How dangerous is Covid-19 to immunodeficiency?

Immunocompromised people are at greater risk of serious illness and death from Covid-19, leading many to worry about how to protect themselves as pandemic restrictions are rolled back across the country. But health experts say there are different tools and treatments available to help the immunocompromised reduce the risk of infection and severe outcomes.

wide range of risks

More than 7 million Americans are considered immunocompromised and are at increased risk of severe Covid-19 outcomes. However, the term covers a variety of conditions, including cancer, autoimmune disorders, organ transplants, and more, resulting in a “wide range of risks,” Fox Reports.

Dimitri Drikonga, an infectious disease physician at University of Minnesota.

For example, a Center for Disease Control An analysis of two-dose Covid-19 vaccine regimens among immunocompromised patients found that different conditions affected their level of protection. Rheumatology patients saw the greatest protection against Covid-19 hospitalizations at 81%, followed by solid cancer patients with 79%, then leukemia patients at 74%, and those born with immunodeficiency at 73%. Organ transplant recipients had the lowest protection of 59%.

At the moment, it is not clear which immunocompromised people are at the greatest risk when it comes to Covid-19, but experts generally agree that there is a high risk of infection and serious outcomes for this population because the coronavirus is still new. Very well, people didn’t. He has a chance to build immunity, unlike cold and flu viruses.

According to Megan Ryan, advocate for people with primary immunodeficiency, immunocompromised people should speak to their health care providers directly to gauge their individual risk.

“It’s a confusing time because there are so many people who are either experts or experts – there are so many voices in the system,” she said. She recommended people consult with a health care team who knows them well “rather than outsourcing an answer.”

How can people with immunodeficiency protect themselves

In addition to assessing individual risks directly with health care providers, immunocompromised people can stay protected against coronavirus with the help of various tools, including:

Vaccines

Currently, the CDC recommends immunocompromised people who initially received the Covid-19 mRNA vaccine to receive a total of four doses, with an optional fifth dose available. For those who initially got a Johnson & Johnson Vaccine, the agency recommends a total of three doses, and subsequent doses are mRNA vaccines, with a fourth dose as an option.

However, several studies indicating that Covid-19 vaccines are less likely to produce protective antibodies and are generally less effective in immunocompromised people, has led to increased vaccine frequency in this population.

Michael Putman, MD, a rheumatologist at Medical College of Wisconsin.

According to Jennifer Nuzzo, Director of Epidemiology Center at Brown University School of Public Health, The idea that Covid-19 vaccines do not protect people who are immunocompromised “is just a complete distortion… it just scares people, it doesn’t save lives.”

Although Covid-19 vaccines offer less protection for immunocompromised people than those with normal immune systems, the ‘protection is not zero’ Fox He writes.

Kristin Koval, who leads the Transplant Infectious Diseases team at Cleveland Clinic.

For example, a Centers for Disease Control and Prevention (CDC) study found that three doses of an mRNA vaccine reduced the risk of hospitalization by 87% in people with immunodeficiency, compared to 97% for people with normal immune systems. Similarly, another Centers for Disease Control and Prevention (CDC) study found that mRNA vaccines were 74% effective against the most severe Covid-19 outcomes, such as needing a ventilator or death, compared to 97% for the others.

“We’re still looking at very high response rates and very strong protection against severe disease,” said Ann Mills, a Virginia physician with rheumatoid arthritis.

covid-19 treatments

The federal government recently launched a treatment locator for Covid-19, which can help health care providers obtain the most effective treatments for their immunocompromised patients.

for example, AstraZenecaEvusheld is a combination antibody that was authorized for emergency use in December 2021. It is intended for use as a prophylactic treatment against MERS-CoV infection in individuals 12 years of age or older who have moderate to severe immunodeficiency and may not produce a robust response to vaccination.

In August, AstraZeneca reported that Evusheld reduced the risk of developing Covid-19 symptoms by 77% in a late-stage clinical trial of 5,197 participants, more than 75% of whom had comorbidities that could make vaccines less effective.

Oral antivirals, such as PfizerPaxlovid and merckMolnopiravir, may also benefit people who are immunocompromised, Fox reports. In a nationwide “treatment test”, patients who test positive for Covid-19 can receive free antiviral pills.

Policies to reduce virus transmission

Although many mask mandates are no longer in effect, people and organizations can still help those who are immunocompromised. Some potential steps include improving air purification and ventilation in buildings and voluntary concealment when high-risk people are present.

Immunocompromised people can also continue to wear high-quality masks, such as N95 fitted masks, and encourage their family members to do the same when they are in public to avoid bringing the virus home.

According to Koval, many immunocompromised people may “receive this message that they are so in danger of dying that they cannot function normally in the world,” but this belief is unrealistic.

“It’s just so uncomfortable to live in these muddy situations, especially when we’re two years away, and the kind of data we have isn’t very helpful for patients, and for us to help them make informed decisions,” she said. “I hope you get better.” (mother, Atlantic Ocean, 4/19; Landmann, Fox4/6)

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