Abstract

Research Article

Immunocompromised patients with SARS-CoV-2 infection in intensive care units, outcome and mortality

Cynthia DENIS*, Hamid MERDJI, Mathieu BALDACINI, Maleka SCHENCK, Thierry ARTZNER, Yoann GRIMAUD, Thierry LAVIGNE, Ferhat MEZIANI, Vincent CASTELAIN, Raphaël CLERE-JEHL, Francis SCHNEIDER and Guillaume MOREL

Published: 17 August, 2021 | Volume 6 - Issue 1 | Pages: 021-025

Background: The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak severely hit Northeastern France from March to May 2020. The massive arrival of SARS-CoV-2 positive patients in the intensive care units (ICU) raised the question of how immunocompromised patients would be affected. Therefore, we analyzed the clinical, biological and radiological features of 24 immunocompromised ICU patients with severe SAR-CoV-2 infection.

Results: The mortality rate was significantly higher for immunocompromised patients compared with other patients (41.7% versus 27.3%, respectively, p = 0.021). Mortality occurred in the first 2 weeks of intensive care, highlighting the possible interest in prolonged full-code managnement of these patients. Finally, patients with lymphoid malignancies appeared to be particularly affected, mostly with monoclonal gamma-pathology.

Conclusion: Mortality rate of SARS-CoV-2 acute respiratory syndrome in immuno-compromised patient is high. No treatment was associated with survival improvement. Prolonged full-code management is required for these patients.

Read Full Article HTML DOI: 10.29328/journal.jcicm.1001036 Cite this Article Read Full Article PDF

Keywords:

SARS-CoV-2; Critical care; Immunocompromised

References

  1. COVID-ICU Group on behalf of the REVA Network and the COVID-ICU Investigators. Clinical characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: a prospective cohort study. Intensive Care Med. 2021; 47: 60-73. PubMed: https://pubmed.ncbi.nlm.nih.gov/33211135/
  2. Kuteifan K, Pasquier P, Meyer C, Escarment J, Theissen O. The outbreak of COVID-19 in Mulhouse: Hospital crisis management and deployment of military hospital during the outbreak of COVID-19 in Mulhouse, France. Ann Intensive Care. 2020; 10: 59. PubMed: https://pubmed.ncbi.nlm.nih.gov/32430597/
  3. Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA. 1993; 270: 2957-2963. PubMed: https://pubmed.ncbi.nlm.nih.gov/8254858/
  4. Moreno R, Vincent JL, Matos R, Mendonça A, Cantraine F, et al. The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care. Results of a prospective, multicentre study. Working Group on Sepsis related Problems of the ESICM. Intensive Care Med. 1999; 25: 686-696. PubMed: https://pubmed.ncbi.nlm.nih.gov/10470572/
  5. Rubin GD, Ryerson CJ, Haramati LB, Sverzellati N, Kanne JP, et al. The Role of Chest Imaging in Patient Management during the COVID-19 Pandemic: A Multinational Consensus Statement from the Fleischner Society. Radiology. 2020; 158: 106-116.
  6. Auld SC, Caridi-Scheible M, Robichaux C, Coopersmith CM, Murphy DJ, et al. Declines in Mortality Over Time for Critically Ill Adults with Coronavirus Disease 2019. Crit Care Med. 2020; 48: e1382-e1384. PubMed: https://pubmed.ncbi.nlm.nih.gov/32991356/
  7. Martin-Loeches I, Lemiale V, Geoghegan P, McMahon MA, Pickkers P, et al. Influenza and associated co-infections in critically ill immunosuppressed patients. Crit Care. 2019; 23: 152. PubMed: https://pubmed.ncbi.nlm.nih.gov/31046842/
  8. Azoulay E, Mokart D, Kouatchet A, Demoule A, Lemiale V. Acute respiratory failure in immunocompromised adults. Lancet Respir Med. 2019; 7: 173-186. PubMed: https://pubmed.ncbi.nlm.nih.gov/30529232/
  9. Fung M, Babik JM. COVID-19 in immunocompromised hosts: What We Know So Far. Clin Infect Dis. 2021; 72: 340-350. PubMed: https://pubmed.ncbi.nlm.nih.gov/33501974/
  10. Malard F, Genthon A, Brissot E, van de Wyngaert Z, Marjanovic Z, et al. COVID-19 outcomes in patients with hematologic disease. Bone Marrow Transplant. 2020; 55: 2180-2184. PubMed: https://pubmed.ncbi.nlm.nih.gov/32376969/
  11. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382: 1708-1720.
  12. Bartoletti M, Pascale R, Cricca M, Rinaldi M, Maccaro A, et al. Epidemiology of invasive pulmonary aspergillosis among COVID-19 intubated patients: a prospective study. Clin Infect Dis. 2020; ciaa1065. PubMed: https://pubmed.ncbi.nlm.nih.gov/32719848/
  13. Helms J, Tacquard C, Severac F, Leonard-Lorant I, Ohana M, et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Med. 2020; 46: 1089-1098. PubMed: https://pubmed.ncbi.nlm.nih.gov/32367170/
  14. Baldacini M, Pop R, Sattler L, Mauvieux L, Bilger K, et al. Concomitant haemorrhagic syndrome and recurrent extensive arterial thrombosis in a patient with COVID-19 and acute promyelocytic leukaemia. Br J Haematol. 2020; 189: 1054-1056. PubMed: https://pubmed.ncbi.nlm.nih.gov/32369614/
  15. Consortium WHOST, Pan H, Peto R, Henao-Restrepo AM, Preziosi MP, et al. Repurposed Antiviral Drugs for Covid-19 - Interim WHO Solidarity Trial Results. N Engl J Med. 2021; 384: 497-511. PubMed: https://pubmed.ncbi.nlm.nih.gov/33264556/

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