Van Leeuwen, LeanneVan Coillie, SamyaPrévot, JohanDrabwell, JoseMahlaoui, NizarSánchez-Ramón, SilviaPoli Harlowe, María CeciliaMeyts, IsabelleAli, AdliLowe, DavidDalm, VirgilPergent, Martine2026-08-192026-08-192025Van Leeuwen LPM, Van Coillie S, Prévot J, Drabwell J, Mahlaoui N, Sánchez-Ramón S, Poli MC, Meyts I, Ali A, Lowe DM, Dalm VASH, Pergent M. Long-term effects of COVID-19 in patients with primary immunodeficiency: An IPOPI worldwide survey. J Allergy Clin Immunol. 2025 Aug;156(2):449-462. doi: 10.1016/j.jaci.2025.04.023.https://hdl.handle.net/11447/11022Background: During the coronavirus disease 2019 (COVID-19) pandemic, many individuals developed persistent symptoms after COVID-19. The data on these long-term effects in the primary immunodeficiency (PID) community are limited. Objective: This study aimed to understand long-term symptoms after COVID-19 in patients with PID, focusing on prevalence, risk factors, viral persistence, and the impact of COVID-19 on their health-related quality of life (HR-QoL). Methods: A global, multilingual web-based survey was conducted by the International Patient Organization for Primary Immunodeficiencies between July and October 2023. Self-reported data on demographics, PID diagnosis, comorbidities, COVID-19, and HR-QoL were collected using the EuroQol 5-Dimensions 5-Level (EQ-5D-5L) survey and analyzed. Results: Of the 1160 respondents, 25% reported persistent symptoms after COVID-19. Common symptoms included fatigue, headache, and nasal symptoms. Compared with those respondents without persistent symptoms, those with persistent symptoms after COVID-19 reported a significantly higher prevalence of symptoms across all categories-systemic, pain, cardiopulmonary, gastrointestinal, neurologic, psychological, neurocognitive, and others-except for upper respiratory tract symptoms. Independent risk factors for development of persistent symptoms included female sex, asthma, neurologic diseases, and predominantly antibody deficiency other than common variable immunodeficiency or agammaglobulinemia. In 30% of patients with persistent symptoms, viral clearance was not achieved within 1 month. During the pandemic, HR-QoL declined across all PID categories-even in those without COVID-19, but especially in those with a symptom duration of more than 6 months. Conclusion: Persistent symptoms after COVID-19 are prevalent among patients with PID, with various risk factors identified. The COVID-19 pandemic had a considerable impact on the HR-QoL of patients with PID regardless of COVID-19 status.enCOVID-19HR-QoLPIDHealth-related quality of lifeLong COVIDPatient-reportedPersistent symptomsPrimary immunodeficienciessurveyviral persistenceArticlehttps://doi.org/10.1016/j.jaci.2025.04.023