What does it mean to be immunocompromised?

While there aren’t distinct ways that people can be immunocompromised, there are differing degrees of the condition—this has a bearing on how susceptible these people are to catching an infection, and how sick they eventually become because of it.

In the case of a patient who is mildly immunocompromised, they may be at greater risk of catching an infection and becoming sick, such as catching a cold or flu. However, those who are on this spectrum of the condition would recover eventually.

But when it comes to someone who is severely immunocompromised, even the most innocuous of infections can prove to be life-threatening, as not only is the person more at risk of catching the infection, but is at a higher risk of suffering from severe complications as a result. An example of this is people living with HIV but without ART therapy.

One can be immunocompromised for a short time, like when they are undergoing treatment for certain diseases. Others may have a more permanent experience of this condition—those with chronic illnesses or genetic disorders often have this problem. For example, people with diabetes are more likely to get severe symptoms if they catch an infection and they take longer than healthy people to heal.

Our immune system is made up of various cells, including T cells, B cells, macrophages and many others that are affected or disrupted due to various conditions affecting the body.

Read more: Immunity to COVID-19 may be higher than previously thought

According to the US Centers for Disease Control and Prevention (CDC), as many as half of all COVID-19 patients with diabetes have needed to be hospitalised, while 78% of the patients who received intensive care were suffering from at least one pre-existing condition. However, in some cases, an overactive immune system is also said to have caused severe complications among COVID-19 patients.

Read more: Cytokine Storm

Some common signs that can show a person may be immunocompromised are as follows:

• Frequent respiratory infections such as the common cold, flu, pneumonia, bronchitis, or inflammation of the sinus (sinusitis)
• Ear infections
• Frequent fever, headaches or skin infections
• Low platelet count in the blood or other blood disorders such as anaemia
• Inflammation of the internal organs
• Digestive problems such as diarrhoea, stomach cramps, nausea or reduced appetite
• Autoimmune disorders
• Delayed or impaired growth or development
• In some cases, signs of infections that become apparent through swelling or fever do not occur, and the patient directly experiences severe symptoms of an illness

One of the reasons why those who may be immunocompromised have been asked to strictly follow preventive measures including physical distancing, avoiding large gatherings and eating healthy foods is because those with a weakened immune system have been known to suffer from the more severe complications of COVID-19. 

Read more: COVID-19 fatality rate in patients with diabetes

There are several factors that are responsible for a weakened immune system or being immunocompromised, some of which are as follows:

• Advancing age
• Very young age, while the immune system hasn't fully developed
• Genetic conditions
• Suffering from chronic conditions such as HIV/AIDS, cancer, heart disease, lung disease and diabetes.
• Suffering from autoimmune disorders such as rheumatoid arthritis, lupus, multiple sclerosis, among others.
• Inadequate nutrition (Read more: Nutritional deficiency)
• Pregnancy (Read more: Vitamins and minerals needed during pregnancy)
• If the patient has had an organ transplant such as a kidney transplant, or bone marrow transplant.
• As a response to heavy medication or while undergoing treatment such as chemotherapy or radiation therapy.
• Smoking has also been considered to be a factor behind a patient suffering more severe forms of infection, and thus a cause of being immunocompromised

Any of the above-mentioned conditions or a combination of any of them can be the reason behind someone being immunocompromised.

Whether it is a primary immunodeficiency such as type 1 diabetes that is affecting a patient, or a weakened immune system has occurred due to an illness or treatment, visiting a doctor to find out the root cause of your symptoms is important. The doctor may ask questions about your medical history and the symptoms that you have been experiencing, before proceeding to perform a physical examination.

Some common tests that are used to diagnose an immune disorder are blood tests, which look at the IgL (immunoglobulin) levels in the blood. These are the proteins that help in fighting off infections and diseases. If the numbers are abnormal, it can signal a weakened immune system. Antibody tests, which have become popular during the COVID-19 pandemic, are also a way to find out if the body is producing antibodies against the pathogen that is causing infection.

Those who are immunocompromised are not only at higher risk of suffering from severe symptoms of an infection but sometimes they do not even respond to vaccinations as well, making it difficult to protect them from future illnesses.

In most cases, preventing the onset of an illness is the best-case scenario for those who are immunocompromised. Besides that, ensuring that the body is getting adequate nourishment and nutrition to boost the immune system is another effective strategy towards preventing future harm.

Treating any infection in people who are immunocompromised has to be done immediately, with the appropriate usage of antibiotics or antivirals as the treatment may take longer than for an average person with a relatively strong immune system.

Those with primary immunodeficiency conditions may be required to take antibiotics for a long time. In the case of patients who show frequent symptoms of pain, fever, cough and cold, over the counter medications may be used to get relief from the symptoms before they become worse.

More complex treatments to boost the immune system include injecting antibodies into a patient's body, or even using growth factor therapy, a treatment that helps increase the level of specific white blood cells that are essential towards building immunity in the body.

A healthy diet and regular exercise are important for ensuring the body is strengthened not only from the outside, but has a strong immune system that can fight off future infections and diseases.

People with weakened immune systems or those who are immunocompromised have a higher likelihood of developing the more severe symptoms of a disease, if and when they become infected.

In the case of COVID-19, various studies have indicated that those with underlying conditions are at a greater risk of suffering from the severe complications of the disease.

Read more: COVID-19 prevention tips for the elderly and people living with lifestyle diseases