Impact of COVID-19 on Mortality and Critical Outcomes Across Various Immunocompromised Conditions: a Meta-Analysis

Abstract

Introduction:

COVID-19 has varying impacts on different immunocompromised populations, necessitating a comprehensive analysis of its effects across these groups.

Objectives:

To evaluate the impact of COVID-19 on mortality and critical outcomes among diverse immunocompromised populations through a meta-analysis of existing studies.

Methods:

Data from 14 studies, involving 6,094 patients, were synthesized. Pooled mortality proportions were calculated using both common effect and random effects models. Subgroup analyses were conducted for different immunocompromised conditions, examining mortality rates, ICU admission, and mechanical ventilation requirements. Sensitivity analyses were performed to assess result robustness.

Results:

The pooled mortality proportion was 0.12 (95% CI: 0.11, 0.12) under the common effect model and 0.06 (95% CI: 0.04, 0.10) under the random effects model, with significant heterogeneity (I2 = 98%). Hematologic cancer patients showed the highest mortality (0.29, 95% CI: 0.25, 0.33).

ICU admission rates were highest for autoimmune rheumatic diseases and hematologic cancers.

Mechanical ventilation was most frequently required in autoimmune rheumatic diseases and solid tumor patients.

Discussion:

The study revealed substantial variability in COVID-19 outcomes across different immunocompromised groups. The high heterogeneity observed emphasizes the need for condition-specific clinical management approaches. Sensitivity analyses confirmed the robustness of the findings.

Conclusion:

This meta-analysis provides critical insights into the differential impact of COVID-19 on various immunocompromised populations, underscoring the importance of tailored clinical strategies for these vulnerable groups.