Description of COVID-19 infection in 92 patients with primary or secondary immunodeficiency followed at the Immunodeficiency Outpatient Clinic of a tertiary hospital

Rationale: COVID-19 pandemic raised doubts about the susceptibility and prognosis of this infection in immunodeficient. We evaluated the profile of these patients infected by SARS-CoV-2 from April/20 to August/22. Methods: Electronic medical records of patients followed at the Immunodeficiency Outpatient Clinic at a tertiary hospital were reviewed. Results: 92 immunodeficient patients infected with COVID-19 were analyzed. 59.8% presented common variable immunodeficiency (CVID); 22.8% IgA deficiency; 8.7% secondary hypogammaglobulinemia; 6.5% agammaglobulinemia (XLA); 2.2% IgM deficiency. The mean age was 43.6 years; being 60.8% women. Most, 71.5%, had a mild form of infection; being moderate in 15.9% and severe in 12.5%. Among the severe cases, 72.7% occurred before full vaccination for COVID-19. We also observed a higher frequency of infections before complete vaccination (65.6% of those infected). The percentage of hospitalization was 25% with 8.3% of deaths. The most frequent comorbidities were chronic lung disease (62.2%); diabetes (17.1%); hypertension (17.7%) and obesity (17.5%). Post-covid-19 syndrome was present in 37.8% of patients; characterized mainly by dyspnea, headache, anosmia, and tiredness. Six patients had the infection more than once. Only 1 CVID patient with comorbidities died after complete vaccination. Overall, lethality in our cohort of patients was 8.3%, however 33% in XLA. Contrasting to brazilian population, wich was 2%. Conclusions: A better understanding of the Immunodeficient patients profile infected by COVID-19 is important to define protection strategies, as they are patients more prone to severe infections. We conclude that most patients with Immunodeficiency had a good evolution, especially after complete vaccination, reinforcing the importance of vaccines.