In-hospital mortality among immunosuppressed patients with COVID-19: Analysis from a national cohort in Spain

Suárez-García I ; Perales-Fraile I ; González-García A ; Muñoz-Blanco A ; Manzano L ; Fabregate M ; Diez-Manglano J (Universidad de Zaragoza) ; Aizpuru EF

Resumen: Background
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.

Methods
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.

Results
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.

Conclusions
IS patients hospitalized with COVID-19 have a higher odds of in-hospital complications and death compared to non-IS patients.

Idioma: Inglés

DOI: 10.1371/journal.pone.0255524

Año: 2021

Publicado en: PLoS ONE 16 (2021)
ISSN: 1932-6203

Factor impacto JCR: 3.752 (2021)

Categ. JCR: MULTIDISCIPLINARY SCIENCES rank: 29 / 74 = 0.392 (2021) - Q2 - T2

Factor impacto SCIMAGO: 0.852 - Multidisciplinary (Q1)

Tipo y forma: Article (Published version)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)