SeyedAhmad SeyedAlinaghi: Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
Amirali Karimi: School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Alireza Barzegary: School of Medicine, Islamic Azad University, Tehran, Iran.
Hengameh Mojdeganlou: Department of Pathology, Urmia University of Medical Sciences, Urmia, Iran.
Farzin Vahedi: School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Seyed Peyman Mirghaderi: School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Parnian Shobeiri: School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Maryam Ramezani: Department of Health Management, Policy & Economics,, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Parisa Yousefi Konjdar: Department of Health Information Management, Faculty of Paramedical, Kashan University of Medical Sciences, Kashan, Iran.
Pegah Mirzapour: Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
Marcarious M Tantuoyir: School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Esmaeil Mehraeen: Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran. es.mehraeen@gmail.com. ORCID
Omid Dadras: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Fabricio Voltarelli: Graduation Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.
INTRODUCTION: Patients with immunodeficiency are usually more prone to worse outcomes of infectious diseases. However, there are some disagreements in the context of COVID-19, for example, in patients with human immunodeficiency virus (HIV). Herein, we aimed to systematically review the risk and predictors of COVID-19 mortality in people with primary or secondary immunodeficiency. METHODS: PubMed, Scopus, Web of Science, and Science Direct were searched. We followed a two-step screening process to identify eligible results. We first reviewed the title and abstract of the records and the unqualified studies were removed. Then, their full texts were evaluated based on their coherence with the purpose and inclusion/exclusion criteria, and those eligible for qualitative synthesis were included. RESULTS: Twenty-two articles were included, which investigated a total of 109,326 with primary or secondary immunodeficiencies. Three studies investigated the pediatric and infant population, while other studies were conducted on the adult population. Overall, studies on both primary and secondary immunodeficiency conflicted as some reported higher and some mentioned lower mortality rates in patients with immunodeficiency. CONCLUSIONS: Overall, there were two points of view in both types of immunodeficiencies. The first is the classical viewpoint that all immunodeficient patients are at a higher risk of infection leading to a higher mortality rate. The second types of studies found that immunodeficiency might play a less important or even an inverse role in mortality rates by lowering the severity of the inflammatory response. However, it is important to take note to comorbidities, such as DM, HTN, CAD, ESRD, history of lower respiratory infection, etc., and demographic factors, such as obesity and age > 70 years, as they appear to influence the mortality rate, especially in patients with secondary immunodeficiency.
