High HIV prevalence in an early cohort of hospital admissions with COVID-19 in Cape Town, South Africa.

Abstract

BACKGROUND:

South Africa (SA) has a high prevalence of HIV and tuberculosis. Cape Town was the SA metropole most affected in the early stages of the COVID-19 pandemic. Early observational data from Africa may provide valuable insight into what can be expected as the pandemic expands across the continent.

OBJECTIVES:

To describe the prevalence, clinical features, comorbidities and outcome of an early cohort of HIV-positive and HIV-negative patients admitted with COVID-19.

METHODS:

This was a descriptive observational study of an early cohort of adults with COVID-19 pneumonia admitted from 25 March to 11 May 2020.

RESULTS:

Of 116 patients (mean age 48 years, 61% female) admitted, 24 were HIV-positive (21%). The most common symptoms reported were cough (n=88; 73%), shortness of breath (n=78; 69%), fever (n=67; 59%), myalgia (n=29; 25%) and chest pain (n=22; 20%). The most common comorbidities were hypertension (n=46; 41%), diabetes mellitus (n=43; 38%), obesity (n=32; 28%) and HIV (n=24; 21%). Mortality was associated with older age (mean (standard deviation) 55 (12) years v. 46 (14) years; p<0.01); the presence of hypertension or hypertension along with diabetes and/or obesity; lower partial pressure of arterial oxygen to fraction of inspired oxygen ratio; and higher urea level, white cell count, neutrophil count, and C-reactive protein, lactate dehydrogenase and ferritin levels, and high neutrophil to lymphocyte ratio. The overall survival rate for all hospital admissions was 86/116 (73%). In this early cohort, survival was similar in patients with HIV (n=18; 75%) compared with those without HIV (n=67; 75%) (p=1). Of the 74 patients admitted to the wards, 63 (85%) survived, whereas 22 of 42 (52%) admitted to the intensive care unit survived.

CONCLUSIONS:

Patients with HIV infection represented a large proportion of all COVID-19 admissions. The presentation and outcome of patients with HIV did not differ significantly from those of patients without HIV.

• Authors: A Parker, C F N Koegelenberg, M S Moolla, E H Louw, A Mowlana, A Nortjé, R Ahmed, N Brittain, U Lalla, B W Allwood, H Prozesky, N Schrueder, J J Taljaard
• Journal: South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde (S Afr Med J) Vol. 110 Issue 10 Pg. 982-987 (08 21 2020) ISSN: 2078-5135 [Electronic] South Africa
• PMID: 33205724 (Publication Type: Journal Article, Observational Study)

Topics

• Betacoronavirus
• Blood Chemical Analysis
• COVID-19
• Cohort Studies
• Comorbidity
• Coronavirus Infections (diagnosis, epidemiology, therapy)
• Critical Care
• Female
• HIV Infections (diagnosis, epidemiology, therapy)
• Hospitalization
• Hospitals, University
• Humans
• Male
• Middle Aged
• Pandemics
• Pneumonia, Viral (diagnosis, epidemiology, therapy)
• Prevalence
• Radiography
• SARS-CoV-2
• South Africa (epidemiology)
• Survival Analysis
• Tertiary Care Centers
• Treatment Outcome