Real-world evidence at ECCMID 2024 shows the disproportionate risk of severe COVID-19 facing immunocompromised individuals

AstraZeneca releases new real-world data showing the significant and disproportionate burden of COVID-19 on immunocompromised patients compared to the general population despite vaccination, underscoring the need for additional protection for these vulnerable populations.

COVID-19 remains a significant public health problem for immunocompromised individuals today. The INFORM retrospective cohort study analyzed data of nearly 12 million people 12 years of age and older in England to assess COVID-19’s impact, risk and healthcare resource use among immunocompromised populations beginning in 2022 as Omicron variants became dominant.

The study also identified specific immunocompromised populations – including those with blood cancers, organ/stem cell transplant recipients, those with end-stage kidney disease on dialysis and those taking certain immunosuppressive medicines – who continue to have an increased risk of severe COVID-19 outcomes.

In addition, a new analysis of INFORM data from 2022 found that individuals with multiple sclerosis (MS) are at increased risk of COVID-19 hospitalization and death compared to the general population, which may be due to use of immunosuppressive therapies that can cause suboptimal responses to vaccination.

Analyses from the INFORM study showed:

• Despite representing just 4% of the study population, immunocompromised individuals account for around a quarter of all COVID-19 hospitalizations (24%) and deaths (23%) even after four or more COVID-19 vaccinations (Jan.-Jun. 2023 analysis).
• Among those having at least four COVID-19 vaccinations, the risk of COVID-19 hospitalization was particularly high in certain immunocompromised groups compared to the general population: 18 times higher for individuals who received stem cell transplants in the last two years, a common treatment for hematological malignancies; 9 times higher for those with hematological malignancies on active treatment in the last six months, and nearly 7 times higher for organ transplant recipients  in the last five years. Other patient populations with at least a 2 times greater risk of COVID-19 hospitalizations, included patients with end-stage kidney disease.  (Jan.-Jun. 2023, adjusted analyses).
• Even with at least three COVID-19 vaccinations, individuals with MS had an almost 6 times greater risk of COVID-19 hospitalization and nearly 4 times greater risk of COVID-19 deaths compared to the general population (Jan.-Dec. 2022, adjusted analyses).

New data from COVIDRIVE analyzing more than 5,000 Europeans hospitalized for severe acute respiratory infections, also being presented at ECCMID, found:

• Among those testing positive for SARS-CoV-2 (and thus diagnosed with severe COVID-19), nearly 30% were immunocompromised (including due to immunodeficiency, organ transplant and/or cancer), despite comprising just up to 4% of the population.

Prof. Lance Turtle PhD FRCP DTMH, Professor of Immunity and Infectious Diseases, University of Liverpool and INFORM investigator, said: “While the overall severity, rate of hospitalization and death from COVID-19 has lessened relative to the height of the pandemic, a compelling and growing body of real-world evidence shows that immunocompromised individuals still suffer disproportionately from the virus. Repeated COVID-19 vaccinations, while helpful and save lives, do not completely close this gap. Therefore, some immunocompromised individuals are still becoming extremely ill or dying from COVID-19. Data from INFORM and COVIDRIVE plays an important role in helping clinicians identify which immunocompromised patients are at high risk of hospitalization and death and who may need additional preventive measures.”

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Related Topics and Keywords

ECCMID 2024, severe COVID-19