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Backgrounds: Currently, clinical details of immunosuppressed patients suffering from COVID-19 are limited. Some studies have shown no more severe diseases among them, but others have highlighted that immunosuppressed patients may have high levels of viral load and impaired immune responses. Herein, this study aimed to specifically address the symptoms, prognosis, laboratory tests, clinical course, and the outcome of SARS-CoV-2 infected immunocompromised patients at a tertiary referral center.
Materials & Methods: Clinical and laboratory information of 75 non-congenital immunosuppressed patients with COVID-19 disease was obtained at a referral center for immunodeficiency diseases and infectious disorders in Tehran, Iran. Three groups of immunocompromised patients were evaluated, including patients with a history of organ transplantation, autoimmune patients receiving medical therapy, and cancer patients undergoing chemotherapy.
Findings: Among 75 immune-deficient patients with COVID-19, there were 32 patients with a kidney transplant, 23 patients with malignancies, and 19 patients with autoimmune disorders. One patient had both malignancy and multiple sclerosis. The mean length of hospitalization was 10.82 days. By the end of the study, 24 (32%) patients were dead, and 51 (68%) patients were discharged. Dyspnea was the most common (64%) symptom. Low levels of O2 saturation and lymphopenia at admission time significantly affected the mortality rate of patients.
Conclusion: This study showed that mortality rate among immunocompromised patients was 32%. It seems that COVID-19 has a worse outcome and a more severe clinical course in immunocompromised patients regardless of age, gender, and underlying diseases.

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The optimization of water use will be an important issue for Iran in the coming years.  In this paper, the gap between current and optimal water use has been estimated using Spatial Durbin Model (SDM), as special case of Spatial Panel Data, for 18 selected provinces during 2003-2015.  Notable characteristic of this model in comparison with other spatial models (including SEM and SAR) is to enter spatial lags of dependent and explanatory variables in the model simultaneously. This model has been selected by Wald Test. Results show that population and income have positive effects on residential water consumption, but water tariff has negative impact on domestic water use. According to the findings, water tariff can be applied as an instrument for controlling the level of water consumption. Especially in high-consumption provinces, water pricing can be more effective in reducing water use.