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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Risk of COVID-19 in-hospital mortality in people living with HIV compared to general population according to age and CD4 strata: data from the ICONA network
International Journal of Infectious Diseases, Volume 136, Year 2023
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Description
Objectives: We aimed to study whether people living with HIV (PLWH) are at higher risk of in-hospital COVID-19 mortality compared to the general population (GenPop). Methods: This was a retrospective study in 19 Italian centers (February 2020 to November 2022) including hospitalized PLWH and GenPop with SARS-CoV-2 infection. The main outcome was in-hospital mortality. Competing risk analyses by Fine-Gray regression model were used to estimate the association between in-hospital mortality and HIV status/age. Results: A total of 7399 patients with COVID-19 were included, 239 (3.2%) PLWH, and 7160 (96.8%) GenPop. By day 40, in-hospital death occurred in 1283/7160 (17.9%) among GenPop and 34/239 (14.2%) among PLWH. After adjusting for potential confounders, compared to GenPop <65 years, a significantly higher risk of death was observed for GenPop ≥65 (adjusted subdistribution hazard ratio [aSHR] 1.79 [95% CI 1.39-2.31]), PLWH ≥65 (aSHR 2.16 [95% CI 1.15-4.04]), PLWH <65 with CD4 ≤200 (aSHR 9.69 [95% CI 5.50-17.07]) and PLWH <65 with CD4 201-350 (aSHR 4.37 [95% CI 1.79-10.63]), whereas no evidence for a difference for PLWH <65 with CD4 >350 (aSHR 1.11 [95% CI 0.41-2.99]). Conclusions: In PLWH aged <65 years a CD4 ≤350 rather than HIV itself seems the driver for the observed higher risk of in-hospital mortality. We cannot however rule out that HIV infection per se is the risk factor in those aged ≥65 years. © 2023 The Authors
Authors & Co-Authors
Giacomelli, Andrea
Italy, Milan
Asst Fatebenefratelli Sacco
Gagliardini, Roberta
Italy, Rome
Irccs Istituto Nazionale Malattie Infettive Lazzaro Spallanzani
Tavelli, Alessandro
Unknown Affiliation
Mazzotta, Valentina
Italy, Rome
Irccs Istituto Nazionale Malattie Infettive Lazzaro Spallanzani
Rizzardini, Giuliano
Italy, Milan
Asst Fatebenefratelli Sacco
Mondi, Annalisa
Italy, Rome
Irccs Istituto Nazionale Malattie Infettive Lazzaro Spallanzani
Antinori, Spinello
Italy, Milan
Asst Fatebenefratelli Sacco
Italy, Milan
Università Degli Studi Di Milano
Vergori, Alessandra
Italy, Rome
Irccs Istituto Nazionale Malattie Infettive Lazzaro Spallanzani
Gori, Andrea
Italy, Milan
Università Degli Studi Di Milano
De Vito, Andrea
Italy, Sassari
Università Degli Studi Di Sassari
d'Arminio-Monforte, Antonella
Unknown Affiliation
Cozzi-Lepri, Alessandro
United Kingdom, London
University College London
Statistics
Authors: 12
Affiliations: 8
Identifiers
Doi:
10.1016/j.ijid.2023.09.015
ISSN:
12019712
Research Areas
Covid
Environmental
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study