The following article is a part of conference coverage from the American College of Allergy, Asthma & Immunology 2021 Annual Scientific Meeting, being held virtually from November 4 to 8, 2021. The team at Pulmonology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the ACAAI 2021 Annual Scientific Meeting.


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In patients with common variable immunodeficiency (CVID) who become infected with COVID-19, the disease course and risk for mortality appear to be similar to that in patients with SARS-CoV-2 infection without CVID, with vaccination shown to be safely tolerated. A chart review methodology was used to identify patients with CVID who were diagnosed with COVID-19 at the Mayo Clinic in Rochester, Minnesota. Results of the study will be presented at the American College of Allergy, Asthma & Immunology (ACAAI) 2021 Annual Scientific Meeting, November 4 to 8 in New Orleans, LA.

The researchers sought to report all outcomes among patients with CVID who were infected with SARS-CoV-2 who were treated at the Mayo Clinic between March 1, 2020, and May 20, 2021. A total of 19 individuals with CVID were diagnosed with COVID-19 at this single institution. All of the individuals received polymerase chain reaction testing, the results of which were all positive.

With all of the 19 patients surviving, 26% (5 of 19) of them were hospitalized and 21% (4 of 19) of the individuals were treated with monoclonal antibodies in the outpatient setting. In 83% (5 of 6) of the patients who were evaluated, postinfection (antinucleocapsid) seroconversion was reported. After recovering from their COVID-19 infection, 32% (6 of 19) of the patients were vaccinated against SARS-CoV-2 infection, which they tolerated well, with no significant adverse events reported. Postimmunization antispike serology was positive in the 1 individual in whom it was performed.

The study was one of the largest US case series to describe the experience at a tertiary care center responsible for the management of patients with coexisting CVID and SARS-CoV-2 infection, according to investigators.  Although CVID is a relatively common primary immunodeficiency that predisposes individuals to respiratory illness, until this study was conducted, little was known about the disease course of COVID-19 in patients with CVID, as well as how these individuals respond to SARS-CoV-2 immunization postinfection. Study findings demonstrate that the presence of CVID per se does not seem to be associated with an increased risk for mortality, investigators concluded.

Disclosure: None of the study authors have declared affiliations with biotech, pharmaceutical, and/or device companies.


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Greenmyer J, Joshi A. COVID-19 in CVID: a large hospital experience. Ann Allergy Asthma Immunol. 2021;127:S3-S17:Abstract A044. Presented at: American College of Allergy, Asthma & Immunology (ACAAI) 2021 Annual Scientific Meeting; November 4-8, 2021; New Orleans, Louisiana.