Factors Associated with COVID-19 Risk and Outcomes for HIV-Positive Persons

Concern has been raised about the potential impact of the overlapping HIV and COVID-19 epidemics. For this study, investigators assessed COVID-19 in patients with HIV infection on antiretroviral therapy (ART) at 60 hospitals in Madrid from February 1 to April 15, 2020. They calculated the 75-day risk for COVID-19 outcomes per 10,000 people in patients on different nucleoside reverse transcriptase inhibitor (NRTI) regimens and the general population aged 20 to 79.

Among 77,590 HIV-infected persons on ART, 236 had a polymerase chain reaction–confirmed COVID-19 diagnosis during the study period. Of these, 151 (64%) were hospitalized, 15 (6%) were admitted to the intensive care unit (ICU), and 20 (8%) died. All these risks except ICU admission were increased in men and those aged >70 years. The risk for COVID-19 diagnosis and hospitalization was lower for patients taking tenofovir disoproxil fumarate (TDF) versus tenofovir alafenamide (TAF), abacavir, or other NRTIs (16.9% diagnosed vs. 39.1%, 28.3%, and 29.7%; 10.5% hospitalized vs. 20.3%, 23.4%, and 20.0%, respectively). No patients on TDF died versus 10 on TAF, 8 on abacavir, 2 on other NRTI regimens. COVID-19 diagnoses and deaths per 10,000 in the general population aged 20 to 79 versus the HIV+ cohort were 41.7 versus 30.4 and 2.1 versus 3.7, respectively.