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    Clinical outcomes of patients with and without HIV hospitalized with COVID-19 in England during the early stages of the pandemic: a matched retrospective multi-centre analysis (RECEDE-C19 study)

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    Author
    Wiselka, Martin
    Pareek, Manish
    Palfreeman, Adrian
    Keyword
    COVID-19
    HIV
    comorbidities
    Date
    2022-01-06
    
    Metadata
    Show full item record
    DOI
    10.1111/hiv.13174
    Publisher's URL
    https://onlinelibrary.wiley.com/doi/10.1111/hiv.13174
    Abstract
    Background: The contribution of HIV to COVID-19 outcomes in hospitalized inpatients remains unclear. We conducted a multi-centre, retrospective matched cohort study of SARS-CoV-2 PCR-positive hospital inpatients analysed by HIV status. Methods: HIV-negative patients were matched to people living with HIV (PLWH) admitted from 1 February 2020 to 31 May 2020 up to a 3:1 ratio by the following: hospital site, SARS-CoV-2 test date ± 7 days, age ± 5 years, gender, and index of multiple deprivation decile ± 1. The primary objective was clinical improvement (two-point improvement or better on a seven-point ordinal scale) or hospital discharge by day 28, whichever was earlier. Results: A total of 68 PLWH and 181 HIV-negative comparators were included. In unadjusted analyses, PLWH had a reduced hazard of achieving clinical improvement or discharge [adjusted hazard ratio (aHR) = 0.57, 95% confidence interval (CI): 0.39-0.85, p = 0.005], but this association was ameliorated (aHR = 0.70, 95% CI: 0.43-1.17, p = 0.18) after additional adjustment for ethnicity, frailty, baseline hypoxaemia, duration of symptoms prior to baseline, body mass index (BMI) categories and comorbidities. Baseline frailty (aHR = 0.79, 95% CI: 0.65-0.95, p = 0.011), malignancy (aHR = 0.37, 95% CI 0.17, 0.82, p = 0.014) remained associated with poorer outcomes. The PLWH were more likely to be of black, Asian and minority ethnic background (75.0% vs 48.6%, p = 0.0002), higher median clinical frailty score [3 × interquartile range (IQR): 2-5 vs, 2 × IQR: 1-4, p = 0.0069), and to have a non-significantly higher proportion of active malignancy (14.4% vs 9.9%, p = 0.29). Conclusions: Adjusting for confounding comorbidities and demographics in a matched cohort ameliorated differences in outcomes of PLWH hospitalized with COVID-19, highlighting the importance of an appropriate comparison group when assessing outcomes of PLWH hospitalized with COVID-19.
    Citation
    Lee, M. J., Snell, L. B., Douthwaite, S. T., Fidler, S., Fitzgerald, N., Goodwin, L., Hamzah, L., Kulasegaram, R., Lawrence, S., Lwanga, J., Marchant, R., Orkin, C., Palfreeman, A., Parthasarathi, P., Pareek, M., Ring, K., Sharaf, H., Shekarchi-Khanghahi, E., Simons, R., Teh, J. J., … Smith, C. (2022). Clinical outcomes of patients with and without HIV hospitalized with COVID-19 in England during the early stages of the pandemic: a matched retrospective multi-centre analysis (RECEDE-C19 study). HIV medicine, 23(2), 121–133. https://doi.org/10.1111/hiv.13174
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15171
    Collections
    Infectious Diseases

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