INFECTIOUS DISEASES / CLINICAL RESEARCH
Outcomes of SARS-CoV-2 infection in patients under
treatment with pharmacological immunosuppression.
A Swiss cohort study
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1
Gastroenterology and Hepatology, Ente Ospedaliero Cantonale, Università della Svizzera Italiana, Lugano, Switzerland
2
Epatocentro Ticino, Università della Svizzera Italiana, Lugano, Switzerland
3
King’s College London Faculty of Life Sciences & Medicine, Institute of Liver Studies, MowatLabs, London, United Kingdom
4
Intensive Care Unit, Ente Ospedaliero Cantonale, Lugano, Switzerland
5
Clinical Trial Unit, Ente Ospedaliero Cantonale, Lugano, Switzerland
6
Division of Pneumology, University Hospital of Geneva, Geneva, Switzerland
7
ICT (Information and Communication Technologies), Ente Ospedaliero Cantonale, Bellinzona, Switzerland
Submission date: 2022-04-15
Final revision date: 2022-06-30
Acceptance date: 2022-07-25
Online publication date: 2022-08-03
Corresponding author
Antonio Galante
Gastroenterology and
Hepatology
Ente Ospedaliero
Cantonale
Università della
Svizzera Italiana
Lugano, Switzerland
Phone: +41 091 811 7637
Arch Med Sci 2025;21(3):845-851
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The impact of pharmacological immunosuppression (IS) on COVID-19 outcomes is unclear. This study aimed to investigate the outcomes of hospitalised patients undergoing IS and focussed on length of hospital stay, admission to intensive care unit (ICU) and mortality.
Material and methods:
Patients admitted to public hospitals in southern Switzerland with SARS-CoV-2 infection (n = 442) were prospectively included, and their demographic, clinical, laboratory and treatment data were collected and analysed. Patients under IS at hospital admission or during the 6 months prior to hospitalisation for a minimum of 4 weeks were compared to patients from the same cohort but without any history of IS.
Results:
Thirty-five patients (7.9%, 65.7% male, median age 70.6 years) were treated with IS at the time of hospital admission. Compared with patients without IS, immunosuppressed patients showed higher mortality (n = 16/35, 45.7% vs. n = 95/407, 23.3% p = 0.003) and longer hospital stay (median = 15.5 days vs. median = 11, p = 0.0144). Moreover, in the univariate and multivariable logistic regression analysis, IS was independently associated with mortality (OR = 2.76 [95% CI: 1.37–5.59] and 2.66 [95% CI: 1.19–5.94]) and in the linear univariate and multivariable regression analysis with the length of stay (p = 0.005 and p = 0.007). Furthermore, patients under IS were more often admitted to the ICU, although the association was not significant (p = 0.069).
Conclusions:
Patients under IS were at a significantly higher risk of severe and prolonged COVID-19, with higher mortality and more extended hospital stay than patients without IS.
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