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CD27 deficiency is a rare primary immune deficiency which affects T cells, B cells and NK cells and is associated with hypogammaglobulinemia. Clinical presentation varies from asymptomatic disease to life-threatening Epstein Barr Virus (EBV)-driven complications including malignancy. Delay in diagnosis and late presentation adversely affects the clinical outcome and survival. We report a 10-year-old girl who had been symptomatic since 3 years of age with recurrent infections, developed bronchiectasis and was found to have hypogammaglobulinemia. Initially diagnosed as common variable immune deficiency, she had persistent lymphadenopathy, hepatosplenomegaly and pancytopenia, raising a clinical suspicion of a lymphoproliferative condition. On investigation, she was found to have a novel mutation involving the CD27 gene with very high EBV load. She was given rituximab injections to which she showed partial response and later developed non-Hodgkin’s lymphoma .

The coronavirus disease (COVID-19) though primarily causes respiratory tract infection, various extra-pulmonary complications have also been reported. We hereby report dilated cardiomyopathy in a one-year old premorbidly healthy boy with COVID-19 infection who had a poor outcome.

Introduction: The catastrophic effects of corona in 2020 identified the use of broad-spectrum antiviral remdesivir (RDV). The beneficial effects of RDV are not proven and documented in many trials in COVID. Materials and Methods: Reverse transcriptase–polymerase chain reaction (RT-PCR)-confirmed cohort cases of COVID were retrospectively analyzed for outcomes including mortality and clinical improvement with and without RDV during the period September 21, 2020–October 9, 2020. The data were analyzed statistically for outcome in COVID. The present study was carried out to evaluate the clinical benefits of RDV and its outcomes in COVID. Results: A total of 91 RT-PCR positive COVID patients were grouped into 37 RDV (41%) and 54 non-RDV (51%). The mean age was 51 and 55. Male-to-female ratio of 67:32 and 65:35 in the RDV and non-RDV groups was found, indicating male predominance in the study. The recovery time for COVID was 11 days with a cure rate of 78% in the RDV group, while it was 21 days with 98% in the non-RDV group. A statistical significant association was found between RDV and the need for oxygen support (hypoxic patients) and noninvasive ventilation (NIV). Twenty-seven percent in RDV group needed NIV (P = 0.009). Morbidity and mortality were 19% (7) and 22% (8) and 7% (4) and 2% (1) in the RDV and non-RDV groups, respectively. Conclusion: RDV use in COVID was associated with increased mortality (22% vs. 2%) but reduced duration of hospitalization by 50% as compared to non-RDV group. Early identification of hypoxia plays an important role in COVID management for initiating RDV treatment.

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