Disparities in Coronavirus Disease 2019 Clinical Outcomes and Vaccination Coverage Among Migrants With Human Immunodeficiency Virus in the PISCIS Cohort: A Population-Based Propensity Score-Matched Analysis
Por:
Nomah, DK, Díaz, Y, Bruguera, A, Moreno-Fornés, S, Aceiton, J, Reyes-Urueña, J, Llibre, JM, Falcó, V, Imaz, A, Fanjul, FJ, Peraire, J, Deig, E, Domingo, P, Inciarte, A, Casabona, J and Miró, JM
Publicada:
2 ene 2024
Ahead of Print:
1 ene 2024
Resumen:
Background. Coronavirus disease 2019 (COVID-19) disproportionately affects migrants and ethnic minorities, including those with human immunodeficiency virus (HIV). Comprehensive studies are needed to understand the impact and risk factors.Methods. Using data from the PISCIS cohort of people with HIV (PWH) in Catalonia, Spain, we investigated COVID-19 outcomes and vaccination coverage. Among 10 640 PWH we compared migrants and non-migrants assessing rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing, diagnosis, and associated clinical outcomes through propensity score matching and multivariable Cox regression.Results. The cohort (mean age, 43 years; 83.5% male) included 57.4% (3053) Latin American migrants. Migrants with HIV (MWH) had fewer SARS-CoV-2 tests (67.8% vs 72.1%, P < .0001) but similar COVID-19 diagnoses (29.2% vs 29.4%, P = .847) compared to Spanish natives. Migrants had lower complete vaccination (78.9% vs 85.1%, P < .0001) and booster doses (63.0% vs 65.5%, P = .027). COVID-19 hospitalizations (8.1% vs 5.1%, P < .0001) and intensive care unit (ICU) admissions (2.9% vs 1.2%, P < .0001) were higher among migrants, with similar hospitalization duration (5.5 vs 4.0 days, P = .098) and mortality (3 [0.2%] vs 6 [0.4%], P = .510). Age >= 40 years, CD4 counts <200 cells/mu L, >= 2 comorbidities, and incomplete/nonreception of the SARS-CoV-2 vaccine increased the risk of severe COVID-19 among migrants.Conclusions. MWH had lower rates of SARS-CoV-2 testing and vaccination coverage, although the rates of COVID-19 diagnosis were similar between migrants and non-migrants. Rates of COVID-19-associated hospitalizations and ICU admissions were higher among migrants in comparison with non-migrants, with similar hospitalization duration and mortality. These findings can inform policies to address disparities in future pandemic responses for MWH.
Filiaciones:
Nomah, DK:
Generalitat Catalunya, Ctr Estudis Epidemiol Infecc Transmissio Sexual &, Dept Salut, Badalona, Spain
Inst Invest Germans Trias & Pujol, Barcelona, Spain
Díaz, Y:
Generalitat Catalunya, Ctr Estudis Epidemiol Infecc Transmissio Sexual &, Dept Salut, Badalona, Spain
Inst Invest Germans Trias & Pujol, Barcelona, Spain
CIBER Epidemiol & Salud Publ, Barcelona, Spain
:
Generalitat Catalunya, Ctr Estudis Epidemiol Infecc Transmissio Sexual &, Dept Salut, Badalona, Spain
Inst Invest Germans Trias & Pujol, Barcelona, Spain
CIBER Epidemiol & Salud Publ, Barcelona, Spain
Univ Autonoma Barcelona, Dept Pediat Obstet & Ginecol & Med Prevent & Salu, Bellaterra, Spain
Moreno-Fornés, S:
Generalitat Catalunya, Ctr Estudis Epidemiol Infecc Transmissio Sexual &, Dept Salut, Badalona, Spain
Inst Invest Germans Trias & Pujol, Barcelona, Spain
CIBER Epidemiol & Salud Publ, Barcelona, Spain
Aceiton, J:
Generalitat Catalunya, Ctr Estudis Epidemiol Infecc Transmissio Sexual &, Dept Salut, Badalona, Spain
Inst Invest Germans Trias & Pujol, Barcelona, Spain
:
Generalitat Catalunya, Ctr Estudis Epidemiol Infecc Transmissio Sexual &, Dept Salut, Badalona, Spain
:
Hosp Badalona Germans Trias & Pujol, Fight Infect Fdn, Badalona, Spain
Falcó, V:
Hosp Univ Vall dHebron, Infect Dis Dept, Barcelona, Spain
Imaz, A:
Hosp Univ Bellvitge IDIBELL, Dept Infect Dis, HIV & STI Unit, Lhospitalet De Llobregat, Spain
Fanjul, FJ:
Hosp Son Espases, Infect Dis Unit, Palma De Mallorca, Spain
Peraire, J:
Univ Rovira & Virgili, Hosp Joan XXIII, Inst Invest Sanitaria Pere Virgili, Tarragona, Spain
Inst Salud Carlos III, CIBERINFEC, Madrid, Spain
Deig, E:
Hosp Gen Granollers, Infect Dis Unit, Granollers, Spain
Domingo, P:
Hosp Santa Creu & Sant Pau, Dept Infect Dis, HIV Infect Unit, Barcelona, Spain
Inciarte, A:
Univ Barcelona, Inst Invest Biomed August Pi i Sunyer, Hosp Clin, Barcelona, Spain
:
Generalitat Catalunya, Ctr Estudis Epidemiol Infecc Transmissio Sexual &, Dept Salut, Badalona, Spain
Inst Invest Germans Trias & Pujol, Barcelona, Spain
CIBER Epidemiol & Salud Publ, Barcelona, Spain
Univ Autonoma Barcelona, Dept Pediat Obstet & Ginecol & Med Prevent & Salu, Bellaterra, Spain
Miró, JM:
Inst Salud Carlos III, CIBERINFEC, Madrid, Spain
Univ Barcelona, Inst Invest Biomed August Pi i Sunyer, Hosp Clin, Barcelona, Spain
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