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感染新冠病毒住院的 HIV 感染者的结局:一项为期 3 年的全国性研究(2020-2022 年)。

Outcomes of Patients Living with HIV Hospitalized due to COVID-19: A 3-Year Nationwide Study (2020-2022).

机构信息

Department of Internal Medicine, Mostoles University Hospital, Rey Juan Carlos University (Madrid), Madrid, Spain.

Department of Preventive Medicine and Public Health, Rey Juan Carlos University (Madrid), Madrid, Spain.

出版信息

AIDS Behav. 2024 Sep;28(9):3093-3102. doi: 10.1007/s10461-024-04394-z. Epub 2024 Jul 4.

Abstract

Scientific reports on the association between human immunodeficiency virus (HIV) in patients with COVID-19 and mortality have not been in agreement. In this nationwide study, we described and analyzed the demographic and clinical characteristics of people living with HIV (PLWH) and established that HIV infection is a risk factor for mortality in patients hospitalized due to COVID-19. We collected data from the National Hospital Data Information System at Hospitalization between 2020 and 2022. We included patients admitted to the hospital with a diagnosis of COVID-19. We established a cohort of patients with PLWH and compared them to patients without HIV (non-PLWH). For multivariate analyses, we performed binary logistic regression, using mortality as the dependent variable. To improve the interpretability of the results we also applied penalized regression and random forest, two well-known machine-learning algorithms. A broad range of comorbidities, as well as sex and age data, were included in the final model as adjusted estimators. Our data of 1,188,160 patients included 6,973 PLWH. The estimated hospitalization rate in this set was between 1.43% and 1.70%, while the rate among the general population was 0.83%. Among patients with COVID-19, HIV infection was a risk factor for mortality with an odds ratio (OR) of 1.25 (95% CI, 1.14-1.37, p < 0.001). PLWH are more likely to be hospitalized due to COVID-19 than are non-PLWH. PLWH are 25% more likely to die due to COVID-19 than non-PLWH. Our results highlight that PLWH should be considered a population at risk for both hospitalization and mortality.

摘要

科学报告表明,人类免疫缺陷病毒(HIV)与 COVID-19 患者的死亡率之间存在关联,但尚未达成一致意见。在这项全国性研究中,我们描述和分析了感染 HIV 的患者(PLWH)的人口统计学和临床特征,并确定 HIV 感染是 COVID-19 住院患者死亡的一个危险因素。我们从 2020 年至 2022 年的国家医院数据信息系统中收集了数据。我们纳入了因 COVID-19 住院的患者。我们建立了一个 PLWH 患者队列,并将其与未感染 HIV 的患者(非 PLWH)进行了比较。对于多变量分析,我们使用死亡率作为因变量进行二元逻辑回归。为了提高结果的可解释性,我们还应用了惩罚回归和随机森林这两种著名的机器学习算法。最终模型中包含了广泛的合并症以及性别和年龄数据,作为调整后的估计值。我们的数据包含了 1188160 名患者,其中包括 6973 名 PLWH。在这个患者群体中,住院率估计在 1.43%至 1.70%之间,而普通人群的住院率为 0.83%。在 COVID-19 患者中,HIV 感染是死亡的危险因素,优势比(OR)为 1.25(95%CI,1.14-1.37,p<0.001)。与非 PLWH 相比,PLWH 因 COVID-19 住院的可能性更高。PLWH 因 COVID-19 死亡的可能性比非 PLWH 高 25%。我们的研究结果强调,PLWH 应被视为住院和死亡风险均较高的人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d55/11390775/6534d8057d4d/10461_2024_4394_Fig1_HTML.jpg

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