Outcomes of COVID-19 in immunocompromised patients: a single center experience

Masoud Mardani; Jafar Mohammadshahi; Roghayeh Teimourpour

doi:10.1007/s13337-023-00832-z

Outcomes of COVID-19 in immunocompromised patients: a single center experience

Virusdisease. 2023 Sep;34(3):373-382. doi: 10.1007/s13337-023-00832-z. Epub 2023 Aug 10.

Authors

Masoud Mardani¹, Jafar Mohammadshahi^{2

3}, Roghayeh Teimourpour^{2

4}

Affiliations

¹ Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical, Tehran, Iran.
² Ardabil University of medical science, Ardabil, Iran.
³ Department of Infectious Diseases, School of Medicine, Ardabil University of Medical Science, Ardabil, Iran.
⁴ Department of Microbiology, School of Medicine, Ardabil University of Medical Science, Ardabil, Iran.

PMID: 37780900
PMCID: PMC10533436 (available on 2024-09-01)
DOI: 10.1007/s13337-023-00832-z

Abstract

Malignancy, bone marrow and organ transplantation are associated with deficient and defective immune systems. Immunocompromised patients are at risk for severe and chronic complication of COVID-19 infection. However, the pathogenesis, diagnosis and management of this comorbidity remain to be elucidated. The purpose of the present study was to describe key aspects of COVID-19 infection in immunocompromised patients. In this retrospective, cross-sectional study, lab findings and outcomes of 418 COVID-19 patients with secondary immunodeficiency disorders admitted to Taleghani Hospital in Tehran, from March 2020 to September 2022 were investigated. Of the 418 immunocompromised patients with COVID-19, 236 (56.5%) ‌ were male and the median age of all studied patients was 56.6 ± 16.4 with range of 14 to 92 years. Totally, 198 (47.4%) of the patients died during hospitalization. Remdesivir was used for treatment of all patients. Mortality rate among patients admitted to ICU ward (86.8%) was significantly higher than non ICU admission (p < 0.001). The death rate in patients with CKD was substantially higher than other underlying disease (p < 0.001). In terms of laboratory finding, there was a significant relationship between ICU admission and worse outcome with WBC count (HR = 1.94, 95% CI = 1. 46-2.59, p < 0.001), PMN count (HR = 1.93, 95% CI = 1.452.56, p < 0.001), Hb (HR = 1.49, 95% CI = 1.042.13, p = 0.028), AST (HR = 2.55, 95% CI = 1.913.41, p < 0.001), BUN (HR = 2.56, 95% CI = 2.063.69, p < 0.001), Cr (HR = 2.63, 95% CI = 1.89-3.64, p < 0.001), Comorbidities index (HR = 1.71, 95% CI = 1.29-2.27, p < 0.001) and aging (HR = 1.91, 95% CI = 1.4-2.54, p < 0.001). Immunocompromised status increased the risk of mortality or worse outcome in patients diagnosed with COVID-19. Our finding showed outcome predicting markers in whom the waned immune system encounter new emerging disease and improved our understanding of COVID-19 virus behavior in immunocompromised individuals.

Keywords: Bone marrow; COVID-19; Comorbidity; Malignancy; Organ transplantation.

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