COVID-19 Hospitalization among People with HIV or Solid Organ Transplant in the US

摘要: Background:The role of immunosuppression/compromise (ISC) in risk of severe COVID-19 is unknown. While ISC could reduce control of SARS-CoV-2 viremia, it might also dampen the severe immune response to the virus; data comparing ISC groups is limited.Methods:Using patient-level data from 34 sites in the US National COVID Cohort Collaborative (N3C), we compared risk of COVID-19 hospitalization amongst COVID-19 patients in 3 ISC groups (1,300 persons with HIV [PWH]; 2,142 solid organ transplant [SOT] patients; 41 PWH with SOT) to 288,743 COVID-19 patients without HIV or SOT (HIV-/SOT-). COVID-19+ was defined by RT-PCR, antibody test, or diagnostic codes. HIV infection, SOT and comorbidities were defined by conditions/diagnostic codes within 2 years prior to first COVID-19+. Hospitalization was defined by inpatient care between 14 days prior to 45 days after the first COVID-19+. Odds ratios of hospitalization were estimated using multivariable logistic regression models adjusting for demographics, study site, and comorbidities (severe liver disease, diabetes, cancer, kidney disease, and total comorbidities [0, 1, 2,≥ 3]).Results:Of 292,226 COVID-19+ patients, the median age was 41 years (IQR 25-58), 46% male, 47% non-Hispanic white (NHW), and 17% non-Hispanic black (NHB). PWH and SOT patients, respectively, were more likely to be older (median 50 & 56), male (70% & 60%), and had≥ 3 comorbidities than overall N3C patients (30% & 64% vs. 8%). PWH were more likely to be NHB (50%) and SOT patients were more likely to be NHW (41%). Overall, 26% of HIV-/SOT-COVID-19 patients were hospitalized. In …