk of B-cell lymphomas and gastric cancer.: Methods: We conducted a five-year prospective study ... ...

Abstract	Introduction: In patients with Common Variable Immunodeficiency, malignancy has been reported as the leading cause of death in adults, with a high risk of B-cell lymphomas and gastric cancer. Methods: We conducted a five-year prospective study aiming to update the incidence and mortality of gastric cancer and the incidence of gastric precancerous lesions in 512 CVID patients who underwent a total of 400 upper gastrointestinal endoscopies. Results: In the pre-pandemic period, 0.58 endoscopies were performed per patient/year and in the COVID-19 period, 0.39 endoscopies were performed per patient/year. Histology revealed areas with precancerous lesions in about a third of patients. Patients who had more than one gastroscopy during the study period were more likely to have precancerous lesions. Two patients received a diagnosis of gastric cancer in the absence of Helicobacter pylori infection. The overall prevalence of Helicobacter pylori infection in biopsy specimens was 19.8% and related only to active gastritis. Among patients who had repeated gastroscopies, about 20% progressed to precancerous lesions, mostly independent of Helicobacter pylori. Discussion: While gastric cancer accounted for one in five deaths from CVID in our previous survey, no gastric cancer deaths were recorded in the past five years, likely consistent with the decline in stomach cancer mortality observed in the general population. However, during the COVID-19 pandemic, cancer screening has been delayed. Whether such a delay or true decline could be the reason for the lack of gastric cancer detection seen in CVID may become clear in the coming years. Due to the high incidence of precancerous lesions, we cannot rely on observed and predicted trends in gastric cancer mortality and strongly recommend tailored surveillance programs.
MeSH term(s)	Adult ; Humans ; Stomach Neoplasms/pathology ; Helicobacter Infections/complications ; Helicobacter Infections/epidemiology ; Helicobacter Infections/diagnosis ; Prospective Studies ; Common Variable Immunodeficiency/epidemiology ; Common Variable Immunodeficiency/complications ; Pandemics ; Helicobacter pylori ; Gastroscopy/adverse effects ; Precancerous Conditions/pathology
Language	English
Publishing date	2023-10-06
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2023.1231242
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Article ; Online: Common and Uncommon CT Findings in CVID-Related GL-ILD: Correlations with Clinical Parameters, Therapeutic Decisions and Potential Implications in the Differential Diagnosis.

Scarpa, Riccardo / Cinetto, Francesco / Milito, Cinzia / Gianese, Sabrina / Soccodato, Valentina / Buso, Helena / Garzi, Giulia / Carrabba, Maria / Messina, Emanuele / Panebianco, Valeria / Catalano, Carlo / Morana, Giovanni / Lougaris, Vassilios / Landini, Nicholas / Bondioni, Maria Pia

Journal of clinical immunology

2023 Volume 43, Issue 8, Page(s) 1903–1915

Abstract: Purpose: To investigate computed tomography (CT) findings of Granulomatous Lymphocytic Interstitial Lung Disease (GL-ILD) in Common Variable Immunodeficiency (CVID), also in comparison with non-GL-ILD abnormalities, correlating GL-ILD features with ... ...

