NYC cohort reports similar outcomes from COVID-19 in HIV positive vs HIV negative adults

A retrospective case-control analysis of outcomes from COVID-19 reports similar outcomes for 88 HIV positive adults in New York compared to HIV negative people. [1]

Of the 4,402 adults hospitalised at five clinics between 12 March and 23 April 2020, 88 were HIV positive (2%). Median age of HIV positive group was 61 years (IQR: 54 to 67) and most were black (40%) or Hispanic/Latino (30%). Cases were then matched to controls (1:5) by age, sex or race/ethnicity.

Significant differences that still remained however including a higher proportion of smokers in the HIV positive group (55% vs 23%, p<0.001) and more comorbidities (compared to matched controls). These included COPD (10% vs 3%, p<0.001), cirrhosis (6% vs 2%, p=0.02) and a history of cancer (17% vs 6%, p=0.001).

All HIV positive people were on ART (78% INSTI-based) with 81% having recent undetectable viral load. However, only 58% had a CD4 count >200 cells/mm³and CD4% was generally reduced compared to most recent pre-admission test (median decline –4% (IQR: 0 to 9%).

Compared to controls, the study reported no differences by HIV status in key outcomes. Severity of COVID-19 on admission (measured by need for oxygen) was similar (p=0.15). Although poor outcomes after hospitalisation were frequent, they were also similar in each group. Overall, 18% vs 23% required mechanical ventilation and 21% vs 20% died, in the positive vs negative groups respectively.

The study reported a similar cumulative incidence of death over time by HIV status (p=0.94).