Higher intensive care unit consultations for COVID-19 patients living with HIV compared to those without HIV coinfection in Uganda.

Abstract

Coronavirus disease‐2019 (COVID‐19) is the leading cause of death worldwide from a single infectious agent. Whether or not HIV infection affects clinical outcomes in patients with COVID‐19 remains inconclusive. This study aimed to compare the clinical outcomes of people living with HIV (PLWH) and non‐HIV‐infected patients hospitalized during the second wave of the COVID‐19 pandemic in Uganda. We retrospectively retrieved data on patients with COVID‐19 who were admitted to the Mulago National Referral Hospital in Uganda between April 2021 and mid‐July 2021. We performed propensity‐score‐matching of 1:5 to compare outcomes in COVID‐19 patients living with and those without HIV coinfection (controls). We included 31 PLWH and 155 non‐HIV controls. The baseline characteristics were similar across groups (all p values > 0.05). PLWH had close to threefold higher odds of having ICU consultation compared to controls (odds ratio [OR]: 2.9, 95% CI: 1.2–6.9, p = 0.015). There was a trend toward having a severe or critical COVID‐19 illness among PLWHIH compared to controls (OR: 1.9, 95% CI: 0.8–4.7, p = 0.164). Length of hospitalization was not significantly different between PLWH and non‐HIV controls (6 days vs. 7 days, p = 0.184). Seven‐day survival was 63% (95% CI: 42%–78%) among PLWH and 72% (95% CI: 61%–82%) among controls while 14‐day survival was 50% (95% CI: 28%–69%) among PLWH and 65% (95% CI: 55%–73%) among controls (p = 0.280). There was another trend toward having 1.7‐fold higher odds of mortality among PLWH compared to controls (OR: 1.7, 95% CI: 0.8–3.8, p = 0.181). Our data suggest that PLWH may be at an increased risk of severe or critical COVID‐19 illness requiring ICU consultation. Further studies with larger sample sizes are recommended.