Matthew S Durstenfeld1,2, Kaiwen Sun1, Yifei Ma1,3, Fatima Rodriguez4, Eric A Secemsky5,6, Rushi V Parikh7, Priscilla Y Hsue1,2. 1. Department of Medicine, University of California, San Francisco. 2. Division of Cardiology, UCSF at Zuckerberg San Francisco General. 3. San Francisco Veteran's Affairs Medical Center, San Francisco. 4. Division of Cardiovascular Medicine & Cardiovascular Institute, Stanford University, Stanford, California. 5. Smith Center for Outcomes Research in Cardiology, Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical Center. 6. Harvard Medical School, Boston, Massachusetts. 7. Division of Cardiology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.
Abstract
OBJECTIVE: The aim of this study was to evaluate the association of HIV infection with outcomes among people hospitalized with COVID-19. DESIGN: A prospectively planned analysis of the American Heart Association's COVID-19 Cardiovascular Disease Registry. SETTING: One hundred and seven academic and community hospitals in the United States from March through December 2020. PARTICIPANTS: Consecutive sample of 21 528 adults hospitalized with COVID-19 at participating hospitals. MAIN OUTCOME AND MEASURE: Primary outcome was predefined as in-hospital mortality. We used hierarchical mixed effects models to assess the association of HIV with in-hospital mortality accounting for patient demographics, comorbidities, and clustering by hospital. Secondary outcomes included major adverse cardiac events (MACE), severity of illness, and length of stay (LOS). RESULTS: The registry included 220 people with HIV (PWH). PWH were younger and more likely to be male, Non-Hispanic Black, on Medicaid, and active tobacco users. Of the study population, 36 PWH (16.4%) died compared with 3290 (15.4%) without HIV [risk ratio 1.06; 95% confidence interval (95% CI) 0.79-1.43; P = 0.71]. After adjustment for age, sex, race, and insurance, HIV was not associated with in-hospital mortality (aOR 1.12; 95% CI 0.76-1.64; P = 0.58) with no change in effect after adding BMI and comorbidities (aOR 1.14; 95% CI 0.78-1.68; P = 0.51). HIV was not associated with MACE (aOR 0.99; 95% CI 0.69-1.44, P = 0.91), COVID severity (aOR 0.96; 95% CI 0.62-1.50; P = 0.86), or LOS (aOR 1.03; 95% CI 0.76-1.66; P = 0.21). CONCLUSION: In the largest study of PWH hospitalized with COVID-19 in the United States to date, we did not find significant associations between HIV and adverse outcomes including in-hospital mortality, MACE, or severity of illness.
OBJECTIVE: The aim of this study was to evaluate the association of HIV infection with outcomes among people hospitalized with COVID-19. DESIGN: A prospectively planned analysis of the American Heart Association's COVID-19 Cardiovascular Disease Registry. SETTING: One hundred and seven academic and community hospitals in the United States from March through December 2020. PARTICIPANTS: Consecutive sample of 21 528 adults hospitalized with COVID-19 at participating hospitals. MAIN OUTCOME AND MEASURE: Primary outcome was predefined as in-hospital mortality. We used hierarchical mixed effects models to assess the association of HIV with in-hospital mortality accounting for patient demographics, comorbidities, and clustering by hospital. Secondary outcomes included major adverse cardiac events (MACE), severity of illness, and length of stay (LOS). RESULTS: The registry included 220 people with HIV (PWH). PWH were younger and more likely to be male, Non-Hispanic Black, on Medicaid, and active tobacco users. Of the study population, 36 PWH (16.4%) died compared with 3290 (15.4%) without HIV [risk ratio 1.06; 95% confidence interval (95% CI) 0.79-1.43; P = 0.71]. After adjustment for age, sex, race, and insurance, HIV was not associated with in-hospital mortality (aOR 1.12; 95% CI 0.76-1.64; P = 0.58) with no change in effect after adding BMI and comorbidities (aOR 1.14; 95% CI 0.78-1.68; P = 0.51). HIV was not associated with MACE (aOR 0.99; 95% CI 0.69-1.44, P = 0.91), COVID severity (aOR 0.96; 95% CI 0.62-1.50; P = 0.86), or LOS (aOR 1.03; 95% CI 0.76-1.66; P = 0.21). CONCLUSION: In the largest study of PWH hospitalized with COVID-19 in the United States to date, we did not find significant associations between HIV and adverse outcomes including in-hospital mortality, MACE, or severity of illness.
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