Viraj V Patel1, Uriel R Felsen2, Molly Fisher3, Melissa J Fazzari4, Mindy S Ginsberg4, Robert Beil1, Matthew J Akiyama1,2, Kathryn Anastos1, David B Hanna4. 1. Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY. 2. Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY. 3. Division of Nephrology, Department of Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY; and. 4. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY.
Abstract
BACKGROUND: Limited data exist about clinical outcomes and levels of inflammatory and immune markers among people hospitalized with COVID-19 by HIV serostatus and by HIV viral suppression. SETTING: Large tertiary care health system in the Bronx, NY, USA. METHODS: We conducted a retrospective cohort study of 4613 SARS-CoV-2 PCR-positive patients admitted between March 10, 2020, and May 11, 2020. We examined in-hospital intubation, acute kidney injury (AKI), hospitalization length, and in-hospital mortality by HIV serostatus, and by HIV-viral suppression and CD4 counts among people living with HIV (PLWH) using adjusted competing risks regression. We also compared immune and inflammatory marker levels by HIV serostatus and viral suppression. RESULTS: Most patients were either non-Hispanic Black (36%) or Hispanic (37%); 100/4613 (2.2%) were PLWH, among whom 15 had detectable HIV viral load. PLWH compared to patients without HIV had increased intubation rates (adjusted hazard ratio 1.73 [95% CI: 1.12 to 2.67], P = 0.01). Both groups had similar rates of AKI, length of hospitalization, and death. No (0%) virally unsuppressed PLWH were intubated or died, versus 21/81 (26%, P = 0.04) and 22/81 (27%, P = 0.02) of virally suppressed PLWH, respectively. Among PLWH, higher CD4 T-cell counts were associated with increased intubation rates. C-reactive protein, IL-6, neutrophil counts, and ferritin levels were similar between virally suppressed PLWH and patients without HIV, but significantly lower for unsuppressed PLWH (all P < 0.05). CONCLUSIONS: PLWH had increased risk of intubation but similarly frequent rates of AKI and in-hospital death as those without HIV. Findings of no intubations or deaths among PLWH with unsuppressed HIV viral load warrant further investigation.
BACKGROUND: Limited data exist about clinical outcomes and levels of inflammatory and immune markers among people hospitalized with COVID-19 by HIV serostatus and by HIV viral suppression. SETTING: Large tertiary care health system in the Bronx, NY, USA. METHODS: We conducted a retrospective cohort study of 4613 SARS-CoV-2 PCR-positive patients admitted between March 10, 2020, and May 11, 2020. We examined in-hospital intubation, acute kidney injury (AKI), hospitalization length, and in-hospital mortality by HIV serostatus, and by HIV-viral suppression and CD4 counts among people living with HIV (PLWH) using adjusted competing risks regression. We also compared immune and inflammatory marker levels by HIV serostatus and viral suppression. RESULTS: Most patients were either non-Hispanic Black (36%) or Hispanic (37%); 100/4613 (2.2%) were PLWH, among whom 15 had detectable HIV viral load. PLWH compared to patients without HIV had increased intubation rates (adjusted hazard ratio 1.73 [95% CI: 1.12 to 2.67], P = 0.01). Both groups had similar rates of AKI, length of hospitalization, and death. No (0%) virally unsuppressed PLWH were intubated or died, versus 21/81 (26%, P = 0.04) and 22/81 (27%, P = 0.02) of virally suppressed PLWH, respectively. Among PLWH, higher CD4 T-cell counts were associated with increased intubation rates. C-reactive protein, IL-6, neutrophil counts, and ferritin levels were similar between virally suppressed PLWH and patients without HIV, but significantly lower for unsuppressed PLWH (all P < 0.05). CONCLUSIONS: PLWH had increased risk of intubation but similarly frequent rates of AKI and in-hospital death as those without HIV. Findings of no intubations or deaths among PLWH with unsuppressed HIV viral load warrant further investigation.
Authors: Daniela Cihakova; Michael B Streiff; Steven P Menez; Teresa K Chen; Nisha A Gilotra; Erin D Michos; Kieren A Marr; Andrew H Karaba; Matthew L Robinson; Paul W Blair; Maria V Dioverti; Wendy S Post; Andrea L Cox; Annukka A R Antar Journal: Future Virol Date: 2021-09-21 Impact factor: 3.015
Authors: Kevin F Kamis; Lauren Barbera; Mona Abdo; Sarah E Rowan; Cory Hussain; Edward M Gardner; Steven C Johnson; Samantha MaWhinney; Amelia J Davis; Jesse Carlson; Katie A Kozacka; Kristine M Erlandson Journal: J Acquir Immune Defic Syndr Date: 2021-11-01 Impact factor: 3.771
Authors: Jing Sun; Rena C Patel; Qulu Zheng; Vithal Madhira; Amy L Olex; Jessica Y Islam; Evan French; Teresa Po-Yu Chiang; Hana Akselrod; Richard Moffitt; G Caleb Alexander; Kathleen M Andersen; Amanda J Vinson; Todd T Brown; Christopher G Chute; Keith A Crandall; Nora Franceschini; Roslyn B Mannon; Gregory D Kirk Journal: medRxiv Date: 2021-07-28