Impact of COVID-19 on 75 Immunocompromised Patients: Does Immunosuppression Alter the Clinical Course?

Currently, clinical details of immunosuppressed patients suffering from COVID-19 are limited. Some studies have shown no more severe diseases among them, but others have highlighted that immunosuppressed patients may have high levels of viral load and impaired immune responses. Herein, this study aimed to specifically address the symptoms, prognosis, laboratory tests, clinical course, and the outcome of SARS-CoV-2 infected immunocompromised patients at a tertiary referral center.

Clinical and laboratory information of 75 non-congenital immunosuppressed patients with COVID-19 disease was obtained at a referral center for immunodeficiency diseases and infectious disorders in Tehran, Iran. Three groups of immunocompromised patients were evaluated, including patients with a history of organ transplantation, autoimmune patients receiving medical therapy, and cancer patients undergoing chemotherapy.

Among 75 immune-deficient patients with COVID-19, there were 32 patients with a kidney transplant, 23 patients with malignancies, and 19 patients with autoimmune disorders. One patient had both malignancy and multiple sclerosis. The mean length of hospitalization was 10.82 days. By the end of the study, 24 (32%) patients were dead, and 51 (68%) patients were discharged. Dyspnea was the most common (64%) symptom. Low levels of O2 saturation and lymphopenia at admission time significantly affected the mortality rate of patients.

This study showed that mortality rate among immunocompromised patients was 32%. It seems that COVID-19 has a worse outcome and a more severe clinical course in immunocompromised patients regardless of age, gender, and underlying diseases.