Objective To analyze the clinical features of COVID-19 infection in hospitalized immunocompromised patients in comparison with immunocompetent patients.Methods A single-center retrospective observational study was conducted on 213 inpatients diagnosed with COVID-19 in the Peking University People's Hospital between December 2022 and October 2023.They were divided into an immunocompromised group(102 patients,47.9％)and an immunocompetent group(111 patients,52.1％),and clinical data were compared between the two groups.The immunocompromised group was further divided into death group(18 cases,17.6％)and non-death group(84 cases,82.4％).The differences in laboratory examination findings were compared.Further analysis was performed on the lymphocyte subset differences between the death group(10 patients,9.8％)and the non-death group(36 patients,35.3％)with complete data.Results The proportion of severe and critical cases and the mortality rate,were significantly higher in the immunocompromised group than the immunocompetent group(47.1％vs.40.5％,18.6％vs.9.0％,17.6％vs.9.0％,P＜0.05).The immunocompromised group had lower vaccination rate(26.5％vs.44.1％,P＜0.05).Hypertension,kidney disease and infections were more common in the immunocompromised group(63.7％vs.48.6％,30.4％vs.9.0％,49.0％vs.19.8％,all P＜0.05).CT findings of consolidation(40.2％vs.18.9％),rate of antiviral treatment(48.0％vs.30.6％)and the positive duration of viral nucleic acid[median 14(7.0,19.3)days vs.9(7.0,18.0)days]were higher in the immunocomprised group(all P＜0.05).Lactate dehydrogenase(LDH),procalcitonin(PCT),interleukin-6(IL-6)and ferritin were higher in the immunocompromised group than those in the immunocompetent group(all P＜0.05).In the death group,neutrophils(NEU),C-reactive protein(CRP),PCT,IL-6,ferritin and D-dimer were higher,while lymphocytes(LY),CD4+T-cells,CD8+T-cells,B-cell counts and hemoglobin(HGB)were significantly lower than those in the non-death group(all P＜0.05).Conclusions More than 60％of patients in the immunocompromised group were classified as severe or critical type,with a higher mortality rate and decreased ability to clear severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Decreases in total lymphocytes,CD4+T lymphocytes,CD8+T lymphocytes,and B lymphocytes,along with elevated levels of procalcitonin,ferritin,and D-dimer,indicated poor prognosis.
NETL
NSTL
万方数据
