Outcomes of Coronavirus Disease 2019 (COVID-19) Related Hospitalization Among People With Human Immunodeficiency Virus (HIV) in the ISARIC World Health Organization (WHO) Clinical Characterization Protocol (UK): A Prospective Observational Study.
Outcomes of Coronavirus Disease 2019 (COVID-19) Related Hospitalization Among People With Human Immunodeficiency Virus (HIV) in the ISARIC World Health Organization (WHO) Clinical Characterization Protocol (UK): A Prospective Observational Study.
复制标题
DOI：
10.1093/cid/ciaa1605
复制
发表时间：
2021-10-05
期刊：
影响因子：
--
通讯作者：
Semple MG
中科院分区：
文献类型：
--
作者：
Geretti AM;Stockdale AJ;Kelly SH;Cevik M;Collins S;Waters L;Villa G;Docherty A;Harrison EM;Turtle L;Openshaw PJM;Baillie JK;Sabin CA;Semple MG
关于人类免疫缺陷病毒（HIV）如何调节2019冠状病毒病（COVID-19）的证据相互矛盾。我们比较了在英国207个中心因COVID-19住院的成年人（感染和未感染艾滋病毒）的表现特征和结局，其数据由国际严重急性呼吸道和新发感染联盟（ISARIC）世界卫生组织（WHO）临床表征方案（CCP）研究前瞻性采集。我们使用Kaplan-Meier方法和考克斯回归来描述HIV状态与第28天死亡率之间的相关性，在对性别、种族、年龄、医院获得COVID-19（排除明确的医院获得）、就诊日期、10种个体合并症和就诊时疾病严重程度（根据缺氧或氧疗定义）进行单独调整后。在47592例患者中，122例（0.26%）已确诊HIV感染，112/122（91.8%）有抗逆转录病毒治疗记录。在就诊时，HIV阳性者更年轻（中位数56岁对74岁; P <0.001），合并症更少，全身症状更多，淋巴细胞计数和C反应蛋白水平更高。 HIV阳性组与HIV阴性组第28天的累积死亡率相似（26.7% vs. 32.1%; P = 0.16），但在60岁以下的患者中，HIV阳性状态与死亡率增加相关（21.3% vs. 9.6%; P <0.001 [对数秩检验]）。 调整年龄后，HIV感染者的死亡率较高（调整后的风险比[aHR] 1.47，95%置信区间[CI] 1.01-2.14; P = 0.05），调整其他变量后（aHR 1.69; 95% CI 1.15-2.48; P = 0.008）和限制分析年龄<60岁的人群（aHR 2.87; 95% CI 1.70-4.84; P <0.001），相关性持续存在。 在因COVID-19住院的患者中，HIV阳性状态与第28天死亡风险增加相关。与同一数据集内的大量艾滋病毒阴性人群相比，因2019年冠状病毒病（COVID-19）住院的人类免疫缺陷病毒（HIV）感染者经年龄调整后的第28天死亡风险高出47%。在调整性别、种族和主要合并症后，该效应持续存在。
Evidence is conflicting about how human immunodeficiency virus (HIV) modulates coronavirus disease 2019 (COVID-19). We compared the presentation characteristics and outcomes of adults with and without HIV who were hospitalized with COVID-19 at 207 centers across the United Kingdom and whose data were prospectively captured by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) World Health Organization (WHO) Clinical Characterization Protocol (CCP) study. We used Kaplan-Meier methods and Cox regression to describe the association between HIV status and day-28 mortality, after separate adjustment for sex, ethnicity, age, hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, 10 individual comorbidities, and disease severity at presentation (as defined by hypoxia or oxygen therapy). Among 47 592 patients, 122 (0.26%) had confirmed HIV infection, and 112/122 (91.8%) had a record of antiretroviral therapy. At presentation, HIV-positive people were younger (median 56 vs 74 years; P < .001) and had fewer comorbidities, more systemic symptoms and higher lymphocyte counts and C-reactive protein levels. The cumulative day-28 mortality was similar in the HIV-positive versus HIV-negative groups (26.7% vs. 32.1%; P = .16), but in those under 60 years of age HIV-positive status was associated with increased mortality (21.3% vs. 9.6%; P < .001 [log-rank test]). Mortality was higher among people with HIV after adjusting for age (adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.01–2.14; P = .05), and the association persisted after adjusting for the other variables (aHR 1.69; 95% CI 1.15–2.48; P = .008) and when restricting the analysis to people aged <60 years (aHR 2.87; 95% CI 1.70–4.84; P < .001). HIV-positive status was associated with an increased risk of day-28 mortality among patients hospitalized for COVID-19. People with human immunodeficiency virus (HIV) hospitalized with coronavirus disease 2019 (COVID-19) had an age-adjusted 47% higher risk of day-28 mortality compared with a large population of HIV-negative people within the same data set. The effect persisted after adjusting for sex, ethnicity, and major comorbidities.
登录
查看更多内容
影响因子：
3
作者：
Waters, L.;Rockstroh, J. K.
通讯作者：
Rockstroh, J. K.
DOI：
10.1097/qad.0000000000000243
发表时间：
2014-05-15
期刊：
AIDS (London, England)
影响因子：
--
作者：
May MT;Gompels M;Delpech V;Porter K;Orkin C;Kegg S;Hay P;Johnson M;Palfreeman A;Gilson R;Chadwick D;Martin F;Hill T;Walsh J;Post F;Fisher M;Ainsworth J;Jose S;Leen C;Nelson M;Anderson J;Sabin C;UK Collaborative HIV Cohort (UK CHIC) Study
通讯作者：
UK Collaborative HIV Cohort (UK CHIC) Study
影响因子：
39.2
作者：
del Amo, Julia;Polo, Rosa;Hernan, Miguel A.
通讯作者：
Hernan, Miguel A.
DOI：
10.1097/qai.0000000000002423
发表时间：
2020-09-01
影响因子：
3.6
作者：
Karmen-Tuohy, Savannah;Carlucci, Philip M.;Rahimian, Joseph
通讯作者：
Rahimian, Joseph
影响因子：
39.2
作者：
Miller, V;Mocroft, A;Lundgren, JD
通讯作者：
Lundgren, JD