How is immunosuppressive status affecting children and adults in SARS-CoV-2 infection? A systematic review

J Infect. 2020 Jul;81(1):e61-e66. doi: 10.1016/j.jinf.2020.04.026. Epub 2020 Apr 23.

Abstract

Objectives: SARS-CoV-2 infection has now a global resonance. Data on how COVID-19 is affecting immunocompromised patients are however few. With our study we aimed to systematically review the current knowledge on SARS-CoV-2 cases in children and adults with immunosuppression, to evaluate outcomes in this special population.

Methods: A systematic review of literature was carried out to identify relevant articles, searching the EMBASE, Medline, and Google Scholar databases. Studies reporting data on pre-defined outcomes and related to immunosuppressed adults and children with SARS-CoV-2 were included.

Results: Sixteen relevant articles were identified with 110 immunosuppressed patients, mostly presenting cancer, along with transplantation and immunodeficiency. Cancer was more often associated with a more severe course, but not necessarily with a bad prognosis. Our data show that both children and adults with immunosuppression seem to have a favorable disease course, as compared to the general population.

Conclusion: Immunosuppressed patients with COVID-19 seem to be few in relation to the overall figures, and to present a favorable outcome as compared to other comorbidities. This might be explained by a hypothetical protective role of a weaker immune response, determining a milder disease presentation and thus underdiagnosis. Nevertheless, surveillance on this special population should be encouraged.

Keywords: Adults; Cancer; Children; Immunosuppression; SARS-CoV-2; Transplant.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Betacoronavirus*
  • COVID-19
  • Child
  • Coronavirus Infections / immunology*
  • Humans
  • Immunocompromised Host*
  • Pandemics
  • Pneumonia, Viral / immunology*
  • SARS-CoV-2