Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study. Parker, A., Boloko, L., Moolla, M. S, Ebrahim, N., Ayele, B. T, Broadhurst, A. G B, Mashigo, B., Titus, G., de Wet, T., Boliter, N., Rosslee, M., Papavarnavas, N., Abrahams, R., Mendelson, M., Dlamini, S., Taljaard, J. J, Prozesky, H. W, Mowlana, A., Viljoen, A. J, Schrueder, N., Allwood, B. W, Lalla, U., Dave, J. A, Calligaro, G., Levin, D., Maughan, D., Ntusi, N. A B, Nyasulu, P. S, Meintjes, G. A, Koegelenberg, C. F N, Mnguni, A. T, & Wasserman, S. BMC Infectious Diseases, 22:559, BioMed Central, jun, 2022. Paper doi abstract bibtex There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02–1.03, p \textless 0.001), male sex (AHR1.38 (95%CI 1.12–1.72, p = 0.003) and being “overweight or obese” (AHR 1.30 95%CI 1.03–1.61 p = 0.024). HIV (AHR 1.28 95%CI 0.95–1.72, p 0.11) and active TB (AHR 1.50 95%CI 0.84–2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count \textless 200 cells/mm3, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population.
@article{Parker2022,
abstract = {There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. PWH comprised 270 (19{\%}) of 1434 admissions. There were 47 patients with active tuberculosis (3.3{\%}), of whom 29 (62{\%}) were PWH. Three-hundred and seventy-three patients (26{\%}) died. The mortality in PWH (n = 71, 26{\%}) and HIV-uninfected patients (n = 296, 25{\%}) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38{\%} vs n = 3, 20{\%}; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95{\%}CI 1.02–1.03, p {\textless} 0.001), male sex (AHR1.38 (95{\%}CI 1.12–1.72, p = 0.003) and being “overweight or obese” (AHR 1.30 95{\%}CI 1.03–1.61 p = 0.024). HIV (AHR 1.28 95{\%}CI 0.95–1.72, p 0.11) and active TB (AHR 1.50 95{\%}CI 0.84–2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count {\textless} 200 cells/mm3, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population.},
author = {Parker, Arifa and Boloko, Linda and Moolla, Muhammad S and Ebrahim, Nabilah and Ayele, Birhanu T and Broadhurst, Alistair G B and Mashigo, Boitumelo and Titus, Gideon and de Wet, Timothy and Boliter, Nicholas and Rosslee, Michael-Jon and Papavarnavas, Nectarios and Abrahams, Riezaah and Mendelson, Marc and Dlamini, Sipho and Taljaard, Jantjie J and Prozesky, Hans W and Mowlana, Abdurasiet and Viljoen, Abraham J and Schrueder, Neshaad and Allwood, Brian W and Lalla, Usha and Dave, Joel A and Calligaro, Greg and Levin, Dion and Maughan, Deborah and Ntusi, Ntobeko A B and Nyasulu, Peter S and Meintjes, Graeme A and Koegelenberg, Coenraad F N and Mnguni, Ayanda T and Wasserman, Sean},
doi = {10.1186/S12879-022-07519-8},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Parker et al. - 2022 - Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculo.pdf:pdf},
issn = {1471-2334},
journal = {BMC Infectious Diseases},
keywords = {Infectious Diseases,Internal Medicine,Medical Microbiology,OA,Parasitology,Tropical Medicine,fund{\_}ack,original},
mendeley-tags = {OA,fund{\_}ack,original},
month = {jun},
pages = {559},
pmid = {35725387},
publisher = {BioMed Central},
title = {{Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study}},
url = {https://link.springer.com/articles/10.1186/s12879-022-07519-8 https://link.springer.com/article/10.1186/s12879-022-07519-8},
volume = {22},
year = {2022}
}
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The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02–1.03, p \\textless 0.001), male sex (AHR1.38 (95%CI 1.12–1.72, p = 0.003) and being “overweight or obese” (AHR 1.30 95%CI 1.03–1.61 p = 0.024). HIV (AHR 1.28 95%CI 0.95–1.72, p 0.11) and active TB (AHR 1.50 95%CI 0.84–2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count \\textless 200 cells/mm3, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. 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