Introduction
SARS-CoV-2 remains a threat to immunodeficient patients. Additional studies examining the natural history of COVID-19 disease in this vulnerable population are needed to maximize patient outcomes.
Methods
This case series included primary or secondary immunodeficient patients with laboratory-confirmed COVID-19 diagnosis admitted between March 1, 2020, and December 1, 2020, to 13 community and academic hospitals in a large health system.
Demographics, comorbidities, laboratory findings, clinical measures and outcomes were collected from a centralized electronic health record.
Results
214 hospitalizations were identified. Descriptive statistics were generated. This cohort was 57.0% (N=122) male, 51.9% (N=111) white, with median age 67 years (range 2-97 years). Secondary immunodeficiency comprised 77.9% (N¼166), 6.1% (N=13) had primary immunodeficiency, 4.7% (N=10) had both, while 11.3% (N=24) had unspecified immunodeficiency. Most common comorbidities included cardiovascular disease (N=104, 48.8%), diabetes mellitus (N¼86, 40.4%), and chronic kidney disease stages I-IV (N=74, 34.7%). This cohort’s clinical outcomes were compared to previously published characteristics of the larger inpatient cohort from the same healthcare network. Cohort median length of stay was 9.0 days (interquartile range 4.0-16.0), ICU admission rate was 23.4% (N=50), and 15.5% (N=33) received renal replacement therapy compared to 4.5 days (interquartile range 2.4-8.1), 14.2%, and 3.2%, respectively. Overall mortality was 26.6% (N=57) with 2.3% (N=5) expiring prior to intubation, compared to 21%, 11.7%, respectively. Work is underway to characterize presentation vitals and laboratory results.
Conclusion
Our preliminary findings suggest that immunodeficient patients hospitalized with COVID-19 experienced increased lengths of stay, ICU admission, and mortality compared to the general population.