Clinical characteristics, risk factors, and incidence of symptomatic coronavirus disease 2019 in a large cohort of adults living with HIV: a single-center, prospective observational study.


Journal

AIDS (London, England)
ISSN: 1473-5571
Titre abrégé: AIDS
Pays: England
ID NLM: 8710219

Informations de publication

Date de publication:
01 10 2020
Historique:
pubmed: 11 8 2020
medline: 17 9 2020
entrez: 11 8 2020
Statut: ppublish

Résumé

It is unclear how characteristics, risk factors, and incidence of coronavirus disease 2019 (COVID-19) in people living with HIV (PLWH) differ from the general population. Prospective observational single-center cohort study of adult PLWH reporting symptoms of COVID-19. We assessed clinical characteristics, risk factors for COVID-19 diagnosis and severity, and standardized incidence rate ratio for COVID-19 cases in PLWH cohort and in Barcelona. From 1 March 2020 to 10 May 2020, 53 out of 5683 (0.9% confidence interval 0.7-1.2%) PLWH were diagnosed with COVID-19. Median age was 44 years, CD4 T cells were 618/μl and CD4/CD8 was 0.90. All but two individuals were virologically suppressed. Cough (87%) and fever (82%) were the most common symptoms. Twenty-six (49%) were admitted, six (14%) had severe disease, four (8%) required ICU admission, and two (4%) died. Several laboratory markers (lower O2 saturation and platelets, and higher leukocytes, creatinine, lactate dehydrogenase, C reactive protein, procalcitonin, and ferritin) were associated with COVID-19 severity. No HIV or antiretroviral-related factors were associated with COVID-19 diagnosis or severity. Standardized incidence rate ratios of confirmed or confirmed/probable COVID-19 in PLWH were 38% (95% confidence interval 27-52%, P < 0.0001) and 33% (95% confidence interval 21-50%, P < 0.0001), respectively relative to the general population. PLWH with COVID-19 did not differ from the rest of the HIV cohort. Clinical presentation, severity rate, and mortality were not dependent on any HIV-related or antiretroviral-related factor. COVID-19 standardized incidence rate was lower in PLWH than in the general population. These findings should be confirmed in larger multicenter cohort studies.

Sections du résumé

BACKGROUND
It is unclear how characteristics, risk factors, and incidence of coronavirus disease 2019 (COVID-19) in people living with HIV (PLWH) differ from the general population.
METHODS
Prospective observational single-center cohort study of adult PLWH reporting symptoms of COVID-19. We assessed clinical characteristics, risk factors for COVID-19 diagnosis and severity, and standardized incidence rate ratio for COVID-19 cases in PLWH cohort and in Barcelona.
RESULTS
From 1 March 2020 to 10 May 2020, 53 out of 5683 (0.9% confidence interval 0.7-1.2%) PLWH were diagnosed with COVID-19. Median age was 44 years, CD4 T cells were 618/μl and CD4/CD8 was 0.90. All but two individuals were virologically suppressed. Cough (87%) and fever (82%) were the most common symptoms. Twenty-six (49%) were admitted, six (14%) had severe disease, four (8%) required ICU admission, and two (4%) died. Several laboratory markers (lower O2 saturation and platelets, and higher leukocytes, creatinine, lactate dehydrogenase, C reactive protein, procalcitonin, and ferritin) were associated with COVID-19 severity. No HIV or antiretroviral-related factors were associated with COVID-19 diagnosis or severity. Standardized incidence rate ratios of confirmed or confirmed/probable COVID-19 in PLWH were 38% (95% confidence interval 27-52%, P < 0.0001) and 33% (95% confidence interval 21-50%, P < 0.0001), respectively relative to the general population.
CONCLUSION
PLWH with COVID-19 did not differ from the rest of the HIV cohort. Clinical presentation, severity rate, and mortality were not dependent on any HIV-related or antiretroviral-related factor. COVID-19 standardized incidence rate was lower in PLWH than in the general population. These findings should be confirmed in larger multicenter cohort studies.

Identifiants

pubmed: 32773471
doi: 10.1097/QAD.0000000000002643
pmc: PMC7493771
pii: 00002030-202010010-00011
doi:

Substances chimiques

Anti-HIV Agents 0

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1775-1780

Références

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Auteurs

Alexy Inciarte (A)

Infectious Diseases Department.

Ana Gonzalez-Cordon (A)

Infectious Diseases Department.

Jhon Rojas (J)

Infectious Diseases Department.

Berta Torres (B)

Infectious Diseases Department.

Elisa de Lazzari (E)

Infectious Diseases Department.

Lorena de la Mora (L)

Infectious Diseases Department.

Maria Martinez-Rebollar (M)

Infectious Diseases Department.

Montserrat Laguno (M)

Infectious Diseases Department.

Pilar Callau (P)

Infectious Diseases Department.

Azucena Gonzalez-Navarro (A)

Immunology Department, Hospital Clinic de Barcelona-Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.

Lorna Leal (L)

Infectious Diseases Department.

Felipe Garcia (F)

Infectious Diseases Department.

Josep Mallolas (J)

Infectious Diseases Department.

Mar Mosquera (M)

Microbiology Department.

Maria A Marcos (MA)

Microbiology Department.

Juan Ambrosioni (J)

Infectious Diseases Department.

Josep M Miro (JM)

Infectious Diseases Department.

Esteban Martinez (E)

Infectious Diseases Department.

Jose L Blanco (JL)

Infectious Diseases Department.

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