Background. Coronavirus disease 2019 (COVID-19) has a high mortality in certain group of patients. We analysed the impact of baseline immunosuppression in COVID-19 mortality and the role of severe lymphopenia in immunocompromised subjects. Methods. We analysed all patients admitted with COVID-19 in a tertiary hospital in Madrid between March 1st and April 30th 2020. Epidemiological and clinical data, including severe lymphopenia (<500 lymphocytes/mm 3 ) during admission, were analysed and compared based on their baseline immunosuppression condition. Results. A total of 1594 patients with COVID-19 pneumonia were hospitalised during the study period. 166 (10.4%) were immunosuppressed. Immunocompromised patients were younger (64 vs. 67 years, p = 0.02) but presented higher rates of hypertension, diabetes, heart, neurological, lung, kidney and liver disease ( p < 0.05). They showed more severe lymphopenia (53% vs 24.1%, p < 0.001), lower SapO 2 /FiO 2 ratios (251 vs 276, p = 0.02) during admission and higher mortality rates (27.1% vs 13.5%, p < 0.001). After adjustment, immunosuppression remained as an independent factor related to mortality (Odds Ratio (OR): 2.24, p < 0.001). In the immunosuppressed group, age (OR = 1.06, p = 0.01), acute respiratory distress syndrome (ARDS) (OR = 12.27, p = 0.017) and severe lymphopenia (OR = 3.48, p = 0.04) were the factors related to high mortality rate. Conclusion. Immunosuppression is an independent mortality risk factor in COVID-19. Severe lymphopenia should be promptly identified in these patients.
【저자키워드】 COVID-19, Immunosuppression, severe lymphopenia, 【초록키워드】 Coronavirus disease 2019, ARDS, Mortality, Pneumonia, hospital, lung, diabetes, hypertension, lymphopenia, kidney, Patient, Immunocompromised, age, mortality rate, Admission, patients, acute respiratory distress, mortality risk, COVID-19 mortality, Liver disease, Immunosuppressed, neurological, Factor, Clinical data, study period, syndrome, high mortality, high mortality rate, hospitalised, independent, remained, analysed, subjects, Ratio, baseline, patients with COVID-19, with COVID-19,