- This paper details a case study of an infant with X-linked severe combined immunodeficiency who was comorbid with COVID-19 while awaiting a stem cell transplant
- The infant’s IgG antibody reactivities were tested with a microfluidic antigen array
- Infant showed signs of mild bronchial wall thickening from CT scan and determined to have gotten COVID-19 from his father
- Infant also contracted hepatitis and traditional treatment methods proved to be ineffective due to his immunological disease
- Infant was then treated with COVID-19 convalescent plasma, patients condition improved after this therapy
- Infant IgG levels were low, however the COVID-19 convalescent plasma therapy attempted to supplement these antibodies
- Infant made recovery and had negative PCR testing after 87 days
- Overall, infant did not manifest as many respiratory issues as most COVID-19 cases, but compromised immune system allowed for the hepatitis infection which worsened patient condition

SARS-CoV-2 infection associated with hepatitis in an infant with X-linked severe combined immunodeficiency

- SARS-CoV-2 infection associated with hepatitis in an infant with X-linked severe combined immunodeficiency

Ohio State University, Columbus

- Cytokine Storm Syndrome
    -  Secondary Haemophagocytic Lymphohistiocytosis
- Common Variable Immunodeficiency 
- Figure illustrating how pathogenic T cells and inflammatory monocytes enter pulmonary circulation and incite an inflammatory storm and immune disorder 
- Severe Combined Immunodeficiency

Immunological Diseases as a Comorbidity of COVID-19

- A severe inflammatory response that presents as a fever, nausea, and swelling
- Has been observed in tandem with COVID-19 pulmonary symptoms
- Involves overproduction of cytokines (key proteins in the immune system)
- Immunosuppression can be helpful in calming the immune system and mitigating this extreme immune response

Secondary Haemophagocytic Lymphiohistocytosis and COVID-19

- Common Variable Immunodeficiency (CVID) is a disorder which lowers the immune systems defenses and makes patients more susceptible to infections in the lungs, sinuses, and ears
- A 53 y/o patient with CVID was admitted with COVID-19
- Patient was already receiving intravenous immunoglobulin (IVIG) for their CVID
- Levels of patient’s immunoglobulin were taken upon arrival and it was noted that their IgG was normal, but IgM and IgA were low and undetectable respectively
- Patient received additional IVIG daily as well as supplemental oxygen in the form of a nasal cannula and then intubation
- Patient was extubated after 3 days and eventually weaned back to room air as well as discharged on day 14 due to clinical improvement
- The paper also noted that there were 2 similar cases of CVID patients receiving supplemental IVIG in Italy who also made a similar recovery
- It was also stated that while testing was not performed for cytokine storm syndrome, 53 y/o did develop some acute respiratory distress syndrome during their treatment

Common Variable Immunodeficiency 

An inflammatory storm may result from pathogenic T cells and inflammatory monocytes with high levels of IL-6 secretion entering pulmonary circulation in large quantities. This occurrence can also cause an immune disorder in COVID-19 patients with severe complications.  

Figure illustrating how pathogenic T cells and inflammatory monocytes enter pulmonary circulation and incite an inflammatory storm and immune disorder 

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