Comparative study between COVID-19 Outcomes for Patients on Chronic Immunosuppressive Drugs, Patients on Active chemotherapy and Non- Immunosuppressed Patients: A Single-Center Egyptian Experience

Abstract

Background: Patients with hematological disorders especially those who underwent bone marrow transplantation are known for having some degree of immune system derangement and cytokine signaling instability as well as patients who were diagnosed with active malignancy and needed chemotherapy.Objective: The study aimed to compare the outcome between patients infected with COVID 19 who use immune suppression (either acute or chronic immune suppression) to fight COVID infection and how our different bodies and immune systems can handle it versus the normal population. Patients and Methods: This study was a cross-sectional study in December 2020 conducted on 96 subjects who caught COVID-19 infection, the subjects were categorized into three groups: Group 1: consists of 32 patients who underwent BMT (patients on chronic immunosuppressive drugs), Group 2: consists of 32 patients with hematological diseases (patients on chemotherapy or acute immunosuppressive drugs), and Group 3: control group (non-immunosuppressed patients) consists of 32 patients with patients had symptomatic COVID-19 infections requiring hospital admission. Results: We found improved overall survival in group 1 with 4 out of the total 32 patients succumbed to their deaths, 2 of the 4 patients were in the peri-engraftment period with the statistically significant improved OS when compared to patients in group 2 with a P-value of 0.038. Conclusion: Acute immune suppression is done by chemotherapy worsen the outcome of COVID-19 infection, while chronic immunosuppression had the best outcome in COVID-19 patients even better than the normal population due to loss of immune cell signaling and absent cytokines storm that might occur.