Top 5 Takeaways

1. Immunocompromised patients represented a significant portion of COVID-19 hospitalizations. Accounting for 12.2% of adult COVID-19 hospitalizations across 10 states, immunocompromised patients had increased odds of ICU admission and in-hospital death compared with nonimmunocompromised patients, regardless of vaccination status.
2. Vaccination status and severe outcomes among immunocompromised. Among vaccinated patients, immunocompromised individuals had higher odds of ICU admission and in-hospital death than nonimmunocompromised patients. However, vaccination reduced the odds of death among nonimmunocompromised patients but not significantly among immunocompromised patients.
3. Impact of specific immunocompromising conditions. Certain conditions, such as AIDS, immunosuppressive therapy use, multiple myeloma, or solid organ transplant, were associated with higher odds of in-hospital death among immunocompromised patients.
4. Demographic and clinical characteristics of immunocompromised patients. These patients were more likely to be older and non-Hispanic White, with a higher prevalence of underlying medical conditions known to worsen COVID-19 outcomes, except for diabetes and neurologic disease.
5. Prevention and treatment strategies. Known prevention measures, including nonpharmaceutical interventions, up-to-date vaccination, early testing, and prophylactic and antiviral treatments, are crucial for preventing severe COVID-19 outcomes among immunocompromised individuals.

Original Article Author and Citation

Corresponding Author

Jason Robert C. Singson, Jason.Singson@cdph.ca.gov.

Suggested Citation

Singson JR, Kirley PD, Pham H, et al. Factors Associated with Severe Outcomes Among Immunocompromised Adults Hospitalized for COVID-19 — COVID-NET, 10 States, March 2020–February 2022. MMWR Morb Mortal Wkly Rep 2022;71:878–884. DOI: http://dx.doi.org/10.15585/mmwr.mm7127a3 .

Summary

This MMWR article focuses on the heightened risk immunocompromised adults face regarding severe COVID-19 outcomes, such as ICU admission and in-hospital death, across 10 states from March 2020 to February 2022. Immunocompromised patients, regardless of vaccination status, showed increased odds of severe outcomes compared to their nonimmunocompromised counterparts.

Methods

The study analyzed data from the COVID-19–Associated Hospitalization Surveillance Network (COVID-NET), covering 10 U.S. states, to assess the impact of immunocompromise on COVID-19 hospitalization outcomes. It evaluated associations between immunocompromise, vaccination status, ICU admission, and in-hospital death.

Discussion

The findings underscore the vulnerability of immunocompromised patients to severe COVID-19 outcomes and highlight the protective role of vaccination, especially among nonimmunocompromised individuals. However, the impact of vaccination among the immunocompromised is less pronounced, necessitating additional preventive measures.

Conclusion

Given the significant risk immunocompromised patients face, the study emphasizes the importance of multilayered prevention strategies, including timely vaccination, nonpharmaceutical interventions, and early therapeutic interventions, to mitigate the risk of severe COVID-19 outcomes.

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