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COVID-19 County Data |
Characteristic | Immunocompromised, no. (weighted %)§ | ||||||||
---|---|---|---|---|---|---|---|---|---|
Overall | Unvaccinated | Vaccinated† | |||||||
Yes | No | p-value | Yes | No | p-value | Yes | No | p-value | |
Total | 2,209 (100.0) | 20,136 (100.0) | — | 1,855 (100.0) | 18,825 (100.0) | — | 354 (100.0) | 1,311 (100.0) | — |
Age group, yrs | |||||||||
18–49 | 492 (17.3) | 6,509 (24.9) | <0.01 | 447 (18.1) | 6,336 (26.9) | <0.01 | 45 (15.5) | 173 (12.1) | 0.09 |
50–64 | 717 (28.2) | 6,298 (29.4) | 625 (31.7) | 5,932 (30.3) | 92 (20.1) | 366 (23.7) | |||
65–74 | 472 (25.8) | 3,192 (19.5) | 377 (24.5) | 2,915 (18.9) | 95 (28.6) | 277 (23.6) | |||
75–84 | 378 (20.8) | 2,501 (15.6) | 296 (18.5) | 2,213 (14.1) | 82 (26.3) | 288 (25.2) | |||
≥85 | 150 (7.9) | 1,636 (10.6) | 110 (7.2) | 1,429 (9.8) | 40 (9.5) | 207 (15.5) | |||
Race or ethnicity¶ | |||||||||
White | 1,219 (52.4) | 9,587 (47.7) | <0.01 | 987 (52.7) | 8,711 (45.7) | <0.01 | 232 (51.7) | 876 (60.0) | 0.46 |
Black | 496 (25.5) | 4,340 (23.2) | 440 (26.5) | 4,142 (24.1) | 56 (23.1) | 198 (18.2) | |||
AI/AN | 34 (1.1)** | 452 (2.0)** | 30 (1.2)** | 431 (2.0)** | 4 (1.1)** | 21 (1.7)** | |||
A/PI | 91 (4.8) | 1,201 (5.1) | 81 (4.3)** | 1159 (5.4) | 10 (6.1)** | 42 (3.6)** | |||
Hispanic | 301 (12.7) | 3,803 (16.5) | 264 (13.0) | 3,678 (17.6) | 37 (12.0) | 125 (10.1) | |||
Other/Unknown†† | 68 (3.4) | 753 (5.5) | 53 (2.3) | 704 (5.4) | 15 (6.1)** | 49 (6.4) | |||
Sex | |||||||||
Male | 1,121 (54.3) | 10,819 (52.3) | 0.25 | 931 (52.4) | 10,145 (52.4) | 0.98 | 190 (58.7) | 674 (51.6) | 0.17 |
Female | 1,088 (45.7) | 9,317 (47.7) | 924 (47.5) | 8,680 (47.6) | 164 (41.3) | 637 (48.4) | |||
Resident of long-term care facility | 172 (8.7) | 1,652 (10.1) | 0.16 | 150 (9.4) | 1448 (9.4) | 0.99 | 22 (7.1) | 204 (14.6) | 0.06 |
Variant predominance§§ | |||||||||
Pre-Delta | 1,730 (54.2) | 16,654 (60.3) | <0.01 | 1,646 (74.2) | 16,350 (69.1) | <0.01 | 84 (7.1) | 304 (5.8) | 0.20 |
Delta | 318 (20.0) | 2,683 (22.6) | 154 (14.3) | 2,047 (20.1) | 164 (33.4) | 636 (38.3) | |||
Omicron | 161 (25.8) | 799 (17.1) | 55 (11.4) | 428 (10.8) | 106 (59.5) | 371 (55.9) | |||
Vaccination status† | |||||||||
Unvaccinated | 1,855 (70.1) | 18,825 (86.1) | <0.01 | 1,855 (100.0) | 18,825 (100.0) | NA | NA | NA | NA |
Vaccinated, without booster or additional doses | 298 (21.3) | 1,186 (11.6) | NA | NA | 298 (71.4) | 1,186 (83.3) | <0.01 | ||
Vaccinated, with booster or additional doses | 56 (8.5) | 125 (2.3) | NA | NA | 56 (28.6) | 125 (16.7) | |||
Type of immunocompromising condition | |||||||||
AIDS or CD4+ count <200 | 37 (1.3) | NA | NA | 33 (1.4) | NA | NA | 4 (0.9)** | NA | NA |
Complement deficiency | 4 (0.1)** | NA | NA | 4 (0.2)** | NA | NA | NA | NA | NA |
Graft versus host disease | 7 (0.3)** | NA | NA | 7 (0.4)** | NA | NA | NA | NA | NA |
HIV infection | 177 (6.7) | NA | NA | 159 (7.7) | NA | NA | 18 (4.2) | NA | NA |
