Clinical outcomes of coronavirus disease 2019 in people living with
human immunodeficiency virus in South Korea: A nationwide
population-based cohort study
Abstract
Background: We aimed to compare the epidemiological and clinical
characteristics of coronavirus disease 2019 (COVID-19) in people living
with human immunodeficiency virus (HIV) (PLWH) with those in the general
population. Methods: This nationwide descriptive epidemiological study
was conducted in South Korea between January 2020 and February 2022. The
National Health Insurance claims data covering the whole nation were
collected through the Health Insurance Review and Assessment Service.
Results: Among 3,653,808 individuals who were diagnosed with COVID-19,
1,311 (0.04%) were PLWH. All the PLWH received antiretroviral therapy,
and 26.47% had more than one underlying disease other than HIV
infection. The overall in-hospital mortality rates of PLWH and the
general population were 0.76% and 0.25%, respectively (P=0.002).
According to the Cox proportional hazard model, no significant
difference was observed in the in-hospital mortality rate [hazard
ratio (HR): 1.80, 95% confidence interval (CI): 0.70–4.67] between
PLWH and the general population. However, progression to severe or
critical COVID-19 was more common in PLWH (HR: 2.70, 95% CI:
1.37–5.33). In PLWH diagnosed with COVID-19, a multivariable Cox
regression analysis found old age (≥60 years old) (HR: 6.9; 95% CI
2.57–18.56) and diabetes mellitus (HR: 5.13; 95% CI: 2.02–13.00) as
the independent risk factors for severe or critical COVID-19.
Conclusions: PLWH had a significantly higher risk of severe or critical
COVID-19 than that of the general population. Our findings suggest the
need for applying differentiated strategies to decrease the impact of
COVID-19 on PLWH.