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?:abstract
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OBJECTIVE We studied clinical outcomes of COVID-19 infection in patients living with HIV (PLH) in comparison to non-HIV population. DESIGN Analysis of a multicenter research network TriNETX was performed including patients > 10 years of age diagnosed with COVID-19. METHODS Outcomes in COVID-19 positive patients with concurrent HIV (PLH) were compared to a propensity matched cohort of patients without HIV (non-PLH). RESULTS 50,167 patients with COVID-19 were identified (49,763 non-PLH, 404 PLH). PLH were more likely to be males, African American, obese, and have concurrent hypertension, diabetes, CKD, and nicotine dependence compared to non-PLH cohort (all p values <0.05).We performed 1:1 matching for BMI, diabetes, hypertension, chronic lung diseases, chronic kidney disease, race, history of nicotine dependence and gender. In unmatched analysis, PLH had higher mortality at 30 days (RR 1.55, 95% CI: 1.01 - 2.39) and were more likely to need inpatient services (RR 1.83, 95% CI: 1.496 - 2.24). After propensity score matching, no difference in mortality was noted (RR 1.33, 95% CI: 0.69 - 2.57). A higher proportion of PLH group needed inpatient services (19.31% vs 11.39%, RR 1.696, 95% CI: 1.21 - 2.38).Mean CRP, ferritin, ESR and LDH levels after COVID-19 diagnosis were not statistically different and mortality was not different for PLH with history of anti-retroviral treatment. CONCLUSION Crude COVID-19 mortality is higher in PLH; however, propensity matched analyses revealed no difference in outcomes, showing that higher mortality is driven by higher burden of comorbidities. Early diagnosis and intensive surveillance are needed to prevent a \'Syndemic\' of diseases in this vulnerable cohort.
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