Assessing the Impact of COVID-19 on Immunocompromised Persons: N3C ImmunoSuppressed/Compromised Clinical Domain Team

Many clinical questions have arisen with the COVID-19 pandemic, from who is at greatest risk for COVID-19 infection to adverse outcomes if infected to how COVID-19 has impacted healthcare utilization patterns. To help answer these questions, and many more, the National COVID Cohort Collaborative (N3C) has integrated real-world clinical observations from across the nation into a harmonized database that now contains data from over 1M patients nationwide.

The N3C ImmunoSuppressed/Compromised (ISC) Clinical Domain Team aims to utilize the N3C data to assess the impact of COVID-19 on those with suppressed or compromised immune systems. Our research is initially focused on comparing the incidence of COVID-19 among subsets of the immunocompromised or suppressed population; identifying if there is a difference in severity of COVID-19 symptoms in this population; looking to see if various types, classes, or durations of immunosuppressive drugs correlate with COVID-19 severity; and characterizing the outcomes of immunosuppressed/compromised patients after COVID-19 infection, such as length of stay, ventilator status, or death.

Initial analyses reveal that the N3C data does contain a cohort of immunosuppressed/compromised patients, including patients with HIV or those receiving a solid organ transplant. In these cohorts, African American patients are over represented in the COVID-19+ subgroup. Future work will include refining our current cohort definitions and well as expanding our cohorts to include patients with an autoimmune skin disease and other autoimmune conditions, and studying the effects of COVID-19 on patients with long-term immunosuppression.