key: cord-0730696-sufe680p
authors: Sarkaria, Sandeep; Kalkat, Amanpreet; Hostoffer, Robert
title: A COVID-19 Vaccinated Patient with Phosphoinositide 3-Kinase Disease with Mild Illness Following SARS-CoV-2 Infection
date: 2022-02-12
journal: Ann Allergy Asthma Immunol
DOI: 10.1016/j.anai.2022.02.004
sha: 2e82cf7e96f73831be9a6a6117e0a5b3379f1c8c
doc_id: 730696
cord_uid: sufe680p

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). Prior to her diagnosis she had presented with a history of recurrent ear, sinus, throat, and bronchopulmonary infections. Infections resolved while being maintained on intravenous immunoglobulin (IVIG) 900 mg/kg every 3 weeks. She received the initial dose of the BNT 162b2 mRNA COVID-19 vaccine on March 8, 2021, and second dose subsequently on March 28, 2021, at the age of 30 years-old. Following the initial dose of the vaccination, the patient had one day of generalized headache and no significant symptoms with the second dose of the vaccination. On September 11, 2021, the patient's mother, and close contact, developed sinus pressure and fatigue. The following day the patient also developed symptoms consisting of sinus pressure, runny nose, sneezing, subjective fever, nausea, ageusia, anosmia, and dry cough.

Symptoms persisted for 48 hours and were associated with progressive fatigue. A rapid COVID-19 antigen test done on September 12, 2021, resulted as positive for both the patient and mother.

COVID-19 polymerase chain reaction (PCR) test 5 days later was also positive for both the mother and the patient. Patient experienced resolution of all symptoms within 1.5 weeks, except for her dry cough which lingered for over 3-weeks from initial infection. Following the infection SARS-CoV-2 nucleocapsid antibody IgG was found to be positive, and SARS-CoV-2 spike total antibody was reactive 10-days after initial positive test. Ultimately, our patient did not require hospitalization following acute infection with COVID-19 after receiving the BNT 162b2 mRNA COVID-19 vaccine.

Patients with inborn errors of immunity (IEI) represent a subset of the high-risk population at risk for viral and bacterial illnesses 3 . Although PIK3RI mutation disease is rare, it is of importance to note the need to vaccinate in this and other immunodeficient populations. Though 

Sandeep Sarkaria. MD: Preparation and revision of case report.

Clinical spectrum and features of activated phosphoinositide 3-kinase δ syndrome: A large patient cohort study

PI3K pathway defects leading to immunodeficiency and immune dysregulation

Immunogenicity of Pfizer-BioNTech COVID-19 vaccine in patients with inborn errors of immunity

Clinical and immunologic phenotype associated with activated phosphoinositide 3-kinase δ syndrome 2: A cohort study

Amanpreet Kalkat. MD: Preparation and revision of case report Robert Hostoffer. DO: Conception of study, preparation, and revision of case report

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