Lysosomal Storage Diseases Do Not Increase COVID-19 Risk

Patients with lysosomal storage diseases (LSDs) such as Pompe disease (PD) do not appear to be at an increased risk of developing coronavirus disease 2019 (COVID-19), according to a study published in the Turkish Archives of Pediatrics.

The study included 87 patients with LSDs, 19 of whom had a history of contact with a COVID-19 patient. Of these patients, 2 had polymerase chain reaction (PCR)-confirmed COVID-19, 3 had PCR-negative results despite having symptoms, 3 did not undergo PCR testing despite having symptoms, and 11 were asymptomatic and did not undergo PCR testing.

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Only 8 patients in the study had PCR-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (9.1%), and only 3 of these had known contact with a COVID-19 patient. Hospitalization was required in 2 SARS-CoV-2-positive patients, while the rest had mild symptoms and were able to recover at home. One patient died at home during a quarantine period while their parents had COVID-19, but COVID-19 could not be confirmed in the patient.

None of the 4 patients with PD included in the study experienced COVID-19, and none had a history of contact with a COVID-19 patient.

“The findings of this study support the idea that LSD patients do not have an increased risk of COVID-19 compared to the population, despite the chronic inflammatory state,” the authors wrote.

The authors mentioned previous research suggesting that patients with LSDs may have a potential resistance to SARS-CoV-2 infection due to the disruption of various lysosomal functions making their cells “unfavorable” hosts for the virus.

Despite potential resistance, some LSD patients with specific forms of mucopolysaccharidosis (MPS) may be at an increased risk of COVID-19 due to thickened mucus and narrow respiratory tracts. This was highlighted by the fact that 2 patients with MPS required hospitalization (one with MPS 1 and one with MPS 6) and an additional patient with MPS 2 died during quarantine under suspicion of COVID-19.

Of the patients over 12 years of age who were eligible to receive a vaccination (n=57), 21 were not vaccinated (37%). Only 51.6% of the patients who were vaccinated received at least 2 doses. None of the patients with PD were vaccinated because they had not reached the age of eligibility.

Within the group of 87 patients with LSDs, 3 had MPS 1, 10 had MPS 2, 16 had MPS 4A, 11 had MPS 6, 1 had MPS 7, 33 had Gaucher disease, 9 had Fabry disease, and 4 had PD.

Reference

Yoldaş Çelik M, Canda E, Yazıcı H, et al. COVID-19 and vaccination status in lysosomal storage diseases: a single-center experience. Turk Arch Pediatr. Published online May 3, 2023. doi:10.5152/TurkArchPediatr.2023.22233