Major cardiovascular events after COVID-19 in people with HIV
Por:
Martin-Iguacel, R, Moreno-Fornes, S, Bruguera, A, Aceiton, J, Nomah, DK, Gonzalez-Cordon, A, Domingo, P, Curran, A, Imaz, A, Juanola, DD, Peraire, J, Borjabad, B, Fernandez, LA, Johansen, IS, Miro, JM, Casabona, J and Llibre, JM
Publicada:
1 may 2024
Ahead of Print:
1 abr 2024
Resumen:
Objectives: To assess the effect of COVID-19 on the postacute risk of cardiovascular events (CVEs) among people with HIV (PWH).
Methods: Population-based matched cohort, including all PWH >= 16 years in the Catalan PISCIS HIV cohort. We estimated the incidence rate of the first CVE after COVID-19, analysed it a composite outcome (2020-2022). We adjusted for baseline differences using inverse probability weighting and used competing risk analysis.
Results: We included 4199 PWH with and 14 004 PWH without COVID-19. The median follow-up was 243 days (interquartile range [IQR]: 93-455), 82% (14 941/18 203) were men, with a median age of 47 years. Overall, 211 PWH with COVID-19 and 621 without developed CVE, with an incidence rate of 70.2 and 56.8/1000 person-years, respectively. During COVID-19 infection, 7.6% (320/4199) required hospitalization and 0.6% (25/4199) intensive care unit admission, 97% (4079/4199) had CD4(+) T-cell >= 200 cells/mL, 90% (3791/4199) had HIV-RNA<50 copies/mL and 11.8% (496/4199) had previous CVE at baseline. The cumulative CVE incidence was higher among PWH after COVID-19 compared with PWH without COVID-19 during the first year (log-rank p=0.011). The multivariable analysis identified significantly increased CVE risk with age, heterosexual men, previous cardiovascular disease (CVD), and chronic kidney or liver disease. COVID-19 was associated with increased subsequent risk of CVE (adjusted hazard ratio 1.30 [95% CI, 1.09-1.55]), also when only including individuals without previous CVD (1.60 [95% CI, 1.11-2.29]) or nonhospitalized patients (1.34 [95% CI, 1.11-1.62]).
Discussion: COVID-19 was associated with a 30% increased risk of major CVE in PWH during the subsequent year, suggesting that COVID-19 should be considered an additional CVD risk in PWH in the short term. (c) 2024 Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases.
Filiaciones:
Martin-Iguacel, R:
Ctr Epidemiol Studies HIV AIDS, Dept Hlth, Badalona, Spain
STI Catalonia CEEISCAT, Dept Hlth, Generalitat Catalunya, Badalona, Spain
Odense Univ Hosp, Dept Infect Dis, Odense, Denmark
Moreno-Fornes, S:
Ctr Epidemiol Studies HIV AIDS, Dept Hlth, Badalona, Spain
STI Catalonia CEEISCAT, Dept Hlth, Generalitat Catalunya, Badalona, Spain
:
Ctr Epidemiol Studies HIV AIDS, Dept Hlth, Badalona, Spain
STI Catalonia CEEISCAT, Dept Hlth, Generalitat Catalunya, Badalona, Spain
CIBER Epidemiol Salud Publ CIBERESP, Seville, Spain
Univ Autonoma Barcelona, Dept Paediat Obstet & Gynecol & Prevent Med, Badalona, Spain
Aceiton, J:
Ctr Epidemiol Studies HIV AIDS, Dept Hlth, Badalona, Spain
STI Catalonia CEEISCAT, Dept Hlth, Generalitat Catalunya, Badalona, Spain
Nomah, DK:
Ctr Epidemiol Studies HIV AIDS, Dept Hlth, Badalona, Spain
STI Catalonia CEEISCAT, Dept Hlth, Generalitat Catalunya, Badalona, Spain
Fdn Inst Dinvestigaci Ciencies Salut Germans & Tr, Badalona, Spain
Gonzalez-Cordon, A:
Univ Barcelona, Hosp Clin Inst Invest Biomedi August Pi i Sunyer, Dept Infect Dis, Barcelona, Spain
Domingo, P:
Hosp Univ Santa Creu & St Pau, Infect Dis Unit, Barcelona, Spain
Curran, A:
Hosp Univ Vall dHebron, Dept Infect Dis, Barcelona, Spain
Imaz, A:
Univ Barcelona, Hosp Univ Bellvitge Bellvitge Biomed Res Inst IDI, Dept Infect Dis, Lhospitalet De Llobregat, Spain
Juanola, DD:
Hosp Univ Mutua Terrassa, Dept Internal Med, Barcelona, Spain
Peraire, J:
Univ Rovira & Virgili, Hosp Univ Tarragona Joan XXIII, Dept Internal Med, IISPV, Tarragona, Spain
Inst Salud Carlos III, CIBERINFEC, Madrid, Spain
Borjabad, B:
Consorci Sanitari Integral, Dept Internal Med, Barcelona, Spain
Fernandez, LA:
Hosp Mataro, Dept Internal Med, Mataro, Spain
Miro, JM:
Univ Barcelona, Hosp Clin Inst Invest Biomedi August Pi i Sunyer, Dept Infect Dis, Barcelona, Spain
:
Ctr Epidemiol Studies HIV AIDS, Dept Hlth, Badalona, Spain
STI Catalonia CEEISCAT, Dept Hlth, Generalitat Catalunya, Badalona, Spain
Univ Autonoma Barcelona, Dept Paediat Obstet & Gynecol & Prevent Med, Badalona, Spain
Fdn Inst Dinvestigaci Ciencies Salut Germans & Tr, Badalona, Spain
:
Univ Hosp Germans Trias & Pujol, Dept Infect Dis, Badalona, Spain
Fight Infect Fdn, Badalona, Spain
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