Sociodemographic, clinical, and immunological factors associated with SARS-CoV-2 diagnosis and severe COVID-19 outcomes in people living with HIV : a retrospective cohort study
Copyright © 2021 Elsevier Ltd. All rights reserved..
BACKGROUND: Factors affecting outcomes of SARS-CoV-2 infection in people living with HIV are unclear. We assessed the factors associated with SARS-CoV-2 diagnosis and severe outcomes among people living with HIV.
METHODS: We did a retrospective cohort study using data from the PISCIS cohort of people with HIV in Catalonia (Spain) between March 1 and Dec 15, 2020. We linked PISCIS data with integrated health-care, clinical, and surveillance registries through the Public Data Analysis for Health Research and Innovation Program of Catalonia (PADRIS) to obtain data on SARS-CoV-2 diagnosis, chronic comorbidities, as well as clinical and mortality outcomes. Participants were aged at least 16 years in care at 16 hospitals in Catalonia. Factors associated with SARS-CoV-2 diagnoses and severe outcomes were assessed using univariable and multivariable Cox regression models. We estimated the effect of immunosuppression on severe outcomes (hospital admission for >24 h with dyspnoea, tachypnoea, hypoxaemia, asphyxia, or hyperventilation; or death) using Kaplan-Meier survival analysis.
FINDINGS: We linked 20 847 (72·8%) of 28 666 participants in the PISCIS cohort with PADRIS data; 13 142 people had HIV. 749 (5·7%) people with HIV were diagnosed with SARS-CoV-2: their median age was 43·5 years (IQR 37·0-52·7), 131 (17·5%) were female, and 618 (82·5%) were male. 103 people with HIV (13·8%) were hospitalised, seven (0·9%) admitted to intensive care, and 13 (1·7%) died. SARS-CoV-2 diagnosis was more common among migrants (adjusted hazard ratio 1·55, 95% CI 1·31-1·83), men who have sex with men (1·42, 1·09-1·86), and those with four or more chronic comorbidities (1·46, 1·09-1·97). Age at least 75 years (5·2, 1·8-15·3), non-Spanish origin (2·1, 1·3-3·4), and neuropsychiatric (1·69, 1·07-2·69), autoimmune disease (1·92, 1·14-3·23), respiratory disease (1·84, 1·09-3·09), and metabolic disease (2·59, 1·59-4·23) chronic comorbidities were associated with increased risk of severe outcomes. A Kaplan-Meier estimator showed differences in the risk of severe outcomes according to CD4 cell count in patients with detectable HIV RNA (p=0·039) but no differences were observed in patients with undetectable HIV RNA (p=0·15).
INTERPRETATION: People living with HIV with detectable HIV viraemia, chronic comorbidities, and some subpopulations could be at increased risk of severe outcomes from COVID-19. These groups should be prioritised in clinical management and SARS-CoV-2 vaccination programmes.
FUNDING: Fundació "la Caixa".
TRANSLATIONS: For the Catalan, Spanish and Russian translations of the Summary see Supplementary Materials section.