Abstract	Purpose: To investigate computed tomography (CT) findings of Granulomatous Lymphocytic Interstitial Lung Disease (GL-ILD) in Common Variable Immunodeficiency (CVID), also in comparison with non-GL-ILD abnormalities, correlating GL-ILD features with functional/immunological parameters and looking for GL-ILD therapy predictive elements. Methods: CT features of 38 GL-ILD and 38 matched non-GL-ILD subjects were retrospectively described. Correlations of GL-ILD features with functional/immunological features were assessed. A logistic regression was performed to find a predictive model of GL-ILD therapeutic decisions. Results: Most common GL-ILD CT findings were bronchiectasis, non-perilymphatic nodules, consolidations, Ground Glass Opacities (GGO), bands and enlarged lymphnodes. GL-ILD was usually predominant in lower fields. Multiple small nodules (≤10 mm), consolidations, reticulations and fibrotic ILD are more indicative of GL-ILD. Bronchiectasis, GGO, Reticulations and fibrotic ILD correlated with decreased lung performance. Bronchiectasis, GGO and fibrotic ILD were associated with low IgA levels, whereas high CD4+ T cells percentage was related to GGO. Twenty out of 38 patients underwent GL-ILD therapy. A model combining Marginal Zone (MZ) B cells percentage, IgA levels, lower field consolidations and lymphnodes enlargement showed a good discriminatory capacity with regards to GL-ILD treatment. Conclusions: GL-ILD is a lower field predominant disease, commonly characterized by bronchiectasis, non-perilymphatic small nodules, consolidations, GGO and bands. Multiple small nodules, consolidations, reticulations and fibrotic ILD may suggest the presence of GL-ILD in CVID. MZ B cells percentage, IgA levels at diagnosis, lower field consolidations and mediastinal lymphnodes enlargement may predict the need of a specific GL-ILD therapy.
MeSH term(s)	Humans ; Diagnosis, Differential ; Common Variable Immunodeficiency/complications ; Common Variable Immunodeficiency/diagnosis ; Common Variable Immunodeficiency/drug therapy ; Retrospective Studies ; Bronchiectasis/diagnosis ; Tomography, X-Ray Computed ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/drug therapy ; Lung Diseases, Interstitial/etiology ; Immunoglobulin A
Chemical Substances	Immunoglobulin A
Language	English
Publishing date	2023-08-07
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	779361-3
ISSN	1573-2592 ; 0271-9142
ISSN (online)	1573-2592
ISSN	0271-9142
DOI	10.1007/s10875-023-01552-1
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Article ; Online: Real-life data on monoclonal antibodies and antiviral drugs in Italian inborn errors of immunity patients during COVID-19 pandemic.

Garzi, Giulia / Cinetto, Francesco / Firinu, Davide / Di Napoli, Giulia / Lagnese, Gianluca / Punziano, Alessandra / Bez, Patrick / Cinicola, Bianca Laura / Costanzo, Giulia / Scarpa, Riccardo / Pulvirenti, Federica / Rattazzi, Marcello / Spadaro, Giuseppe / Quinti, Isabella / Milito, Cinzia

Frontiers in immunology

2022 Volume 13, Page(s) 947174

Abstract: Background: Since the beginning of the COVID-19 pandemic, patients with Inborn Errors of Immunity have been infected by SARS-CoV-2 virus showing a spectrum of disease ranging from asymptomatic to severe COVID-19. A fair number of patients did not ... ...

Abstract	Background: Since the beginning of the COVID-19 pandemic, patients with Inborn Errors of Immunity have been infected by SARS-CoV-2 virus showing a spectrum of disease ranging from asymptomatic to severe COVID-19. A fair number of patients did not respond adequately to SARS-CoV-2 vaccinations, thus early therapeutic or prophylactic measures were needed to prevent severe or fatal course or COVID-19 and to reduce the burden of hospitalizations. Methods: Longitudinal, multicentric study on patients with Inborn Errors of Immunity immunized with mRNA vaccines treated with monoclonal antibodies and/or antiviral agents at the first infection and at reinfection by SARS-CoV-2. Analyses of efficacy were performed according to the different circulating SARS-CoV-2 strains. Results: The analysis of the cohort of 192 SARS-CoV-2 infected patients, across 26 months, showed the efficacy of antivirals on the risk of hospitalization, while mabs offered a positive effect on hospitalization, and COVID-19 severity. This protection was consistent across the alpha, delta and early omicron waves, although the emergence of BA.2 reduced the effect of available mabs. Hospitalized patients treated with mabs and antivirals had a lower risk of ICU admission. We reported 16 re-infections with a length of SARS-CoV-2 positivity at second infection shorter among patients treated with mabs. Treatment with antivirals and mabs was safe. Conclusions: The widespread use of specific therapy, vaccination and better access to care might have contributed to mitigate risk of mortality, hospital admission, and severe disease. However, the rapid spread of new viral strains underlines that mabs and antiviral beneficial effects should be re- evaluated over time.
MeSH term(s)	Antibodies, Monoclonal/therapeutic use ; Antineoplastic Agents, Immunological ; Antiviral Agents/therapeutic use ; COVID-19/drug therapy ; Humans ; Pandemics ; SARS-CoV-2
Chemical Substances	Antibodies, Monoclonal ; Antineoplastic Agents, Immunological ; Antiviral Agents
Language	English
Publishing date	2022-07-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.947174
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Article: Mortality in Severe Antibody Deficiencies Patients during the First Two Years of the COVID-19 Pandemic: Vaccination and Monoclonal Antibodies Efficacy.