Immunoglobulin deficiency/ Immunodeficiency | 48 (1.8) | NA | NA | 44 (1.6) | NA | NA | 4 (2.4)** | NA | NA |
Immunosuppressive therapy | 664 (32.2) | NA | NA | 529 (28.3) | NA | NA | 135 (41.4) | NA | NA |
Leukemia | 135 (6.6) | NA | NA | 111 (6.9) | NA | NA | 24 (5.8)** | NA | NA |
Lymphoma (Hodgkin or non-Hodgkin) | 125 (5.9) | NA | NA | 96 (5.5) | NA | NA | 29 (6.9) | NA | NA |
Metastatic cancer | 212 (11.0) | NA | NA | 172 (11.1) | NA | NA | 40 (10.6) | NA | NA |
Multiple myeloma | 52 (2.7) | NA | NA | 37 (2.1) | NA | NA | 15 (3.9)** | NA | NA |
Solid organ malignancy | 791 (37.2) | NA | NA | 649 (34.2) | NA | NA | 142 (44.2) | NA | NA |
Steroid therapy | 610 (26.5) | NA | NA | 533 (30.4) | NA | NA | 77(17.2) | NA | NA |
Transplant, hematopoietic stem cell | 26 (1.3)** | NA | NA | 20 (0.8)** | NA | NA | 6 (2.7)** | NA | NA |
Transplant, solid organ | 253 (14.1) | NA | NA | 195 (10.6) | NA | NA | 58 (22.2) | NA | NA |
Underlying medical condition | |||||||||
Any underlying medical condition††† | 2,097 (94.5) | 17,888 (90.3) | <0.01 | 1,758 (94.2) | 16,643 (89.5) | <0.01 | 339 (95.4) | 1245 (95.1) | 0.87 |
Hypertension | 1,374 (67.0) | 10,649 (58.2) | <0.01 | 1,125 (64.1) | 9,732 (56.2) | <0.01 | 249 (74.0) | 917 (70.6) | 0.30 |
Diabetes mellitus | 738 (37.5) | 6,745 (35.2) | 0.05 | 599 (35.5) | 6,212 (34.4) | 0.39 | 139 (42.0) | 533 (40.2) | 0.66 |
Chronic lung disease | 868 (39.1) | 5,674 (29.0) | <0.01 | 726 (40.2) | 5,146 (27.1) | <0.01 | 142 (36.4) | 528 (41.1) | 0.15 |
Chronic metabolic (except diabetes) | 380 (18.1) | 2,469 (13.9) | <0.01 | 307 (16.9) | 2,212 (13.3) | <0.01 | 73 (20.8) | 257 (17.3) | 0.11 |
Cardiovascular disease | 1,043 (52.1) | 6,629 (38.8) | <0.01 | 838 (52.8) | 5,894 (35.8) | <0.01 | 205 (50.5) | 735 (57.4) | 0.13 |
Liver disease | 253 (11.5) | 1,082 (5.6) | <0.01 | 200 (10.2) | 966 (5.1) | <0.01 | 53 (14.5) | 116 (8.2) | <0.01 |
Renal disease | 575 (30.6) | 2,816 (16.3) | <0.01 | 458 (26.7) | 2,462 (14.6) | <0.01 | 117 (39.8) | 354 (27.1) | <0.01 |
Blood disorder | 195 (10.1) | 555 (3.0) | <0.01 | 151 (9.0) | 489 (2.6) | <0.01 | 44 (12.5) | 66 (5.3) ** | 0.04 |
Neurologic disease | 475 (22.5) | 3,917 (20.2) | 0.14 | 381 (19.8) | 3,514 (18.4) | 0.31 | 94 (29.0) | 403 (31.8) | 0.53 |
Rheumatologic/Autoimmune condition | 542 (27.1) | 707 (4.7) | <0.01 | 432 (25.1) | 617 (4.1) | <0.01 | 110 (31.9) | 90 (8.0) | <0.01 |
Obesity | 951 (38.4) | 9,823 (45.3) | <0.01 | 811 (40.2) | 9276 (46.4) | <0.01 | 140 (34.1) | 547 (38.5) | 0.19 |
No. of underlying conditions | |||||||||
0 | 112 (5.5) | 2,248 (9.7) | <0.01 | 97 (5.8) | 2,182 (10.5) | <0.01 | 15 (4.6)** | 66 (4.9) | 0.17 |
1 | 252 (9.3) | 3,630 (15.9) | 227 (11.3) | 3,500 (17.1) | 25 (4.8) | 130 (8.5) | |||
2 | 371 (15.8) | 4,356 (21.2) | 323 (15.6) | 4,149 (21.9) | 48 (16.4) | 207 (17.0) | |||
≥3 | 1,474 (69.3) | 9,902 (53.2) | 1,208 (67.3) | 8,994 (50.6) | 266 (74.2) | 908 (69.7) |
Abbreviations: A/PI = Asian or Pacific Islander; AI/AN = American Indian or Alaska Native; COVID-NET = COVID-19–Associated Hospitalization Surveillance Network; NA = not applicable.
