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@article{Lee:2021:10.1111/hiv.13174,
author = {Lee, MJ and Snell, LB and Douthwaite, ST and Fidler, S and Fitzgerald, N and Goodwin, L and Hamzah, L and Kulasegaram, R and Lawrence, S and Lwanga, J and Marchant, R and Orkin, C and Palfreeman, A and Parthasarathi, P and Pareek, M and Ring, K and Sharaf, H and Shekarchi-Khanghahi, E and Simons, R and Teh, JJ and Thornhill, J and van, Halsema C and Williamson, M and Wiselka, M and Nori, A and Fox, J and Smith, C},
doi = {10.1111/hiv.13174},
journal = {HIV Medicine},
pages = {121--133},
title = {Clinical outcomes of patients with and without HIV hospitalized with COVID-19 in England during the early stages of the pandemic: a matched retrospective multi-centre analysis (RECEDE-C19 study)},
url = {http://dx.doi.org/10.1111/hiv.13174},
volume = {23},
year = {2021}
}

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TY  - JOUR
AB  - BackgroundThe contribution of HIV to COVID-19 outcomes in hospitalized inpatients remains unclear. We conducted a multi-centre, retrospective matched cohort study of SARS-CoV-2 PCR-positive hospital inpatients analysed by HIV status.MethodsHIV-negative patients were matched to people living with HIV (PLWH) admitted from 1 February 2020 to 31 May 2020 up to a 3:1 ratio by the following: hospital site, SARS-CoV-2 test date ± 7 days, age ± 5 years, gender, and index of multiple deprivation decile ± 1. The primary objective was clinical improvement (two-point improvement or better on a seven-point ordinal scale) or hospital discharge by day 28, whichever was earlier.ResultsA total of 68 PLWH and 181 HIV-negative comparators were included. In unadjusted analyses, PLWH had a reduced hazard of achieving clinical improvement or discharge [adjusted hazard ratio (aHR) = 0.57, 95% confidence interval (CI): 0.39–0.85, p = 0.005], but this association was ameliorated (aHR = 0.70, 95% CI: 0.43–1.17, p = 0.18) after additional adjustment for ethnicity, frailty, baseline hypoxaemia, duration of symptoms prior to baseline, body mass index (BMI) categories and comorbidities. Baseline frailty (aHR = 0.79, 95% CI: 0.65–0.95, p = 0.011), malignancy (aHR = 0.37, 95% CI 0.17, 0.82, p = 0.014) remained associated with poorer outcomes. The PLWH were more likely to be of black, Asian and minority ethnic background (75.0% vs 48.6%, p = 0.0002), higher median clinical frailty score [3 × interquartile range (IQR): 2–5 vs, 2 × IQR: 1–4, p = 0.0069), and to have a non-significantly higher proportion of active malignancy (14.4% vs 9.9%, p = 0.29).ConclusionsAdjusting for confounding comorbidities and demographics in a matched cohort ameliorated differences in outcomes of PLWH hospitalized with COVID-19, highlighting the importance of an appropriate comparison group when assessing outcomes of PLWH hospitalized with COVID-19.
AU  - Lee,MJ
AU  - Snell,LB
AU  - Douthwaite,ST
AU  - Fidler,S
AU  - Fitzgerald,N
AU  - Goodwin,L
AU  - Hamzah,L
AU  - Kulasegaram,R
AU  - Lawrence,S
AU  - Lwanga,J
AU  - Marchant,R
AU  - Orkin,C
AU  - Palfreeman,A
AU  - Parthasarathi,P
AU  - Pareek,M
AU  - Ring,K
AU  - Sharaf,H
AU  - Shekarchi-Khanghahi,E
AU  - Simons,R
AU  - Teh,JJ
AU  - Thornhill,J
AU  - van,Halsema C
AU  - Williamson,M
AU  - Wiselka,M
AU  - Nori,A
AU  - Fox,J
AU  - Smith,C
DO  - 10.1111/hiv.13174
EP  - 133
PY  - 2021///
SN  - 1464-2662
SP  - 121
TI  - Clinical outcomes of patients with and without HIV hospitalized with COVID-19 in England during the early stages of the pandemic: a matched retrospective multi-centre analysis (RECEDE-C19 study)
T2  - HIV Medicine
UR  - http://dx.doi.org/10.1111/hiv.13174
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000698430500001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://onlinelibrary.wiley.com/doi/10.1111/hiv.13174
VL  - 23
ER  -

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Professor Sarah Fidler BSc. MBBS. FRCP. PhD

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