Immunocompromised individuals remain at risk of COVID-19: 2023 results from the observational INFORM study.

Quint JK, Dube S, Carty L, Yokota R, Bell S, Turtle L, Lu Y, Evans K, Justo N, Harley M, Peters J, Talarico C, McNulty R, Goios A, Taylor S, Evans RA

J Infect 90 (3) 106432 [2025-03-00; online 2025-01-31]

We aimed to characterise coronavirus disease 2019 (COVID-19) severity, mortality and healthcare utilisation in immunocompromised individuals in England during 2023, using INFORM (INvestigation oF cOvid-19 Risk among iMmunocompromised populations) study data. Retrospective cohort study (ISRCTN53375662) using pseudonymised electronic health records of individuals aged ≥12 years from a random 25% sample of England's population. Over 1 January-31 December 2023, adjusted incidence rate ratios (aIRRs; adjusted for age, sex, non-immunocompromising comorbidities) between immunocompromised and non-immunocompromised individuals for COVID-19-related hospitalisation, death, and healthcare utilisation were estimated. Immunocompromised individuals represented 4.0% of 12,056,685 individuals studied but accounted for 21.7% and 21.9% of COVID-19 hospitalisations and deaths, respectively. Risk of severe COVID-19 was elevated for immunocompromised vs. non-immunocompromised; aIRRs: 2.04, 95% CI 1.95-2.14 (COVID-19 hospitalisation); 1.69, 95% CI 1.53-1.87 (COVID-19 death). COVID-19 vaccination was more likely in immunocompromised vs. non-immunocompromised (≥4 doses 72.6% vs. 29.8%). The aIRRs for COVID-19-related general practitioner consultations and accident and emergency/day case visits were 2.26 (95% CI 2.22-2.29) and 3.02 (95% CI 2.84-3.20), respectively, for immunocompromised vs. non-immunocompromised. Beyond three years since the start of the COVID-19 pandemic, immunocompromised individuals remain disproportionately impacted from COVID-19 despite increased vaccination. These findings highlight a persistent need for additional COVID-19 interventions for immunocompromised populations.

PubMed 39894447

DOI 10.1016/j.jinf.2025.106432

Crossref 10.1016/j.jinf.2025.106432

pii: S0163-4453(25)00026-X