COVID-19-induced immune dysfunction is fast evolving from a theoretical construct to a major unfavorable effect of COVID-19 infection.
People with immunological dysfunction are more likely to have severe COVID-19 results, and has the potential to bring the healthcare system to its knees and harm individuals long after they become COVID-19-negative.
Patients on stretchers are seen at Tongren hospital in Shanghai on January 3, 2023.
Rise of Viral Infections Linked to Immune Dysfunction
Increases in seasonal influenza and respiratory syncytial virus (RSV) infections have recently been a major source of worry. According to the report in Infection Control Today, patients have flocked to hospitals, and an "Anything But Covid" (ABC) narrative has taken hold.
Many people and even a few big federal institutions blamed the previous year's masking and social isolation. This "immune debt" story inhibits people from engaging in public health mitigation efforts.
But the first flaw with this story is that in 2022, few people were concealing or avoiding crowded indoor settings. More so, seasonal influenza affects from 9 to 41 million inhabitants in the United States each year, accounting for 3 to 12% of the population. A mild influenza season for one or two years should not result in a major "immune debt."
Secondly, a large RSV wave was also recorded last year in many countries, like Germany and Sweden. A nonpeer-reviewed study on medRxiv found that 19.2% of RSV-infected infants had documented COVID-19 infections compared to just 9.7% of RSV-uninfected toddlers.
Now, the UK and the US are reporting an increase in group A streptococcal infections that affect both children and adults. The UK recorded over 27,000 notifications of scarlet fever, a severe manifestation of the infection, from September 2022 to January 2023 compared to the 2017-2018 period with only 3,200 cases.
A study published in BMJ revealed that COVID-19 patients were 34% more likely than equivalent controls to develop Strep tonsillitis. This discovery was dubbed a "low but considerable extra risk" of infection.
Furthermore, the fungus Aspergillus fumigatus can be deadly to patients with severe SARS-CoV-2 infection that may lead to two types of white blood cells not working together and allowing the fungus to spread further. Meanwhile, China is experiencing a newly surging pandemic in which reinfections were attributed to the damage done to the immune system by COVID-19.
Other infections that were observed to increase due to immune dysfunction also include herpes simplex, herpes zoster, and the Epstein-Barr virus. Experts said that laboratory evidence points to SARS-CoV-2 as a lympho-manipulative pathogen that distorts T-cell function that leads to more infection and deaths.
Associations Between Immune Dysfunction and COVID-19 After Vaccination
Immune dysfunction is linked with an increased risk for COVID-19 breakthrough infection even after receiving the vaccination. In the 2021 study published in JAMA Network, researchers that those who received at least 1 dose of the COVID-19 vaccine and have immune dysfunction have a higher rate of COVID-19 breakthrough compared to those without immune dysfunction.
Findings suggest that people with immune dysfunction should use nonpharmaceutical interventions, such as mask-wearing, and alternative vaccination approaches even after full vaccination.
Overall, the study links full vaccination to reduced risk of COVID-19 breakthrough infection regardless of immune status. For those with immune dysfunction, continued use of face masks and social distancing are highly recommended.
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