COVID-19 Outcomes among People Living with HIV in Colorado

It is known that people who are immunocompromised or have a comorbidity are at an increased risk for acquiring COVID-19, having a longer duration of COVID-19 symptoms, and a greater likelihood of severe outcomes, including people living with HIV (PLHIV) (Centers for Disease Control and Prevention. (n.d.). Basics of covid-19. Centers for Disease Control and Prevention. Retrieved October 31. 2022, from https://www.cdc.gov/coronavirus/2019-ncov/your-health/about-covid-19/basics-covid-19.html ). However, treatment for PLHIV can greatly reduce the amount of HIV in a person's blood, known as viral suppression. This study compared the outcome of COVID-associated hospitalization among virally suppressed and unsuppressed PLHIV in Colorado. A retrospective cohort analysis was conducted including all known PLHIV in Colorado that were diagnosed with COVID-19 between March 2020 and September 2022. Relevant covariates were identified including race/ethnicity, age at time of diagnosis, region of diagnosis, and vaccination status. An initial univariate logistic regression was then built to test the statistical significance of the association between viral suppression and hospitalization. The final model included all associated covariates and crude and adjusted odds ratios were analyzed. When controlling for covariates, PLHIV who were not virally suppressed at the time of their COVID-19 diagnosis were 2.5 (OR 2.5, 95% CI 1.6-4.0) times as likely to be hospitalized at the time of their first COVID-19 diagnosis compared to those that were suppressed. These findings suggest that viral suppression among PLHIV is protective against poor COVID-19 outcomes. This study is an important first step in highlighting the importance of PLHIV being retained in care and achieving viral suppression in reducing hospitalizations due to COVID-19 in Colorado.