Management of COVID-19 in immunocompromised patients: an European Society of Clinical Microbiology and Infectious Diseases consensus document.
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Bartoletti Michele, Azap Ozlem, Barac Aleksandra, Ben Selma Manel, Ergonul Onder, Gkrania-Klotsas Effrossyni, Grossi Paolo Antonio, Krause Robert, Nagavci Blin, Paño-Pardo José Ramón, Pierrotti Ligia Camera, Power Nicholas, Rodríguez-Baño Jesús, Sibani Marcella, Slavin Monica A, Szabo Balint Gergely, Tazza Beatrice, Yung Tsang Nicole Ngai, Tsiodras Sotirios, Zollner-Schwetz Ines, Chemaly Roy F, ESCMID Study Group for Infections in Compromised Hosts and the ESCMID Study Group for Respiratory Viruses
Аннотация
AIM AND METHODS: To develop consensus statements derived from evidence and expert opinion on management of COVID-19 in immunocompromised patients, an expert panel was convened by European Society for Clinical Microbiology and Infectious Diseases. The expert panel developed a list of questions which are of general interest for clinicians and readers with backgrounds in clinical microbiology and infectious diseases. Six questions were selected. For each question, systematic literature searches were undertaken. We considered most study types, including clinical trials, observational studies with or without a control group, systematic reviews, case series, and case reports. Detailed inclusion criteria were defined for each research question using the Population Intervention Comparison Outcome format. Immunocompromised patients included patients with (a) primary immune deficiencies; (b) active malignancy or malignancy diagnosed or received cancer therapies within 1 year of COVID-19 diagnosis, (c) HIV with a CD4+ T-lymphocyte count <200 cells/mm3 or percentage <14%; (d) receipt of solid organ transplant within 1 year of COVID-19 diagnosis; (e) receipt of haematopoietic cell transplant or chimeric antigen receptor T-cell therapy within 1 year of COVID-19 diagnosis; (f) receipt of systemic corticosteroid therapy with a dose of ≥20 mg prednisone or equivalent daily for ≥14 days or a cumulative dose of >600 mg of prednisone; (g) receipt of biological immune modulators; or (h) receipt of disease-modifying antirheumatic drugs or other immunosuppressive drugs. The panel's consensus statements were based on evidence, supplemented by experience and expert opinion, especially in cases when evidence was limited or scarce. This document is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standard.