More Data on COVID-19 Among Persons with HIV

Available data suggest that persons with HIV may not be at increased risk for severe COVID-19 illness compared with the general population, but most studies have been small and from single institutions (NEJM JW Infect Dis Sep 2020). In this study, investigators conducted an analysis of the multicenter research network TriNETX, which contains data on more than 50 million patients from more than 35 U.S. healthcare organizations.

Of 50,167 patients with COVID-19 identified, 404 were persons with HIV. Median age of the HIV cohort was 48.2 years and was not significantly different from the non-HIV cohort. However, those with HIV were more likely than those without HIV to be male (70.6% vs. 44.9%) and African-American (49.8% vs. 25.2%). Most of those with HIV were in the Southern U.S. (44%) followed by the Northeast (22%). Persons with HIV most often had histories of receiving antiretroviral therapy (70%) and were more likely to have hypertension, diabetes, chronic kidney disease, chronic lower-respiratory disease, ischemic heart disease, to be smokers, and to be obese (body-mass index [BMI] ≥30). In an unmatched analysis, patients with HIV were more likely to need inpatient services and had higher 30-day mortality from COVID-19. However, after propensity score matching for BMI, diabetes, hypertension, chronic lung disease, chronic kidney disease, race, history of nicotine dependence, and sex, mortality did not differ significantly between those with and without HIV (5% vs. 3.7%), however the need for inpatient services was more common in those with HIV (19.3% vs. 11.4%).