Joint statement on the current epidemics of new Coronavirus SARS-CoV-2— COVID-19 From IPOPI, ESID, INGID, APSID, ARAPID, ASID, LASID, SEAPID

Joint statement on the current epidemics of new Coronavirus
(Original statement, as of 2020, 13th February,
1st update, as of 2020, 10th March).

Coronavirus SARS-CoV-2— COVID-19

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Coronavirus – what is it?
In December 2019, a cluster of pneumonia cases was reported in Wuhan, Hubei
Province, China, linked to be caused by a novel coronavirus (SARS-CoV-2, leading to COVID-19
disease).1 Coronaviruses are common in many different animal species and it is rare that they infect
people and spread between them, but it happens. Recent examples include Severe Acute Respiratory
Syndrome (SARS-CoV), and Middle-East Respiratory Syndrome (MERS-CoV). The SARS-CoV-2 is
distinct from the previous two coronaviruses and causes COVID-19 disease.2
Is COVID-19 worse than influenza?
Every year the World Health Organization (WHO) estimates about 3-5 million severe cases of
influenza worldwide with 250,000 – 650,000 deaths. Data on the epidemiology of COVID-19 remains
scarce. The apparent difference with flu is that COVID19 seems to be spreading to more people
quicker than the flu. In significant outbreaks, this translates in overwhelming the local medical care
institutions and generates the emergency situation that is now reflected in the news. A better picture of
the similarities and the differences between flu and COVID-19 is likely to be available in the near
What is the current situation regarding COVID-19?
The situation is changing all the time and we advise you to monitor for the latest advice applicable to
your area.
As of 2020 9th March, more than 110,000 cases of COVID-19 have been reported worldwide (111
countries). The majority are in mainland China and in other countries in Asia, but now cases have also
been reported in Europe and America and to a lesser extent in Oceania and Africa.3 Excluding China,
the countries with the highest number of reported cases are South Korea, Iran, Italy, France,
Germany, Spain, Japan and the United States.4
1 European Centre for Disease Prevention and Control. Infection prevention and control for the care of patients with
2019-nCoV in healthcare settings. ECDC: Stockholm; 2020. Available at:
settings.pdf [Accessed 04-04-2020]
2 Centers for Disease Control and Prevention. 2019 Novel Coronavirus, situation summary. 02-02-2020. Available at: [Accessed 03-02-2020].
3 European Centre for Disease Prevention and Control. Situation update worldwide, 4 March 2020. Available at: [Accessed 04-03-2020].
4 Ibid.
A comprehensive response from the public health sector depending on the severeness of the virus
and its spread highlights the fact that the recent COVID-19 outbreak should be taken seriously, but it
should also be contrasted with the seasonal influenzas that in terms of number of patients and spread
can pose a bigger threat to patients with a primary immunodeficiency (PID).
How does it spread?
The transmission mode of COVID-19 is similar to the previous coronavirus outbreaks, spreading from
person to person through:
• Respiratory droplets spreading when coughing or sneezing
• Close personal contact with an infected person (shaking hands or touching)
• Touching something with the virus on it and then touching your eyes, nose or mouth with
unwashed hands.5
Self-isolation (confinement) to prevent exposure is not currently recommended.
The spread is similar to the spread of classic yearly influenza.
Clinical symptoms due to COVID-19 infection
Human coronaviruses commonly cause mild to moderate illness in the general population. So far, the
main clinical signs and symptoms reported in this outbreak includes fever, tiredness, dry cough and
running nose. Some patients also experience aches and pains, nasal congestion, sore throat and/or
diarrhoea. These symptoms are usually mild and begin gradually. Some people become infected but
don’t develop any symptoms and don’t feel unwell. Approximately 80% of the affected people recover
from the disease without needing special treatment.6
Should PID patients get systematically tested for COVID-19?
The situation is changing all the time and we advise you to monitor for the latest advice applicable to
your area.
The test usually consists in a nasal swab, that would be sent to a dedicated microbiology laboratory
for detection of this virus (by polymerase chain reaction (PCR) method, within a few hours).
However, in light of shortage of manpower and availability of PCR, most national guidelines do not
include or manage patients with chronic diseases including PID differently than other patients. At this
stage, it is not recommended to have PID patients with no or very limited symptoms tested.
Furthermore, in some cases, a negative PCR does not rule out to be infected (“false negative”).
Hence, it is advised to adhere to local and national guidelines for testing.
