Impact of SARS-CoV-2 on patients with lysosomal diseases in a major NYC hospital system

Lau, Heather A.

During the height of the pandemic in NYC (March–June 2020), the NYU Langone Health Lysosomal Storage Disorders (LSD) Program reached out to 183 patients to provide information on how to mitigate exposure to COVID19 and to ascertain who had been exposed and/or infected. 139 patients were successfully contacted. Recommendations on how to safely continue enzyme replacement therapy (ERT) or substrate reduction therapy (SRT) were provided. 135 of the 139 respondents during March 2020–June 2020 had Gaucher disease (GD). Twenty-six patients with GD endorsed 2 or more symptoms consistent with COVID19 infection and/or were confirmed to have COVID19 either through RT-PCR test for SARS-CoV-2 RNA or through antibodies to the virus. The remaining 4 who had suspected or confirmed COVID19 infection were patients with Fabry (2), Pompe (1), and Mucopolysaccharidosis Type IIIA (1). This case series describes the impact of COVID19 on 30 patients with LSDs with details of symptomatology, duration of illness, and treatment. Baseline demographics were collected including age, sex, genotype, current disease burden, LSD treatment history, biomarkers and co-morbidities. At time of infection, 21 patients were on ERT (20 GD, 1 PD), 3 on SRT for GD, and 6 were naïve to therapy. There was only 1 hospitalization of a 55 year old woman with GD on ERT that resulted in ARDS who subsequently died due to SARS-CoV-2. Her co-morbidities included morbid obesity, COPD, hypertension and diabetes. Her GD burden was minimal. The rest of the affected patients had a mild to moderate COVID19 course. In conclusion, patients with LSDs experienced varied symptomatology and severity from COVID19 infection, ranging from asymptomatic to critically ill. Risk factors included baseline health status regardless of specific LSD, age, and associated co-morbidities. The sample is too small to make conclusions on specific impact of treatment status on COVID19 severity.-.