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COVID-19 IN HOSPITALIZED HIV-POSITIVE AND HIV-NEGATIVE PATIENTS: A MATCHED STUDY
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CROI 2021 March 6-10 reported by Jules Levin
Cristina Diez1, Jorge Del Romero-Raposo2, Rafael Mican3, Juan Lopez1, Ana Delgado-Hierro3, Lucio Jesús F. Garcia-Fraile4, Maria Saumoy5, Gloria Samperiz6, Sonia Calzado7, Jose R. Arribas3, Santiago Moreno8, Juan Gonzalez-Garcia3, Inmaculada Jarrin2, Juan Berenguer1, for the CoRIS Research Group
1Hospital General Universitario Gregorio Maranon, Madrid, Spain, 2Instituto de Salud Carlos III, Madrid, Spain, 3La Paz University Hospital, Madrid, Spain, 4Hospital Universitario de La Princesa, Madrid, Spain, 5Hospital Universitario de Bellvitge, Barcelona, Spain, 6Hospital Universitario Miguel Servet, Zaragoza, Spain, 7Hospital Universitario Parc Tauli, Sabadell, Spain, 8Hospital Ramon y Cajal, Madrid, Spain
Background: We compared the characteristics and clinical outcomes of hospitalized patients with COVID-19 with and without HIV infection (HIV-pos and HIV-neg) in Spain during the first wave of the pandemic.
Methods: HIV-pos were identified by reviewing clinical records and laboratory registries of 10,922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to June 30, 2020. Each HIV-pos was matched with 5 HIV-neg of the same age and sex randomly selected from COVID-19@Spain, a multicenter cohort of 4,035 patients hospitalized with PCR confirmed COVID-19 in Spain (Clin Microbiol Infect 2020;26:1525-36). Data were collected with the ISARIC-WHO Core case report form (https://isaric.org/document/covid-19-crf/). The COVID-19 SEIMC score (predictive of 30-day mortality), based on age, sex, dyspnea, O2 saturation, neutrophil-to-lymphocyte ratio, and estimated glomerular filtration rate, was calculated at admission in all patients (ESCMID Conference on Coronavirus Disease, 2020, Abstract#00513). Outcomes included the need for mechanical ventilation and all-cause in-hospital mortality.
Results: Forty-five patients with PCR confirmed COVID-19 were identified in CoRIS, 21 of which were hospitalized. A total of 105 age/sex-matched controls were selected from COVID-19@Spain. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In HIV-pos, 19.1% were IDUs, 95.2% were on ART, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4+ count was 595 (349 – 798) cells/mm3. No statistically significant differences were found between groups in number and type of comorbidities, presenting signs and symptoms, laboratory parameters, and radiology findings. The median (Q1-Q3) COVID-19 SEIMC score on admission was 4 (2 – 7) and 5 (3 -7) in HIV-pos and HIV-neg, respectively; P=.890. Corticosteroids were administered to 33.3% and 27,4% HIV-pos and HIV-neg, respectively; P=.58. Remdesivir was administered to 0 and 2.9% of HIV-pos and HIV-neg, respectively; P=.426. During admission, 9.5% HIV-pos and 23.3% HIV-neg underwent mechanical ventilation; P=.158. In-hospital mortality was 9.5% in HIV-pos and 11.4% in HIV-neg; P=.800.
Conclusion: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes in patients hospitalized with COVID-19.
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