5 The World Health Organization. Q&A on coronaviruses (COVID-19). 23 February 2020. Available at: [Accessed 04-03-2020].
6 The World Health Organization. Q&A on coronaviruses (COVID-19). 23 February 2020. Available at: [Accessed 04-03-2020].
Any respiratory virus that can be spread from person-to-person may be a risk for PID patients.
Therefore, PID patients should be cautious and keep track of developments of COVID-19 in their
region. Whilst immunoglobulin replacement therapy provides protection against a wide range of
infections, it does not guarantee immunity against coronavirus. The World Health Organization’s
(WHO)7 and the Centers for Disease Control and Prevention’s (CDC)8 recommendations to reduce
exposure to and transmission of COVID-19 include but are not limited to the list below.
• The MOST IMPORTANT means to prevent infection are:
o Wash hands frequently (every hour) by using alcohol-based hand rub or soap and water
(20 seconds), especially after direct contact with ill people or their environment
o Avoid touching eyes, nose and mouth Avoid close contact (1 meter) with people suffering
from acute respiratory infections
o Avoid close contact (1 meter) with anyone who has fever and cough
o Avoid greeting people by shaking hands or kissing
• People with symptoms of acute respiratory infection should practice cough etiquette (maintain
distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands) and
wear a respiratory mask.
• If you feel unwell and experience symptoms such as fever, cough and/or difficulty breathing, seek
prompt medical assistance from your health care provider
Should I wear a mask?
Masks are generally not effective at preventing infection. Most people do not have the appropriate
training for a good fitting mask. Masks need to be replaced regularly and there is likely a greater risk of
contaminating your face from your hands adjusting a mask than the benefit from wearing one. The
exception to this is in a healthcare setting when you are given a mask, shown how to wear it and it is
disposed of appropriately.
Can my child go to school?
The situation is changing all the time and we advise you to monitor for the latest advice applicable to
your area.
School attendance depends on the local epidemiological situation and the underlying PID and needs
to be discussed by the PID expert physician.
Can I travel?
The situation is changing all the time and we advise you to monitor for the latest advice applicable to
your area.
7 The World Health Organization. Q&A on coronaviruses (COVID-19). 23 February 2020. Available at: [Accessed 04-03-2020].
8 Centers for Disease Control and Prevention. Prevention & Treatment. 29-01-2020. Available at: [Accessed 03-02-2020].
Travelers who suffer from acute respiratory illness before, during or after travel, are encouraged to
seek medical attention and share travel history with their health care provider as soon as possible.
Overall, it is recommended to postpone personal and professional trips as much as possible.
Is there a vaccine?
There is currently no vaccine available for COVID-19. However, updating influenza vaccination where
applicable, to assist in preventing seasonal flu (a disease with similar symptoms to SARS-CoV-2),
should be discussed with your PID expert.
Our recommendations for PID patients
There is currently no data pointing to whether PID patients are actually at higher risk of more severe
disease from COVID-19 (as per the WHO, CDCs and PID expert healthcare professionals and NMO
representatives along with patients themselves).
However, it is believed that PID patients might be at higher risk for this infection or a more severe
course of the disease. Thus, patients with PID need to take extra care to prevent from getting this
Patients with PID living in areas of high prevalence should follow every precautions and local, regional
and national recommendations (staying at home, teleconsultation, work from home, etc…).
However, for PID patients, beyond the precautions mentioned above, we advise prompt phone contact
with a doctor if an infection is suspected (should it be your PID expert, or your GP who should
probably let your PID expert know about your condition in order to provide the best advice for each
PID patient’s specific condition). Patients should always keep the details of their PID diagnosis and
medical charts, medications, PID expert doctor and next of kin at hand, in case urgent medical care is
PID patients with lung and/or heart complications, solid organ transplants PID patients recipients,
recent recipients of hematopoietic stem cell transplantation or gene therapy, PID patients undergoing
treatment for a cancer (malignancy), as well as patients under immunosuppressive or
immunomodulatory drugs (for autoimmune or inflammatory or autoinflammatory complicating the PID
course) should remain on their specific therapy until recommended otherwise by their PID expert
physician. Immunosuppressive drugs (in particular corticosteroids), might limit signs of infections
(fever and other clinical symptoms). It is this recommended to contact your PID expert physician in
case of unexplained change in clinical status including your well-being.
PID patients with significant respiratory issues (severe asthma, bronchiectasis or chronic respiratory
failure) should receive special attention (as for any risk of respiratory infection).
Keep in mind that it is always essential to regularly continue to take the treatment for your PID.
Plasma Derived Medicinal Products (PDMPs), such as immunoglobulins (IVIG or SCIG) are safe and
will protect you from many other infections.
