SARS-COV-2 infections within Inborn Errors of Immunity Populations.

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Background

Since its beginning in December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), has infected almost 500 million individuals and caused 6 million deaths with significant regional differences.
To date only few (< 700) COVID-19 cases in patients with inborn errors of immunity (IEI) were reported. Current data suggest that morbidity and mortality of COVID-19 is increased in IEI patients. However, IEI form a very heterogeneous group of patients and consequently, clinical presentation of COVID-19 in these patients may range from asymptomatic to fatal disease course with a higher risk for severe disease occurring in older patients and in those with comorbidities. Recently identified immunological host factors for severe disease include type I interferon (IFN) autoantibodies or disruption of type I IFN signaling (e.g. in TLR7), affecting innate immune response to SARS-CoV-2.

Moreover, immunocompromised patients with impaired humoral and /or cellular immunity were reported to present with prolonged viral shedding. This observation requires specific screening and follow-up strategies for this patient group. In addition, delayed viral clearance is associated with marked within-host genomic evolution of SARS-CoV-2 with continuous turnover of dominant viral variants possibly contributing to the generation of new virus variants.

In addition, the restrictions imposed by pandemic has severely affected the care of patients with most chronic diseases and patients with IEIs are no exceptions. This might have contributed to an increase in morbidity and possibly mortality in these patients.

Data on SARS-CoV-2-specific antibody and T cell immunity in IEI patients are still rare and include limited observation on T cell response, including data on (cross)reactive T cells against other endemic human coronaviruses. Detailed reports on response to the different worldwide used COVID-19 vaccinations are also scarce.

Reports on prevention and clinical management of COVID-19 in IEI patients are urgently needed to support decision making for this vulnerable patient group. Clinical observations and treatment approaches in patients with IEI may also contribute to our general understanding of COVID-19 immunity.

We welcome submissions of Original Research, Review, and Mini Review related to COVID-19 infection and immune response, including but not limited to:
• consequences of clinical management of IEI patients during the COVID-19 pandemic
• COVID-19 pathogenesis and lessons learnt from immunodeficiency patients
• Frequencies and clinical consequences of anti-cytokine autoantibodies during COVID-19
•Severe COVID-19 illness as the first important clue to an underlying IEI
• Summarizing updated clinical and immunological observations on COVID-19 in vaccinated and non-vaccinated IEI patients
• Response of IEI patients to different COVID-19 vaccines and adverse events
• prevention of (severe) COVID-19 in IEIs using convalescent plasma and monoclonal antibodies
• Clinical and immunological observations with regard to multisystem inflammatory syndrome in patients with IEIs
• Impact of COVID-19 in IEI pediatric and adult patients (quality of life, for example)

Keywords: SARS-COV-2, autoimmunity, autoantibodies, inborn error of immunity, primary immunodeficiency, interferons, immunodeficiency, vaccination, T cell response, memory response, COVID-19

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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