Errataetall: |
CommentIn: Lancet HIV. 2021 Nov;8(11):e661-e662. - PMID 34655548 |
---|---|
Medienart: |
E-Artikel |
Erscheinungsjahr: |
2021 |
---|---|
Erschienen: |
2021 |
Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
---|---|
Enthalten in: |
The lancet. HIV - 8(2021), 11 vom: 01. Nov., Seite e701-e710 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Nomah, Daniel K [VerfasserIn] |
---|
Links: |
---|
Themen: |
COVID-19 Vaccines |
---|
Anmerkungen: |
Date Completed 30.11.2021 Date Revised 03.01.2023 published: Print-Electronic CommentIn: Lancet HIV. 2021 Nov;8(11):e661-e662. - PMID 34655548 Citation Status MEDLINE |
---|
doi: |
10.1016/S2352-3018(21)00240-X |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM331960001 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM331960001 | ||
003 | DE-627 | ||
005 | 20231225214625.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2021 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1016/S2352-3018(21)00240-X |2 doi | |
028 | 5 | 2 | |a pubmed24n1106.xml |
035 | |a (DE-627)NLM331960001 | ||
035 | |a (NLM)34655549 | ||
035 | |a (PII)S2352-3018(21)00240-X | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Nomah, Daniel K |e verfasserin |4 aut | |
245 | 1 | 0 | |a Sociodemographic, clinical, and immunological factors associated with SARS-CoV-2 diagnosis and severe COVID-19 outcomes in people living with HIV |b a retrospective cohort study |
264 | 1 | |c 2021 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 30.11.2021 | ||
500 | |a Date Revised 03.01.2023 | ||
500 | |a published: Print-Electronic | ||
500 | |a CommentIn: Lancet HIV. 2021 Nov;8(11):e661-e662. - PMID 34655548 | ||
500 | |a Citation Status MEDLINE | ||
520 | |a Copyright © 2021 Elsevier Ltd. All rights reserved. | ||
520 | |a BACKGROUND: Factors affecting outcomes of SARS-CoV-2 infection in people living with HIV are unclear. We assessed the factors associated with SARS-CoV-2 diagnosis and severe outcomes among people living with HIV | ||
520 | |a METHODS: We did a retrospective cohort study using data from the PISCIS cohort of people with HIV in Catalonia (Spain) between March 1 and Dec 15, 2020. We linked PISCIS data with integrated health-care, clinical, and surveillance registries through the Public Data Analysis for Health Research and Innovation Program of Catalonia (PADRIS) to obtain data on SARS-CoV-2 diagnosis, chronic comorbidities, as well as clinical and mortality outcomes. Participants were aged at least 16 years in care at 16 hospitals in Catalonia. Factors associated with SARS-CoV-2 diagnoses and severe outcomes were assessed using univariable and multivariable Cox regression models. We estimated the effect of immunosuppression on severe outcomes (hospital admission for >24 h with dyspnoea, tachypnoea, hypoxaemia, asphyxia, or hyperventilation; or death) using Kaplan-Meier survival analysis | ||
520 | |a FINDINGS: We linked 20 847 (72·8%) of 28 666 participants in the PISCIS cohort with PADRIS data; 13 142 people had HIV. 749 (5·7%) people with HIV were diagnosed with SARS-CoV-2: their median age was 43·5 years (IQR 37·0-52·7), 131 (17·5%) were female, and 618 (82·5%) were male. 103 people with HIV (13·8%) were hospitalised, seven (0·9%) admitted to intensive care, and 13 (1·7%) died. SARS-CoV-2 diagnosis was more common among migrants (adjusted hazard ratio 1·55, 95% CI 1·31-1·83), men who have sex with men (1·42, 1·09-1·86), and those with four or more chronic comorbidities (1·46, 1·09-1·97). Age at least 75 years (5·2, 1·8-15·3), non-Spanish origin (2·1, 1·3-3·4), and neuropsychiatric (1·69, 1·07-2·69), autoimmune disease (1·92, 1·14-3·23), respiratory disease (1·84, 1·09-3·09), and metabolic disease (2·59, 1·59-4·23) chronic comorbidities were associated with increased risk of severe outcomes. A Kaplan-Meier estimator showed differences in the risk of severe outcomes according to CD4 cell count in patients with detectable HIV RNA (p=0·039) but no differences were observed in patients with undetectable HIV RNA (p=0·15) | ||
