Outcomes Among HIV-Positive Patients Hospitalized With COVID-19

Savannah Karmen-Tuohy, BS; Philip M. Carlucci, BS; Fainareti N. Zervou, MD; Ioannis M. Zacharioudakis, MD; Gabriel Rebick, MD; Elizabeth Klein, BS; Jenna Reich, BS; Simon Jones, PhD; Joseph Rahimian, MD

Disclosures

J Acquir Immune Defic Syndr. 2020;85(1):6-10. 

In This Article

Abstract and Introduction

Abstract

Background: SARS-CoV-2 infection continues to cause significant morbidity and mortality worldwide. Preliminary data on SARS-CoV-2 infection suggest that some immunocompromised hosts experience worse outcomes. We performed a retrospective matched cohort study to characterize outcomes in HIV-positive patients with SARS-CoV-2 infection.

Methods: Leveraging data collected from electronic medical records for all patients hospitalized at NYU Langone Health with COVID-19 between March 2, 2020, and April 23, 2020, we matched 21 HIV-positive patients with 42 non-HIV patients using a greedy nearest-neighbor algorithm. Admission characteristics, laboratory test results, and hospital outcomes were recorded and compared between the 2 groups.

Results: Although there was a trend toward increased rates of intensive care unit admission, mechanical ventilation, and mortality in HIV-positive patients, these differences were not statistically significant. Rates for these outcomes in our cohort are similar to those previously published for all patients hospitalized with COVID-19. HIV-positive patients had significantly higher admission and peak C-reactive protein values. Other inflammatory markers did not differ significantly between groups, although HIV-positive patients tended to have higher peak values during their clinical course. Three HIV-positive patients had superimposed bacterial pneumonia with positive sputum cultures, and all 3 patients died during hospitalization. There was no difference in frequency of thrombotic events or myocardial infarction between these groups.

Conclusions: This study provides evidence that HIV coinfection does not significantly impact presentation, hospital course, or outcomes of patients infected with SARS-CoV-2, when compared with matched non-HIV patients. A larger study is required to determine whether the trends we observed apply to all HIV-positive patients.

Introduction

The coronavirus disease 2019 (COVID-19) pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in significant morbidity and mortality around the world. Since first tracking the global outbreak in December 2019, researchers have reported worse outcomes for patients with pre-existing conditions, including diabetes, hypertension, cardiovascular disease, underlying respiratory disease, and cancer.[1,2] However, there are minimal data exploring the effect of SARS-CoV-2 infection on the world's estimated 37.9 million HIV-positive patients.[3] A single clinical case series of 5 patients and 1 case report have described the characteristics and outcomes of HIV-positive patients, but, to the best of our knowledge, nothing has been published to date comparing a cohort of HIV-positive patients with a matched non-HIV cohort.[4,5] This retrospective observational study aims to understand whether coinfection with HIV alters the initial presentation, hospital course, and outcomes of patients infected with SARS-CoV-2.

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