@article{Boulle2020,
abstract = {Background Risk factors for COVID-19 death in sub-Saharan Africa and the effects of HIV and tuberculosis on COVID-19 outcomes are unknown. Methods We conducted a population cohort study using linked data from adults attending public sector health facilities in the Western Cape, South Africa. We used Cox-proportional hazards models adjusted for age, sex, location and comorbidities to examine the association between HIV, tuberculosis and COVID-19 death from 1 March-9 June 2020 among (i) public sector “active patients” (≥1 visit in the 3 years before March 2020), (ii) laboratory-diagnosed COVID-19 cases and (iii) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19 comparing HIV positive vs. negative adults using modelled population estimates. Results Among 3,460,932 patients (16{\%} HIV positive), 22,308 were diagnosed with COVID-19, of whom 625 died. COVID-19 death was associated with male sex, increasing age, diabetes, hypertension and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR] 2.14; 95{\%} confidence interval [CI] 1.70-2.70), with similar risks across strata of viral load and immunosuppression. Current and previous tuberculosis were associated with COVID-19 death (aHR [95{\%}CI] 2.70 [1.81-4.04] and 1.51 [1.18-1.93] respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95{\%}CI 1.96-2.86); population attributable fraction 8.5{\%} (95{\%}CI 6.1-11.1). Conclusion While our findings may over-estimate HIV- and tuberculosis-associated COVID-19 mortality risks due to residual confounding, both HIV and current tuberculosis were independently associated with increased COVID-19 mortality. The associations between age, sex and other comorbidities and COVID-19 mortality were similar to other settings.},
author = {{Western Cape Department of Health in collaboration with the National Institute for Communicable Diseases}},
doi = {10.1093/cid/ciaa1198},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Western Cape Department of Health in collaboration with the National Institute for Communicable Diseases - 2021 - Risk factors for COVID.pdf:pdf;:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Western Cape Department of Health in collaboration with the National Institute for Communicable Diseases - 2021 - Risk factors for CO(2).pdf:pdf},
issn = {1058-4838},
journal = {Clinical Infectious Diseases},
keywords = {OA,africa south of the sahara,covid-19,fund{\_}ack,original,south africa,tuberculosis and hiv},
mendeley-tags = {OA,fund{\_}ack,original},
number = {7},
pages = {e2005--e2015},
pmid = {32860699},
publisher = {Oxford University Press (OUP)},
title = {{Risk factors for COVID-19 death in a population cohort study from the Western Cape Province, South Africa}},
url = {https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1198/5899044},
volume = {73},
year = {2021}
}

{"_id":"6WnLh7JFvGb7mnitt","bibbaseid":"westerncapedepartmentofhealthincollaborationwiththenationalinstituteforcommunicablediseases-riskfactorsforcovid19deathinapopulationcohortstudyfromthewesterncapeprovincesouthafrica-2021","author_short":["Western Cape Department of Health in collaboration with the National Institute for Communicable Diseases"],"bibdata":{"bibtype":"article","type":"article","abstract":"Background Risk factors for COVID-19 death in sub-Saharan Africa and the effects of HIV and tuberculosis on COVID-19 outcomes are unknown. Methods We conducted a population cohort study using linked data from adults attending public sector health facilities in the Western Cape, South Africa. We used Cox-proportional hazards models adjusted for age, sex, location and comorbidities to examine the association between HIV, tuberculosis and COVID-19 death from 1 March-9 June 2020 among (i) public sector “active patients” (≥1 visit in the 3 years before March 2020), (ii) laboratory-diagnosed COVID-19 cases and (iii) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19 comparing HIV positive vs. negative adults using modelled population estimates. Results Among 3,460,932 patients (16% HIV positive), 22,308 were diagnosed with COVID-19, of whom 625 died. COVID-19 death was associated with male sex, increasing age, diabetes, hypertension and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR] 2.14; 95% confidence interval [CI] 1.70-2.70), with similar risks across strata of viral load and immunosuppression. Current and previous tuberculosis were associated with COVID-19 death (aHR [95%CI] 2.70 [1.81-4.04] and 1.51 [1.18-1.93] respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95%CI 1.96-2.86); population attributable fraction 8.5% (95%CI 6.1-11.1). Conclusion While our findings may over-estimate HIV- and tuberculosis-associated COVID-19 mortality risks due to residual confounding, both HIV and current tuberculosis were independently associated with increased COVID-19 mortality. The associations between age, sex and other comorbidities and COVID-19 mortality were similar to other settings.","author":[{"firstnames":[],"propositions":[],"lastnames":["Western Cape Department of Health in collaboration with the National Institute for Communicable