A large medical data assessment of 30 million individuals shows that immunocompromised individuals comprise approximately one quarter of all COVID-19 hospitalisations, ICU admissions and deaths. This is despite such individuals making up only 4 percent of the population.
For the research, COVID-19-related hospitalisations, ICU admissions and deaths were compared among different groups of immunocompromised individuals compared with the general population using de-identified, routinely collected electronic health data from a random 25 percent sample representative of the total English population 12 years of age and older using the National Health Service’s databases.
Immunocompromising conditions included: haematologic or solid tumour under active treatment; solid organ or stem cell transplant; primary immunodeficiency or end-stage renal disease.
This means that people with weakened immune systems, are congenital or acquired (primary or secondary immunodeficiency), remain most at risk from COVID-19.
The findings also mean there is a pressing need for preventative options for people with weakened immune systems and that such individuals remain inadequately protected by COVID-19 vaccination alone. Even after repeated doses of COVID-19 vaccines, immunocompromised individuals carry up to a 14 times greater risk of COVID-19 hospitalisation compared to the general population.
This arises because, as with other vaccines, COVID-19 vaccines are not as effective in immunocompromised individuals as they are in the general population. This is due to an inability by such individuals to produce a robust protective response to the vaccine.
In particular, solid organ and stem cell transplant recipients and those recently treated for blood cancers, demonstrated greater than 10-fold increases in risk compared to those without these conditions.
Commenting on the research, Paul Moss, Professor of Haematology, University of Birmingham, UK states: “To date, our understanding of the burden of COVID-19 in the immunocompromised population has been limited due to a lack of dedicated research in this area.”
He adds that these “are the first large-scale studies that jointly provide detailed insight into the impact that COVID-19 continues to have on those patient groups across different geographies. As our data show, vaccination alone is often not enough to protect these individuals from potential devastating consequences of COVID-19 and effective prevention strategies are needed for this population. We must work together to find solutions so that this vulnerable population can move on from the pandemic.”
The findings are published in the journal Lancet Regional Health Europe (“Impact of COVID-19 on Immunocompromised Populations During the Omicron Era: Insights from the Observational Population-Based INFORM Study”) and in the journal Current Medical Research and Opinion (“Assessing the Risk and Costs of COVID-19 in Immunocompromised Populations in a Large United States Commercial Insurance Health Plan: The EPOCH-US Study”).
