Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study.
Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study.
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DOI：
10.1186/s12879-022-07519-8
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发表时间：
2022-06-20
影响因子：
3.7
通讯作者：
Wasserman, Sean
中科院分区：
文献类型：
--
作者：
Parker, Arifa;Boloko, Linda;Moolla, Muhammad S.;Ebrahim, Nabilah;Ayele, Birhanu T.;Broadhurst, Alistair G. B.;Mashigo, Boitumelo;Titus, Gideon;de Wet, Timothy;Boliter, Nicholas;Rosslee, Michael-Jon;Papavarnavas, Nectarios;Abrahams, Riezaah;Mendelson, Marc;Dlamini, Sipho;Taljaard, Jantjie J.;Prozesky, Hans W.;Mowlana, Abdurasiet;Viljoen, Abraham J.;Schrueder, Neshaad;Allwood, Brian W.;Lalla, Usha;Dave, Joel A.;Calligaro, Greg;Levin, Dion;Maughan, Deborah;Ntusi, Ntobeko A. B.;Nyasulu, Peter S.;Meintjes, Graeme;Koegelenberg, Coenraad F. N.;Mnguni, Ayanda T.;Wasserman, Sean
关于 2019 年冠状病毒病 (COVID-19) 对人类免疫缺陷病毒 (PWH) 感染者和结核病 (TB) 合并感染者的影响仍然缺乏证据，特别是在这些疾病常见的地区。我们描述了住院的感染者和人类免疫缺陷病毒 (HIV) 未感染的 COVID-19 患者以及合并感染结核病 (TB) 患者的临床特征、实验室检查结果和结果。我们在南非开普敦的三家医院进行了一项多中心队列研究。对 2020 年 3 月至 7 月期间所有因确诊的 COVID-19 肺炎而需要住院的成年人进行了分析。 1434 名入院患者中，有 270 名 (19%) 是 PWH。活动性结核病患者 47 例（3.3%），其中 29 例（62%）为感染者。三百七十三名患者（26%）死亡。 PWH (n = 71, 26%) 和未感染 HIV 的患者 (n = 296, 25%) 的死亡率具有可比性。在结核病患者中，PWH 的死亡率高于未感染 HIV 的患者（n = 11，38% vs n = 3，20%；p = 0.001）。在多变量生存分析中，较高的死亡风险与年龄较大（调整后危险比（AHR）1.03 95%CI 1.02–1.03，p < 0.001）、男性（AHR1.38（95%CI 1.12–1.72，p = 0.003）和“超重或肥胖”（AHR）相关。 1.30 95%CI 1.03–1.61 p = 0.024) HIV (AHR 1.28 95%CI 0.95–1.72, p < 0.11) 和活动性结核病 (AHR 1.50 95%CI 0.84–2.67, p = 0.17) 与感染风险增加没有独立相关性。 PWH 住院患者死亡的危险因素包括 CD4 细胞计数< 200 个细胞/mm3、较高的入院需氧量、绝对白细胞计数、中性粒细胞/淋巴细胞比率、C 反应蛋白和肌酐水平，在 HIV 和结核病高发人群中，超重/肥胖与 COVID-19 住院患者死亡风险增加相关，这强调了对该患者采取公共卫生干预措施的必要性。人口。
There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02–1.03, p < 0.001), male sex (AHR1.38 (95%CI 1.12–1.72, p = 0.003) and being “overweight or obese” (AHR 1.30 95%CI 1.03–1.61 p = 0.024). HIV (AHR 1.28 95%CI 0.95–1.72, p 0.11) and active TB (AHR 1.50 95%CI 0.84–2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count < 200 cells/mm3, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population.
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影响因子：
6.9
作者：
Malavazos, Alexis Elias;Romanelli, Massimiliano Marco Corsi;Iacobellis, Gianluca
通讯作者：
Iacobellis, Gianluca
影响因子：
64.5
作者：
Sette A;Crotty S
通讯作者：
Crotty S
DOI：
10.1093/cid/ciaa1605
发表时间：
2021-10-05
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
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
通讯作者：
Semple MG
DOI：
10.7196/samj.2020.v110i6.14809
发表时间：
2020-06-01
期刊：
SAMJ: South African Medical Journal
影响因子：
--
作者：
Parker, A;Karamchand, S;Taljaard, J J
通讯作者：
Taljaard, J J
影响因子：
39.2
作者：
del Amo, Julia;Polo, Rosa;Hernan, Miguel A.
通讯作者：
Hernan, Miguel A.