Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study
Background There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). Methods We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. Results PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02–1.03, p < 0.001), male sex (AHR1.38 (95%CI 1.12–1.72, p = 0.003) and being “overweight or obese” (AHR 1.30 95%CI 1.03–1.61 p = 0.024). HIV (AHR 1.28 95%CI 0.95–1.72, p 0.11) and active TB (AHR 1.50 95%CI 0.84–2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count < 200 cells/$ mm^{3} $, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. Conclusion In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
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| Enthalten in: |
BMC infectious diseases - 22(2022), 1 vom: 20. Juni |
| Sprache: |
Englisch |
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| Links: |
Volltext [kostenfrei] |
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| Themen: |
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| Anmerkungen: |
© The Author(s) 2022 |
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| doi: |
10.1186/s12879-022-07519-8 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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OLC2130994652 |
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| 100 | 1 | |a Parker, Arifa |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study |
| 264 | 1 | |c 2022 | |
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| 520 | |a Background There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). Methods We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. Results PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02–1.03, p < 0.001), male sex (AHR1.38 (95%CI 1.12–1.72, p = 0.003) and being “overweight or obese” (AHR 1.30 95%CI 1.03–1.61 p = 0.024). HIV (AHR 1.28 95%CI 0.95–1.72, p 0.11) and active TB (AHR 1.50 95%CI 0.84–2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count < 200 cells/$ mm^{3} $, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. Conclusion In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population. | ||
| 650 | 4 | |a HIV | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Tuberculosis | |
| 650 | 4 | |a Obesity | |
| 700 | 1 | |a Boloko, Linda |4 aut | |
| 700 | 1 | |a Moolla, Muhammad S. |4 aut | |
| 700 | 1 | |a Ebrahim, Nabilah |4 aut | |
| 700 | 1 | |a Ayele, Birhanu T. |4 aut | |
| 700 | 1 | |a Broadhurst, Alistair G. B. |4 aut | |
| 700 | 1 | |a Mashigo, Boitumelo |4 aut | |
| 700 | 1 | |a Titus, Gideon |4 aut | |
| 700 | 1 | |a de Wet, Timothy |4 aut | |
| 700 | 1 | |a Boliter, Nicholas |4 aut | |
| 700 | 1 | |a Rosslee, Michael-Jon |4 aut | |
| 700 | 1 | |a Papavarnavas, Nectarios |4 aut | |
| 700 | 1 | |a Abrahams, Riezaah |4 aut | |
| 700 | 1 | |a Mendelson, Marc |4 aut | |
| 700 | 1 | |a Dlamini, Sipho |4 aut | |
| 700 | 1 | |a Taljaard, Jantjie J. |4 aut | |
| 700 | 1 | |a Prozesky, Hans W. |4 aut | |
| 700 | 1 | |a Mowlana, Abdurasiet |4 aut | |
| 700 | 1 | |a Viljoen, Abraham J. |4 aut | |
| 700 | 1 | |a Schrueder, Neshaad |4 aut | |
| 700 | 1 | |a Allwood, Brian W. |4 aut | |
| 700 | 1 | |a Lalla, Usha |4 aut | |
| 700 | 1 | |a Dave, Joel A. |4 aut | |
| 700 | 1 | |a Calligaro, Greg |4 aut | |
| 700 | 1 | |a Levin, Dion |4 aut | |
| 700 | 1 | |a Maughan, Deborah |4 aut | |
| 700 | 1 | |a Ntusi, Ntobeko A. B. |4 aut | |
| 700 | 1 | |a Nyasulu, Peter S. |4 aut | |
| 700 | 1 | |a Meintjes, Graeme |4 aut | |
| 700 | 1 | |a Koegelenberg, Coenraad F. N. |4 aut | |
| 700 | 1 | |a Mnguni, Ayanda T. |4 aut | |
| 700 | 1 | |a Wasserman, Sean |4 aut | |
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