Publication date: Feb 16, 2025

Real-world data on hospitalised SARS-CoV-2-positive patients are important for post-pandemic preventive measures. This study aims to explore 60-day mortality of immunocompromised patients hospitalised in later Omicron period, accounting for the relevance of COVID-19 for hospital care. A retrospective population-based cohort study in cD6stergcF6tland County, Sweden, included all adult patients with a positive SARS-CoV-2 PCR test within 3 weeks of hospital admission. Clinical data including functional level (combined assessment of frailty and performance status), and COVID-19’s impact on hospital care were collected from medical records. An adjusted binary logistic regression model was applied for the main outcome of 60-day COVID-19-related mortality, with immunosuppression as the main exposure. 1128 hospitalised SARS-CoV-2-positive patients were included in the analysis whereof 12. 9% were immunocompromised. Hospital admission due to COVID-19 was significantly more common among immunocompromised than non-immunocompromised (71. 9% vs 49. 5%), and 60-day COVID-19 mortality was 10. 5% and 8. 0% (p = 0. 41), respectively. The median age of patients hospitalised due to COVID-19 was 78 years, with most having low/very low functional levels and ≥3 comorbidities. Adjusted for possible confounders, immunosuppression showed a significantly increased risk of 60-day COVID-19-related mortality (OR 2. 41, 95% CI 1. 06-5. 47, p = 0. 04). A majority of COVID-19-related hospitalisations during later Omicron period in a high immunity population, involved people over 70 years with low/very low functional levels and multiple comorbidities. Immunocompromised patients had a 2. 5 times higher risk of 60-day COVID-19-related mortality. These findings underscore the need for targeted preventive measures in vulnerable elderly and immunocompromised populations to mitigate COVID-19-related hospitalisations and deaths.

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