Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational study
<p><strong>Background.</strong> There is conflicting evidence about how HIV infection influences COVID-19. We compared the presentation characteristics and outcomes of people with and without HIV hospitalised with COVID-19 at 207 centres across the United Kingdom. </p> <p&...
| Main Authors: | , , , , , , , , , , , , , , |
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| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
Cold Spring Harbor Laboratory Press
2020
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| _version_ | 1826268175607529472 |
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| author | Geretti, AM Stockdale, AJ Kelly, SH Cevik, M Collins, S Waters, L Villa, G Docherty, A Harrison, EM Turtle, L Openshaw, P Baillie, JK Sabin, C Semple, M CHASE Study Group |
| author2 | Sigfrid, L |
| author_facet | Sigfrid, L Geretti, AM Stockdale, AJ Kelly, SH Cevik, M Collins, S Waters, L Villa, G Docherty, A Harrison, EM Turtle, L Openshaw, P Baillie, JK Sabin, C Semple, M CHASE Study Group |
| author_sort | Geretti, AM |
| collection | OXFORD |
| description | <p><strong>Background.</strong> There is conflicting evidence about how HIV infection influences COVID-19. We compared the presentation characteristics and outcomes of people with and without HIV hospitalised with COVID-19 at 207 centres across the United Kingdom. </p>
<p><strong>Methods.</strong> We analysed data from people with laboratory confirmed or highly likely COVID-19 enrolled into the ISARIC CCP-UK study. The primary endpoint was day-28 mortality after presentation. We used Kaplan-Meier methods and Cox regression to describe the association with HIV status after adjustment for sex, ethnicity, age, indeterminate/probable hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, and presence/absence of ten comorbidities. We additionally adjusted for disease severity at presentation as defined by hypoxia/oxygen therapy. </p>
<p><strong>Findings.</strong> Among 47,539 patients, 115 (0.24%) had confirmed HIV-positive status and 103/115 (89.6%) had a record of antiretroviral therapy. At presentation, relative to the HIV-negative group, HIV-positive people were younger (median 55 versus 74 years; p<0.001), had a higher prevalence of obesity and moderate/severe liver disease, higher lymphocyte counts and C-reactive protein, and more systemic symptoms. The cumulative incidence of day-28 mortality was 25.2% in the HIV-positive group versus 32.1% in the HIV-negative group (p=0.12); however, stratification for age revealed a higher mortality among HIV-positive people aged below 60 years. The effect of HIV-positive status was confirmed in adjusted analyses (adjusted hazard ratio [HR] 1.49, 95% confidence interval [CI] 0.99-2.25; p=0.06). Following additional adjustment for disease severity at presentation, mortality was higher in HIV-positive people (adjusted HR 1.63; 95% CI 1.07-2.48; p=0.02). In the HIV-positive group, mortality was more common among those who were slightly older and among people with obesity and diabetes with complications. </p>
<p><strong>Interpretation.</strong> HIV-positive status may be associated with an increased risk of day-28 mortality following a COVID-19 related hospitalisation.</p> |
| first_indexed | 2024-03-06T21:05:37Z |
| format | Journal article |
| id | oxford-uuid:3c57c0b6-5d31-4456-88e8-6a784179e445 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:05:37Z |
| publishDate | 2020 |
| publisher | Cold Spring Harbor Laboratory Press |
| record_format | dspace |
| spelling | oxford-uuid:3c57c0b6-5d31-4456-88e8-6a784179e4452022-03-26T14:13:05ZOutcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:3c57c0b6-5d31-4456-88e8-6a784179e445EnglishSymplectic ElementsCold Spring Harbor Laboratory Press2020Geretti, AMStockdale, AJKelly, SHCevik, MCollins, SWaters, LVilla, GDocherty, AHarrison, EMTurtle, LOpenshaw, PBaillie, JKSabin, CSemple, MCHASE Study GroupSigfrid, L<p><strong>Background.</strong> There is conflicting evidence about how HIV infection influences COVID-19. We compared the presentation characteristics and outcomes of people with and without HIV hospitalised with COVID-19 at 207 centres across the United Kingdom. </p> <p><strong>Methods.</strong> We analysed data from people with laboratory confirmed or highly likely COVID-19 enrolled into the ISARIC CCP-UK study. The primary endpoint was day-28 mortality after presentation. We used Kaplan-Meier methods and Cox regression to describe the association with HIV status after adjustment for sex, ethnicity, age, indeterminate/probable hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, and presence/absence of ten comorbidities. We additionally adjusted for disease severity at presentation as defined by hypoxia/oxygen therapy. </p> <p><strong>Findings.</strong> Among 47,539 patients, 115 (0.24%) had confirmed HIV-positive status and 103/115 (89.6%) had a record of antiretroviral therapy. At presentation, relative to the HIV-negative group, HIV-positive people were younger (median 55 versus 74 years; p<0.001), had a higher prevalence of obesity and moderate/severe liver disease, higher lymphocyte counts and C-reactive protein, and more systemic symptoms. The cumulative incidence of day-28 mortality was 25.2% in the HIV-positive group versus 32.1% in the HIV-negative group (p=0.12); however, stratification for age revealed a higher mortality among HIV-positive people aged below 60 years. The effect of HIV-positive status was confirmed in adjusted analyses (adjusted hazard ratio [HR] 1.49, 95% confidence interval [CI] 0.99-2.25; p=0.06). Following additional adjustment for disease severity at presentation, mortality was higher in HIV-positive people (adjusted HR 1.63; 95% CI 1.07-2.48; p=0.02). In the HIV-positive group, mortality was more common among those who were slightly older and among people with obesity and diabetes with complications. </p> <p><strong>Interpretation.</strong> HIV-positive status may be associated with an increased risk of day-28 mortality following a COVID-19 related hospitalisation.</p> |
| spellingShingle | Geretti, AM Stockdale, AJ Kelly, SH Cevik, M Collins, S Waters, L Villa, G Docherty, A Harrison, EM Turtle, L Openshaw, P Baillie, JK Sabin, C Semple, M CHASE Study Group Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational study |
| title | Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational study |
| title_full | Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational study |
| title_fullStr | Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational study |
| title_full_unstemmed | Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational study |
| title_short | Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational study |
| title_sort | outcomes of covid 19 related hospitalisation among people with hiv in the isaric who clinical characterisation protocol uk protocol prospective observational study |
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