NYC cohort reports similar outcomes from COVID-19 in HIV positive vs HIV negative adults
22 July 2020. Related: COVID-19: HIV and COVID-19 coinfection, COVID-19.
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. 
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/mm3 and 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).
- Sigel K et al. Covid-19 and People with HIV Infection: Outcomes for Hospitalized Patients in New York City. Clinical Infectious Diseases, ciaa880, DOI: 10.1093/cid/ciaa880. (28 June 2020).