Disproportionate burden of coronavirus disease 2019 among racial minorities and those in congregate settings among a large cohort of people with HIV
Disproportionate burden of coronavirus disease 2019 among racial minorities and those in congregate settings among a large cohort of people with HIV
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DOI：
10.1097/qad.0000000000002607
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发表时间：
2020-10-01
期刊：
影响因子：
3.8
通讯作者：
Gandhi, Rajesh T.
中科院分区：
文献类型：
--
作者：
Meyerowitz, Eric A.;Kim, Arthur Y.;Gandhi, Rajesh T.
背景：许多艾滋病毒感染者（PLWH）患有合并症，这些合并症是2019年严重冠状病毒病（COVID-19）的危险因素，或者暴露于可能导致获得严重急性呼吸窘迫综合征冠状病毒2的环境中。然而，关于COVID-19在艾滋病毒感染者中的人口统计学、合并症、临床表现或结果的研究很少。目的：评价一大队列PLWH合并COVID-19患者的危险因素、临床表现和转归。方法：我们系统地确定了2020年3月3日至4月26日在马萨诸塞州爆发期间在一家大型医院被诊断为COVID-19的所有PLWH。我们分析了每个病例，以提取包括人口统计学、医疗合并症、临床表现和COVID-19诊断后的病程等信息。结果：我们描述了一组36例确诊COVID-19的PLWH患者和另外11例可能患有COVID-19的患者。确诊COVID-19的PLWH中，近85%患有严重疾病的合并症，包括肥胖、心血管疾病或高血压。约77%患有COVID-19的PLWH是非西班牙裔黑人或拉丁裔，而我们诊所的PLWH中只有40%是黑人或拉丁裔。近一半感染COVID-19的PLWH暴露于聚集环境。除了确诊的COVID-19患者外，我们还确定了另外11名疑似COVID-19患者，几乎所有人的PCR检测结果均为阴性。结论：在迄今为止最大的PLWH和确诊COVID-19队列中，几乎所有人都有与严重疾病相关的合并症，这突出了非hiv危险因素在该人群中的重要性。迫切需要探讨PLWH的种族差异以及聚集环境与COVID-19之间的频繁联系。版权所有：威科集团有限公司版权所有。
Background: Many people living with HIV (PLWH) have comorbidities which are risk factors for severe coronavirus disease 2019 (COVID-19) or have exposures that may lead to acquisition of severe acute respiratory distress syndrome coronavirus 2. There are few studies, however, on the demographics, comorbidities, clinical presentation, or outcomes of COVID-19 in people with HIV.Objective: To evaluate risk factors, clinical manifestations, and outcomes in a large cohort of PLWH with COVID-19.Methods: We systematically identified all PLWH who were diagnosed with COVID-19 at a large hospital from 3 March to 26 April 2020 during an outbreak in Massachusetts. We analyzed each of the cases to extract information including demographics, medical comorbidities, clinical presentation, and illness course after COVID-19 diagnosis.Results: We describe a cohort of 36 PLWH with confirmed COVID-19 and another 11 patients with probable COVID-19. Almost 85% of PLWH with confirmed COVID-19 had a comorbidity associated with severe disease, including obesity, cardiovascular disease, or hypertension. Approximately 77% of PLWH with COVID-19 were non-Hispanic Black or Latinx whereas only 40% of the PLWH in our clinic were Black or Latinx. Nearly half of PLWH with COVID-19 had exposure to congregate settings. In addition to people with confirmed COVID-19, we identified another 11 individuals with probable COVID-19, almost all of whom had negative PCR testing.Conclusion: In the largest cohort to date of PLWH and confirmed COVID-19, almost all had a comorbidity associated with severe disease, highlighting the importance of non-HIV risk factors in this population. The racial disparities and frequent link to congregate settings in PLWH and COVID-19 need to be explored urgently. Copyright (C) 2020 Wolters Kluwer Health, Inc. All rights reserved.