520 | |a INTERPRETATION: People living with HIV with detectable HIV viraemia, chronic comorbidities, and some subpopulations could be at increased risk of severe outcomes from COVID-19. These groups should be prioritised in clinical management and SARS-CoV-2 vaccination programmes | ||
520 | |a FUNDING: Fundació "la Caixa" | ||
520 | |a TRANSLATIONS: For the Catalan, Spanish and Russian translations of the Summary see Supplementary Materials section | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Research Support, Non-U.S. Gov't | |
650 | 7 | |a COVID-19 Vaccines |2 NLM | |
650 | 7 | |a Immunoglobulin G |2 NLM | |
650 | 7 | |a Immunologic Factors |2 NLM | |
700 | 1 | |a Reyes-Urueña, Juliana |e verfasserin |4 aut | |
700 | 1 | |a Díaz, Yesika |e verfasserin |4 aut | |
700 | 1 | |a Moreno, Sergio |e verfasserin |4 aut | |
700 | 1 | |a Aceiton, Jordi |e verfasserin |4 aut | |
700 | 1 | |a Bruguera, Andreu |e verfasserin |4 aut | |
700 | 1 | |a Vivanco-Hidalgo, Rosa M |e verfasserin |4 aut | |
700 | 1 | |a Llibre, Josep M |e verfasserin |4 aut | |
700 | 1 | |a Domingo, Pere |e verfasserin |4 aut | |
700 | 1 | |a Falcó, Vicenç |e verfasserin |4 aut | |
700 | 1 | |a Imaz, Arkaitz |e verfasserin |4 aut | |
700 | 1 | |a Cortés, Cristina |e verfasserin |4 aut | |
700 | 1 | |a Force, Lluís |e verfasserin |4 aut | |
700 | 1 | |a Letang, Emili |e verfasserin |4 aut | |
700 | 1 | |a Vilaró, Ingrid |e verfasserin |4 aut | |
700 | 1 | |a Casabona, Jordi |e verfasserin |4 aut | |
700 | 1 | |a Miro, Jose M |e verfasserin |4 aut | |
700 | 0 | |a PISCIS study group |e verfasserin |4 aut | |
700 | 1 | |a Muntada, Esteve |e investigator |4 oth | |
700 | 1 | |a Esteve, Anna |e investigator |4 oth | |
700 | 1 | |a Riera, Melchor |e investigator |4 oth | |
700 | 1 | |a Navarro, Gemma |e investigator |4 oth | |
700 | 1 | |a Knobel, Hernando |e investigator |4 oth | |
700 | 1 | |a Mallolas, Josep |e investigator |4 oth | |
700 | 1 | |a Podzamczer, Daniel |e investigator |4 oth | |
700 | 1 | |a Curran, Adrià |e investigator |4 oth | |
700 | 1 | |a Burgos, Joaquín |e investigator |4 oth | |
700 | 1 | |a Mateo, Maria Gracia |e investigator |4 oth | |
700 | 1 | |a Gutierrez, Maria Del Mar |e investigator |4 oth | |
700 | 1 | |a Murillas, Javier |e investigator |4 oth | |
700 | 1 | |a Homar, Francisco |e investigator |4 oth | |
700 | 1 | |a Fernández-Montero, Jose Vicente |e investigator |4 oth | |
700 | 1 | |a González, Eva |e investigator |4 oth | |
700 | 1 | |a Peraire, Joaquim |e investigator |4 oth | |
700 | 1 | |a Vidal, Francesc |e investigator |4 oth | |
700 | 1 | |a Leon, Elena |e investigator |4 oth | |
700 | 1 | |a Masabeu, Àngels |e investigator |4 oth | |
700 | 1 | |a Orti, Amat-Joaquim |e investigator |4 oth | |
700 | 1 | |a Dalmau, David |e investigator |4 oth | |
700 | 1 | |a Jaen, Àngels |e investigator |4 oth | |
700 | 1 | |a Deig, Elisabet |e investigator |4 oth | |
700 | 1 | |a De Lazzari, Elisa |e investigator |4 oth | |
700 | 1 | |a Berrocal, Leire |e investigator |4 oth | |
700 | 1 | |a Fernandez, Guillem |e investigator |4 oth | |
700 | 1 | |a Rodríguez, Lucía |e investigator |4 oth | |
