Long COVID Between People With and Without HIV: A Statewide Cohort Analysis

Area of Science:

• Infectious Diseases
• Public Health
• Epidemiology

Background:

• Long COVID (LC) is a growing concern following COVID-19 infection.
• Understanding differential risks of LC in various populations is crucial for public health strategies.
• People with HIV (PWH) may have unique vulnerabilities to post-viral complications.

Purpose of the Study:

• To compare the incidence and risk of various long COVID manifestations between people with HIV (PWH) and people without HIV (PWoH).
• To identify specific long COVID diagnosis groups with significantly different risks between the two cohorts.

Main Methods:

• Utilized integrated South Carolina electronic health record data (March 2020 - January 2022).
• Identified 838,520 COVID-19 positive individuals, stratifying by HIV status (2,662 PWH, 835,858 PWoH).
• Employed inverse probability weighting and Cox regression to analyze 131 long COVID categories across 13 diagnosis groups, adjusting for covariates.

Main Results:

• PWH had a higher prevalence of any long COVID diagnosis (16.3%) compared to PWoH (10.6%).
• PWH exhibited a significantly higher risk for at least one long COVID diagnosis (HR=1.29).
• Elevated risks were most pronounced for nervous system disorders (HR=2.04), mental disorders (HR=1.78), and respiratory system disorders (HR=1.78) in PWH.

Conclusions:

• People with HIV experience a consistently elevated burden of long COVID.
• Sustained clinical follow-up for COVID-19 survivors, particularly PWH, is essential for improving outcomes.
• This research underscores the need for targeted interventions and monitoring for long COVID in PWH.