Characteristics, Comorbidities, and Outcomes in a Multicenter Registry of Patients With Human Immunodeficiency Virus and Coronavirus Disease 2019
Por:
Dandachi, D, Geiger, G, Montgomery, MW, Karmen-Tuohy, S, Golzy, M, Antar, AAR, Llibre, JM, Camazine, M, Diaz-De Santiago, A, Carlucci, PM, Zacharioudakis, IM, Rahimian, J, Wanjalla, CN, Slim, J, Arinze, F, Kratz, AMP, Jones, JL, Patel, SM, Kitchell, E, Francis, A, Ray, M, Koren, DE, Baddley, JW, Hill, B, Sax, PE and Chow, J
Publicada:
1 oct 2021
Resumen:
Background. People living with human immunodeficiency virus (HIV) may have numerous risk factors for acquiring coronavirus disease 2019 (COVID-19) and developing severe outcomes, but current data are conflicting.
Methods. Health-care providers enrolled consecutively, by nonrandom sampling, people living with HIV (PWH) with lab-confirmed COVID-19, diagnosed at their facilities between 1 April and 1 July 2020. Deidentified data were entered into an electronic Research Electronic Data Capture (REDCap) system. The primary endpoint was a severe outcome, defined as a composite endpoint of intensive care unit (ICU) admission, mechanical ventilation, or death. The secondary outcome was the need for hospitalization.
Results. There were 286 patients included; the mean age was 51.4 years (standard deviation, 14.4), 25.9% were female, and 75.4% were African American or Hispanic. Most patients (94.3%) were on antiretroviral therapy, 88.7% had HIV virologic suppression, and 80.8% had comorbidities. Within 30 days of testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 164 (57.3%) patients were hospitalized, and 47 (16.5%) required ICU admission. Mortality rates were 9.4% (27/286) overall, 16.5% (27/164) among those hospitalized, and 51.5% (24/47) among those admitted to an ICU. The primary composite endpoint occurred in 17.5% (50/286) of all patients and 30.5% (50/164) of hospitalized patients. Older age, chronic lung disease, and hypertension were associated with severe outcomes. A lower CD4 count (<200 cells/mm(3)) was associated with the primary and secondary endpoints. There were no associations between the ART regimen or lack of viral suppression and the predefined outcomes.
Conclusions. Severe clinical outcomes occurred commonly in PWH with COVID-19. The risks for poor outcomes were higher in those with comorbidities and lower CD4 cell counts, despite HIV viral suppression.
Filiaciones:
Dandachi, D:
Univ Missouri, Div Infect Dis, Columbia, MO 65212 USA
Geiger, G:
Univ Missouri, Sch Med, Columbia, MO 65212 USA
Montgomery, MW:
Brigham & Womens Hosp, Dept Infect Dis, 75 Francis St, Boston, MA 02115 USA
Karmen-Tuohy, S:
NYU, Sch Med, Grossman Sch Med, New York, NY USA
Golzy, M:
Univ Missouri, Dept Hlth Management & Informat, Columbia, MO 65212 USA
Antar, AAR:
Johns Hopkins Univ, Sch Med, Div Infect Dis, Baltimore, MD 21205 USA
:
Univ Hosp Germans Trias, Infect Dis & Fight Aids Fdn, Badalona, Spain
Camazine, M:
Univ Missouri, Sch Med, Columbia, MO 65212 USA
Diaz-De Santiago, A:
Puerta de Hierro Majadahonda Univ Hosp, Internal Med Dept, Human Immunodeficiency Virus HIV Infect Unit, Madrid, Spain
Carlucci, PM:
NYU, Sch Med, Grossman Sch Med, New York, NY USA
Zacharioudakis, IM:
NYU, Div Infect Dis & Immunol, Grossman Sch Med, New York, NY USA
Rahimian, J:
NYU, Div Infect Dis & Immunol, Grossman Sch Med, New York, NY USA
Wanjalla, CN:
Vanderbilt Univ, Med Ctr, Div Infect Dis, Nashville, TN USA
Slim, J:
St Michaels Hosp, Div Infect Dis, Newark, NJ USA
Arinze, F:
Wellstar Hlth Syst, Dept Internal Med, Atlanta, GA USA
Kratz, AMP:
Tower Hlth, Dept Pharm, W Reading, PA USA
Jones, JL:
Johns Hopkins Univ, Sch Med, Div Infect Dis, Baltimore, MD 21205 USA
Patel, SM:
Baylor Coll Med, Med, Tect Infect Dis, Houston, TX 77030 USA
Kitchell, E:
Univ Texas Southwestern Med Ctr Dallas, Div Infect Dis, Dallas, TX 75390 USA
Francis, A:
Wellstar Hlth Syst, Dept Internal Med, Atlanta, GA USA
Ray, M:
Santa Clara Valley Hlth & Hosp Syst, Div Infect Dis, San Jose, CA USA
Koren, DE:
Temple Univ Hlth Syst, Dept Pharm, Philadelphia, PA USA
Baddley, JW:
Univ Maryland, Div Infect Dis, Baltimore, MD 21201 USA
Hill, B:
Univ Arkansas Med Sci, Dept Pharm, Little Rock, AR 72205 USA
Sax, PE:
Brigham & Womens Hosp, Dept Infect Dis, 75 Francis St, Boston, MA 02115 USA
Chow, J:
Univ Texas Southwestern Med Ctr Dallas, Div Infect Dis, Dallas, TX 75390 USA
Green Published, Bronze
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