tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2024 Jan 5;11(1)
fad693.
doi: 10.1093/ofid/ofad693. eCollection 2024 Jan. Disparities in Coronavirus Disease 2019 Clinical Outcomes and Vaccination Coverage Among Migrants With Human Immunodeficiency Virus in the PISCIS Cohort: A Population-Based Propensity Score-Matched Analysis
Daniel K Nomah[SUP] 1 2 [/SUP], Yesika Díaz[SUP] 1 2 3 [/SUP], Andreu Bruguera[SUP] 1 2 3 4 [/SUP], Sergio Moreno-Fornés[SUP] 1 2 3 [/SUP], Jordi Aceiton[SUP] 1 2 [/SUP], Juliana Reyes-Urueña[SUP] 1 [/SUP], Josep M Llibre[SUP] 5 [/SUP], Vicenç Falcó[SUP] 6 [/SUP], Arkaitz Imaz[SUP] 7 [/SUP], Francisco Javier Fanjul[SUP] 8 [/SUP], Joaquim Peraire[SUP] 9 10 [/SUP], Elisabet Deig[SUP] 11 [/SUP], Pere Domingo[SUP] 12 [/SUP], Alexy Inciarte[SUP] 13 [/SUP], Jordi Casabona[SUP] 1 2 3 4 [/SUP], José M Miró[SUP] 10 13 [/SUP]
Affiliations
Background: Coronavirus disease 2019 (COVID-19) disproportionately affects migrants and ethnic minorities, including those with human immunodeficiency virus (HIV). Comprehensive studies are needed to understand the impact and risk factors.
Methods: Using data from the PISCIS cohort of people with HIV (PWH) in Catalonia, Spain, we investigated COVID-19 outcomes and vaccination coverage. Among 10 640 PWH we compared migrants and non-migrants assessing rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing, diagnosis, and associated clinical outcomes through propensity score matching and multivariable Cox regression.
Results: The cohort (mean age, 43 years; 83.5% male) included 57.4% (3053) Latin American migrants. Migrants with HIV (MWH) had fewer SARS-CoV-2 tests (67.8% vs 72.1%, P < .0001) but similar COVID-19 diagnoses (29.2% vs 29.4%, P = .847) compared to Spanish natives. Migrants had lower complete vaccination (78.9% vs 85.1%, P < .0001) and booster doses (63.0% vs 65.5%, P = .027). COVID-19 hospitalizations (8.1% vs 5.1%, P < .0001) and intensive care unit (ICU) admissions (2.9% vs 1.2%, P < .0001) were higher among migrants, with similar hospitalization duration (5.5 vs 4.0 days, P = .098) and mortality (3 [0.2%] vs 6 [0.4%], P = .510). Age ≥40 years, CD4 counts <200 cells/μL, ≥2 comorbidities, and incomplete/nonreception of the SARS-CoV-2 vaccine increased the risk of severe COVID-19 among migrants.
Conclusions: MWH had lower rates of SARS-CoV-2 testing and vaccination coverage, although the rates of COVID-19 diagnosis were similar between migrants and non-migrants. Rates of COVID-19-associated hospitalizations and ICU admissions were higher among migrants in comparison with non-migrants, with similar hospitalization duration and mortality. These findings can inform policies to address disparities in future pandemic responses for MWH.
Keywords: COVID-19; HIV; SARS-CoV-2; migrants; vaccination.
. 2024 Jan 5;11(1)
fad693.doi: 10.1093/ofid/ofad693. eCollection 2024 Jan. Disparities in Coronavirus Disease 2019 Clinical Outcomes and Vaccination Coverage Among Migrants With Human Immunodeficiency Virus in the PISCIS Cohort: A Population-Based Propensity Score-Matched Analysis
Daniel K Nomah[SUP] 1 2 [/SUP], Yesika Díaz[SUP] 1 2 3 [/SUP], Andreu Bruguera[SUP] 1 2 3 4 [/SUP], Sergio Moreno-Fornés[SUP] 1 2 3 [/SUP], Jordi Aceiton[SUP] 1 2 [/SUP], Juliana Reyes-Urueña[SUP] 1 [/SUP], Josep M Llibre[SUP] 5 [/SUP], Vicenç Falcó[SUP] 6 [/SUP], Arkaitz Imaz[SUP] 7 [/SUP], Francisco Javier Fanjul[SUP] 8 [/SUP], Joaquim Peraire[SUP] 9 10 [/SUP], Elisabet Deig[SUP] 11 [/SUP], Pere Domingo[SUP] 12 [/SUP], Alexy Inciarte[SUP] 13 [/SUP], Jordi Casabona[SUP] 1 2 3 4 [/SUP], José M Miró[SUP] 10 13 [/SUP]
Affiliations
- PMID: 38221982
- PMCID: PMC10785217
- DOI: 10.1093/ofid/ofad693
Background: Coronavirus disease 2019 (COVID-19) disproportionately affects migrants and ethnic minorities, including those with human immunodeficiency virus (HIV). Comprehensive studies are needed to understand the impact and risk factors.
Methods: Using data from the PISCIS cohort of people with HIV (PWH) in Catalonia, Spain, we investigated COVID-19 outcomes and vaccination coverage. Among 10 640 PWH we compared migrants and non-migrants assessing rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing, diagnosis, and associated clinical outcomes through propensity score matching and multivariable Cox regression.
Results: The cohort (mean age, 43 years; 83.5% male) included 57.4% (3053) Latin American migrants. Migrants with HIV (MWH) had fewer SARS-CoV-2 tests (67.8% vs 72.1%, P < .0001) but similar COVID-19 diagnoses (29.2% vs 29.4%, P = .847) compared to Spanish natives. Migrants had lower complete vaccination (78.9% vs 85.1%, P < .0001) and booster doses (63.0% vs 65.5%, P = .027). COVID-19 hospitalizations (8.1% vs 5.1%, P < .0001) and intensive care unit (ICU) admissions (2.9% vs 1.2%, P < .0001) were higher among migrants, with similar hospitalization duration (5.5 vs 4.0 days, P = .098) and mortality (3 [0.2%] vs 6 [0.4%], P = .510). Age ≥40 years, CD4 counts <200 cells/μL, ≥2 comorbidities, and incomplete/nonreception of the SARS-CoV-2 vaccine increased the risk of severe COVID-19 among migrants.
Conclusions: MWH had lower rates of SARS-CoV-2 testing and vaccination coverage, although the rates of COVID-19 diagnosis were similar between migrants and non-migrants. Rates of COVID-19-associated hospitalizations and ICU admissions were higher among migrants in comparison with non-migrants, with similar hospitalization duration and mortality. These findings can inform policies to address disparities in future pandemic responses for MWH.
Keywords: COVID-19; HIV; SARS-CoV-2; migrants; vaccination.