Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2023 Feb 8;76(3):e172-e178.
doi: 10.1093/cid/ciac571.

Clinical Characteristics and Outcomes of Immunocompromised Patients With Coronavirus Disease 2019 Caused by the Omicron Variant: A Prospective, Observational Study

S Reshwan K Malahe  1   2 , Rogier A S Hoek  2   3 , Virgil A S H Dalm  4   5 , Annoek E C Broers  6 , Caroline M den Hoed  2   7 , Olivier C Manintveld  2   8 , Carla C Baan  1   2 , Charlotte M van Deuzen  9 , Grigorios Papageorgiou  10 , Hannelore I Bax  9 , Jeroen J Van Kampen  11 , Merel E Hellemons  2   3 , Marcia M L Kho  1   2 , Rory D de Vries  11 , Richard Molenkamp  11 , Marlies E J Reinders  1   2 , Bart J A Rijnders  9
Affiliations
Observational Study

Clinical Characteristics and Outcomes of Immunocompromised Patients With Coronavirus Disease 2019 Caused by the Omicron Variant: A Prospective, Observational Study

S Reshwan K Malahe et al. Clin Infect Dis. .

Abstract

Background: Illness after infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant is less severe compared with previous variants. Data on the disease burden in immunocompromised patients are lacking. We investigated the clinical characteristics and outcomes of immunocompromised patients with coronavirus disease 2019 (COVID-19) caused by Omicron.

Methods: Organ transplant recipients, patients on anti-CD20 therapy, and allogenic hematopoietic stem cell transplantation recipients infected with the Omicron variant were included. Characteristics of consenting patients were collected and patients were contacted regularly until symptom resolution. To identify possible risk factors for hospitalization, a univariate logistic analysis was performed.

Results: 114 consecutive immunocompromised patients were enrolled. Eighty-nine percent had previously received 3 mRNA vaccinations. While only 1 patient died, 23 (20%) were hospitalized for a median of 11 days. A low SARS-CoV-2 immunoglobulin G (IgG) antibody response (<300 BAU [binding antibody units]/mL) at diagnosis, being older, being a lung transplant recipient, having more comorbidities, and having a higher frailty score were associated with hospital admission (all P < .01). At the end of follow-up, 25% had still not fully recovered. Of the 23 hospitalized patients, 70% had a negative and 92% had a low IgG (<300 BAU/mL) antibody response at admission. Sotrovimab was administered to 17 of these patients, and 1 died.

Conclusions: While the mortality in immunocompromised patients infected with Omicron was low, hospital admission was frequent and the duration of symptoms often prolonged. In addition to vaccination, other interventions are needed to limit the morbidity from COVID-19 in immunocompromised patients.

Keywords: COVID-19; Omicron; immunocompromised patients; outcome; therapy.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. B. J. A. R. has served on advisory boards of Roche and AstraZeneca. R. A. S. H. and O. C. M. have served on the advisory board of AstraZeneca. V. A. S. H. D. received grants from ZonMw (paid to their institution), Horizon 2020–Marie Curie Sklodowska (paid to their institution), and Takeda (paid to their institution) and has received payment from Takeda, Pharming, GSK, and CSL Behring paid to their institution for lectures. M. M. L. K. has served on the advisory board of Takeda. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Time to symptom resolution in 114 immunocompromised patients. One minus the Kaplan-Meier estimator (multiplies by 100%) is shown as a solid line, the 95% confidence interval is shown as a dotted line, and the censored observations are shown as tick marks.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Williamson EJ, Walker AJ, Bhaskaran K, et al. . Factors associated with COVID-19-related death using OpenSAFELY. Nature 2020; 584:430–6. - PMC - PubMed
    1. Hoek RAS, Manintveld OC, Betjes MGH, et al. . COVID-19 in solid organ transplant recipients: a single-center experience. Transpl Int 2020; 33:1099–105. - PMC - PubMed
    1. Vinson AJ, Agarwal G, Dai R, et al. . COVID-19 in solid organ transplantation: results of the National COVID Cohort Collaborative. Transplant Direct 2021; 7:e775. - PMC - PubMed
    1. Corey L, Beyrer C, Cohen MS, Michael NL, Bedford T, Rolland M. SARS-CoV-2 variants in patients with immunosuppression. N Engl J Med 2021; 385:562–6. - PMC - PubMed
    1. Feikin DR, Higdon MM, Abu-Raddad LJ, et al. . Duration of effectiveness of vaccines against SARS-CoV-2 infection and COVID-19 disease: results of a systematic review and meta-regression. Lancet 2022; 399:924–44. - PMC - PubMed

Publication types

Supplementary concepts