Diseases"],"suffixes":[]}],"doi":"10.1093/cid/ciaa1198","file":":C$\\$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Western Cape Department of Health in collaboration with the National Institute for Communicable Diseases - 2021 - Risk factors for COVID.pdf:pdf;:C$\\$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Western Cape Department of Health in collaboration with the National Institute for Communicable Diseases - 2021 - Risk factors for CO(2).pdf:pdf","issn":"1058-4838","journal":"Clinical Infectious Diseases","keywords":"OA,africa south of the sahara,covid-19,fund_ack,original,south africa,tuberculosis and hiv","mendeley-tags":"OA,fund_ack,original","number":"7","pages":"e2005–e2015","pmid":"32860699","publisher":"Oxford University Press (OUP)","title":"Risk factors for COVID-19 death in a population cohort study from the Western Cape Province, South Africa","url":"https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1198/5899044","volume":"73","year":"2021","bibtex":"@article{Boulle2020,\r\nabstract = {Background Risk factors for COVID-19 death in sub-Saharan Africa and the effects of HIV and tuberculosis on COVID-19 outcomes are unknown. Methods We conducted a population cohort study using linked data from adults attending public sector health facilities in the Western Cape, South Africa. We used Cox-proportional hazards models adjusted for age, sex, location and comorbidities to examine the association between HIV, tuberculosis and COVID-19 death from 1 March-9 June 2020 among (i) public sector “active patients” (≥1 visit in the 3 years before March 2020), (ii) laboratory-diagnosed COVID-19 cases and (iii) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19 comparing HIV positive vs. negative adults using modelled population estimates. Results Among 3,460,932 patients (16{\\%} HIV positive), 22,308 were diagnosed with COVID-19, of whom 625 died. COVID-19 death was associated with male sex, increasing age, diabetes, hypertension and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR] 2.14; 95{\\%} confidence interval [CI] 1.70-2.70), with similar risks across strata of viral load and immunosuppression. Current and previous tuberculosis were associated with COVID-19 death (aHR [95{\\%}CI] 2.70 [1.81-4.04] and 1.51 [1.18-1.93] respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95{\\%}CI 1.96-2.86); population attributable fraction 8.5{\\%} (95{\\%}CI 6.1-11.1). Conclusion While our findings may over-estimate HIV- and tuberculosis-associated COVID-19 mortality risks due to residual confounding, both HIV and current tuberculosis were independently associated with increased COVID-19 mortality. The associations between age, sex and other comorbidities and COVID-19 mortality were similar to other settings.},\r\nauthor = {{Western Cape Department of Health in collaboration with the National Institute for Communicable Diseases}},\r\ndoi = {10.1093/cid/ciaa1198},\r\nfile = {:C$\\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Western Cape Department of Health in collaboration with the National Institute for Communicable Diseases - 2021 - Risk factors for COVID.pdf:pdf;:C$\\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Western Cape Department of Health in collaboration with the National Institute for Communicable Diseases - 2021 - Risk factors for CO(2).pdf:pdf},\r\nissn = {1058-4838},\r\njournal = {Clinical Infectious Diseases},\r\nkeywords = {OA,africa south of the sahara,covid-19,fund{\\_}ack,original,south africa,tuberculosis and hiv},\r\nmendeley-tags = {OA,fund{\\_}ack,original},\r\nnumber = {7},\r\npages = {e2005--e2015},\r\npmid = {32860699},\r\npublisher = {Oxford University Press (OUP)},\r\ntitle = {{Risk factors for COVID-19 death in a population cohort study from the Western Cape Province, South Africa}},\r\nurl = {https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1198/5899044},\r\nvolume = {73},\r\nyear = {2021}\r\n}\r\n","author_short":["Western Cape Department of Health in collaboration with the National Institute for Communicable Diseases"],"key":"Boulle2020","id":"Boulle2020","bibbaseid":"westerncapedepartmentofhealthincollaborationwiththenationalinstituteforcommunicablediseases-riskfactorsforcovid19deathinapopulationcohortstudyfromthewesterncapeprovincesouthafrica-2021","role":"author","urls":{"Paper":"https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1198/5899044"},"keyword":["OA","africa south of the sahara","covid-19","fund_ack","original","south africa","tuberculosis and hiv"],"metadata":{"authorlinks":{}}},"bibtype":"article","biburl":"https://drive.google.com/uc?export=download&id=1-JLqZ7RwZ3VC2d6ErLGHAtOeMRS_7GCz","dataSources":["Krmt6gt9ktB2s6ARh"],"keywords":["oa","africa south of the sahara","covid-19","fund_ack","original","south africa","tuberculosis and hiv"],"search_terms":["risk","factors","covid","death","population","cohort","study","western","cape","province","south","africa","western cape department of health in collaboration with the national institute for communicable diseases"],"title":"Risk factors for COVID-19 death in a population cohort study from the Western Cape Province, South Africa","year":2021}