P104: EXPERIENCE OF COVID‐19 IN ROYAL MELBOURNE HOSPITAL PATIENTS WITH PRIMARY IMMUNODEFICIENCY
Jessie Zhou 1, Celina Jin1,2, Xiang Leang1, Josh Chatelier1,6, Jack Godsell1, Shuk‐Yin Tsang1, Michelle Yong 3,4,5, Monica Slavin3,4,5, Charlotte A. Slade1,2, Samantha Chan1,2,6.
1 Department of Clinical Immunology & Allergy, The Royal Melbourne Hospital, Melbourne, Australia; 2 Immunology Division, Walter & Eliza Hall Institute, Melbourne, Australia; 3 Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia; 4 Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia; 5 National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia; 6 Department of Medicine, The University of Melbourne, Melbourne, Australia
Introduction: Patients with primary immunodeficiency (PID) are believed to be at greater risk of morbidity and mortality from COVID‐19 infection compared with the general population. Patient outcomes have varied considerably, likely due to specific local and historical factors, such as strain virulence and the availability of vaccination and targeted treatments. This study examines the characteristics of PID patients infected with COVID‐19 at a single metropolitan health service.
Method: A retrospective audit of electronic medical records was conducted until the end of April 2022 at the Royal Melbourne Hospital (RMH) for patients with known immunodeficiency. 176 patients were identified. Patients who were deceased, had secondary immunodeficiency syndromes, or whose care had been transferred to a different hospital were excluded.
Results: Data from 138 patients – including 31 patients with a history of COVID‐19 infection(s) and 107 without – were included for multivariate analysis. Most COVID‐19 infections occurred in January 2022 (47%). Among the 31 affected patients (22%, c.f. 31% in the general Victorian population), the most prevalent PID was common variable immunodeficiency (68%). The affected group had a greater proportion of male patients (69% vs. 38%, p = 0.01) and a lower mean age (38 vs. 48 years, p = 0.04). There was no significant difference in trough IgG levels, vaccination rates, prevalence of comorbidities, use of prophylactic antibiotics and immunosuppression between the two groups. 72% of affected patients received either Sotrovimab or Paxlovid. Disease severity was mild in all, with no cases of hospitalisation or mortality.
Conclusion: This retrospective study indicated relatively benign clinical courses in PID patients affected by COVID‐19 in the RMH cohort but is limited by a lack of long‐term follow up for post‐acute sequalae. There was a predisposition towards younger age and male sex in the affected group, though this did not ultimately affect outcomes.