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

• 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
• Journal Title: AIDS (London, England)
• Volume: Volume 34, Number 12
• Publisher: Wolters Kluwer | 2020-10-01, Pages 1789-1794
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1097/QAD.0000000000002632
• Subjects: Health Sciences, Immunology; Biology, Virology
• Keywords: African Americans; CD4 Lymphocyte Count; Comorbidity; Coronavirus Infections; Female; Georgia; HIV Infections; Hospitalization; Humans; Male; Middle Aged; Pandemics; Pneumonia, Viral; Retrospective Studies

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.