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Incidence and Severity of COVID-19 in HIV-Positive Persons Receiving Antiretroviral Therapy : A Cohort Study.
Del Amo, Julia; Polo, Rosa; Moreno, Santiago; Díaz, Asunción; Martínez, Esteban; Arribas, José Ramón; Jarrín, Inma; Hernán, Miguel A.
  • Del Amo J; Ministry of Health, Madrid, Spain (J.D., R.P.).
  • Polo R; Ministry of Health, Madrid, Spain (J.D., R.P.).
  • Moreno S; University Hospital Ramón y Cajal and HIV Network of Excellence, Madrid, Spain (S.M.).
  • Díaz A; Ministry of Health, HIV Network of Excellence, and Institute of Health Carlos III, Madrid, Spain (A.D.).
  • Martínez E; HIV Network of Excellence, Madrid, and University Hospital Clinic, Barcelona, Spain (E.M.).
  • Arribas JR; HIV Network of Excellence and University Hospital La Paz, IdiPAZ, Madrid, Spain (J.R.A.).
  • Jarrín I; HIV Network of Excellence and Institute of Health Carlos III, Madrid, Spain (I.J.).
  • Hernán MA; Harvard T.H. Chan School of Public Health and Harvard-MIT Division of Health Sciences and Technology, Boston, Massachusetts (M.A.H.).
Ann Intern Med ; 173(7): 536-541, 2020 10 06.
Article in English | MEDLINE | ID: covidwho-614702
Semantic information from SemMedBD (by NLM)
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Persons
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COVID-19
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4. Hospitalization TREATS Male population group
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Male population group
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6. tenofovir disoproxil fumarate ADMINISTERED_TO Patients
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tenofovir disoproxil fumarate
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7. American College of Cardiology/American Heart Association Lesion Complexity Score A PROCESS_OF Patients
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12. Hospitalization TREATS Male population group
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Male population group
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tenofovir disoproxil fumarate
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15. American College of Cardiology/American Heart Association Lesion Complexity Score A PROCESS_OF Patients
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ABSTRACT

BACKGROUND:

The incidence and severity of coronavirus disease 2019 (COVID-19) among HIV-positive persons receiving antiretroviral therapy (ART) have not been characterized in large populations.

OBJECTIVE:

To describe the incidence and severity of COVID-19 by nucleos(t)ide reverse transcriptase inhibitor (NRTI) use among HIV-positive persons receiving ART.

DESIGN:

Cohort study.

SETTING:

HIV clinics in 60 Spanish hospitals between 1 February and 15 April 2020.

PARTICIPANTS:

77 590 HIV-positive persons receiving ART. MEASUREMENTS Estimated risks (cumulative incidences) per 10 000 persons and 95% CIs for polymerase chain reaction-confirmed COVID-19 diagnosis, hospitalization, intensive care unit (ICU) admission, and death. Risk and 95% CIs for COVID-19 diagnosis and hospital admission by use of the NRTIs tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC), tenofovir alafenamide (TAF)/FTC, abacavir (ABC)/lamivudine (3TC), and others were estimated through Poisson regression models.

RESULTS:

Of 77 590 HIV-positive persons receiving ART, 236 were diagnosed with COVID-19, 151 were hospitalized, 15 were admitted to the ICU, and 20 died. The risks for COVID-19 diagnosis and hospitalization were greater in men and persons older than 70 years. The risk for COVID-19 hospitalization was 20.3 (95% CI, 15.2 to 26.7) among patients receiving TAF/FTC, 10.5 (CI, 5.6 to 17.9) among those receiving TDF/FTC, 23.4 (CI, 17.2 to 31.1) among those receiving ABC/3TC, and 20.0 (CI, 14.2 to 27.3) for those receiving other regimens. The corresponding risks for COVID-19 diagnosis were 39.1 (CI, 31.8 to 47.6), 16.9 (CI, 10.5 to 25.9), 28.3 (CI, 21.5 to 36.7), and 29.7 (CI, 22.6 to 38.4), respectively. No patient receiving TDF/FTC was admitted to the ICU or died.

LIMITATION:

Residual confounding by comorbid conditions cannot be completely excluded.

CONCLUSION:

HIV-positive patients receiving TDF/FTC have a lower risk for COVID-19 and related hospitalization than those receiving other therapies. These findings warrant further investigation in HIV preexposure prophylaxis studies and randomized trials in persons without HIV. PRIMARY FUNDING SOURCE Instituto de Salud Carlos III and National Institutes of Health.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / HIV Infections / Coronavirus Infections / Antiretroviral Therapy, Highly Active Type of study: Controlled clinical trial / Etiology study / Incidence study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Ann Intern Med Year: 2020 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / HIV Infections / Coronavirus Infections / Antiretroviral Therapy, Highly Active Type of study: Controlled clinical trial / Etiology study / Incidence study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Ann Intern Med Year: 2020 Document Type: Article