* Vaccinated patients were defined as those with a positive SARS-CoV-2 test result from a specimen collected ≥14 days after either the second dose of a 2-dose vaccination series or after 1 dose of a single dose vaccine. When not
otherwise specified, vaccinated patients include those who might have received additional or booster doses. Vaccinated patients without additional or booster doses include both those eligible and not yet eligible for an additional or booster dose. Vaccinated patients with additional booster doses received additional or booster doses on or after August 13, 2021, with a positive SARS-CoV-2 test result from a specimen collected ≥14 days after receipt of the additional or booster dose.
† Selected counties in California, Colorado, Connecticut, Georgia, Michigan, Minnesota, New Mexico, New York, Oregon, and Tennessee.
§ Representative sample of all cases reported to COVID-NET, stratified by patient age and COVID-NET site. Percentages were weighted to account for the probability of selection for sampled cases.
¶ White, Black, AI/AN, and A/PI persons were non-Hispanic; Hispanic persons could be of any race.
** Relative SE >30.
Estimates might be unstable; results should be interpreted with caution.
†† Includes patients who were classified as multiracial, non-Hispanic. Non-Hispanic ethnicity was assumed for patients with unknown ethnicity.
§§ Pre-Delta variant–predominant period = March 1, 2020–June 26, 2021; Delta variant–predominant period = June 27–December 18, 2021; Omicron variant–predominant period = December 19, 2021–February 28, 2022.
https://www.cdc.gov/mmwr/volumes/71/wr/mm7116e1.htm
††† Defined as one or more of the following: chronic lung disease (including asthma), chronic metabolic disease, diabetes mellitus, blood disorder/hemoglobinopathy, cardiovascular disease, neurologic disease, renal disease, gastrointestinal/liver disease, rheumatologic/autoimmune condition, obesity, feeding tube dependence, or wheelchair
dependence.
TABLE 2. Association of immunocompromise status with intensive care unit admission and in-hospital death among patients hospitalized for COVID-19, by vaccination status* — COVID-NET, 10 states,† March 1, 2020–February 28, 2022
Immunocompromised | No. (weighted %)§ | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Unvaccinated¶ | Vaccinated*,** | |||||||||||
ICU admission | Death | ICU admission | Death | |||||||||
Yes | No | aOR (95% CI) | Yes | No | aOR (95% CI) | Yes | No | aOR (95% CI) | Yes | No | aOR (95% CI) | |
Yes | 533 (26.6) | 1,322 (73.4) | 1.26 (1.08–1.49)†† | 272 (14.5) | 1,582 (85.5) | 1.34 (1.05–1.70)§§ | 85 (25.0) | 269 (75.0) | 1.40 (1.01–1.92)§§ | 55 (16.5) | 298 (83.5) | 1.87 (1.28–2.75)†† |
No | 4,884 (22.8) | 13,875 (77.2) | Ref | 1,881 (11.0) | 16,906 (89.0) | Ref | 257 (18.7) | 1,047 (81.3) | Ref | 114 (9.6) | 1,190 (90.4) | Ref |
Abbreviations: aOR = adjusted odds ratio; COVID-NET = COVID-19–Associated Hospitalization Surveillance Network; ICU = intensive care unit; Ref = referent group.
* Vaccinated patients were defined as those with a positive SARS-CoV-2 test result from a specimen collected ≥14 days after the second dose of a 2-dose vaccination series or after 1 dose of a single dose vaccine. When not otherwise specified,
vaccinated patients include those who might have received additional or booster doses.
† Selected counties in California, Colorado, Connecticut, Georgia, Michigan, Minnesota, New Mexico, New York, Oregon, and Tennessee.
§ Representative sample of all cases reported to COVID-NET, stratified by age and COVID-NET site. Percentages were weighted to account for the probability of selection for sampled cases.
