Outcomes Among HIV-Positive Patients Hospitalized With COVID-19

J Acquir Immune Defic Syndr. 2020 Sep 1;85(1):6-10. doi: 10.1097/QAI.0000000000002423.


Background: SARS-CoV-2 infection continues to cause significant morbidity and mortality worldwide. Preliminary data on SARS-CoV-2 infection suggest that some immunocompromised hosts experience worse outcomes. We performed a retrospective matched cohort study to characterize outcomes in HIV-positive patients with SARS-CoV-2 infection.

Methods: Leveraging data collected from electronic medical records for all patients hospitalized at NYU Langone Health with COVID-19 between March 2, 2020, and April 23, 2020, we matched 21 HIV-positive patients with 42 non-HIV patients using a greedy nearest-neighbor algorithm. Admission characteristics, laboratory test results, and hospital outcomes were recorded and compared between the 2 groups.

Results: Although there was a trend toward increased rates of intensive care unit admission, mechanical ventilation, and mortality in HIV-positive patients, these differences were not statistically significant. Rates for these outcomes in our cohort are similar to those previously published for all patients hospitalized with COVID-19. HIV-positive patients had significantly higher admission and peak C-reactive protein values. Other inflammatory markers did not differ significantly between groups, although HIV-positive patients tended to have higher peak values during their clinical course. Three HIV-positive patients had superimposed bacterial pneumonia with positive sputum cultures, and all 3 patients died during hospitalization. There was no difference in frequency of thrombotic events or myocardial infarction between these groups.

Conclusions: This study provides evidence that HIV coinfection does not significantly impact presentation, hospital course, or outcomes of patients infected with SARS-CoV-2, when compared with matched non-HIV patients. A larger study is required to determine whether the trends we observed apply to all HIV-positive patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus*
  • COVID-19
  • Case-Control Studies
  • Cohort Studies
  • Coinfection / mortality
  • Coinfection / virology*
  • Coronavirus Infections / complications*
  • Coronavirus Infections / mortality
  • Critical Care
  • Female
  • HIV Infections / complications*
  • HIV Infections / mortality
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / mortality
  • Respiration, Artificial
  • Retrospective Studies
  • SARS-CoV-2
  • Treatment Outcome