Background Immunocompromised (IC) patients are at higher risk of severe SARS-CoV-2 infection, morbidity, and mortality compared to the general population. They should be prioritized for primary prevention through vaccination. This study aimed to evaluate the efficacy of COVID-19 mRNA vaccines in IC patients through a systematic review and meta-analysis approach. Method PubMed-MEDLINE, Scopus, and Web of Science were searched for original articles reporting the immunogenicity of two doses of mRNA COVID-19 vaccines in adult patients with IC condition between June 1, 2020 and September 1, 2021. Meta-analysis was performed using either random or fixed effect according to the heterogeneity of the studies. Subgroup analysis was performed to identify potential sources of heterogeneity. Results A total of 26 studies on 3207 IC patients and 1726 healthy individuals were included. The risk of seroconversion in IC patients was 48% lower than those in controls (RR = 0.52 [0.42, 0.65]). IC patients with autoimmune conditions were 54%, and patients with malignancy were 42% more likely to have positive seroconversion than transplant recipients ( P < 0.01). Subgroup meta-analysis based on the type of malignancy, revealed significantly higher proportion of positive seroconversion in solid organ compared to hematologic malignancies (RR = 0.88 [0.85, 0.92] vs. 0.61 [0.44, 0.86], P = 0.03). Subgroup meta-analysis based on type of transplantation (kidney vs. others) showed no statistically significant between-group difference of seroconversion ( P = 0.55). Conclusions IC patients, especially transplant recipients, developed lower immunogenicity with two-dose of COVID-19 mRNA vaccines. Among patients with IC, those with autoimmune conditions and solid organ malignancies are mostly benefited from COVID-19 vaccination. Findings from this meta-analysis could aid healthcare policymakers in making decisions regarding the importance of the booster dose or more strict personal protections in the IC patients. Supplementary Information The online version contains supplementary material available at 10.1186/s40001-022-00648-5.
【저자키워드】 COVID-19, SARS-CoV-2, Efficacy, vaccination, Immunocompromised patient, Autoimmune, malignancy, transplantation, 【초록키워드】 Meta-analysis, Mortality, Infection, systematic review, risk, heterogeneity, kidney, Seroconversion, COVID-19 vaccination, healthcare, morbidity, Patient, Control, General population, booster dose, patients, Analysis, dose, Hematologic malignancy, COVID-19 mRNA vaccine, on type, autoimmune condition, mRNA COVID-19 vaccine, COVID-19 mRNA vaccines, Web of Science, supplementary material, higher risk, recipients, article, finding, random, positive, recipient, organ, approach, severe SARS-CoV-2, Result, identify, evaluate, proportion, was performed, searched, significantly higher, statistically significant, fixed, healthy individual, 【제목키워드】 Meta-analysis, immunogenicity, systematic review, Immunocompromised, COVID-19 mRNA vaccine,