|
?:abstract
|
-
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), the etiologic agent of coronavirus disease 2019 (COVID-19), causes variable clinical manifestations, ranging from asymptomatic disease to immune dysregulation and multi-organ failure The immunologic features of COVID-19 are incompletely understood From reports of resolved COVID-19 infection in patients with primary antibody deficiency, it has been postulated that B cells may be dispensable for immunologic clearance Case Description: A 14-month-old female patient with compound heterozygous mutation (maternal deletion and paternal missense mutation) in DCLRE1C (Artemis) presented on day 2 of illness with rhinorrhea, congestion, cough, and transient fever She was PCR-positive for SARS-CoV2 Prior immunophenotyping showed normal NK cell numbers, near-absent B cells (CD19+ 42), T cell lymphopenia (CD3+ 743), declining phytohemagglutinin mitogen testing (last 37% of control), and polyclonal T-cell repertoire, consistent with the diagnosis of hypomorphic severe combined immunodeficiency (SCID) Admission workup demonstrated lymphopenia (ALC 720);normal CRP;elevations in IFN-gamma (40 5), IL-8 (19 7), and TNF-alpha (5 8);and minimal Burr cells with no schistocytes on peripheral blood smear She was discharged after 36 hours of observation Discussion: Given this patient’s unclear clinical trajectory at presentation, the decision was made to admit for further evaluation Remarkably, despite T cell dysfunction and near-absence of B cells, she improved without medical intervention This outcome lends credence to the notion that B cells may be dispensable for clinical resolution of COVID-19 infection Further elucidation of immune responses to SARS-CoV2 will benefit from continued surveillance of clinical outcomes in patients with defined immunologic deficits
|
![[This page as RDF]](https://research.tib.eu/covid-19/static/rdf-icon.gif){kind=icon}