In-Hospital mortality for immunocompromised patients with SARS-CoV-2 community-acquired pneumonia (CAP)

Data on immunocompromised patients who are hospitalized due to SARS-CoV-2 CAP are lacking. We designed an observational retrospective study enrolling consecutive immunocompromised adults hospitalized due to CAP in IRCCS Humanitas Research Hospital, Rozzano (Milan), from 1 January 2021 to 31 August 2022. Two study groups were identified: SARS-CoV-2 CAP (Group A) versus the rest of the population (Group B). The primary outcome was in-hospital mortality. Among 346 patients (median age 73 years, 61.3% male), 113 (32.6%) belonged to Group A. These patients had lower levels of white blood cells (p-value 0.0002), C-reactive protein (p-value < 0.0001), and procalcitonin (p-value < 0.0001), more frequently had acute respiratory distress syndrome on admission (p-value 0.005) as well as an increased use of helmet continue positive airway pressure (p-value <0.0001) and high-flow nasal cannula (p-value 0.009) than patients in Group B. 13 (3.8%) patients in the study population were transferred to the ICU, and no difference in ICU admission rate was observed between the two groups. In-hospital mortality of the entire study population was 21.7% (n=75): patients in Group A had a higher mortality than those in Group B (27.4% [n=31] vs 18.9% [n=44], p-value 0.07). Among Immunocompromised patients who are hospitalized because of CAP, those with SARS-CoV-2 have the highest mortality rate.