OBJECTIVE To evaluate the association of HIV infection with outcomes among people hospitalized with COVID-19. DESIGN Prospectively-planned analysis of the American Heart Association's COVID-19 Cardiovascular Disease Registry. SETTING 107 academic and community hospitals in the United States from March through December 2020. PARTICIPANTS Consecutive sample of 21,528 adults hospitalized with COVID-19 at participating hospitals. MAIN OUTCOME AND MEASURE Primary outcome was pre-defined as in-hospital mortality. We used hierarchical mixed effects models to assess the association of HIV with in-hospital mortality accounting for patient demographics, comorbidities and clustering by hospital. Secondary outcomes included major adverse cardiac events (MACE), severity of illness, and length of stay (LOS). RESULTS The registry included 220 people living with HIV (PLWH). PLWH were younger and more likely to be male, Non-Hispanic Black, on Medicaid, and active tobacco users. Of the study population, 36 PLWH (16.4%) died compared with 3,290 (15.4%) without HIV (Risk ratio 1.06; 95%CI 0.79-1.43; p = 0.71). After adjustment for age, sex, race, and insurance, HIV was not associated with in-hospital mortality (aOR 1.13; 95%CI 0.77-1.6; p = 0.54) with no change in effect after adding body mass index and comorbidities (aOR 1.15; 95%CI 0.78-1.70; p = 0.48). HIV was not associated with MACE (aOR 0.99; 95%CI 0.69-1.44, p = 0.91), COVID severity (aOR 0.96; 95%CI 0.62-1.50; p = 0.86), or LOS (aOR 1.03; 95% CI 0.76-1.66; p = 0.21). CONCLUSIONS In the largest study of PLWH hospitalized with COVID-19 in the United States to date, we did not find significant associations between HIV and adverse outcomes including in-hospital mortality, MACE, or severity of illness.
Association of human immunodeficiency virus infection with outcomes among adults hospitalized with COVID-19.