Background In 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. Methods Solid 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. Results A 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. Conclusions While 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.

中文翻译：

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由 Omicron 变异引起的 COVID-19 免疫功能低下患者的临床特征和结果：一项前瞻性观察研究

背景 在普通人群中，感染 SARS-CoV-2 Omicron 变体后的疾病与以前的变体相比没有那么严重。缺乏关于 Omicron 在免疫功能低下患者中的疾病负担的数据。我们调查了一组由 Omicron 引起的 COVID-19 免疫功能低下患者的临床特征和结果。方法 纳入实体器官移植受者、接受抗 CD20 治疗的患者和接受 Omicron 变体感染的免疫抑制治疗的同种异体造血干细胞移植受者。定期联系患者，直到症状消失。通过他们的电子患者档案收集同意患者的临床特征。为了确定可能的住院风险因素，进行了单变量逻辑分析。结果 总共纳入了 114 名连续的免疫功能低下患者。89% 的人之前接受过 3 次 mRNA 疫苗接种。虽然只有一名患者死亡，但 23 名 (20%) 需要住院 11 天的中位数。诊断时 SARS-CoV-2 IgG 抗体反应低（<300 BAU/mL）、年龄较大、接受肺移植、合并症较多和虚弱程度较高与入院相关（所有 p < 0.01）。随访结束时，仍有25%未完全康复。在 23 名住院患者中，入院时 70% 的 IgG 抗体反应为阴性，92% 的患者为低 IgG (<300 BAU/mL) 抗体反应。其中 17 人接受了 Sotrovimab 治疗，其中 1 人死亡。结论 虽然感染 Omicron 的免疫功能低下患者的死亡率很低，入院频率高，症状持续时间往往延长。除了疫苗接种外，还需要采取其他干预措施来限制免疫功能低下患者因 COVID-19 引起的发病率。