Does HIV Raise the Risk of Adverse COVID-19 Outcomes?

Although few studies have elucidated the risks between HIV and adverse COVID-19 outcomes, a large US-based study has identified various risk factors for worse COVID-19 outcomes.

“Given the COVID-19 pandemic's exacerbating effects on health inequities, public health and clinical communities must strengthen services and support to prevent aggravated COVID-19 outcomes among people with HIV, particularly for those with pronounced immunodeficiency,” the researchers wrote.

To conduct their study, the researchers used data from COVID-19 cases reported to the US-based National COVID Cohort Collaborative to evaluate COVID-19 disease severity, hospitalizations, and mortality rates among patients with HIV. In all, 13,170 cases of COVID-19 had been reported among adult patients with HIV infection between January 1, 2020, to May 8, 2021.

“After adjusting for all the covariates, people with HIV had higher odds of COVID-19 death (adjusted odds ratio 1.29, 95% CI 1.16–1.44) and hospitalisation (1.20, 1.15–1.26), but lower odds of mild or moderate COVID-19 (0.61, 0.59–0.64) than people without HIV,” the researchers wrote.

Older age, male gender, and Black, African American, Hispanic, or Latinx ethnicities were associated with increased odds of poor outcomes. Moreover, a CD4 cell count of less than 200 cells/μL was associated with worse COVID-19 disease severity, increased hospitalizations, and higher mortality rates among patients with HIV.

—Amanda Balbi


Yang X, Sun J, Patel RC, et al. Associations between HIV infection and clinical spectrum of COVID-19: a population level analysis based on US National COVID Cohort Collaborative (N3C) data. Lancet HIV. 2021;8(11):e690-e700.