The COV-AD consortium has published new findings showing that people with compromised or suppressed immune systems are still at higher risk of poor outcomes from COVID-19 compared to the general population, and has reiterated the need for targeted mitigation, vaccination and treatment strategies for this group.
It was established early in the pandemic that people with immunodeficiency were at higher risk of severe illness and death from COVID-19, and that vaccines worked less well in many among this group.
In this study, the COV-AD team set out to understand whether these risks had changed following the roll out of vaccines and the introduction of therapies since the emergence of new COVID-19 variants.
They compared the outcomes of two groups of people with immunodeficiency – one where people were infected with COVID-19 between March and July 2020 (prior to vaccination and treatments) and a second who were infected after these interventions became available (between January 2021 and April 2022). The results are published in the journal Frontiers in Immunology.
The researchers found that hospitalisation rates among people with immunodeficiency who became infected fell from 53.3% to 17.9%, and mortality rates fell from 20.0% to 3.4%. However, both rates are still higher than those seen in the general population.
They also found that the duration of illness was reduced for those people who were shown to have produced antibodies after vaccination. Early outpatient treatment with antivirals or monoclonal antibodies was also seen to reduce the risk of hospitalisation during the Omicron wave.
22.7% of people with immunodeficiency have had COVID-19 at least once since the start of the pandemic, compared to over 70% of the general population.
They concluded that “SARS-CoV-2 continues to pose a significant risk to patients with primary and secondary immune deficiency and there remains an unmet need to understand the correlates of protection against severe disease and optimize mitigation, prophylactic and therapeutic strategies to minimize the ongoing burden of the pandemic to these vulnerable groups.”