COVID‐19 in hospitalized HIV‐positive and HIV‐negative patients: A matched study

OBJECTIVES: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID‐19 with [people with HIV (PWH)] and without (non‐PWH) HIV co‐infection in Spain during the first wave of the pandemic. METHODS: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active‐follow‐up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non‐PWH of the same age and sex randomly selected from COVID‐19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID‐19. The main outcome was all‐cause in‐hospital mortality. RESULTS: Forty‐five PWH with PCR‐confirmed COVID‐19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex‐matched controls were selected from the COVID‐19@Spain cohort. The median age in both groups was 53 (Q1–Q3, 46–56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV‐RNA < 50 copies/mL, and the median (Q1–Q3) CD4 count was 595 (349–798) cells/μL. No statistically significant differences were found between PWH and non‐PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non‐PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non‐PWH (P = 0.800). CONCLUSIONS: Our findings suggest that well‐controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID‐19 hospitalization.