BackgroundIn the general
population, illness after
infection with the
SARS-CoV-2 Omicron variant is less severe compared with previous variants. Data on the
disease burden of Omicron in
immunocompromised patients are lacking. We investigated the clinical characteristics and outcome of a cohort of
immunocompromised patients with COVID-19 caused by Omicron. MethodsSolid
organ transplant recipients,
patients on anti-CD20
therapy, and allogenic
hematopoietic stem cell transplantation recipients on immunosuppressive
therapy infected with the Omicron variant, were included.
Patients were contacted regularly until symptom resolution. Clinical characteristics of consenting
patients were collected through their
electronic patient files. To identify possible
risk factors for
hospitalization, a univariate logistic
analysis was performed. ResultsA total of 114 consecutive
immunocompromised patients were enrolled. Eighty-nine percent had previously received three
mRNA vaccinations. While only one
patient died, 23 (20%) required
hospital admission for a median of 11 days. A low
SARS-CoV-2 IgG antibody response (<300 BAU/mL) at
diagnosis, higher age, being a
lung transplant recipient, more comorbidities and a higher
frailty were associated with
hospital admission (all p<0.01). At the end of follow-up, 25% had still not fully recovered. Of the 23 hospitalized
patients, 70% had a negative and 92% a low
IgG (<300 BAU/mL)
antibody response at admission. Sotrovimab was administered to 17 of them, of which one died. ConclusionsWhile the
mortality in
immunocompromised patients infected with Omicron was low,
hospital admission was frequent and the duration of symptoms often prolonged. Besides
vaccination, other interventions are needed to limit the
morbidity from COVID-19 in
immunocompromised patients. SummaryCOVID-19-associated
morbidity and
mortality in
immunocompromised patients is unknown for the
SARS-CoV-2 Omicron variant. This prospective
registry, demonstrated low COVID-19-associated
mortality in these vulnerable
patients. However,
morbidity remained substantial. Other interventions to
abate COVID-19 severity are needed.