A comparison of COVID-19 inpatients by HIV status. (October 2021)

• Record Type: Journal Article
• Authors: Flannery, Sarah; Schwartz, Rebecca; Rasul, Rehana; Hirschwerk, David A; Wallach, Frances; Hirsch, Bruce; McGowan, Joseph
• Is Part Of: International journal of STD & AIDS. Volume 32:Number 12(2021)
• Page Start: 1149
• Page End: 1156
• Publication Date: 2021-10
• Subjects: AIDS < viral disease -- human immunodeficiency virus < viral disease -- viral disease; Sexually transmitted diseases -- Periodicals; AIDS (Disease) -- Periodicals; 616.951
• DOI: 10.1177/09564624211023015
• Languages: English
• ISSNs: 0956-4624

Abstract

COVID-19 in-hospital morbidity and mortality in people living with HIV (PLWH) were compared to HIV-negative COVID-19 patients within a New York City metropolitan health system, the hardest hit region in the United States early in the pandemic. A total of 10, 202 inpatients were diagnosed with COVID-19, of which 99 were PLWH. PLWH were younger (58.3 years (SD = 12.42) versus 64.32 years (SD = 16.77), p &lt; 0.001) and had a higher prevalence of men (73.7% versus 57.9%, p = 0.002) and Blacks (43.4% versus 21.7%, p &lt; 0.001) than the HIV-negative population. PLWH had a higher prevalence of malignancies (18% versus 7%, p = &lt; 0.001), chronic liver disease (12% versus 3%, p &lt; 0.001), and end-stage renal disease (11% versus 4%, p = 0.007). Use of a ventilator, admission to the ICU, and in-hospital mortality were not different. Of the 99 PLWH, 12 were virally unsuppressed and 9 had CD4% &lt; 14. Two of the 12 virally unsuppressed patients and 4/9 patients with CD4% &lt; 14 died. Ninety-one of the 99 PLWH were on treatment for HIV, and 5 of the 8 not on treatment died. Among PLWH with prior values, absolute CD4 count decreased an average of 192 cells/mm 3 at the time of COVID-19 diagnosis ( p &lt; 0.001). Hospitalized patients with HIV and COVID-19 coinfection did not have worse outcomes than the general population. Among PLWH, those with CD4%&lt;14 or not on treatment for HIV had higher mortality rates. Those PLWH who received IL-6 inhibitors had lower mortality rates. PLWH given antifungal medications, hydroxychloroquine, antibiotics (including azithromycin), steroids, and vasopressors had higher mortality rates.