Takeaway
- People with HIV (PWH) have outcomes for severe COVID-19 disease that are comparable to the general population's.
- However, several HIV-specific risk factors are prognostic for severe COVID-19.
Why this matters
- To mitigate a COVID-19 effect, close observation and monitoring are warranted for patients with advanced HIV immunosuppression, especially in areas with ongoing SARS-CoV-2 transmission.
Key results
- n=286; mean age, 51.4 years.
- At COVID-19 diagnosis:
- 77.9% (180/231) had HIV >5 years,
- 88.7% (235/265) were virologically suppressed,
- 94.3% (263/279) were on antiretroviral therapy, and
- 26.9% (77) had ≥3 comorbidities.
- 57.3% (164) were hospitalized at ≤30 days following positive SARS-CoV-2 test.
- 28.7% (47) required ICU admission.
- Median interval to admission: 2.0 (interquartile range [IQR], 0.0-9.0) days from testing.
- Outcomes:
- 22.6% (37) required invasive mechanical ventilation.
- 16.5% died (median, 16 [IQR, 8-24] days from testing).
- On multivariate analysis, independent predictors of hospitalization (ORs):
- Higher age: 1.04 (P=.01).
- Lower CD4: 5.22 (P=.02).
- Chronic kidney disease: 5.12 (P<.01>
- Chronic lung disease: 4.54 (P<.01>
- >3 comorbidities: 4.56 (P<.01>
- Older age: 1.04 (P=.02).
- Hypertension: 2.44 (P=.03).
- Chronic lung disease: 3.65 (P<.01>
- >3 comorbidities: 5.09 (P=.04).
Study design
- Retrospective, multicenter registry evaluation of severe clinical outcomes in PWH with lab-confirmed COVID-19.
- Funding: None.
Limitations
- Selection bias.
- Missing confounders.
- Cause of death unverified.
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