Characteristics, Comorbidities, and Outcomes in a Multicenter Registry of Patients With Human Immunodeficiency Virus and Coronavirus Disease 2019

Dima Dandachi, Grant Geiger, Mary W. Montgomery, Savannah Karmen-Tuohy, Mojgan Golzy, Annukka A.R. Antar, Josep M. Llibre, Maraya Camazine, Alberto Díaz-De Santiago, Philip M. Carlucci, Ioannis M. Zacharioudakis, Joseph Rahimian, Celestine N. Wanjalla, Jihad Slim, Folasade Arinze, Ann Marie Porreca Kratz, Joyce L. Jones, Shital M. Patel, Ellen Kitchell, Adero FrancisManoj Ray, David E. Koren, John W. Baddley, Brannon Hill, Paul E. Sax, Jeremy Chow

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

BACKGROUND: People living with human immunodeficiency virus (HIV) may have numerous risk factors for acquiring coronavirus disease 2019 (COVID-19) and developing severe outcomes, but current data are conflicting. METHODS: Health-care providers enrolled consecutively, by nonrandom sampling, people living with HIV (PWH) with lab-confirmed COVID-19, diagnosed at their facilities between 1 April and 1 July 2020. Deidentified data were entered into an electronic Research Electronic Data Capture (REDCap) system. The primary endpoint was a severe outcome, defined as a composite endpoint of intensive care unit (ICU) admission, mechanical ventilation, or death. The secondary outcome was the need for hospitalization. RESULTS: There were 286 patients included; the mean age was 51.4 years (standard deviation, 14.4), 25.9% were female, and 75.4% were African American or Hispanic. Most patients (94.3%) were on antiretroviral therapy, 88.7% had HIV virologic suppression, and 80.8% had comorbidities. Within 30 days of testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 164 (57.3%) patients were hospitalized, and 47 (16.5%) required ICU admission. Mortality rates were 9.4% (27/286) overall, 16.5% (27/164) among those hospitalized, and 51.5% (24/47) among those admitted to an ICU. The primary composite endpoint occurred in 17.5% (50/286) of all patients and 30.5% (50/164) of hospitalized patients. Older age, chronic lung disease, and hypertension were associated with severe outcomes. A lower CD4 count (<200 cells/mm3) was associated with the primary and secondary endpoints. There were no associations between the ART regimen or lack of viral suppression and the predefined outcomes. CONCLUSIONS: Severe clinical outcomes occurred commonly in PWH with COVID-19. The risks for poor outcomes were higher in those with comorbidities and lower CD4 cell counts, despite HIV viral suppression. CLINICAL TRIALS REGISTRATION: NCT04333953.

Original languageEnglish (US)
Pages (from-to)e1964-e1972
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Volume73
Issue number7
DOIs
StatePublished - Oct 5 2021

Keywords

  • AIDS
  • COVID-19
  • HIV
  • SARS-CoV-2

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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