Trends in COVID-19 admissions and deaths among people living with HIV in South Africa : analysis of national surveillance data

Show simple item record

dc.contributor.author Jassat, Waasila
dc.contributor.author Mudara, Caroline
dc.contributor.author Ozougwu, Lovelyn Uzoma
dc.contributor.author Welch, Richard
dc.contributor.author Arendse, Tracy
dc.contributor.author Masha, Maureen
dc.contributor.author Blumberg, Lucille Hellen
dc.contributor.author Kufa, Tendesayi
dc.contributor.author Puren, Adrian
dc.contributor.author Groome, Michelle J.
dc.contributor.author Govender, Nevashan
dc.contributor.author Pisa, Pedro Terrence
dc.contributor.author Govender, Sharlene
dc.contributor.author Sanne, Ian
dc.contributor.author Brahmbhatt, Heena
dc.contributor.author Parmley, Lauren
dc.contributor.author Wolmarans, Milani
dc.contributor.author Rousseau, Petro
dc.contributor.author Selikow, Anthony
dc.contributor.author Burgess, Melissa
dc.contributor.author Hankel, Lauren
dc.contributor.author Parker, Arifa
dc.contributor.author Cohen, Cheryl
dc.date.accessioned 2024-10-28T10:46:48Z
dc.date.issued 2024-02
dc.description DATA SHARING : Aggregated data are available on request to the South African National Institute for Communicable Diseases. The data dictionary is available on request to the corresponding author, waasila.jassat@health.gov.za. en_US
dc.description.abstract BACKGROUND : In 2021, the HIV prevalence among South African adults was 18% and more than 2 million people had uncontrolled HIV and, therefore, had increased risk of poor outcomes with SARS-CoV-2 infection. We investigated trends in COVID-19 admissions and factors associated with in-hospital COVID-19 mortality among people living with HIV and people without HIV. METHODS : In this analysis of national surveillance data, we linked and analysed data collected between March 5, 2020, and May 28, 2022, from the DATCOV South African national COVID-19 hospital surveillance system, the SARS-CoV-2 case line list, and the Electronic Vaccination Data System. All analyses included patients hospitalised with SARS-CoV-2 with known in-hospital outcomes (ie, who were discharged alive or had died) at the time of data extraction. We used descriptive statistics for admissions and mortality trends. Using post-imputation random-effect multivariable logistic regression models, we compared characteristics and the case fatality ratio of people with HIV and people without HIV. Using modified Poisson regression models, we compared factors associated with mortality among all people with COVID-19 admitted to hospital and factors associated with mortality among people with HIV. FINDINGS : Among 397 082 people with COVID-19 admitted to hospital, 301 407 (75·9%) were discharged alive, 89 565 (22·6%) died, and 6110 (1·5%) had no recorded outcome. 270 737 (68·2%) people with COVID-19 had documented HIV status (22 858 with HIV and 247 879 without). Comparing characteristics of people without HIV and people with HIV in each COVID-19 wave, people with HIV had increased odds of mortality in the D614G (adjusted odds ratio 1·19, 95% CI 1·09–1·29), beta (1·08, 1·01–1·16), delta (1·10, 1·03–1·18), omicron BA.1 and BA.2 (1·71, 1·54–1·90), and omicron BA.4 and BA.5 (1·81, 1·41–2·33) waves. Among all COVID-19 admissions, mortality was lower among people with previous SARS-CoV-2 infection (adjusted incident rate ratio 0·32, 95% CI 0·29–0·34) and with partial (0·93, 0·90–0·96), full (0·70, 0·67–0·73), or boosted (0·50, 0·41–0·62) COVID-19 vaccination. Compared with people without HIV who were unvaccinated, people without HIV who were vaccinated had lower risk of mortality (0·68, 0·65–0·71) but people with HIV who were vaccinated did not have any difference in mortality risk (1·08, 0·96–1·23). In-hospital mortality was higher for people with HIV with CD4 counts less than 200 cells per μL, irrespective of viral load and vaccination status. INTERPRETATION : HIV and immunosuppression might be important risk factors for mortality as COVID-19 becomes endemic. en_US
dc.description.department Human Nutrition en_US
dc.description.embargo 2025-02-01
dc.description.librarian hj2024 en_US
dc.description.sdg SDG-03:Good heatlh and well-being en_US
dc.description.sponsorship South African National Institute for Communicable Diseases, the South African National Government, and the United States Agency for International Development. en_US
dc.description.uri http://www.thelancet.com/hiv en_US
dc.identifier.citation Jassat, W., Mudara, C., Ozougwu, L. et al. 2024, 'Trends in COVID-19 admissions and deaths among people living with HIV in South Africa : analysis of national surveillance data', Lancet HIV, vol. 11, no. 2, pp. e96-e105, doi : 10.1016/S2352-3018(23)00266-7. en_US
dc.identifier.issn 2405-4704 (print)
dc.identifier.issn 2352-3018 (online)
dc.identifier.other 10.1016/S2352-3018(23)00266-7
dc.identifier.uri http://hdl.handle.net/2263/98793
dc.language.iso en en_US
dc.publisher Elsevier en_US
dc.rights © 2024 Elsevier Ltd. All rights reserved. Notice : this is the author’s version of a work that was accepted for publication in Lancet HIV. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. A definitive version was subsequently published in Lancet HIV, vol. 11, no. 2, pp. e96-e105, doi : 10.1016/S2352-3018(23)00266-7. en_US
dc.subject Human immunodeficiency virus (HIV) en_US
dc.subject Mortality en_US
dc.subject COVID-19 pandemic en_US
dc.subject Coronavirus disease 2019 (COVID-19) en_US
dc.subject Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) en_US
dc.subject People living with HIV (PLHIV) en_US
dc.subject SDG-03: Good health and well-being en_US
dc.title Trends in COVID-19 admissions and deaths among people living with HIV in South Africa : analysis of national surveillance data en_US
dc.type Postprint Article en_US


Files in this item

This item appears in the following Collection(s)

Show simple item record