TY - JOUR
AU - Evans, Rachael A.
AU - Dube, Sabada
AU - Lu, Yi
AU - Yates, Mark
AU - Arnetorp, Sofie
AU - Bell, Samira
AU - Carty, Lucy
AU - Evans, Kathryn
AU - Graham, Sophie
AU - Justo, Nahila
AU - Moss, Paul
AU - Venkatesan, Sudhir
AU - Yokota, Renata
AU - Ferreira, Catia
AU - McNulty, Richard
AU - Taylor, Sylvia
AU - Quint, Jennifer K.
PY - 2023
DA - October
TI - Impact of COVID-19 on immunocompromised populations during the Omicron era: insights from the observational population-based INFORM study
JO - The Lancet Regional Health - Europe
DO - https://doi.org/10.1016/j.lanepe.2023.100747
AB - Background: Immunocompromised individuals are not optimally protected by COVID-19 vaccines and potentially require additional preventive interventions to mitigate the risk of severe COVID-19. We aimed to characterise and describe the risk of severe COVID-19 across immunocompromised groups as the pandemic began to transition to an endemic phase. Methods: COVID-19-related hospitalisations, intensive care unit (ICU) admissions, and deaths (01/01/2022-31/12/2022) were compared among different groups of immunocompromised individuals vs the general population, using a retrospective cohort design and electronic health data from a random 25% sample of the English population aged ≥12 years (Registration number: ISRCTN53375662). Findings: Overall, immunocompromised individuals accounted for 3.9% of the study population, but 22% (4585/20,910) of COVID-19 hospitalisations, 28% (125/440) of COVID-19 ICU admissions, and 24% (1145/4810) of COVID-19 deaths in 2022. Restricting to those vaccinated with ≥3 doses of COVID-19 vaccine (∼84% of immunocompromised and 51% of the general population), all immunocompromised groups remained at increased risk of severe COVID-19 outcomes, with adjusted incidence rate ratios (aIRR) for hospitalisation ranging from 1.3 to 13.1. At highest risk for COVID-19 hospitalisation were individuals with: solid organ transplant (aIRR 13.1, 95% confidence interval [95% CI] 11.2–15.3), moderate to severe primary immunodeficiency (aIRR 9.7, 95% CI 6.3–14.9), stem cell transplant (aIRR 11.0, 95% CI 6.8–17.6), and recent treatment for haematological malignancy (aIRR 10.6, 95% CI 9.5–11.9). Results were similar for COVID-19 ICU admissions and deaths. Interpretation: Immunocompromised individuals continue to be impacted disproportionately by COVID-19 and have an urgent need for additional preventive measures beyond current vaccination programmes. These data can help determine the immunocompromised groups for which targeted prevention strategies may have the highest impact.
PB - Elsevier
UR - https://discovery.dundee.ac.uk/en/publications/24a216ef-7009-4763-887e-a2f4fa60cc3c
KW - Coronavirus (COVID-19)
KW - Immunisation and screening
ER