Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study

dc.contributor.authorParker, Arifa
dc.contributor.authorBoloko, Linda
dc.contributor.authorMoolla, Muhammad S
dc.contributor.authorEbrahim, Nabilah
dc.contributor.authorAyele, Birhanu T
dc.contributor.authorBroadhurst, Alistair G B
dc.contributor.authorMashigo, Boitumelo
dc.contributor.authorTitus, Gideon
dc.contributor.authorde Wet, Timothy
dc.contributor.authorBoliter, Nicholas
dc.contributor.authorRosslee, Michael-Jon
dc.contributor.authorPapavarnavas, Nectarios
dc.contributor.authorAbrahams, Riezaah
dc.contributor.authorMendelson, Marc
dc.contributor.authorDlamini, Sipho
dc.contributor.authorTaljaard, Jantjie J
dc.contributor.authorProzesky, Hans W
dc.contributor.authorMowlana, Abdurasiet
dc.contributor.authorViljoen, Abraham J
dc.contributor.authorSchrueder, Neshaad
dc.contributor.authorAllwood, Brian W
dc.contributor.authorLalla, Usha
dc.contributor.authorDave, Joel A
dc.contributor.authorCalligaro, Greg
dc.contributor.authorLevin, Dion
dc.contributor.authorMaughan, Deborah
dc.contributor.authorNtusi, Ntobeko A B
dc.contributor.authorNyasulu, Peter S
dc.contributor.authorMeintjes, Graeme
dc.contributor.authorKoegelenberg, Coenraad F N
dc.contributor.authorMnguni, Ayanda T
dc.contributor.authorWasserman, Sean
dc.date.accessioned2022-09-15T12:24:45Z
dc.date.available2022-09-15T12:24:45Z
dc.date.issued2022-06-20
dc.date.updated2022-06-26T03:12:55Z
dc.description.abstractBackground There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). Methods We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. Results PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02–1.03, p < 0.001), male sex (AHR1.38 (95%CI 1.12–1.72, p = 0.003) and being “overweight or obese” (AHR 1.30 95%CI 1.03–1.61 p = 0.024). HIV (AHR 1.28 95%CI 0.95–1.72, p 0.11) and active TB (AHR 1.50 95%CI 0.84–2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count < 200 cells/mm3, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. Conclusion In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population.en_US
dc.identifier.apacitationParker, A., Boloko, L., Moolla, M. S., Ebrahim, N., Ayele, B. T., Broadhurst, A. G. B., ... Wasserman, S. (2022). Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study. <i>BMC Infectious Diseases</i>, 22(1), 559. http://hdl.handle.net/11427/36814en_ZA
dc.identifier.chicagocitationParker, Arifa, Linda Boloko, Muhammad S Moolla, Nabilah Ebrahim, Birhanu T Ayele, Alistair G B Broadhurst, Boitumelo Mashigo, et al "Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study." <i>BMC Infectious Diseases</i> 22, 1. (2022): 559. http://hdl.handle.net/11427/36814en_ZA
dc.identifier.citationParker, A., Boloko, L., Moolla, M.S., Ebrahim, N., Ayele, B.T., Broadhurst, A.G.B., Mashigo, B. & Titus, G. et al. 2022. Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study. <i>BMC Infectious Diseases.</i> 22(1):559. http://hdl.handle.net/11427/36814en_ZA
dc.identifier.ris TY - Journal Article AU - Parker, Arifa AU - Boloko, Linda AU - Moolla, Muhammad S AU - Ebrahim, Nabilah AU - Ayele, Birhanu T AU - Broadhurst, Alistair G B AU - Mashigo, Boitumelo AU - Titus, Gideon AU - de Wet, Timothy AU - Boliter, Nicholas AU - Rosslee, Michael-Jon AU - Papavarnavas, Nectarios AU - Abrahams, Riezaah AU - Mendelson, Marc AU - Dlamini, Sipho AU - Taljaard, Jantjie J AU - Prozesky, Hans W AU - Mowlana, Abdurasiet AU - Viljoen, Abraham J AU - Schrueder, Neshaad AU - Allwood, Brian W AU - Lalla, Usha AU - Dave, Joel A AU - Calligaro, Greg AU - Levin, Dion AU - Maughan, Deborah AU - Ntusi, Ntobeko A B AU - Nyasulu, Peter S AU - Meintjes, Graeme AU - Koegelenberg, Coenraad F N AU - Mnguni, Ayanda T AU - Wasserman, Sean AB - Background There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). Methods We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. Results PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02–1.03, p < 0.001), male sex (AHR1.38 (95%CI 1.12–1.72, p = 0.003) and being “overweight or obese” (AHR 1.30 95%CI 1.03–1.61 p = 0.024). HIV (AHR 1.28 95%CI 0.95–1.72, p 0.11) and active TB (AHR 1.50 95%CI 0.84–2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count < 200 cells/mm3, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. Conclusion In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population. DA - 2022-06-20 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Infectious Diseases KW - HIV KW - COVID-19 KW - Tuberculosis KW - Obesity LK - https://open.uct.ac.za PY - 2022 T1 - Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study TI - Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study UR - http://hdl.handle.net/11427/36814 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12879-022-07519-8
dc.identifier.urihttp://hdl.handle.net/11427/36814
dc.identifier.vancouvercitationParker A, Boloko L, Moolla MS, Ebrahim N, Ayele BT, Broadhurst AGB, et al. Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study. BMC Infectious Diseases. 2022;22(1):559. http://hdl.handle.net/11427/36814.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDepartment of Medicineen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Infectious Diseasesen_US
dc.source.journalissue1en_US
dc.source.journalvolume22en_US
dc.source.pagination559en_US
dc.source.urihttps://bmcinfectdis.biomedcentral.com/
dc.subjectHIVen_US
dc.subjectCOVID-19en_US
dc.subjectTuberculosisen_US
dc.subjectObesityen_US
dc.titleClinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort studyen_US
dc.typeJournal Articleen_US
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