COVID-19 outcomes in patients undergoing B cell depletion therapy and those with humoral immunodeficiency states: A scoping review

Jessica M. Jones, Aiman J. Faruqi, James K. Sullivan, Cassandra Calabrese, Leonard H. Calabrese*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background: The role of humoral immunity has been well established in reducing infection risk and facilitating viral clearance in patients with COVID-19. However, the relationship between specific antibody responses and severity of COVID-19 is less well understood. Methods: To address this question and identify gaps in knowledge, we utilized the methodology of a scoping review to interrogate risk of infection and clinical outcomes of COVID-19 in patients with iatrogenic and inborn humoral immunodeficiency states based on existing literature. Results: Among patients with iatrogenic B-cell depletion, particularly with agents targeting CD20, our analysis found increased risk of severe COVID-19 and death across a range of underlying disease states. Among patients with humoral inborn errors of immunity with COVID-19, our synthesis found that patients with dysregulated humoral immunity, predominantly common variable immunodeficiency (CVID), may be more susceptible to severe COVID-19 than patients with humoral immunodeficiency states due to X-linked agammaglobulinemia and other miscellaneous forms of humoral immunodeficiency. There were insufficient data to appraise the risk of COVID-19 infection in both populations of patients. Conclusions: Our work identifies potentially significant predictors of COVID-19 severity in patients with humoral immunodeficiency states and highlights the need for larger studies to control for clinical and biologic confounders of disease severity.

Original languageEnglish
Pages (from-to)76-103
Number of pages28
JournalPathogens and Immunity
Issue number1
Publication statusPublished - 14 May 2021
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by The R J Fasenmyer Center for Clinical Immunology Research Endowment.

Publisher Copyright:
© 2021 Pathogens and Immunity.


  • Antibodies
  • B-cell
  • CD20
  • COVID-19
  • Inborn errors of immunity
  • Scoping Review


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