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People with HIV Have Higher Risk of COVID-19 Diagnosis but Similar Outcomes than the General Population
Michael E Tang; Thaidra Gaufin; Ryan Anson; Wenhong Zhu; William C Mathews; Edward R Cachay.
Affiliation
  • Michael E Tang; University of California San Diego
  • Thaidra Gaufin; Sansum Clinic
  • Ryan Anson; University of California San Diego
  • Wenhong Zhu; University of California San Diego
  • William C Mathews; University of California San Diego
  • Edward R Cachay; University of California San Diego
Preprint in English | medRxiv | ID: ppmedrxiv-22269178
ABSTRACT
BackgroundWe investigated the effect of HIV on COVID-19 outcomes with attention to selection bias due to differential testing and to comorbidity burden. MethodsRetrospective cohort analysis using four hierarchical

outcomes:

positive SARS-CoV-2 test, COVID-19 hospitalization, intensive care unit (ICU) admission, and hospital mortality. The effect of HIV status was assessed using traditional covariate-adjusted, inverse probability weighted (IPW) analysis based on covariate distributions for testing bias (testing IPWs), HIV infection status (HIV IPWs), and combined models. Among PWH, we evaluated whether CD4 count and HIV plasma viral load (pVL) discriminated between those who did or did not develop study outcomes using receiver operating characteristic analysis. ResultsBetween March and November 2020, 63,319 people were receiving primary care services at UCSD, of whom 4,017 were people living with HIV (PWH). PWH had 2.1 times the odds of a positive SARS-CoV-2 test compared to those without HIV after weighting for potential testing bias, comorbidity burden, and HIV-IPW (95% CI 1.6-2.8). Relative to persons without HIV, PWH did not have an increased rate of COVID-19 hospitalization after controlling for comorbidities and testing bias [adjusted incidence rate ratio (aIRR) 0.5, 95% CI 0.1 - 1.4]. PWH had neither a different rate of ICU admission (aIRR1.08, 95% CI; 0.31 - 3.80) nor in-hospital death (aIRR0.92, 95% CI; 0.08 - 10.94) in any examined model. Neither CD4 count nor pVL predicted any of the hierarchical outcomes among PWH. ConclusionsPWH have a higher risk of COVID-19 diagnosis but similar outcomes compared to those without HIV. Summary pointAfter considering the effects of potential bias due to differential testing, comorbidities, and other patient characteristics, people with HIV had an increased rate of SARS-CoV-2 positivity and similar rates of hospitalization, ICU admission, and death.
License
cc_by_nc_nd
Full text: Available Collection: Preprints Database: medRxiv Type of study: Cohort_studies / Diagnostic study / Experimental_studies / Observational study / Prognostic study Language: English Year: 2022 Document type: Preprint
Full text: Available Collection: Preprints Database: medRxiv Type of study: Cohort_studies / Diagnostic study / Experimental_studies / Observational study / Prognostic study Language: English Year: 2022 Document type: Preprint
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