COVID-19 Outcomes Among People With HIV and COVID-19 in New York City

Background: Literature on the impact of HIV on COVID-19-related clinical outcomes remains mixed. Some studies have found that COVID-19 outcomes, including hospitalization and death, are comparable between people with HIV (PWH) and people without HIV, while others have suggested a link between HIV status and poor outcomes. Few studies have used population-based data to evaluate COVID-19 outcomes by HIV status. Methods: Using data from a match of the New York City (NYC) COVID-19 surveillance system case and death data against the HIV surveillance registry, we conducted a retrospective cohort study comparing the risk of COVID-19 hospitalization and mortality by HIV status among NYC residents aged 13 years and older. SARS-CoV-2 diagnoses from February 29, 2020, through October 17, 2020, and COVID-19-related outcomes through December 16, 2020, were assessed.Findings: The risk of hospitalization and death among PWH with COVID-19 were both nearly 30% higher compared with people without HIV. The incidence of adverse COVID-19 outcomes among PWH compared to people without HIV was elevated in certain groups, including women, Black people, Hispanic/Latino people, Native American and multiracial people. CD4 cell count at the time of SARS-CoV-2 diagnosis and presence of an underlying non-HIV-related condition were both independently and strongly associated with risk for COVID-19 hospitalization and death among PWH.Interpretation: New Yorkers with HIV experienced elevated risk for poor outcomes from COVID-19 compared to those without HIV during the COVID-19 epidemic in 2020. PWH, particularly those with low CD4 counts or underlying medical conditions, should be an ongoing focus for vaccination against COVID-19 and for rigorous identification and treatment of SARS-CoV-2 infections to prevent hospitalization and death due to COVID-19.Funding Information: Collection and management of data used for this work was supported by grant number 1 U62PS924575- 01-00 from the Centers for Disease Control and Prevention (HIV surveillance). Declaration of Interests: None to declare.Ethics Approval Statement: None required for non-research, public health surveillance activity.