Clinical characteristics, comorbidities and outcomes among persons with HIV hospitalized with coronavirus disease 2019 in Atlanta, GA

AIDS. 2020 Jul 23. doi: 10.1097/QAD.0000000000002632. Online ahead of print.

Abstract

Background: There are limited data describing the presenting characteristics and outcomes among U.S. persons with HIV (HIV) requiring hospitalization for coronavirus disease 2019 (COVID-19).

Methods: We performed a case series of all PWH sequentially admitted with COVID-19 from 3/8/2020 to 4/23/2020 at three hospitals in Atlanta, Georgia. Sociodemographic, clinical and HIV-associated characteristics were collected.

Results: Of 530 confirmed COVID-19 cases hospitalized during this period, 20 occurred among PWH (3.8%). The median age was 57 (Q1-Q3, 48-62) years, 65% were men, and 85% were non-Hispanic Black. Presenting median symptom duration was 5 (Q1-Q3, 3-7) days; cough (90%), fever (65%), malaise (60%) and dyspnea (60%) were most common. On admission, 40% of patients required oxygenation support and 65% had an abnormal chest radiograph. Median length of hospitalization was 5 (Q1-Q3, 4-12) days, 30% required intensive care, 15% required intubation, and 15% died. Median CD4 count prior to admission was 425 (Q1-Q3, 262-815) cells/mm and 90% of patients had HIV-1 RNA <200 copies/ml. Half of the patients had ≥5 comorbidities; hypertension (70%), dyslipidemia (60%) and diabetes (45%) were most prevalent. All three patients who died had CD4 count >200, HIV suppression and each had a total of 5 comorbidities.

Conclusions: This multisite series in the Southern U.S. provides characteristics and early outcomes of hospitalized PWH with COVID-19. Nearly all patients had controlled HIV and a high comorbidity burden. Additional study of COVID-19 among PWH is needed to determine the role of age, comorbidities, and HIV control in mediating COVID-19 presentation and its sequelae.