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Multicenter Study
. 2020 Nov 1;34(13):F3-F8.
doi: 10.1097/QAD.0000000000002666.

Characteristics and outcomes of COVID-19 in patients with HIV: a multicentre research network study

Yousaf B Hadi  1 , Syeda F Z Naqvi  2 , Justin T Kupec  1 , Arif R Sarwari  3
Affiliations
Multicenter Study

Characteristics and outcomes of COVID-19 in patients with HIV: a multicentre research network study

Yousaf B Hadi et al. AIDS. .

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 1 : 1 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.

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Conflict of interest statement

Conflicts of interest

There are no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Propensity score density in the HIV-positive and negative cohorts before and after propensity score matching in the HIV-positive (purple) and non-HIV (blue) cohorts.
Fig. 2.
Fig. 2.
Survival probability after COVID-19 in the HIV-positive (purple) and non-HIV (blue) cohorts in the matched analysis.
See this image and copyright information in PMC

References

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