700 | 1 | |a Gargoulas, Freya |e investigator |4 oth | |
700 | 1 | |a Vanrell, Toni |e investigator |4 oth | |
700 | 1 | |a Rubia, Jose Carlos |e investigator |4 oth | |
700 | 1 | |a Vilà, Josep |e investigator |4 oth | |
700 | 1 | |a Martínez, Marina |e investigator |4 oth | |
700 | 1 | |a Morell, Bibiana |e investigator |4 oth | |
700 | 1 | |a Tamayo, Maribel |e investigator |4 oth | |
700 | 1 | |a Palacio, Jorge |e investigator |4 oth | |
700 | 1 | |a Ambrosioni, Juan |e investigator |4 oth | |
700 | 1 | |a Laguno, Montse |e investigator |4 oth | |
700 | 1 | |a Martínez-Rebollar, María |e investigator |4 oth | |
700 | 1 | |a Blanco, José Luis |e investigator |4 oth | |
700 | 1 | |a Garcia, Felipe |e investigator |4 oth | |
700 | 1 | |a Martínez, Esteban |e investigator |4 oth | |
700 | 1 | |a Torres, Berta |e investigator |4 oth | |
700 | 1 | |a de la Mora, Lorena |e investigator |4 oth | |
700 | 1 | |a Inciarte, Alexy |e investigator |4 oth | |
700 | 1 | |a Ugarte, Ainoa |e investigator |4 oth | |
700 | 1 | |a Chivite, Iván |e investigator |4 oth | |
700 | 1 | |a González-Cordon, Ana |e investigator |4 oth | |
700 | 1 | |a Leal, Lorna |e investigator |4 oth | |
700 | 1 | |a Jou, Antoni |e investigator |4 oth | |
700 | 1 | |a Saumoy, Maria |e investigator |4 oth | |
700 | 1 | |a Silva, Ana |e investigator |4 oth | |
700 | 1 | |a Scévola, Sofia |e investigator |4 oth | |
700 | 1 | |a Navarro, Jordi |e investigator |4 oth | |
700 | 1 | |a Suanzes, Paula |e investigator |4 oth | |
700 | 1 | |a Mur, Isabel |e investigator |4 oth | |
700 | 1 | |a Ribas, Maria Àngels |e investigator |4 oth | |
700 | 1 | |a Campins, Antoni A |e investigator |4 oth | |
700 | 1 | |a Fanjul, Francisco |e investigator |4 oth | |
700 | 1 | |a Leyes, María |e investigator |4 oth | |
700 | 1 | |a Peñaranda, María |e investigator |4 oth | |
700 | 1 | |a Martin, María Luisa |e investigator |4 oth | |
700 | 1 | |a Vilchez, Helem Haydee |e investigator |4 oth | |
700 | 1 | |a Calzado, Sònia |e investigator |4 oth | |
700 | 1 | |a Cervantes, Manel |e investigator |4 oth | |
700 | 1 | |a Amengual, M José |e investigator |4 oth | |
700 | 1 | |a Navarro, Marta |e investigator |4 oth | |
700 | 1 | |a Payeras, Antoni |e investigator |4 oth | |
700 | 1 | |a Cifuentes, Carmen |e investigator |4 oth | |
700 | 1 | |a Villoslada, Aroa |e investigator |4 oth | |
700 | 1 | |a Sorní, Patrícia |e investigator |4 oth | |
700 | 1 | |a Molero, Marta |e investigator |4 oth | |
700 | 1 | |a Abdulghani, Nadia |e investigator |4 oth | |
700 | 1 | |a Comella, Thaïs |e investigator |4 oth | |
700 | 1 | |a Sola, Rocio |e investigator |4 oth | |
700 | 1 | |a Vargas, Montserrat |e investigator |4 oth | |
700 | 1 | |a Viladés, Consuleo |e investigator |4 oth | |
700 | 1 | |a Martí, Anna |e investigator |4 oth | |
700 | 1 | |a Barrufet, Pilar |e investigator |4 oth | |
700 | 1 | |a Arbones, Laia |e investigator |4 oth | |
700 | 1 | |a Chamarro, Elena |e investigator |4 oth | |
700 | 1 | |a Cairó, Mireia |e investigator |4 oth | |
700 | 1 | |a Martinez-Lacas, Xavier |e investigator |4 oth | |
700 | 1 | |a Font, Roser |e investigator |4 oth | |
700 | 1 | |a Macorigh, Lizza |e investigator |4 oth | |
773 | 0 | 8 | |i Enthalten in |t The lancet. HIV |d 2014 |g 8(2021), 11 vom: 01. Nov., Seite e701-e710 |w (DE-627)NLM244270694 |x 2352-3018 |7 nnns |
773 | 1 | 8 | |g volume:8 |g year:2021 |g number:11 |g day:01 |g month:11 |g pages:e701-e710 |
856 | 4 | 0 | |u http://dx.doi.org/10.1016/S2352-3018(21)00240-X |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 8 |j 2021 |e 11 |b 01 |c 11 |h e701-e710 |