Milito, Cinzia / Cinetto, Francesco / Palladino, Andrea / Garzi, Giulia / Punziano, Alessandra / Lagnese, Gianluca / Scarpa, Riccardo / Rattazzi, Marcello / Pesce, Anna Maria / Pulvirenti, Federica / Di Napoli, Giulia / Spadaro, Giuseppe / Carsetti, Rita / Quinti, Isabella

Biomedicines

2022 Volume 10, Issue 5

Abstract: Patients with severely impaired antibody responses represent a group at-risk in the SARS-CoV-2 pandemic due to the lack of Spike-specific neutralizing antibodies. The main objective of this paper was to assess, by a longitudinal prospective study, COVID- ... ...

Abstract	Patients with severely impaired antibody responses represent a group at-risk in the SARS-CoV-2 pandemic due to the lack of Spike-specific neutralizing antibodies. The main objective of this paper was to assess, by a longitudinal prospective study, COVID-19 infection and mortality rates, and disease severity in the first two years of the pandemic in a cohort of 471 Primary Antibody Defects adult patients. As secondary endpoints, we compared SARS-CoV-2 annual mortality rate to that observed over a 10-year follow-up in the same cohort, and we assessed the impact of interventions done in the second year, vaccination and anti-SARS-CoV-2 monoclonal antibodies administration on the disease outcome. Forty-one and 84 patients were infected during the first and the second year, respectively. Despite a higher infection and reinfection rate, and a higher COVID-19-related mortality rate compared to the Italian population, the pandemic did not modify the annual mortality rate for any cause in our cohort compared to that registered over the last ten years in the same cohort. PADs patients who died from COVID-19 had an underlying end-stage lung disease. We showed a beneficial effect of MoAbs administration on the likelihood of hospitalization and development of severe disease. In conclusion, COVID-19 did not cause excess mortality in Severe Antibody Deficiencies.
Language	English
Publishing date	2022-04-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines10051026
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Article ; Online: Safety of mRNA COVID-19 Vaccines in Patients with Inborn Errors of Immunity: an Italian Multicentric Study.

Milito, Cinzia / Cinetto, Francesco / Garzi, Giulia / Palladino, Andrea / Puca, Marco / Brambilla, Elena / De Vitis, Camilla / Costanzo, Giulia / Scarpa, Riccardo / Punziano, Alessandra / Lagnese, Gianluca / Del Giacco, Stefano / Spadaro, Giuseppe / Quinti, Isabella / Firinu, Davide

Journal of clinical immunology

2022 Volume 43, Issue 2, Page(s) 299–307

Abstract: Purpose: Little is known about vaccine safety in inborn errors of immunity (IEI) patients during the current vaccination campaign for COVID-19. To better investigate the reactogenicity and adverse event profile after two, three, and four doses of mRNA ... ...

Abstract	Purpose: Little is known about vaccine safety in inborn errors of immunity (IEI) patients during the current vaccination campaign for COVID-19. To better investigate the reactogenicity and adverse event profile after two, three, and four doses of mRNA vaccines, we conducted an observational, multicentric study on 342 PID patients from four Italian Referral Centres. Methods: We conducted a survey on self-reported adverse reactions in IEI patients who received mRNA vaccine by administering a questionnaire after each dose. Results: Over the whole study period, none of the patients needed hospitalization or had hypersensitivity reactions, including anaphylaxis and delayed injection site reaction. After two vaccination doses, 35.4% of patients showed only local reactogenicity-related symptoms (RrS), 44.4% reported both systemic and local RrS, and 5% reported only systemic RrS. In more than 60% of cases, local or systemic RrS were mild. After the first and second booster doses, patients showed fewer adverse events (AEs) than after the first vaccination course. Patients aged 50 years and older reported adverse events and RrS less frequently. Among AEs requiring treatment, one common variable immune deficiency patient affected by T cell large granular lymphocytic leukemia developed neutropenia and one patient had Bell's paralysis perhaps during herpes zoster reactivation. Conclusion: Although our follow-up period is relatively short, the safety data we reported are reassuring. This data would help to contrast the vaccine hesitancy often manifested by patients with IEI and to better inform their healthcare providers.
MeSH term(s)	Aged ; Humans ; Middle Aged ; Anaphylaxis/etiology ; COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; RNA, Messenger ; Vaccination/adverse effects
Chemical Substances	COVID-19 Vaccines ; RNA, Messenger
Language	English
Publishing date	2022-11-14
Publishing country	Netherlands
Document type	Observational Study ; Multicenter Study ; Journal Article
ZDB-ID	779361-3
ISSN	1573-2592 ; 0271-9142
ISSN (online)	1573-2592
ISSN	0271-9142
DOI	10.1007/s10875-022-01402-6
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Article ; Online: Health-Related Quality of Life in Common Variable Immunodeficiency Italian Patients Switched to Remote Assistance During the COVID-19 Pandemic.

