Characteristics and outcomes of COVID-19 in patients with HIV: a multicentre research network study.
AIDS
; 34(13): F3-F8, 2020 11 01.
Article
in English
| MEDLINE | ID: covidwho-1087866
ABSTRACT
OBJECTIVE:
We studied clinical outcomes of COVID-19 infection in patients living with HIV (PLH) in comparison to non-HIV population.DESIGN:
Analysis of a multicentre research network TriNETX was performed including patients more than 10 years of age diagnosed with COVID-19.METHODS:
Outcomes in COVID-19 positive patients with concurrent HIV (PLH) were compared with a propensity-matched cohort of patients without HIV (non-PLH).RESULTS:
Fifty thousand one hundred and sixty-seven patients with COVID-19 were identified (49,763 non-PLH, 404 PLH). PLH were more likely to be men, African-American, obese and have concurrent hypertension, diabetes, chronic kidney disease and nicotine dependence compared with non-PLH cohort (all P values <0.05). We performed 1ââ1 matching for BMI, diabetes, hypertension, chronic lung diseases, chronic kidney disease, race, history of nicotine dependence and sex. In unmatched analysis, PLH had higher mortality at 30 days [risk ratio 1.55, 95% confidence interval (95% CI) 1.01-2.39] and were more likely to need inpatient services (risk ratio 1.83, 95% CI 1.496-2.24). After propensity score matching, no difference in mortality was noted (risk ratio 1.33, 95% CI 0.69-2.57). A higher proportion of PLH group needed inpatient services (19.31 vs. 11.39%, risk ratio 1.696, 95% CI 1.21-2.38). Mean C-reactive protein, ferritin, erythrocyte sedimentation rate and lactate dehydrogenase levels after COVID-19 diagnosis were not statistically different and mortality was not different for PLH with a history of antiretroviral treatment.CONCLUSION:
Crude COVID-19 mortality is higher in PLH; however, propensity-matched analyses revealed no difference in outcomes, showing that higher mortality is driven by higher burden of comorbidities. Early diagnosis and intensive surveillance are needed to prevent a 'Syndemic' of diseases in this vulnerable cohort.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
HIV Infections
/
Coronavirus Infections
Type of study:
Cohort study
/
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
North America
Language:
English
Journal:
AIDS
Journal subject:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Year:
2020
Document Type:
Article
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