111 - Outcomes Related to COVID-19 Among People Living with HIV: Cohort from a Large Academic Center

Background: The COVID-19 pandemic has resulted in nearly 8 million cases and close to 500,000 deaths globally.  Little is known about risk factors for favorable or adverse outcomes from COVID-19 among people living with HIV (PWH). Small case series have described outcomes for hospitalized PWH with COVID19.

Methods: This is a retrospective chart review of PWH with confirmed diagnosis of COVID-19 from 2 HIV ambulatory clinics from March 1 to May 31, 2020 in a large urban academic center that serves a substantial proportion of underserved minorities. Data on demographics, clinical characteristics, and outcomes were abstracted using a standardized data collection tool. Bivariate analysis was performed to identify correlates of hospitalization.
 

Results: Among the clinic cohort of 1469 PWH, 94 (6.4%) were tested for SARS-CoV-2 and 40 (42.5%) were positive. Fifty-percent were women, 65% were 50 years and older, 65% were black, 65% were former or active smokers, and 40% were active alcohol or substance users. The majority (90%) were on ART and 87.5% had HIV viral suppression (< 50 copies/ml). Among comorbidities, 50% had hypertension, 42.5% chronic lung disease, 42.5% cardiovascular disease (CVD), 40% obesity, 27.5% diabetes (DM), and 20% chronic kidney disease (CKD). Hospitalization occurred in 19 patients (47.5%) and of those, 4 (21%) required escalation of care. The median length of stay was 12 days (IQR5.5-15.5) and there was no inpatient mortality. Among the 12 PWH who had HIV viral load test during hospitalization, 11 (91.7%) maintained viral suppression and none of the 19 patients had ART interruption. Those who were hospitalized were more likely to be >50 years old (p=0.02); have CVD (p=0.003), DM (p=0.01), and CKD (p=0.02); or have multiple comorbidities (p=0.007) compared to those managed as outpatients.  Furthermore, incremental numbers of comorbidities were associated with hospitalization (p=0.009).  A history of AIDS, black race, obesity, smoking, and substance use disorders were not associated with hospitalization or adverse outcome. 

Conclusion: In this initial and to our knowledge largest cohort in an urban academic center, PWH with COVID-19 had favorable short-term outcomes. The risk factors associated with hospitalization were older age and multiple non-HIV related comorbidities.