Associations between HIV infection and clinical spectrum of COVID-19: a population level analysis based on US National COVID Cohort Collaborative (N3C) data

  1. Xueying Yang
  2. Jing Sun
  3. Rena C Patel
  4. Jiajia Zhang
  5. Siyuan Guo
  6. Qulu Zheng
  7. Amy L Olex
  8. Bankole Olatosi
  9. Sharon B Weissman
  10. Jessica Y Islam
  11. Christopher G Chute
  12. Melissa Haendel
  13. Gregory D Kirk
  14. Xiaoming Li
  15. Richard Moffitt
  16. Hana Akelsrod
  17. Keith A Crandall
  18. Nora Francheschini
  19. Evan French
  20. Teresa Po-Yu Chiang
  21. G Caleb-Alexander
  22. Kathleen M Andersen
  23. Amanda J Vinson
  24. Todd T Brown
  25. Roslyn B Mannon

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Abstract

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  1. Version published to 10.1016/s2352-3018(21)00239-3
  2. Version published to 10.1101/2021.06.03.21258324v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.06.03.21258324: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: An Institutional Data Use Agreement was signed between University of South Carolina and National Center for Advancing Translational Sciences (NCATS) N3C Data Enclave and our study protocol received approval from the institutional review board in University of South Carolina.
    Sex as a biological variableBesides, we fitted stratified models with HIV infection, demographics, lifestyle and comorbidities on each selected sub-groups (i.e., male, female, 18-49, 56-64, ≥65, white, black/African American and Asian/other/unknown).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your code.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    It is noteworthy that the association in the present study was similar to a New York state-level setting involving 2,988 PLWH with COVID-19 (in-hospital death: sRR: 1.23; 95%CI: 1.07-1.40)15, although limitations this study included a lack of control for lifestyle factors and comorbidity data, and a short observation period (March 1-June 7, 2020). Regarding the clinical severity of COVID-19, we found that PLWH were less likely to have mild illness, but more likely to have severe outcomes when only adjusting for demographics and lifestyle factors. The adjustment for comorbidities obviated the estimated risk of severe outcomes among PLWH. This finding suggests that PLWH might show less symptoms at the earlier stage of SARS-CoV-2 infection. Such a protection from the most serious sequelae of COVID-19 might be attributable to the immunocompromised system (avoided the immune(over)reaction) and/or because of the possible anti-SARS-CoV-2 activity of HIV antiretroviral treatments30. For hospitalization, our study showed PLWH required more COVID-19 hospitalization (AOR: 1.23; 95%CI: 1.18, 1.28), a level of risk similar to a New York study (sRR: 1.38, 95%CI: 1.29, 1.47)15 and another US study using TriNETX network data (RR: 1.69; 95%CI: 1.21-2.38), which controlled for BMI and various comorbidities.6 In this study, the sex and race disparities in COVID-19 cases were pronounced among PLWH with COVID-19, with 31.1% of PLWH identified as black/African American compared with only 14.0% amo...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  4. Version published to 10.1101/2021.06.03.21258324v1 on medRxiv