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Updated: May 14, 2025

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HIV Infection and Long COVID: A RECOVER Program, Electronic Health Record-Based Cohort Study.

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Summary

People with HIV have a slightly higher risk of long COVID when using a computed phenotype definition. However, no association was found when using ICD-10 codes, suggesting potential underdiagnosis.

Keywords:
Chronic diseasesHIVHealth disparitiesLong COVIDSARS-CoV-2

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Area of Science:

  • Infectious Diseases
  • Public Health
  • Epidemiology

Background:

  • People with HIV may face elevated risks for long COVID following SARS-CoV-2 infection.
  • Understanding this association is crucial for public health strategies and clinical management.

Purpose of the Study:

  • To investigate the association between HIV status and the risk of developing long COVID.
  • To compare long COVID risk using different diagnostic definitions in individuals with and without HIV.

Main Methods:

  • Utilized two large electronic health record databases (PCORnet and N3C) with data from 1/1/2018 to 4/30/2024.
  • Included over 4.6 million adult patients with SARS-CoV-2, classifying them by HIV status.
  • Employed logistic regression to estimate the odds ratio (aOR) of long COVID, controlling for covariates and using both computed phenotype and ICD-10 code definitions.

Main Results:

  • Using a computed phenotype definition, a modest but significant increase in long COVID odds was observed in people with HIV (PCORnet aOR 1.09; N3C aOR 1.18).
  • When using ICD-10 codes for diagnosis, no significant association between HIV and long COVID was found (PCORnet aOR 1.01; N3C aOR 1.07).

Conclusions:

  • People with HIV demonstrated a modestly increased risk of long COVID when defined by a computed phenotype, but not by ICD-10 codes.
  • Findings suggest long COVID may be under-recognized in people with HIV, highlighting diagnostic challenges in those with pre-existing chronic conditions.