TABLE 1. Characteristics of hospitalizations among immunocompromised adults aged ≥18 years with COVID-19–like illness, by COVID-19 vaccination status and SARS-CoV-2 test result status — VISION, September 2023–February 2024.
| Characteristic | Overall, no. (col. %) N = 14,586 | SARS-CoV-2 status,
no. (column %) |
SMD§ | Vaccination status, no. (row %) |
SMD§ | |||
|---|---|---|---|---|---|---|---|---|
| Case-patients* (n = 1,392) | Control patients† (n = 13,194) | No updated dose¶ (n = 11,990) | Updated dose, 7–59 days earlier (n = 1,381) | Updated dose, 60–119 days earlier (n = 1,215) | ||||
|
Site** | ||||||||
| HealthPartners |
966 (7)
|
91 (7) |
875 (7) |
0.18 |
709 (73) |
141 (15) |
116 (12) |
0.49 |
| Intermountain Health |
1,608 (11)
|
201 (14) |
1,407 (11) |
1,358 (84) |
125 (8) |
125 (8) |
||
| KPNC |
5,790 (40)
|
466 (33) |
5,324 (40) |
4,430 (77) |
709 (12) |
651 (11) |
||
| KPNW |
863 (6)
|
72 (5) |
791 (6) |
659 (76) |
124 (14) |
80 (9) |
||
| Regenstrief Institute |
3,541 (24)
|
353 (25) |
3,188 (24) |
3,154 (89) |
206 (6) |
181 (5) |
||
| University of Colorado |
1,818 (12)
|
209 (15) |
1,609 (12) |
1,680 (92) |
76 (4) |
62 (3) |
||
|
COVID-19 vaccination status
| ||||||||
| No updated dose¶ |
11,990 (82)
|
1,197 (86) |
10,793 (82) |
0.12 |
11,990 (100) |
0 (—) |
0 (—) |
NA |
| Updated dose, ≥7 days earlier |
2,596 (18)
|
195 (14) |
2,401 (18) |
0 (—) |
1,381 (53) |
1,215 (47) |
||
| Updated dose, 7–59 days earlier |
1,381 (9)
|
100 (7) |
1,281 (10) |
0 (—) |
1,381 (100) |
0 (—) |
||
| Updated dose, 60–119 days earlier |
1,215 (8)
|
95 (7) |
1,120 (8) |
0 (—) |
0 (—) |
1,215 (100) |
||
|
Median age, yrs (IQR)
|
70 (60–79)
|
72 (63–80) |
70 (60–78) |
0.16 |
69 (59–78) |
74 (66–81) |
75 (68–82) |
0.36 |
|
Age group, yrs
| ||||||||
| 18–64 |
5,017 (34)
|
393 (28) |
4,624 (35) |
0.15 |
4,524 (90) |
288 (6) |
205 (4) |
0.43 |
| ≥65 |
9,569 (66)
|
999 (72) |
8,570 (65) |
7,466 (78) |
1,093 (11) |
1,010 (11) |
||
|
Female sex
|
7,420 (51)
|
669 (48) |
6,751 (51) |
0.06 |
6,159 (83) |
675 (9) |
586 (8) |
0.06 |
|
Race and ethnicity
| ||||||||
| Black or African American, non-Hispanic |
1,390 (10)
|
110 (8) |
1,280 (10) |
0.12 |
1,196 (86) |
113 (8) |
81 (6) |
0.14 |
| White, non-Hispanic |
10,008 (69)
|
1,022 (73) |
8,986 (68) |
8,126 (81) |
996 (10) |
886 (9) |
||
| Hispanic or Latino |
1,620 (11)
|
127 (9) |
1,493 (11) |
1,378 (85) |
135 (8) |
107 (7) |
||
| Other, non-Hispanic†† |
1,419 (10)
|
121 (9) |
1,298 (10) |
1,157 (82) |
130 (9) |
132 (9) |
||
| Unknown§§ |
149 (1)
|
12 (1) |
137 (1) |
133 (89) |
7 (5) |
9 (6) |
||
|
No. of chronic medical condition categories¶¶ in addition to immunocompromising conditions
| ||||||||
| 0 |
555 (4)
|
31 (2) |
524 (4) |
0.13 |
495 (89) |
33 (6) |
27 (5) |
0.17 |
| 1 |
1,310 (9)
|
144 (10) |
1,166 (9) |
1,138 (87) |
91 (7) |
81 (6) |
||
| 2 |
2,681 (18)
|
267 (19) |
2,414 (18) |
2,204 (82) |
255 (10) |
222 (8) |
||
| 3 |
4,115 (28)
|
400 (29) |
3,715 (28) |
3,307 (80) |
404 (10) |
404 (10) |
||
| 4 |
3,378 (23)
|
333 (24) |
3,045 (23) |
2,741 (81) |
354 (10) |
283 (8) |
||
| ≥5 |
2,547 (17)
|
217 (16) |
2,330 (18) |
2,105 (83) |
244 (10) |
198 (8) |
||
|
Chronic respiratory condition*** |
6,192 (42)
|
550 (40) |
5,642 (43) |
0.07 |
5,012 (81) |
628 (10) |
552 (9) |
0.07 |
|
Type of immunocompromising condition†††
| ||||||||
| Solid organ malignancy |
6,185 (42)
|
500 (36) |
5,685 (43) |
0.15 |
5,052 (82) |
600 (10) |
533 (9) |
0.03 |
| Hematologic malignancy |
2,124 (15)
|
241 (17) |
1,883 (14) |
0.08 |
1,699 (80) |
234 (11) |
191 (9) |
0.06 |
| Rheumatologic or inflammatory disorder |
3,684 (25)
|
411 (30) |
3,273 (25) |
0.11 |
3,025 (82) |
345 (9) |
314 (9) |
0.01 |
| Other intrinsic immune condition or immunodeficiency |
5,140 (35)
|
525 (38) |
4,615 (35) |
0.06 |
4,304 (84) |
445 (9) |
391 (8) |
0.08 |
| Organ or stem cell transplant |
1,191 (8)
|
162 (12) |
1,029 (8) |
0.13 |
974 (82) |
122 (10) |
95 (8) |
0.02 |
| HIV/AIDS |
315 (2)
|
17 (1) |
298 (2) |
0.08 |
258 (82) |
34 (11) |
23 (7) |
0.02 |
|
ICU admission
|
3,386 (23)
|
283 (20) |
3,103 (24) |
0.08 |
2,871 (85) |
298 (9) |
217 (6) |
0.10 |
|
Receipt of invasive mechanical ventilation
