Journal Article

The clinical and epidemiological characteristics of a series of patients living with HIV admitted for COVID-19 in a district hospital

Ebrahim, Nabilah, Sonday, Nawhaal, Jalavu, Thumeka, Mnguni, Ayanda Trevor, Tamuzi, Jacques L., English, Rene, Nyasulu, Peter S., Boliter, Nicholas, Chapanduka, Zivanai C., Gabriels, Shiraaz, Schietekat, Denzil, Zemlin, Annalise E., Schrueder, Neshaad, Davies, Mary-Ann, Abdullah, Ibtisam, Tembo, Yamanya, Sigwadhi, Lovemore N., Yalew, Anteneh, Ngah, Veranyuy

2023

Overview

Background The coronavirus disease 2019 (COVID-19) pandemic continues to evolve. Globally, COVID-19 continues to strain even the most resilient healthcare systems, with Omicron being the latest variant. We made a thorough search for literature describing the effects of the COVID-19 in a high human immunodeficiency virus (HIV)/tuberculosis (TB) burden district-level hospital setting. We found scanty literature. Methods A retrospective observational study was conducted at Khayelitsha District Hospital in Cape Town, South Africa (SA) over the period March 2020–December 2021. We included confirmed COVID-19 cases with HIV infection aged from 18 years and above. Analysis was performed to identify predictors of mortality or hospital discharge among people living with HIV (PLWH). Predictors investigated include CD4 count, antiretroviral therapy (ART), TB, non-communicable diseases, haematological, and biochemical parameters. Findings This cohort of PLWH with SARS-CoV-2 infection had a median (IQR) age of 46 (37–54) years, male sex distribution of 29.1%, and a median (IQR) CD4 count of 267 (141–457) cells/mm3. Of 255 patients, 195 (76%) patients were discharged, 60 (24%) patients died. One hundred and sixty-nine patients (88%) were on ART with 73(28%) patients having acquired immunodeficiency syndrome (AIDS). After multivariable analysis, smoking (risk ratio [RR]: 2.86 (1.75–4.69)), neutrophilia [RR]: 1.024 (1.01–1.03), and glycated haemoglobin A1 (HbA1c) [RR]: 1.01 (1.007–1.01) were associated with mortality. Conclusion The district hospital had a high COVID-19 mortality rate among PLWH. Easy-to-access biomarkers such as CRP, neutrophilia, and HbA1c may play a significant role in informing clinical management to prevent high mortality due to COVID-19 in PLWH at the district-level hospitals.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acquired immune deficiency syndrome / Adult / AIDS / Antigens / Antiretroviral agents / Antiretroviral drugs / Antiretroviral therapy / Antiviral agents / Biomarkers / Body mass index / Care and treatment / CD4 antigen / Communicable diseases / Coronaviruses / COVID-19 / COVID-19 - epidemiology / COVID-19 - mortality / COVID-19 vaccines / Data collection / Development and progression / Diabetes / Disease / District hospital / Dosage and administration / Epidemiology / Ethics / Female / Glycated Hemoglobin / Glycosylated hemoglobin / Health aspects / Hemoglobin / Highly active antiretroviral therapy / HIV / HIV (Viruses) / HIV infection / HIV Infections - complications / HIV Infections - drug therapy / HIV Infections - epidemiology / HIV patients / Hospitals / Hospitals, District / Human immunodeficiency virus / Humans / Hypertension / Immune system / Infection / Infections / Infectious Diseases / Internal Medicine / Laboratories / Leukocytosis / Male / Measurement / Medical Microbiology / Medicine / Medicine & Public Health / Middle Aged / Mortality / Neutrophilia / Observational studies / Pandemics / Parasitology / Patients / PLWH / Pneumonia / Population / Public health / Risk analysis / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Sexually transmitted diseases / South Africa / South Africa - epidemiology / STD / Steroids / Systematic review / Taiwan / Tropical Medicine / Tuberculosis / Unemployment / Viral diseases / Viremia