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COVID-19 and HIV: Clinical Outcomes among Hospitalized Patients in the United States

Zohaa Faiz1, Mohammed A Quazi2, Neel Vahil3

  • 1Department of Medicine, School of Medicine, Aga Khan University, Karachi 74000, Pakistan.

Biomedicines
|July 29, 2023
PubMed

Insights

Patients with HIV and COVID-19 had similar mortality rates but higher rates of acute kidney injury (AKI) compared to those with COVID-19 alone. Further research is needed on factors influencing these outcomes in co-infected individuals.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Internal Medicine

Background:

  • The co-occurrence of Human Immunodeficiency Virus (HIV) and Coronavirus Disease 2019 (COVID-19) presents unique healthcare challenges.
  • Individuals with HIV may be at increased risk for SARS-CoV-2 infection and adverse clinical outcomes.
  • COVID-19 disproportionately affects marginalized populations, including African Americans and those with lower socioeconomic status.

Purpose of the Study:

  • To compare in-hospital mortality and secondary outcomes between patients with both HIV and COVID-19 and those with COVID-19 alone.
  • To identify specific complications and resource utilization differences in co-infected patients.

Main Methods:

  • Retrospective analysis of the National Inpatient Sample (NIS) database.
  • Comparison of patients diagnosed with both HIV and COVID-19 against a cohort with COVID-19 only.
  • Primary outcome: in-hospital mortality. Secondary outcomes included intubation, vasopressor use, acute myocardial infarction, acute kidney injury (AKI), AKI requiring hemodialysis, venous thromboembolism, septic shock, cardiac arrest, length of stay, financial burden, and resource utilization.

Main Results:

  • A total of 1,572,815 patients were analyzed (99.4% COVID-19 only, 0.56% HIV and COVID-19).
  • No significant difference in in-hospital mortality was observed between the two groups (10.2% vs. 11.3%, p=0.35).
  • Patients with both HIV and COVID-19 exhibited a significantly higher rate of AKI (33.6% vs. 28.6%, aOR: 1.26, p<0.001).

Conclusions:

  • While mortality risk was similar, HIV and COVID-19 co-infection is associated with an increased incidence of acute kidney injury.
  • Further prospective research is warranted to explore the impact of viral load, CD4 count, and antiretroviral therapy on outcomes in co-infected patients.
  • Understanding these complex interactions is crucial for optimizing care for individuals living with HIV during the COVID-19 pandemic.

Keywords:
COVID-19HIVNational Inpatient SampleUnited Statescomplicationsmortalityprevalence

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