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Multicenter Study
. 2022 Jun 20;22(1):559.
doi: 10.1186/s12879-022-07519-8.

Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study

Arifa Parker  1 , Linda Boloko  2 , Muhammad S Moolla  3 , Nabilah Ebrahim  4 , Birhanu T Ayele  5 , Alistair G B Broadhurst  3 , Boitumelo Mashigo  3 , Gideon Titus  3 , Timothy de Wet  2 , Nicholas Boliter  4 , Michael-Jon Rosslee  2 , Nectarios Papavarnavas  6 , Riezaah Abrahams  7 , Marc Mendelson  6 , Sipho Dlamini  6 , Jantjie J Taljaard  7 , Hans W Prozesky  7 , Abdurasiet Mowlana  3 , Abraham J Viljoen  3 , Neshaad Schrueder  3 , Brian W Allwood  8 , Usha Lalla  8 , Joel A Dave  2 , Greg Calligaro  2 , Dion Levin  2 , Deborah Maughan  2 , Ntobeko A B Ntusi  2   9 , Peter S Nyasulu  5 , Graeme Meintjes  2   6   10 , Coenraad F N Koegelenberg  8 , Ayanda T Mnguni #  3   4 , Sean Wasserman #  6   10
Affiliations
Multicenter Study

Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study

Arifa Parker et al. BMC Infect Dis. .

Abstract

Background: There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB).

Methods: We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed.

Results: PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02-1.03, p < 0.001), male sex (AHR1.38 (95%CI 1.12-1.72, p = 0.003) and being "overweight or obese" (AHR 1.30 95%CI 1.03-1.61 p = 0.024). HIV (AHR 1.28 95%CI 0.95-1.72, p 0.11) and active TB (AHR 1.50 95%CI 0.84-2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count < 200 cells/mm3, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels.

Conclusion: In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population.

Keywords: COVID-19; HIV; Obesity; Tuberculosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Consort diagram: distribution of study participants
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