Pulvirenti, Federica / Cinetto, Francesco / Milito, Cinzia / Bonanni, Livia / Pesce, Anna Maria / Leodori, Giorgia / Garzi, Giulia / Miglionico, Marzia / Tabolli, Stefano / Quinti, Isabella

The journal of allergy and clinical immunology. In practice

2020 Volume 8, Issue 6, Page(s) 1894–1899.e2

Abstract: Background: A rapidly expanding pandemic of the new coronavirus has become the focus of global scientific attention. Data are lacking on the impact of the pandemic caused by the severe acute respiratory syndrome coronavirus 2 on health-related quality ... ...

Abstract	Background: A rapidly expanding pandemic of the new coronavirus has become the focus of global scientific attention. Data are lacking on the impact of the pandemic caused by the severe acute respiratory syndrome coronavirus 2 on health-related quality of life among patients affected by primary antibody deficiencies (PADs). Objective: To identify factors impacting the health-related-quality of life (HRQOL) among Italian patients affected by PADs switched to remote assistance at the time of the coronavirus disease 2019 pandemic. Methods: The quality of life was surveyed in 158 patients with PADs by the Common Variable Immune Deficiency Quality of Life questionnaire, a disease-specific tool, and by the 12-item General Health Questionnaire, a generic tool to assess the risk of anxiety/depression. Since the beginning of the coronavirus disease 2019 epidemic, we shifted all patients with PADs to home therapy, and activated remote visits. Questionnaires were sent by email 4 weeks later. Common Variable Immune Deficiency Quality of Life questionnaire and 12-item General Health Questionnaire data scores were compared with the same set of data from a survey done in 2017. Results: Of 210 patients, 158 (75%) agreed to participate. The quality of life was worse in the group of patients who were at risk of anxiety/depression at the study time. HRQOL was similar in patients forced to shift from hospital-based to home-based immunoglobulin treatment and in patients who continued their usual home-based replacement. The risk of anxiety/depression is associated with pandemia caused by the severe acute respiratory syndrome coronavirus 2 and with patients' fragility, and not with related clinical conditions associated with common variable immune deficiencies. Anxiety about running out of medications is a major new issue. Conclusions: The coronavirus disease 2019 epidemic impacted HRQOL and the risk of anxiety/depression of patients with PADs. The remote assistance program was a useful possibility to limit personal contacts without influencing the HRQOL.
MeSH term(s)	Adolescent ; Adult ; Aged ; Anxiety/psychology ; COVID-19 ; Common Variable Immunodeficiency/psychology ; Common Variable Immunodeficiency/therapy ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Depression/psychology ; Female ; Home Infusion Therapy/psychology ; Humans ; Immunoglobulins/administration & dosage ; Infusions, Subcutaneous ; Italy/epidemiology ; Male ; Middle Aged ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Quality of Life/psychology ; Surveys and Questionnaires ; Telemedicine ; Young Adult
Chemical Substances	Immunoglobulins
Keywords	covid19
Language	English
Publishing date	2020-04-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2843237-X
ISSN	2213-2201 ; 2213-2198
ISSN (online)	2213-2201
ISSN	2213-2198
DOI	10.1016/j.jaip.2020.04.003
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In stock of ZB MED Cologne/Königswinter

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