Abstract
Whether immunosuppressed (IS) patients have a worse prognosis of COVID-19 compared to non-IS patients is not known. The aim of this study was to evaluate the clinical characteristics and outcome of IS patients hospitalized with COVID-19 compared to non-IS patients. We designed a retrospective cohort study. We included all patients hospitalized with laboratory-confirmed COVID-19 from the SEMI-COVID-19 Registry, a large multicentre national cohort in Spain, from March 27th until June 19th, 2020. We used multivariable logistic regression to assess the adjusted odds ratios (aOR) of in-hospital death among IS compared to non-IS patients. Among 13 206 included patients, 2 111 (16.0%) were IS. A total of 166 (1.3%) patients had solid organ (SO) transplant, 1081 (8.2%) had SO neoplasia, 332 (2.5%) had hematologic neoplasia, and 570 (4.3%), 183 (1.4%) and 394 (3.0%) were receiving systemic steroids, biological treatments, and immunosuppressors, respectively. Compared to non-IS patients, the aOR (95% CI) for in-hospital death was 1.60 (1.43-1.79) for all IS patients, 1.39 (1.18-1.63) for patients with SO cancer, 2.31 (1.76-3.03) for patients with haematological cancer and 3.12 (2.23-4.36) for patients with SO transplant. The aOR (95% CI) for death for patients who were receiving systemic steroids, biological treatments and immunosuppressors compared to non-IS patients were 2.16 (1.80-2.61), 1.97 (1.33-2.91) and 2.06 (1.64-2.60), respectively. IS patients had a higher odds than non-IS patients of in-hospital acute respiratory distress syndrome, heart failure, myocarditis, thromboembolic disease and multiorgan failure. IS patients hospitalized with COVID-19 have a higher odds of in-hospital complications and death compared to non-IS patients.
Highlights
Immune suppression is a major condition associated with a high risk of serious infectious
IS patients hospitalized with COVID-19 have a higher odds of in-hospital complications and death compared to non-IS patients
Common viral agents, such as influenza, adenovirus, rhinovirus and respiratory syncytial virus, usually cause severe disease in immunosuppressed patients [1]; whether novel severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) has a more severe course among immunosuppressed patients is still unclear. Demographic factors such as advanced age or male sex, as well as several conditions such as hypertension, obesity, diabetes mellitus or cardiovascular diseases, have been described as risk factors associated with adverse outcomes of coronavirus disease 2019 (COVID-19) [2, 3], but there is little evidence about its course among immunosuppressed patients
Summary
Immune suppression is a major condition associated with a high risk of serious infectious Common viral agents, such as influenza, adenovirus, rhinovirus and respiratory syncytial virus, usually cause severe disease in immunosuppressed patients [1]; whether novel severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) has a more severe course among immunosuppressed patients is still unclear. Demographic factors such as advanced age or male sex, as well as several conditions such as hypertension, obesity, diabetes mellitus or cardiovascular diseases, have been described as risk factors associated with adverse outcomes of coronavirus disease 2019 (COVID-19) [2, 3], but there is little evidence about its course among immunosuppressed patients. The aim of this study was to evaluate the clinical characteristics and outcome of IS patients hospitalized with COVID-19 compared to non-IS patients
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