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COVID-19 Outcomes in a US Cohort of Persons Living with HIV (PLWH)

Amanda Blair Spence1, Sameer Desale2, Jennifer Lee1

  • 1Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC 20007, USA.

Reports (MDPI)
|April 17, 2023
PubMed

Insights

Persons living with HIV (PLWH) experienced higher hospitalization rates and overall mortality from COVID-19 compared to HIV-seronegative individuals. However, mortality rates were similar once hospitalized, indicating a need for targeted interventions for PLWH.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Epidemiology

Background:

  • Outcomes of coronavirus disease 2019 (COVID-19) in persons living with HIV (PLWH) have varied across studies.
  • Understanding these outcomes is crucial for effective public health strategies and clinical management.

Purpose of the Study:

  • To compare the clinical characteristics and outcomes of COVID-19 in PLWH versus a matched HIV-seronegative cohort.
  • To identify factors associated with severe outcomes, including hospitalization and mortality, among PLWH with COVID-19.

Main Methods:

  • A retrospective cohort study was conducted within a mid-Atlantic US healthcare system.
  • Multivariate logistic regression analysis was used to determine factors associated with hospitalization and death/mechanical ventilation.
  • PLWH with COVID-19 were compared to a matched cohort of HIV-seronegative individuals diagnosed with COVID-19.

Main Results:

  • PLWH had significantly higher hospitalization rates (47% vs. 24%) and overall mortality (6% vs. 3%) compared to the HIV-seronegative group.
  • Cardiovascular events, thrombotic events, acute kidney injury, and infections were similar between groups.
  • Among hospitalized patients, mortality rates were comparable (14% for PLWH vs. 13% for HIV-seronegative).
  • Older age, Medicaid insurance, and multimorbidity were associated with increased hospitalization and mortality risk in PLWH.

Conclusions:

  • PLWH with COVID-19 face higher risks of hospitalization and overall mortality but not necessarily in-hospital mortality compared to HIV-seronegative individuals.
  • Factors such as older age, multimorbidity, and insurance status contribute to worse outcomes in PLWH.
  • Targeted interventions are essential to address modifiable inequities and improve COVID-19 outcomes for PLWH.

Keywords:
COVID-19HIVSARS-CoV-2complicationsoutcomes

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