If you are on immunosuppressive or immunomodulatory treatment, we strongly advise not to
undertake any treatment changes except upon your medical caregiver’s suggestion.
For everyone, including PID patients, we strongly recommend you to keep aware of the latest
information on the COVID-19 outbreak in your region, for example provided by the World Health
Organization (WHO), the European Centre for Disease Prevention and Control (ECDC) and by your
national and local public health authorities.
Plasma Derived Medicinal Products (PDMPs), including Immunoglobulins
According to a statement from Plasma Protein Therapeutics Association (PPTA) there is no risk of
transmission of COVID-19 into PDMPs.9
For PID patients who are on immunoglobulin replacement therapy, there is no evidence to date that
more frequent dosing of immunoglobulin will offer more protection. Whilst immunoglobulin
replacement therapy provides protection against a range of infections, it does not guarantee immunity
against coronavirus.
For PID patients whose condition does not require to be under regular Ig replacement therapy, there is
no need to start Ig since there should be no antibodies targeting COVID-19 is expected to be
contained in the existing preparations.
There is no recommendation to give immunoglobulins to the general population to protect or treat
people against COVID-19.
National guidelines provided by your national health authorities should be followed (the
epidemiological situation and the management might differ from one country to another).
We should stress the fact that only your PID expert would know best what to recommend to you.
9 The Plasma Protein Therapeutics Association. New Coronavirus (SARS-CoV-2) and Plasma Protein Therapies.
Updated February 17, 2020. Available at:
2019-novel-coronavirus-2019-ncov-and-plasma-protein-therapies [Accessed 04-03-2020].
IPOPI is the leading advocate for primary immunodeficiencies’ patients worldwide working in
collaboration with patients, doctors, politicians, regulators, pharmaceutical industry and other relevant
stakeholders. IPOPI is the Association of national PID patient organisations currently representing 68
countries. More info:, Facebook, Twitter
About ESID
The European Society for Immunodeficiencies (ESID) is a non-profit organization whose main
objectives are to facilitate the exchange of ideas and information among doctors, nurses, biomedical
investigators, patients and their families concerned with primary immunodeficiency diseases and also
to promote research on causes, mechanisms and treatment of these disorders. ESID was established
as an informal group in 1983 and became a society in 1994.
The aims of INGID are to improve and extend the quality of nursing care of patients with primary
immune deficiencies, and to increase the awareness and understanding of primary
immunodeficiencies amongst nurses. More info:, Facebook, Twitter, Instagram.
The Asia Pacific Society for Immunodeficiencies (APSID) works to provide PID care, education and
research for PID patients, through collaborative infrastructure and various APSID Working Parties. A
group of over 60 Asian paediatricians and scientists interested in Primary Immunodeficiency met in
Osaka, April 2015 and pledged to establish APSID with the following missions: To care and cure
patients with primary immunodeficiency (PID), To share PID experience so as to promote
collaboration & education, To improve PID management through understanding its genetics &
pathogenesis and To advocate and advance the care of PID patients through engaging governments,
patient organizations & industry.
ARAPID is the Arab Society for PID. Its purpose is to bring together the English-speaking east region
of the Arab world, closer to the French-speaking west region, to better serve PID patients from the
Arab world who are united by consanguinity, etiological profile of PIDs and culture (awareness).
About ASID
The African Society for Immunodeficiency (ASID) is a PID focused scientific society. Its main
objectives are to improve PID awareness and care within Africa and has been working on addressing
continental African PID peculiarities. ASID thrives to support African patients through collaborating
with national and international patient groups and works with national societies and other relevant
authorities to achieve its objectives. ASID also collaborates with international PID societies and
alliances, and the industry to promote better PID care and research. Please visit website: www.asidafrica.
The Latin American Society for Immunodeficiencies (LASID) is a vibrant and inclusive international
society. This is the home of all professionals dedicated to the field of Primary Immunodeficiencies
aiming to develop and perfect the education, scientific research, and health care within this medical
specialty. LASID’s mission comprises the following: To increase awareness in Primary
Immunodeficiency Diseases (PIDD) at all levels all over the continent, to develop diagnostic
capabilities to reach as many as possible patients and to favour the development of centers providing
appropriate treatments for PIDD patients.
South East Asia Primary Immunodeficiency Network or “SEAPID” is a regional NGO – the South East
Asian network of Primary Immunodeficiency Experts. It was established in Bangkok, Thailand on 26th
January 2015, following an accord reached by experts from the six South East Asian founding
countries, namely, Indonesia, Malaysia, the Philippines, Singapore, Thailand and Vietnam.

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