¶ ICU admission model among unvaccinated
patients was adjusted for age, sex, site, variant predominant period, race/ethnicity, hypertension, diabetes, chronic lung disease, cardiovascular disease, renal disease, and obesity. ICU status was not known for 66 nonimmunocompromised patients. Death model among unvaccinated patients was adjusted for age, sex, site, variant predominant period, race/ethnicity, long-term care facility, hypertension, diabetes, chronic lung disease, cardiovascular disease, renal disease, blood disorders,
neurologic disease, and rheumatologic/autoimmune condition. Death outcome was unknown for one immunocompromised patient and 38 nonimmunocompromised patients.
** ICU admission model among vaccinated patients was adjusted for age, sex, site, variant predominant period, race/ethnicity (American Indian or Alaska Native and Asian or Pacific Islander were reclassified as other/unknown because of small numbers as well as patients who identified as multiracial or unknown race), chronic metabolic
disease, liver disease, and rheumatologic/autoimmune condition. ICU status was not known for seven nonimmunocompromised patients. Death model among vaccinated patients was adjusted for age, sex, site, variant predominant period, race/ethnicity, cardiovascular disease, renal disease, and rheumatologic/autoimmune condition. Death outcome was unknown for one immunocompromised patient and seven nonimmunocompromised patients.
†† p-value <0.01.
§§ p-value <0.05.
TABLE 3. Association of vaccination status* with intensive care unit admission and in-hospital death among patients hospitalized for COVID-19, by immunocompromise status—COVID-NET, 10 states,† March 1, 2021–February 28, 2022
Vaccination status* | No. (weighted %)§ | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Immunocompromised¶ | Not immunocompromised** | |||||||||||
ICU admission | Death | ICU admission | Death | |||||||||
Yes | No | aOR (95% CI) | Yes | No | aOR (95% CI) | Yes | No | aOR (95% CI) | Yes | No | aOR (95% CI) | |
Vaccinated | 85 (25.0) | 269 (75.0) | 1.01 (0.64–1.58) | 55 (16.5) | 298 (83.5) | 1.34 (0.71–2.51) | 257 (18.7) | 1,044 (81.3) | 0.85 (0.60–1.12) | 113 (9.5) | 1,188 (90.5) | 0.58 (0.39–0.86)†† |
Unvaccinated | 129 (25.5) | 351 (74.5) | Ref | 66 (12.9) | 413 (87.1) | Ref | 1,121 (21.6) | 3,771 (78.4) | Ref | 488 (10.1) | 4,409 (89.9) | Ref |
Abbreviations: aOR = adjusted odds ratio; COVID-NET = COVID-19–Associated Hospitalization Surveillance Network; ICU = intensive care unit; Ref = referent group.
* Vaccinated patients were defined as those with a positive SARS-CoV-2 test result from a specimen collected ≥14 days after either the second dose of a 2-dose vaccination series or after 1 dose of a single dose vaccine. When not otherwise specified,
vaccinated patients include those who might have received additional or booster doses.
† Selected counties in California, Colorado, Connecticut, Georgia, Michigan, Minnesota, New Mexico, New York, Oregon, and Tennessee.
§ Representative sample of all cases reported to COVID-NET, stratified by age and COVID-NET site. Percentages were weighted to account for the probability of selection for sampled cases.
¶ ICU admission model among immunocompromise
patients was adjusted for age, sex, site, variant predominant period, rheumatologic/autoimmune condition, and obesity. Death model among immunocompromised patients was adjusted for age, sex, site, variant predominant period hypertension, renal disease, and rheumatologic/autoimmune condition. Death outcome among immunocompromised patients was not known for one unvaccinated patient and one vaccinated patient without additional or booster doses.
** ICU admission model among nonimmunocompromised
patients was adjusted for age, sex, site, variant predominant period, diabetes, and obesity. Death model among nonimmunocompromised patients was adjusted for age, sex, site, variant predominant period, long-term care facility residence, hypertension, diabetes mellitus, chronic metabolic disease, cardiovascular disease, renal disease, and neurologic disease. Death outcome among nonimmunocompromised patients was not known for 11 unvaccinated patients, three patients vaccinated without additional
or booster doses, and three patients vaccinated with additional or booster doses.
†† p-value <0.05.
Suggested citation for this article: Singson JR, Kirley PD, Pham H, et al. Factors Associated with Severe Outcomes Among Immunocompromised Adults Hospitalized for COVID-19 — COVID-NET, 10 States, March 2020–February 2022. MMWR Morb Mortal Wkly Rep 2022;71:878–884. DOI: http://dx.doi.org/10.15585/mmwr.mm7127a3.
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