Characteristics, Comorbidities, and Outcomes in a Multicenter Registry of Patients With Human Immunodeficiency Virus and Coronavirus Disease 2019
Characteristics, Comorbidities, and Outcomes in a Multicenter Registry of Patients With Human Immunodeficiency Virus and Coronavirus Disease 2019
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DOI：
10.1093/cid/ciaa1339
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发表时间：
2021-10-01
影响因子：
11.8
通讯作者：
Chow, Jeremy
中科院分区：
文献类型：
--
作者：
Dandachi, Dima;Geiger, Grant;Chow, Jeremy
背景资料。人类免疫缺陷病毒携带者可能有许多感染冠状病毒2019年(新冠肺炎)并发展为严重后果的危险因素，但目前的数据相互矛盾。卫生保健提供者通过非随机抽样，连续登记了2020年4月1日至7月1日在其机构诊断为经实验室确认的新冠肺炎的艾滋病毒(PWH)感染者。已查明的数据被输入电子研究电子数据采集系统(RedCap)。主要终点是严重结局，定义为重症监护病房(ICU)入院、机械通气或死亡的综合终点。次要结果是需要住院治疗。共有286名患者，平均年龄为51.4岁(标准差，14.4岁)，25.9%为女性，75.4%为非裔美国人或西班牙裔。大多数患者(94.3%)接受了抗逆转录病毒治疗，88.7%的患者接受了HIV病毒学抑制，80.8%的患者合并疾病。在严重急性呼吸综合征冠状病毒(SARS-CoV-2)检测阳性的30天内，164例(57.3%)患者住院，47例(16.5%)需要ICU入院。死亡率为9.4%(27/286)，住院患者死亡率为16.5%(27/164)，ICU患者死亡率为51.5%(24/47)。主要复合终点出现在17.5%(50/286)的患者和30.5%(50/164)的住院患者中。年龄较大、慢性肺部疾病和高血压与严重预后相关。较低的CD4计数(
Background. People living with human immunodeficiency virus (HIV) may have numerous risk factors for acquiring coronavirus disease 2019 (COVID-19) and developing severe outcomes, but current data are conflicting.Methods. Health-care providers enrolled consecutively, by nonrandom sampling, people living with HIV (PWH) with lab-confirmed COVID-19, diagnosed at their facilities between 1 April and 1 July 2020. Deidentified data were entered into an electronic Research Electronic Data Capture (REDCap) system. The primary endpoint was a severe outcome, defined as a composite endpoint of intensive care unit (ICU) admission, mechanical ventilation, or death. The secondary outcome was the need for hospitalization.Results. There were 286 patients included; the mean age was 51.4 years (standard deviation, 14.4), 25.9% were female, and 75.4% were African American or Hispanic. Most patients (94.3%) were on antiretroviral therapy, 88.7% had HIV virologic suppression, and 80.8% had comorbidities. Within 30 days of testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 164 (57.3%) patients were hospitalized, and 47 (16.5%) required ICU admission. Mortality rates were 9.4% (27/286) overall, 16.5% (27/164) among those hospitalized, and 51.5% (24/47) among those admitted to an ICU. The primary composite endpoint occurred in 17.5% (50/286) of all patients and 30.5% (50/164) of hospitalized patients. Older age, chronic lung disease, and hypertension were associated with severe outcomes. A lower CD4 count (