HIV status shows no association with COVID-19 severity in hospitalized patients

  • Sigel K & al.
  • Clin Infect Dis
  • 28/06/2020

  • Liz Scherer
  • Clinical Essentials
L'accesso ai contenuti di questo sito è riservato agli operatori del settore sanitario italiano L'accesso ai contenuti di questo sito è riservato agli operatori del settore sanitario italiano

Takeaway

  • COVID-19 does not appear to manifest differently or more severely in people with HIV vs those without.

Why this matters

  • Consider non-HIV causes of immunodeficiency, such as organ transplant history, among patients with HIV hospitalized with COVID-19.

Key results

  • 88 people with HIV and 405 without HIV, hospitalized with confirmed COVID-19.
  • Median age, 61 (interquartile range [IQR], 54-67) years; 40% Black; 30% Hispanic/Latino. 
  • People with HIV had more comorbidities vs those without:
    • COPD: 10% vs 3% (P<.0001>
    • Cirrhosis: 6% vs 2% (P=.02).
    • Cancer history: 17% vs 6% (P=.001).
    • 73% had lower CD4 percentages at admission (median decline, 4% [IQR, 0%-9%]).
    • 81% had high viral suppression.
  • No difference in ICU use by HIV status.
  • Mechanical ventilation: 18% with HIV vs 23% without.
  • Mortality: 21% with HIV vs 20% without.
  • Cumulative death incidence was similar between groups (P=.94).
  • Mortality among patients with HIV: 17% with organ transplant vs 1% without (P=.006).
  • Among patients with HIV, admission C-reactive protein and procalcitonin were higher among those who died.
  • Following adjustments, factors associated with mortality risk (subhazard ratios; 95% CIs):
    • Organ transplant: 3.85 (1.87-7.94).
    • Use of non-nucleoside reverse transcriptase inhibitors: 0.31 (0.12-0.80).

Study design

  • Case-cohort analysis, patients in the New York health system.
  • Funding: NIH.

Limitations

  • Missing confounders.
  • Small sample size.