tetano
Editor, Senior Moderator
Clin Infect Dis
. 2020 Sep 9;ciaa1339.
doi: 10.1093/cid/ciaa1339. Online ahead of print.
Characteristics, Comorbidities, and Outcomes in a Multicenter Registry of Patients with HIV and Coronavirus Disease-19
Dima Dandachi[SUP] 1 [/SUP], Grant Geiger[SUP] 2 [/SUP], Mary W Montgomery[SUP] 3 [/SUP], Savannah Karmen-Tuohy[SUP] 4 [/SUP], Mojgan Golzy[SUP] 5 [/SUP], Annukka A R Antar[SUP] 6 [/SUP], Josep M Llibre[SUP] 7 [/SUP], Maraya Camazine[SUP] 2 [/SUP], Alberto D?az-De Santiago[SUP] 8 [/SUP], Philip M Carlucci[SUP] 4 [/SUP], Ioannis M Zacharioudakis[SUP] 9 [/SUP], Joseph Rahimian[SUP] 9 [/SUP], Celestine N Wanjalla[SUP] 10 [/SUP], Jihad Slim[SUP] 11 [/SUP], Folasade Arinze[SUP] 12 [/SUP], Ann Marie Porreca Kratz[SUP] 13 [/SUP], Joyce L Jones[SUP] 6 [/SUP], Shital M Patel[SUP] 14 [/SUP], Ellen Kitchell[SUP] 15 [/SUP], Adero Francis[SUP] 12 [/SUP], Manoj Ray[SUP] 16 [/SUP], David E Koren[SUP] 17 [/SUP], John W Baddley[SUP] 18 [/SUP], Brannon Hill[SUP] 19 [/SUP], Paul E Sax[SUP] 3 [/SUP], Jeremy Chow[SUP] 15 [/SUP], HIV-COVID-19 consortium
Affiliations
Abstract
Background: People with HIV (PWH) may have numerous risk factors for acquiring Coronavirus disease-19 (COVID-19) and developing severe outcomes, but current data are conflicting.
Methods: Healthcare providers enrolled consecutively by non-random sampling PWH with lab-confirmed COVID-19, diagnosed at their facilities between April 1st and July 1st, 2020. De-identified data were entered into an electronic Research Electronic Data Capture (REDCap). The primary endpoint was 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: 286 patients were included; the mean age was 51.4 years (SD, 14.4), 25.9% were female, and 75.4% were African-American or Hispanic. Most patients (94.3%) were on antiretroviral therapy (ART), 88.7% had HIV virologic suppression, and 80.8% had comorbidities. Within 30 days of positive SARS-CoV-2 testing, 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/mm?) was associated with the primary and secondary endpoints. There was no association between the antiretroviral regimen or lack of viral suppression and predefined outcomes.
Conclusion: Severe clinical outcomes occurred commonly in PWH and COVID-19. The risk for poor outcomes was higher in those with comorbidities and lower CD4 cell counts, despite HIV viral suppression.
Keywords: AIDS; COVID-19; HIV; SARS-CoV-2.
. 2020 Sep 9;ciaa1339.
doi: 10.1093/cid/ciaa1339. Online ahead of print.
Characteristics, Comorbidities, and Outcomes in a Multicenter Registry of Patients with HIV and Coronavirus Disease-19
Dima Dandachi[SUP] 1 [/SUP], Grant Geiger[SUP] 2 [/SUP], Mary W Montgomery[SUP] 3 [/SUP], Savannah Karmen-Tuohy[SUP] 4 [/SUP], Mojgan Golzy[SUP] 5 [/SUP], Annukka A R Antar[SUP] 6 [/SUP], Josep M Llibre[SUP] 7 [/SUP], Maraya Camazine[SUP] 2 [/SUP], Alberto D?az-De Santiago[SUP] 8 [/SUP], Philip M Carlucci[SUP] 4 [/SUP], Ioannis M Zacharioudakis[SUP] 9 [/SUP], Joseph Rahimian[SUP] 9 [/SUP], Celestine N Wanjalla[SUP] 10 [/SUP], Jihad Slim[SUP] 11 [/SUP], Folasade Arinze[SUP] 12 [/SUP], Ann Marie Porreca Kratz[SUP] 13 [/SUP], Joyce L Jones[SUP] 6 [/SUP], Shital M Patel[SUP] 14 [/SUP], Ellen Kitchell[SUP] 15 [/SUP], Adero Francis[SUP] 12 [/SUP], Manoj Ray[SUP] 16 [/SUP], David E Koren[SUP] 17 [/SUP], John W Baddley[SUP] 18 [/SUP], Brannon Hill[SUP] 19 [/SUP], Paul E Sax[SUP] 3 [/SUP], Jeremy Chow[SUP] 15 [/SUP], HIV-COVID-19 consortium
Affiliations
- PMID: 32905581
- DOI: 10.1093/cid/ciaa1339
Abstract
Background: People with HIV (PWH) may have numerous risk factors for acquiring Coronavirus disease-19 (COVID-19) and developing severe outcomes, but current data are conflicting.
Methods: Healthcare providers enrolled consecutively by non-random sampling PWH with lab-confirmed COVID-19, diagnosed at their facilities between April 1st and July 1st, 2020. De-identified data were entered into an electronic Research Electronic Data Capture (REDCap). The primary endpoint was 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: 286 patients were included; the mean age was 51.4 years (SD, 14.4), 25.9% were female, and 75.4% were African-American or Hispanic. Most patients (94.3%) were on antiretroviral therapy (ART), 88.7% had HIV virologic suppression, and 80.8% had comorbidities. Within 30 days of positive SARS-CoV-2 testing, 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/mm?) was associated with the primary and secondary endpoints. There was no association between the antiretroviral regimen or lack of viral suppression and predefined outcomes.
Conclusion: Severe clinical outcomes occurred commonly in PWH and COVID-19. The risk for poor outcomes was higher in those with comorbidities and lower CD4 cell counts, despite HIV viral suppression.
Keywords: AIDS; COVID-19; HIV; SARS-CoV-2.