Clinical characteristics and outcomes of Coronavirus Disease 2019 in immunocompromised hosts

Objective To investigate the clinical characteristics and outcomes of Coronavirus Disease 2019 in immunocompromised hosts.

Methods A retrospective analysis was conducted on the clinical data of 230 hospitalized patients diagnosed with Coronavirus Disease 2019 at Nanjing Yimin Hospital from December 2022 to November 2023. The patients were divided into three groups based on their immune status: immunocompromised group (n=59), relatively immunocompromised group (n=129), and immunocompetent group (n=42). The clinical characteristics (such as clinical manifestations, imaging features, and laboratory examinations) and outcomes (such as length of hospital stay and in-hospital mortality) were compared among three groups.

Results Compared with there latively immunocompromised and immunocompetent groups, the immunocompromised group showed no obvious specific clinical manifestations. However, the proportions of patients with symptoms such as cough and expectoration were lower, and the occurrences of symptoms such as myalgia and fatigue were less frequent in the immunocompromised group (P < 0.05). The chest CT findings in the immunocompromised group also lacked specific changes, mainly presenting as subpleural ground-glass opacities and consolidations with multilobar distribution, but fibrotic changes were more common (P < 0.05). The proportion of patients with decreased absolute lymphocyte counts in the immunocompromised group was higher than that in the immunocompetent group, and the proportion of patients with elevated procalcitonin levels was higher than that in the other two groups (P < 0.05). The proportion of severe case sand the length of hospital stay in the immunocompromised group were higher and longer than those in the relatively immunocompromised and immunocompetent groups(P < 0.05). The in-hospital mortality rates in the immunocompromised, relatively immunocompromised, and immunocompetent groups were 10.17%, 6.98%, and 2.38%, respectively, with no statistically significant difference (P>0.05).

Conclusion After Coronavirus Disease 2019, immunocompromised hosts do not show obvious clinical and imaging features. However, they have a prolonged length of hospital stay, a significantly higher proportion of severe cases, and a tendency towards increased in-hospital mortality, which should be given high clinical attention.