Missed and misdiagnosis of immunodeficiency: Good syndrome presenting as persistent COVID-19 shedding
Bibliographic record
Abstract
A 61-year-old man was referred to the immunology clinic due to prolonged COVID-19 infection and absent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. His infection, confirmed by polymerase chain reaction (PCR) testing upon returning to Hong Kong from Vancouver, resulted in a 31-day hospitalization due to persistent positive PCR results, despite his remaining asymptomatic. Laboratory tests revealed lymphopenia, low immunoglobulin levels, and unremarkable serum protein electrophoresis, with all viral serologies, including HIV, being negative. Although he received 3 doses of the Pfizer BioNTech vaccine, he showed no detectable SARS-CoV-2 antibodies. Further evaluation indicated almost-absent CD19 cells and low CD4 and CD8 counts, and coupled with his history of thymoma, this led to a diagnosis of Good syndrome. The patient began subcutaneous immunoglobulin replacement therapy and was started on long-term valganciclovir for moderate cytomegalovirus antigenemia.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".