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COVID-19-related outcomes in immunocompromised patients: A nationwide study in Korea
Moon Seong Baek1, Min-Taek Lee2,3, Won-Young Kim1
1Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Insights
Immunocompromised patients with coronavirus disease 2019 (COVID-19) face a higher risk of death. This study found that immunocompromised status independently increases mortality risk in COVID-19 patients.
Area of Science:
- Immunology
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) has seen a rapid increase in cases and mortality.
- Identifying vulnerable patient groups is crucial for managing the pandemic.
- Immunocompromised individuals are considered at higher risk for severe COVID-19 outcomes.
Purpose of the Study:
- To investigate the association between immunocompromised status and mortality risk in COVID-19 patients.
- To determine if immunocompromised patients with COVID-19 have an increased risk of in-hospital mortality.
Main Methods:
- A cohort of 6,435 COVID-19 patients (≥18 years) was analyzed.
- Immunocompromised status was defined by specific diagnoses (malignancy, HIV/AIDS), recent organ transplantation, or use of corticosteroids/immunosuppressants.
- Propensity score weighting and multivariable logistic regression were used to assess mortality risk.
Main Results:
- The study included 871 immunocompromised (13.5%) and 5,564 non-immunocompromised patients.
- Immunocompromised patients were older, had more comorbidities, and a higher unadjusted mortality rate (9.6% vs. 2.3%).
- After adjustment, immunocompromised status remained independently associated with a significantly higher risk of mortality (aOR: 2.09, 95% CI: 1.62-2.68).
Conclusions:
- Immunocompromised status is a significant independent risk factor for mortality in COVID-19 patients.
- These findings highlight the vulnerability of immunocompromised individuals to severe COVID-19 outcomes.
- Further research and targeted interventions for this population are warranted.
Background:
Given the rapid increased in confirmed coronavirus disease 2019 (COVID-19) and related mortality, it is important to identify vulnerable patients. Immunocompromised status is considered a risk factor for developing severe COVID-19. We aimed to determine whether immunocompromised patients with COVID-19 have an increased risk of mortality.
Method:
The groups' baseline characteristics were balanced using a propensity score-based inverse probability of treatment weighting approach. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated for the risks of in-hospital mortality and other outcomes according to immunocompromised status using a multivariable logistic regression model. We identified immunocompromised status based on a diagnosis of malignancy or HIV/AIDS, having undergone organ transplantation within 3 years, prescriptions for corticosteroids or oral immunosuppressants for ≥30 days, and at least one prescription for non-oral immunosuppressants during the last year.
Results:
The 6,435 COVID-19 patients (≥18 years) included 871 immunocompromised (13.5%) and 5,564 non-immunocompromised (86.5%). Immunocompromised COVID-19 patients were older (60.1±16.4 years vs. 47.1±18.7 years, absolute standardized mean difference: 0.738). The immunocompromised group had more comorbidities, a higher Charlson comorbidity index, and a higher in-hospital mortality rate (9.6% vs. 2.3%; p < .001). The immunocompromised group still had a significantly higher in-hospital mortality rate after inverse probability of treatment weighting (6.4% vs. 2.0%, p < .001). Multivariable analysis adjusted for baseline imbalances revealed that immunocompromised status was independently associated with a higher risk of mortality among COVID-19 patients (adjusted odds ratio [aOR]: 2.09, 95% CI: 1.62-2.68, p < .001).
Conclusions:
Immunocompromised status among COVID-19 patients was associated with a significantly increased risk of mortality.
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