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. 2021 Oct 1;16(10):e0257641.
doi: 10.1371/journal.pone.0257641. eCollection 2021.

COVID-19-related outcomes in immunocompromised patients: A nationwide study in Korea

Moon Seong Baek  1 , Min-Taek Lee  2   3 , Won-Young Kim  1 , Jae Chol Choi  1 , Sun-Young Jung  2   3
Affiliations

COVID-19-related outcomes in immunocompromised patients: A nationwide study in Korea

Moon Seong Baek et al. PLoS One. .

Abstract

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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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Kaplan-Meier survival curves for patients with COVID-19 according to immunocom-promised status after the inverse probability of treatment weighting (log-rank P-value <0.001).
See this image and copyright information in PMC

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