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撒哈拉以南非洲一家三级保健医院感染艾滋病毒的 COVID-19 患者的负担和特征:一项回顾性队列研究。

The burden and characteristics of HIV-infected COVID-19 patients at a tertiary care hospital in sub-Saharan Africa-A retrospective cohort study.

机构信息

Department of Internal Medicine, Aga Khan University, Nairobi, Kenya.

Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.

出版信息

PLoS One. 2022 Aug 31;17(8):e0273859. doi: 10.1371/journal.pone.0273859. eCollection 2022.

Abstract

BACKGROUND

After the first case of COVID-19 caused by the novel SARS-CoV-2 virus was discovered in Wuhan, China, in December 2019, the disease spread viciously throughout the world. Little is known about the impact of HIV infection on the clinical outcomes of patients co-infected with SARS-CoV-2. Studying the characteristics and outcomes of COVID-19 among HIV-positive patients is key to characterising the risk of morbidity and mortality of HIV-positive patients from COVID-19.

METHODS

In this retrospective cohort study, we included patients admitted to Aga Khan University Hospital, Nairobi, with laboratory-confirmed COVID-19 infection and who had consented to HIV screening. We compared the prevalence and characteristics of HIV patients with those of non-HIV patients and described the results for both groups.

RESULTS

In our sample of 582 patients, the mean age was 49.2 years (SD = 15.2), with 68% of the sample being men. The cumulative HIV prevalence was 3.7%, and the most common symptoms were cough (58.1%), fever (45.2%), difficulty in breathing (36.8%) and general body malaise (23.9%). The most common comorbidities included hypertension (28.5%), diabetes mellitus (26.1%), and heart disease (4.1%). Most participants (228 or 49.5%) had mild COVID-19, and the mortality rate was 5%. Overall, there were no statistically significant differences in demographic characteristics, clinical characteristics, and outcomes between HIV-positive and HIV-negative patients.

CONCLUSIONS

There was a 3.7% prevalence of HIV in COVID-19 positive patients. Demographic characteristics and clinical outcomes were similar between the two groups. Future studies should seek to achieve larger samples, include multiple study sites and conduct subgroup analyses based on the immunologic status of HIV-positive patients.

摘要

背景

2019 年 12 月,中国武汉首次发现新型 SARS-CoV-2 病毒引起的 COVID-19 病例后,该疾病在全球迅速蔓延。目前,人们对 HIV 感染对同时感染 SARS-CoV-2 的患者临床结局的影响知之甚少。研究 HIV 阳性患者 COVID-19 的特征和结局,对于描述 HIV 阳性患者 COVID-19 的发病率和死亡率风险至关重要。

方法

本回顾性队列研究纳入了在肯尼亚内罗毕 Aga Khan 大学医院住院且经实验室确诊为 COVID-19 感染并同意进行 HIV 筛查的患者。我们比较了 HIV 患者和非 HIV 患者的患病率和特征,并分别对两组患者的结果进行了描述。

结果

在我们的 582 例患者样本中,平均年龄为 49.2 岁(SD=15.2),其中 68%为男性。HIV 累计患病率为 3.7%,最常见的症状是咳嗽(58.1%)、发热(45.2%)、呼吸困难(36.8%)和全身不适(23.9%)。最常见的合并症包括高血压(28.5%)、糖尿病(26.1%)和心脏病(4.1%)。大多数患者(228 例或 49.5%)患有轻度 COVID-19,死亡率为 5%。总体而言,HIV 阳性和 HIV 阴性患者在人口统计学特征、临床特征和结局方面无统计学显著差异。

结论

在 COVID-19 阳性患者中,HIV 的患病率为 3.7%。两组患者的人口统计学特征和临床结局相似。未来的研究应寻求获得更大的样本量,纳入多个研究地点,并根据 HIV 阳性患者的免疫状态进行亚组分析。

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