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- Title
Predictors of in-hospital mortality in HIV-infected patients with COVID-19.
- Authors
Moreno-Torres, V; Mendoza, C de; Martínez-Urbistondo, M; Mills, P; Treviño, A; Fuente, S de la; Santiago, A Díaz de; Calderón-Parra, J; Pintos-Pascual, I; Corpas, M; Soriano, V
- Abstract
Background Underlying immunodeficiency is associated with severe COVID-19, but the prognosis of persons with human immunodeficiency virus (HIV) (PWH) with COVID-19 is under debate. Aim: assessment of the mortality rate and major determinants of death in HIV-infected patients hospitalized with COVID-19 in Spain before vaccine availability. Design: Retrospective nationwide public database analysis. Methods Nationwide, retrospective, observational analysis of all hospitalizations with COVID-19 during year 2020 in Spain. Stratification was made according to HIV status. The National Registry of Hospital Discharges was used with the ICD-10 coding list. Results A total of 117 694 adults were hospitalized with COVID-19 during 2020. Only 234 (0.2%) were HIV-positives. More than 95% were on antiretroviral therapy. Compared to HIV-negatives, PWH were younger (mean age 53.2 vs. 66.5 years old; P <0.001) and more frequently male (74.8% vs. 56.6%; P <0.001). Most co-morbidities predisposing to severe COVID-19 (diabetes, hypertension, dementia and cardiovascular disease) were more frequent in HIV-negatives. In contrast, the rate of baseline liver disease was over 6-fold higher in PWH (27.4% vs. 4.4%; P <0.001). In-hospital mortality was lower in PWH (9.4% vs. 16%; P =0.004). In multivariate analysis, older age, dementia and especially advanced liver disease (relative risk (RR): 7.6) were the major determinants of death in PWH hospitalized with COVID-19. Conclusion HIV-infected patients hospitalized in Spain with COVID-19 during 2020 had better survival than HIV-negatives, most likely explained by younger age and lower rate of co-morbidities. However, advanced liver disease was a major predictor of death in PWH hospitalized with COVID-19.
- Subjects
SPAIN; COVID-19; COVID-19 pandemic; HOSPITAL mortality; HIV; HIV-positive persons
- Publication
QJM: An International Journal of Medicine, 2023, Vol 116, Issue 1, p57
- ISSN
1460-2725
- Publication type
Article
- DOI
10.1093/qjmed/hcac215