Year: 2021
Type: article
Abstract: Background Whether HIV infection is associated with differences in clinical outcomes among people hospitalized with COVID-19 is uncertain. Objective To evaluate the impact of HIV infection on COVID-19 outcomes among hospitalized patients. Methods Using the American Heart Association’s COVID-19 Cardiovascular Disease registry, we used hierarchical mixed effects models to assess the association of HIV with in-hospital mortality accounting for patient demographics and comorbidities and clustering by hospital. Secondary outcomes included major adverse cardiac events (MACE), severity of illness, and length of stay (LOS). Results The registry included 21,528 hospitalization records of people with confirmed COVID-19 from 107 hospitals in 2020, including 220 people living with HIV (PLWH). PLWH were younger (56.0+/-13.0 versus 61.3+/-17.9 years old) and more likely to be male (72.3% vs 52.7%), Non-Hispanic Black (51.4% vs 25.4%), on Medicaid (44.5% vs 24.5), and active tobacco users (12.7% versus 6.5%). Of the study population, 36 PLWH (16.4%) had in-hospital mortality compared with 3,290 (15.4%) without HIV (Risk ratio 1.06, 95%CI 0.79-1.43; risk difference 0.9%, 95%CI −4.2 to 6.1%; p=0.71). After adjustment for age, sex, race, and insurance, HIV was not associated with in-hospital mortality (aOR 1.13; 95%CI 0.77-1.6; p 0.54) even after adding body mass index and comorbidities (aOR 1.15; 95%CI 0.78-1.70; p=0.48). HIV was not associated with MACE (aOR 0.99, 95%CI 0.69-1.44, p=0.91), severity of illness (aOR 0.96, 95%CI 0.62-1.50, p=0.86), or LOS (aOR 1.03; 95% CI 0.76-1.66, p=0.21). Conclusion HIV was not associated with adverse outcomes of COVID-19 including in-hospital mortality, MACE, or severity of illness. Condensed Abstract We studied 21,528 patients hospitalized with COVID-19 at 107 hospitals in AHA’s COVID-19 registry to examine the association between HIV and COVID-19 outcomes. More patients with HIV were younger, male, non-Hispanic Black, on Medicaid and current smokers. HIV was not associated with worse COVID-19 in-hospital mortality (Risk ratio 1.06, 95%CI 0.79-1.43; p=0.71) even after adjustment (aOR 1.15; 95%CI 0.78-1.70; p=0.48). HIV was also not associated with MACE (aOR 0.99, 95%CI 0.69-1.44, p=0.91) or severity of illness (aOR 0.96, 95%CI 0.62-1.50, p=0.86. Our findings do not support that HIV is a major risk factor for adverse COVID-19 outcomes.
Source: AIDS
Institutions: San Francisco General Hospital, University of California, San Francisco, San Francisco VA Medical Center, Stanford Cardiovascular Institute, Stanford University, Beth Israel Deaconess Medical Center, Harvard University, Beth Israel Deaconess Hospital, University of California, Los Angeles
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Gordon and Betty Moore Foundation, American Heart Association, AstraZeneca, Gilead Sciences, Beth Israel Deaconess Medical Center, Boston Scientific Corporation, InfraRedx, National Institutes of Health, Abbott Vascular, National Heart, Lung, and Blood Institute, National Institute of Allergy and Infectious Diseases
Awards: Impact of Endothelin-1 on the Development of Cardiac Allograft Vasculopathy in Heart Transplant Recipients, G1636177350, Impact of Treating Asymptomatic CMV Replication on Cardiovascular Risk in Treated HIV Infection, Role of Hematopoietic System and Proteomics in HIV-Associated CardiovascularDisease, G4144835359, UCSF Career Development Program in Cardiopulmonary, Hematologic, and Immunologic Comorbidities of HIV (CHIC), SURPASS: (Statin Use and Risk Prediction of Atherosclerotic Cardiovascular Disease in minority Subgroups), G5258229927, G5316515788, G5514976981, G5871254648, Shared Decision-Making to Improve the Health Status of Patients with Claudication: Developing and Implementing Strategies to Individualize Treatment Decisions, Molecular and Cellular Basis of Cardiovascular Disease
OpenAlex ID: W3212163640