Lymphopenia and IgG2 subclass deficiency in patients with severe COVID-19 pneumonia

dc.contributor.authorTaban, E.M.
dc.contributor.authorTintinger, Gregory Ronald
dc.contributor.authorJoseph, Darren
dc.contributor.authorGaylard. P.
dc.contributor.authorRichards, D.
dc.date.accessioned2022-01-28T09:29:37Z
dc.date.available2022-01-28T09:29:37Z
dc.date.issued2021-03-29
dc.description.abstractBACKGROUND : COVID-19 caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) manifests with a range of disease severities. A small proportion of COVID-19 patients are severely ill; however, a significant proportion of these patients are critically ill, and require admission and mechanical ventilation, which is associated with a high mortality. OBJECTIVE : To identify factors that may predispose patients with COVID-19 to severe disease that requires mechanical ventilation (MV). METHODS : We performed a retrospective audit of patients admitted with COVID-19 pneumonia to the intensive care unit (ICU) and medical wards to evaluate the potential associations between comorbid conditions, lymphopenia and IgG subclass deficiency with a need for MV. RESULTS : A total of 51 patients were included in the study. Almost half of the patients (47%; n=24) were documented to have IgG2 deficiency, 43% (n=22) had lymphopenia and 37% (n=19) had combined lymphopenia and IgG2 subclass deficiency. Of the 24 patients who required MV, 75% had IgG2 subclass deficiency, 73% had lymphopenia and 50% had both. The relative risk for requiring MV was 2.64, 3.38 and 2.81 for lymphopenia, IgG2 subclass deficiency and both, respectively. CONCLUSIONS : These findings suggest that lymphopenia, low IgG2 concentrations or the combination of both may be used to identify patients with severe COVID-19 that are at increased risk for MV. This may facilitate earlier identification of patients at high risk, who may benefit from more intensive therapy.en_ZA
dc.description.departmentInternal Medicineen_ZA
dc.description.librarianam2022en_ZA
dc.description.urihttps://journals.co.za/journal/m.ajtccmen_ZA
dc.identifier.citationTaban, E.M., Tintinger, G.R., Joseph, D. et al. 2021, 'Lymphopenia and IgG2 subclass deficiency in patients with severe COVID-19 pneumonia', African Journal of Thoracic and Critical Care Medicine, vol. 27, no. 2, pp. 1-6.en_ZA
dc.identifier.issn2617-0191
dc.identifier.other10.7196/AJTCCM.2021.v27i2.134
dc.identifier.urihttp://hdl.handle.net/2263/83506
dc.language.isoenen_ZA
dc.publisherSouth African Medical Association NPCen_ZA
dc.rightsSouth African Medical Association NPCen_ZA
dc.subjectPatientsen_ZA
dc.subjectCOVID-19 pandemicen_ZA
dc.subjectCoronavirus disease 2019 (COVID-19)en_ZA
dc.subjectSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)en_ZA
dc.subjectIntensive care unit (ICU)en_ZA
dc.subjectMechanical ventilation (MV)en_ZA
dc.subjectLymphopeniaen_ZA
dc.subjectIgG2 concentrationsen_ZA
dc.titleLymphopenia and IgG2 subclass deficiency in patients with severe COVID-19 pneumoniaen_ZA
dc.typeArticleen_ZA

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