long-standing covid-19 disease in immunocompromised and immunocompetent patients; case reports and literature review

Patients with immunodeficiency are at higher risk of severe disease and death following sars-cov-2 infection compared to the general population. here, we describe humoral and cellular immune responses in 5 patients with immunodeficiency, 2 patients with multiple sclerosis, 1 patient with chronic lymphocytic leukemia (cll), 1 patient with good’s syndrome, and 1human immunodeficiency virus (hiv) positive with developed acquired immunodeficiency syndrome (aids)- patient.t-cell responses were evaluated using the quantiferon sars-cov-2 assay following incubation with the sars-cov-2 ag1, ag2, and ag3 viral antigens. immunophenotyping of cd4+ and cd8+ t cells and cd19+ and cd20+ b cells was determined by flow cytometry.all studied immunocompromised patients or those with acquired immune dysregulation patients showed reduced cellular immune responses (release of interferon (ifn)-g) to sars-cov-2 antigens than healthy controls [patients; ag1, ag2 and ag3 and nil (median 5-95% percentile) (12 (1-95), 12 (1.5-78), 13.5 (12-95) and 3 (1-98) u/ml)], controls; ag1, ag2 and ag3 and nil (median 5-95% percentile) 24.5 (7-89), 65 (31-173), 53.5 (13-71.5) and 3 (1-14) u/ml)]. the frequency of peripheral blood b cells was also reduced in these patients compared to healthy control subjects.t-cell-dependent antibody responses require the activation of b cells by helper t cells. reduced b cell numbers in immunocompromised patients infected with sars-cov-2 indicate the need for these patients to take additional precautions to prevent covid-19 infection.