Suárez-García, InésPerales-Fraile, IsabelGonzález-García, AndrésMuñoz-Blanco, ArturoManzano, LuisFabregate, MartínDíez-Manglano, JesúsFonseca Aizpuru, EvaArnalich Fernández, FranciscoGarcía García, AlejandraGómez-Huelgas, RicardoRamos-Rincón, José-Manuel2023-01-112023-01-112021-08-03Suárez-García I, Perales-Fraile I, González-García A, Muñoz-Blanco A, Manzano L, Fabregate M, et al. In-hospital mortality among immunosuppressed patients with COVID-19: Analysis from a national cohort in Spain. PLoS One. 2021 Aug 3;16(8):e0255524http://hdl.handle.net/10668/4570Background Whether immunosuppressed (IS) patients have a worse prognosis of COVID-19 compared to non-IS patients is not known. The aim of this study was to evaluate the clinical characteristics and outcome of IS patients hospitalized with COVID-19 compared to non-IS patients. Methods We designed a retrospective cohort study. We included all patients hospitalized with laboratory-confirmed COVID-19 from the SEMI-COVID-19 Registry, a large multicentre national cohort in Spain, from March 27th until June 19th, 2020. We used multivariable logistic regression to assess the adjusted odds ratios (aOR) of in-hospital death among IS compared to non-IS patients. Results Among 13 206 included patients, 2 111 (16.0%) were IS. A total of 166 (1.3%) patients had solid organ (SO) transplant, 1081 (8.2%) had SO neoplasia, 332 (2.5%) had hematologic neoplasia, and 570 (4.3%), 183 (1.4%) and 394 (3.0%) were receiving systemic steroids, biological treatments, and immunosuppressors, respectively. Compared to non-IS patients, the aOR (95% CI) for in-hospital death was 1.60 (1.43–1.79) for all IS patients, 1.39 (1.18–1.63) for patients with SO cancer, 2.31 (1.76–3.03) for patients with haematological cancer and 3.12 (2.23–4.36) for patients with SO transplant. The aOR (95% CI) for death for patients who were receiving systemic steroids, biological treatments and immunosuppressors compared to non-IS patients were 2.16 (1.80–2.61), 1.97 (1.33–2.91) and 2.06 (1.64–2.60), respectively. IS patients had a higher odds than non-IS patients of in-hospital acute respiratory distress syndrome, heart failure, myocarditis, thromboembolic disease and multiorgan failure. Conclusions IS patients hospitalized with COVID-19 have a higher odds of in-hospital complications and death compared to non-IS patients.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/COVID-19SpainOdds ratioMyocarditisHospital mortalityMultiple organ failureHeart failureHematologic neoplasmsPrognosisImmunosuppressionEspañaOportunidad relativaMiocarditisMortalidad hospitalariaInsuficiencia multiorgánicaInsuficiencia cardíacaNeoplasias hematológicasDiagnósticoInmunosupresiónMedical Subject Headings::Persons::Persons::Age Groups::Adult::AgedMedical Subject Headings::Persons::Persons::Age Groups::Adult::Aged::Aged, 80 and overMedical Subject Headings::Diseases::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus InfectionsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort StudiesMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Diseases::Hemic and Lymphatic Diseases::Hematologic Diseases::Hematologic NeoplasmsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::HospitalizationMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Phenomena and Processes::Immune System Phenomena::Immunocompromised HostMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Logistic ModelsMedical Subject Headings::Check Tags::MaleMedical Subject Headings::Persons::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Shock::Multiple Organ FailureMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Odds RatioMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::RegistriesMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective StudiesMedical Subject Headings::Geographical Locations::Geographic Locations::Europe::SpainMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Hospital MortalityMedical Subject Headings::Diseases::Cardiovascular Diseases::Heart Diseases::Cardiomyopathies::MyocarditisMedical Subject Headings::Diseases::Cardiovascular Diseases::Heart Diseases::Heart FailureMedical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Respiratory Distress Syndrome, AdultMedical Subject Headings::Chemicals and Drugs::Polycyclic Compounds::SteroidsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::PrognosisMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Biological Therapy::Immunomodulation::Immunotherapy::Immunosuppressionresearch article34343222open access10.1371/journal.pone.02555241932-6203PMC8330927