Universidade Federal de São João del-Rei, Campus Centro Oeste Dona Lindu, Divinópolis, MG, Brazil; Instituto de Avaliação de Tecnologia em Saúde (IATS), Porto Alegre, RS, Brazil.
Department of Internal Medicine, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Clinics (Sao Paulo). 2023 May 25;78:100223. doi: 10.1016/j.clinsp.2023.100223. eCollection 2023.
To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection.
This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables.
Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999).
Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group.
评估感染 HIV 的 COVID-19 患者的临床特征和结局，并与未感染 HIV 的配对样本进行比较。
这是巴西多中心队列的一项子研究，该研究分为两个时期（2020 年和 2021 年）。数据通过回顾病历获得。主要结局为入住重症监护病房、接受有创机械通气和死亡。采用倾向评分匹配（最多 4:1）对 HIV 患者和对照组的年龄、性别、共病数量和来源医院进行匹配。使用卡方检验或 Fisher 精确检验比较分类变量，使用 Wilcoxon 检验比较数值变量。
在整个研究过程中，共有 17101 例 COVID-19 患者住院，其中 130 例（0.76%）感染了 HIV。2020 年和 2021 年的中位年龄分别为 54（IQR：43.0；64.0）岁和 53（IQR：46.0；63.5）岁，两个时期均以女性为主。在两个时期，接受有创机械通气和入住 ICU 的 PLHIV 与对照组的发生率相似，无显著差异。2020 年，PLHIV 的住院死亡率高于对照组（27.9%比 17.7%；p=0.049），但 2021 年两组死亡率无差异（25.0%比 25.1%；p>0.999）。
我们的结果再次表明，在大流行早期，PLHIV 感染 COVID-19 的死亡率较高，但这一发现并未在 2021 年持续，当时死亡率与对照组相似。
