tetano
Editor, Senior Moderator
BMC Infect Dis
. 2022 Jun 20;22(1):559.
doi: 10.1186/s12879-022-07519-8.
Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study
Arifa Parker[SUP] 1 [/SUP], Linda Boloko[SUP] 2 [/SUP], Muhammad S Moolla[SUP] 3 [/SUP], Nabilah Ebrahim[SUP] 4 [/SUP], Birhanu T Ayele[SUP] 5 [/SUP], Alistair G B Broadhurst[SUP] 3 [/SUP], Boitumelo Mashigo[SUP] 3 [/SUP], Gideon Titus[SUP] 3 [/SUP], Timothy de Wet[SUP] 2 [/SUP], Nicholas Boliter[SUP] 4 [/SUP], Michael-Jon Rosslee[SUP] 2 [/SUP], Nectarios Papavarnavas[SUP] 6 [/SUP], Riezaah Abrahams[SUP] 7 [/SUP], Marc Mendelson[SUP] 6 [/SUP], Sipho Dlamini[SUP] 6 [/SUP], Jantjie J Taljaard[SUP] 7 [/SUP], Hans W Prozesky[SUP] 7 [/SUP], Abdurasiet Mowlana[SUP] 3 [/SUP], Abraham J Viljoen[SUP] 3 [/SUP], Neshaad Schrueder[SUP] 3 [/SUP], Brian W Allwood[SUP] 8 [/SUP], Usha Lalla[SUP] 8 [/SUP], Joel A Dave[SUP] 2 [/SUP], Greg Calligaro[SUP] 2 [/SUP], Dion Levin[SUP] 2 [/SUP], Deborah Maughan[SUP] 2 [/SUP], Ntobeko A B Ntusi[SUP] 2 9 [/SUP], Peter S Nyasulu[SUP] 5 [/SUP], Graeme Meintjes[SUP] 2 6 10 [/SUP], Coenraad F N Koegelenberg[SUP] 8 [/SUP], Ayanda T Mnguni[SUP] #[/SUP][SUP] 3 4 [/SUP], Sean Wasserman[SUP] #[/SUP][SUP] 6 10 [/SUP]
Affiliations
Abstract
Background: 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).
Methods: 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.
Results: 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 < 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 < 200 cells/mm[SUP]3[/SUP], higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels.
Conclusion: 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.
Keywords: COVID-19; HIV; Obesity; Tuberculosis.
. 2022 Jun 20;22(1):559.
doi: 10.1186/s12879-022-07519-8.
Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study
Arifa Parker[SUP] 1 [/SUP], Linda Boloko[SUP] 2 [/SUP], Muhammad S Moolla[SUP] 3 [/SUP], Nabilah Ebrahim[SUP] 4 [/SUP], Birhanu T Ayele[SUP] 5 [/SUP], Alistair G B Broadhurst[SUP] 3 [/SUP], Boitumelo Mashigo[SUP] 3 [/SUP], Gideon Titus[SUP] 3 [/SUP], Timothy de Wet[SUP] 2 [/SUP], Nicholas Boliter[SUP] 4 [/SUP], Michael-Jon Rosslee[SUP] 2 [/SUP], Nectarios Papavarnavas[SUP] 6 [/SUP], Riezaah Abrahams[SUP] 7 [/SUP], Marc Mendelson[SUP] 6 [/SUP], Sipho Dlamini[SUP] 6 [/SUP], Jantjie J Taljaard[SUP] 7 [/SUP], Hans W Prozesky[SUP] 7 [/SUP], Abdurasiet Mowlana[SUP] 3 [/SUP], Abraham J Viljoen[SUP] 3 [/SUP], Neshaad Schrueder[SUP] 3 [/SUP], Brian W Allwood[SUP] 8 [/SUP], Usha Lalla[SUP] 8 [/SUP], Joel A Dave[SUP] 2 [/SUP], Greg Calligaro[SUP] 2 [/SUP], Dion Levin[SUP] 2 [/SUP], Deborah Maughan[SUP] 2 [/SUP], Ntobeko A B Ntusi[SUP] 2 9 [/SUP], Peter S Nyasulu[SUP] 5 [/SUP], Graeme Meintjes[SUP] 2 6 10 [/SUP], Coenraad F N Koegelenberg[SUP] 8 [/SUP], Ayanda T Mnguni[SUP] #[/SUP][SUP] 3 4 [/SUP], Sean Wasserman[SUP] #[/SUP][SUP] 6 10 [/SUP]
Affiliations
- PMID: 35725387
- DOI: 10.1186/s12879-022-07519-8
Abstract
Background: 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).
Methods: 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.
Results: 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 < 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 < 200 cells/mm[SUP]3[/SUP], higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels.
Conclusion: 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.
Keywords: COVID-19; HIV; Obesity; Tuberculosis.