Non-neutralizing antibodies and limitations of serologic testing for severe acute respiratory syndrome coronavirus 2 in patients receiving immunoglobulin replacement products

Abstract

With the growing surges in coronavirus disease 2019 (COVID-19) cases caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across the globe, there has been a growing concern regarding its implications among patients with primary immune deficiency disorders (PIDs). Common variable immunodeficiency is a common PID characterized by a failure in B cell differentiation with defective immunoglobulin production, making the patients uniquely susceptible to recurrent infections.1 Although current evidence suggests a higher risk for more severe disease in patients with both primary and secondary immune deficiency states, the exact burden of COVID-19 in these disease states is unknown.