Outcomes Among HIV-Positive Patients Hospitalized With COVID-19
Outcomes Among HIV-Positive Patients Hospitalized With COVID-19
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DOI：
10.1097/qai.0000000000002423
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发表时间：
2020-09-01
影响因子：
3.6
通讯作者：
Rahimian, Joseph
中科院分区：
文献类型：
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作者：
Karmen-Tuohy, Savannah;Carlucci, Philip M.;Rahimian, Joseph
背景：SARS-CoV-2感染继续在世界范围内造成显著的发病率和死亡率。关于SARS-CoV-2感染的初步数据表明，一些免疫功能低下的宿主会出现更糟糕的结果。我们进行了一项回顾性匹配队列研究，以表征感染SARS-CoV-2的hiv阳性患者的结局。方法：利用从2020年3月2日至2020年4月23日期间纽约大学朗格尼医疗中心所有COVID-19住院患者的电子病历中收集的数据，我们使用贪婪最近邻算法将21名hiv阳性患者与42名非hiv患者进行匹配。记录两组患者的入院特征、实验室检查结果和住院结果并进行比较。结果：尽管hiv阳性患者的重症监护病房住院率、机械通气率和死亡率呈上升趋势，但这些差异没有统计学意义。在我们的队列中，这些结果的发生率与之前发表的所有COVID-19住院患者的发生率相似。hiv阳性患者的入院率和c反应蛋白峰值均显著高于其他患者。其他炎症标志物在两组之间没有显著差异，尽管hiv阳性患者在其临床过程中往往具有更高的峰值。3例hiv阳性患者痰培养阳性合并细菌性肺炎，3例患者均在住院期间死亡。两组之间血栓形成事件或心肌梗死的频率没有差异。结论：本研究提供的证据表明，与匹配的非HIV患者相比，HIV合并感染对SARS-CoV-2感染患者的表现、住院过程或结局没有显著影响。需要更大规模的研究来确定我们观察到的趋势是否适用于所有hiv阳性患者。
Background: SARS-CoV-2 infection continues to cause significant morbidity and mortality worldwide. Preliminary data on SARS-CoV-2 infection suggest that some immunocompromised hosts experience worse outcomes. We performed a retrospective matched cohort study to characterize outcomes in HIV-positive patients with SARS-CoV-2 infection. Methods: Leveraging data collected from electronic medical records for all patients hospitalized at NYU Langone Health with COVID-19 between March 2, 2020, and April 23, 2020, we matched 21 HIV-positive patients with 42 non-HIV patients using a greedy nearest-neighbor algorithm. Admission characteristics, laboratory test results, and hospital outcomes were recorded and compared between the 2 groups. Results: Although there was a trend toward increased rates of intensive care unit admission, mechanical ventilation, and mortality in HIV-positive patients, these differences were not statistically significant. Rates for these outcomes in our cohort are similar to those previously published for all patients hospitalized with COVID-19. HIV-positive patients had significantly higher admission and peak C-reactive protein values. Other inflammatory markers did not differ significantly between groups, although HIV-positive patients tended to have higher peak values during their clinical course. Three HIV-positive patients had superimposed bacterial pneumonia with positive sputum cultures, and all 3 patients died during hospitalization. There was no difference in frequency of thrombotic events or myocardial infarction between these groups. Conclusions: This study provides evidence that HIV coinfection does not significantly impact presentation, hospital course, or outcomes of patients infected with SARS-CoV-2, when compared with matched non-HIV patients. A larger study is required to determine whether the trends we observed apply to all HIV-positive patients.