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COVID-19 hospitalization outcomes in adults by HIV status; a nation-wide register-based study

Möller, Isabela Killander ; Gisslén, Magnus ; Wagner, Philippe LU ; Sparén, Pär and Carlander, Christina (2023) In HIV Medicine 24(10). p.1045-1055
Abstract

Objectives: To assess the outcome of patients hospitalized with COVID-19 by HIV status and risk factors for severe COVID-19 in people living with HIV (PWH), we performed a nationwide cohort study using register data. Methods: All people aged ≥18 years hospitalized with a primary COVID-19 diagnosis (U07.1 or U07.2) in Sweden between February 2020 and October 2021 were included. The primary outcome was severe COVID-19 [intensive care unit (ICU) admission or 90-day mortality]. Secondary outcomes were days in hospital and ICU, complications in hospital, and risk factors for severe COVID-19 in PWH. Regression analyses were performed to assess severe COVID-19 by HIV status and risk factors. Results: Data from 64 815 hospitalized patients were... (More)

Objectives: To assess the outcome of patients hospitalized with COVID-19 by HIV status and risk factors for severe COVID-19 in people living with HIV (PWH), we performed a nationwide cohort study using register data. Methods: All people aged ≥18 years hospitalized with a primary COVID-19 diagnosis (U07.1 or U07.2) in Sweden between February 2020 and October 2021 were included. The primary outcome was severe COVID-19 [intensive care unit (ICU) admission or 90-day mortality]. Secondary outcomes were days in hospital and ICU, complications in hospital, and risk factors for severe COVID-19 in PWH. Regression analyses were performed to assess severe COVID-19 by HIV status and risk factors. Results: Data from 64 815 hospitalized patients were collected, of whom 121 were PWH (0.18%). PWH were younger (p < 0.001), and larger proportions were men (p = 0.014) and migrants (p < 0.001). Almost all PWH had undetectable HIV-RNA (93%) and high CD4 T-cell counts (median = 560 cells/μL, interquartile range: 376–780). In an unadjusted model, PWH had statistically significant lower odds of severe COVID-19 compared with patients without HIV [odds ratio (OR) = 0.6, 95% confidence interval (CI): 0.34–0.94], but there was no significant difference after adjusting for age and comorbidity (adjusted OR = 0.7, 95% CI: 0.43–1.26). A statistically significant lower proportion of PWH (8%, 95% CI: 5–15%) died within 90 days compared with those without HIV (16%, 95% CI: 15–16%, p = 0.024). There was no statistically significant difference in days in hospital and complications during the hospital stay between PWH and patients without HIV. Conclusions: In this nationwide study including well-treated PWH, HIV was not a risk factor in hospitalized patients for developing severe COVID-19.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
COVID-19, HIV, hospitalization, mortality, SARS-CoV-2
in
HIV Medicine
volume
24
issue
10
pages
1045 - 1055
publisher
Wiley-Blackwell
external identifiers
  • pmid:37286199
  • scopus:85161581349
ISSN
1464-2662
DOI
10.1111/hiv.13515
language
English
LU publication?
yes
id
22e2ea1a-e16c-41a8-bc82-a9d97ae25ab0
date added to LUP
2023-08-23 12:39:43
date last changed
2025-03-09 08:01:20
@article{22e2ea1a-e16c-41a8-bc82-a9d97ae25ab0,
  abstract     = {{<p>Objectives: To assess the outcome of patients hospitalized with COVID-19 by HIV status and risk factors for severe COVID-19 in people living with HIV (PWH), we performed a nationwide cohort study using register data. Methods: All people aged ≥18 years hospitalized with a primary COVID-19 diagnosis (U07.1 or U07.2) in Sweden between February 2020 and October 2021 were included. The primary outcome was severe COVID-19 [intensive care unit (ICU) admission or 90-day mortality]. Secondary outcomes were days in hospital and ICU, complications in hospital, and risk factors for severe COVID-19 in PWH. Regression analyses were performed to assess severe COVID-19 by HIV status and risk factors. Results: Data from 64 815 hospitalized patients were collected, of whom 121 were PWH (0.18%). PWH were younger (p &lt; 0.001), and larger proportions were men (p = 0.014) and migrants (p &lt; 0.001). Almost all PWH had undetectable HIV-RNA (93%) and high CD4 T-cell counts (median = 560 cells/μL, interquartile range: 376–780). In an unadjusted model, PWH had statistically significant lower odds of severe COVID-19 compared with patients without HIV [odds ratio (OR) = 0.6, 95% confidence interval (CI): 0.34–0.94], but there was no significant difference after adjusting for age and comorbidity (adjusted OR = 0.7, 95% CI: 0.43–1.26). A statistically significant lower proportion of PWH (8%, 95% CI: 5–15%) died within 90 days compared with those without HIV (16%, 95% CI: 15–16%, p = 0.024). There was no statistically significant difference in days in hospital and complications during the hospital stay between PWH and patients without HIV. Conclusions: In this nationwide study including well-treated PWH, HIV was not a risk factor in hospitalized patients for developing severe COVID-19.</p>}},
  author       = {{Möller, Isabela Killander and Gisslén, Magnus and Wagner, Philippe and Sparén, Pär and Carlander, Christina}},
  issn         = {{1464-2662}},
  keywords     = {{COVID-19; HIV; hospitalization; mortality; SARS-CoV-2}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1045--1055}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{HIV Medicine}},
  title        = {{COVID-19 hospitalization outcomes in adults by HIV status; a nation-wide register-based study}},
  url          = {{http://dx.doi.org/10.1111/hiv.13515}},
  doi          = {{10.1111/hiv.13515}},
  volume       = {{24}},
  year         = {{2023}},
}