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Immunocompromised patients with SARS-CoV-2 infection in intensive care units, outcome and mortality

, Merdji Hamid, Baldacini Mathieu, Schenck Maleka, Artzner Thierry, Grimaud Yoann, Lavigne Thierry, Meziani Ferhat, Castelain Vincent, Clere-Jehl Raphaël,
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Abstract: Background: The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak severely hit Northeastern France from March to May 2020. The massive arrival of SARS-CoV-2 positive patients in the intensive care units (ICU) raised the question of how immunocompromised patients would be affected. Therefore, we analyzed the clinical, biological and radiological features of 24 immunocompromised ICU patients with severe SAR-CoV-2 infection. Results: The mortality rate was significantly higher for immunocompromised patients compared with other patients (41.7% versus 27.3%, respectively, p = 0.021). Mortality occurred in the first 2 weeks of intensive care, highlighting the possible interest in prolonged full-code managnement of these patients. Finally, patients with lymphoid malignancies appeared to be particularly affected, mostly with monoclonal gamma-pathology. Conclusion: Mortality rate of SARS-CoV-2 acute respiratory syndrome in immuno-compromised patient is high. No treatment was associated with survival improvement. Prolonged full-code management is required for these patients.
Keywords: Mortality / SARS CoV / acute respiratory syndrome / immunocompromised / ICU

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