| ||||||||
| Yes |
1,467 (10)
|
117 (8) |
1,350 (10) |
0.07 |
1,271 (87) |
107 (7) |
89 (6) |
0.27 |
| No |
10,967 (75)
|
1,059 (76) |
9,908 (75) |
8,788 (80) |
1,155 (11) |
1,024 (9) |
||
| Unknown |
2,152 (15)
|
216 (16) |
1,936 (15) |
1,931 (90) |
119 (6) |
102 (5) |
||
|
In-hospital death§§§
|
1,479 (10)
|
112 (8) |
1,367 (10) |
0.08 |
1,249 (84) |
125 (8) |
105 (7) |
0.05 |
|
Month and year of COVID-19–like illness hospitalization
| ||||||||
| Sep 2023 |
931 (6)
|
68 (5) |
863 (7) |
0.20 |
931 (100) |
0 (—) |
0 (—) |
1.10 |
| Oct 2023 |
3,045 (21)
|
247 (18) |
2,798 (21) |
2,901 (95) |
144 (5) |
0 (—) |
||
| Nov 2023 |
3,015 (21)
|
285 (20) |
2,730 (21) |
2,503 (83) |
496 (16) |
16 (1) |
||
| Dec 2023 |
3,394 (23)
|
394 (28) |
3,000 (23) |
2,596 (76) |
482 (14) |
316 (9) |
||
| Jan 2024 |
3,214 (22)
|
337 (24) |
2,877 (22) |
2,334 (73) |
223 (7) |
657 (20) |
||
| Feb 2024 |
987 (7)
|
61 (4) |
926 (7) |
725 (73) |
36 (4) |
226 (23) |
||
| SARS-CoV-2 JN.1 lineage predominant period ¶¶¶ | 5,089 (35) | 512 (37) | 4,577 (35) | 0.04 | 3,732 (73) | 346 (7) | 1,011 (20) | 0.69 |
Abbreviations: ICU = intensive care unit; KPNC = Kaiser Permanente Northern California; KPNW = Kaiser Permanente Northwest; NA = not applicable; SMD = standardized mean or proportion difference; VISION = Virtual SARS-CoV-2, Influenza, and Other respiratory viruses Network.
* Patient received a positive SARS-CoV-2 test result using a molecular test and received a negative or indeterminate test result or had an unknown test result for both respiratory syncytial virus and influenza.
† Patient received a negative SARS-CoV-2 test result using a molecular test and received a negative influenza test result or had an unknown influenza test result.
§ A larger SMD indicates a larger difference in variable distributions between hospitalizations for vaccinated versus unvaccinated patients, or for patients who received a positive SARS-CoV-2 test result versus patients who received a negative SARS-CoV-2 test result. For mRNA COVID-19 vaccination status, a single SMD was calculated by averaging the absolute SMDs obtained from pairwise comparisons of each vaccinated category versus unvaccinated. Specifically, SMD was calculated as the average of the absolute value of the SMDs for 1) updated dose, 7–59 days earlier versus no updated dose; and 2) updated dose, 60–119 days earlier versus no updated dose.
¶ The “no updated dose” group included all eligible persons who did not receive an updated COVID-19 vaccine dose, regardless of number of previous (i.e., original monovalent and bivalent) doses (if any) received.
** Date ranges of hospitalizations by site: HealthPartners (September 21, 2023–February 17, 2024), Intermountain Health (September 21, 2023–February 17, 2024), KPNC (September 21, 2023–February 17, 2024), KPNW (September 21, 2023–February 17, 2024), Regenstrief Institute (September 21, 2023–February 13, 2024), and University of Colorado (September 21, 2023–February 4, 2024).
†† “Other, non-Hispanic” race persons reporting non-Hispanic ethnicity and any of the following options for race: American Indian or Alaska Native, Asian, Native Hawaiian or other Pacific Islander, other races not listed, and multiple races; because of small numbers, these categories were combined.
§§ “Unknown” includes persons with missing race and ethnicity in their electronic health records.
¶¶ Underlying condition categories included pulmonary, cardiovascular, cerebrovascular, musculoskeletal, neurologic, hematologic, endocrine, renal, and gastrointestinal. All persons in the analysis had one or more immunocompromising condition.
*** Chronic respiratory condition was defined using International Classification of Diseases, Tenth Revision discharge codes for asthma, chronic obstructive pulmonary disease, cystic fibrosis, or other lung disease.
††† Persons included in the analysis might have one or more immunocompromising conditions; therefore, column totals might add to more than 100%.
§§§ In-hospital death was defined as death while hospitalized within 28 days after admission.
¶¶¶ The JN.1 predominant period was considered to have started December 24, 2023.