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

• Type of Material: Article
• Authors: Lauren Collins, Emory University; Caitlin Moran, Emory University; Nora Oliver, Emory University; Abeer Moanna, Emory University; Cecile Lahiri, Emory University; Jonathan Colasanti, Emory University; Colleen Kelley, Emory University; Minhly Nguyen, Emory University; Vincent Marconi, Emory University; Wendy Armstrong, Emory University; Ighovwerha Ofotokun, Emory University; Anandi Sheth, Emory University
• Language: English
• Date: 2020-10-01
• Publisher: Wolters Kluwer
• Publication Version: Final Published Version
• Copyright Statement: © 2020 Wolters Kluwer Health, Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1097/QAD.0000000000002632
• Title of Journal or Parent Work: AIDS (London, England)
• Volume: 34
• Issue: 12
• Start Page: 1789
• End Page: 1794
• Grant/Funding Information: C.D.L. is also supported by the National Institute of Allergy and Infectious Diseases (NIAID) of the NIH (award number K23-AI124913).; L.F.C. is also supported by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) (award numbers UL1TR002378 and TL1TR002382) and C.A.M. by the NCATS of the NIH (award number KL2TR002381).; The current work was supported by the Emory Center for AIDS Research (award number P30-AI-050409) as well as the Emory Specialized Center of Research Excellence (SCORE) on Sex Differences (award number U54AG062334; to I.O.).
• Keywords: Retrospective Studies; Male; Humans; Comorbidity; Coronavirus Infections; Georgia; CD4 Lymphocyte Count; Pandemics; Female; Pneumonia, Viral; Middle Aged; Hospitalization; HIV Infections; African Americans
• Research Categories: Biology, Virology; Health Sciences, Immunology

Abstract

BACKGROUND: There are limited data describing the presenting characteristics and outcomes among US persons with HIV (PWH) requiring hospitalization for coronavirus disease 2019 (COVID-19). METHODS: We performed a case series of all PWH sequentially admitted with COVID-19 from 8 March 2020 to 23 April 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 cell count prior to admission was 425 (Q1-Q3, 262-815) cells/μl and 90% of patients had HIV-1 RNA less than 200 copies/ml. Half of the patients had at least five comorbidities; hypertension (70%), dyslipidemia (60%) and diabetes (45%) were most prevalent. All three patients who died had CD4 cell count more than 200, HIV suppression and each had a total of five comorbidities. CONCLUSION: The multisite series in the Southern United States 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.