COVID-19 outcomes among people with HIV and COVID-19 in New York City.

BACKGROUND Literature on the impact of HIV on COVID-19-related outcomes remains mixed. Few studies have evaluated COVID-19 outcomes by HIV status using population-based data. METHODS Using data from New York City (NYC)'s COVID-19 surveillance and HIV surveillance systems prior to the widespread availability of COVID-19 vaccines, we conducted a retrospective cohort study comparing the risk of COVID-19 hospitalization and mortality by HIV status among SARS-CoV-2 diagnoses from February 29-October 17, 2020. RESULTS Risk of hospitalization and death among people with HIV (PWH) with COVID-19 were both nearly 30% higher compared with non-PWH. In crude models, incidence of adverse COVID-19 outcomes among PWH compared to non-PWH was elevated in certain groups, including women, Black people, Hispanic/Latino people, Native American people, and multiracial people. CD4 cell count at SARS-CoV-2 diagnosis and presence of an underlying, non-HIV-related condition were independently and strongly associated with risk for COVID-19 hospitalization and death among PWH. CONCLUSION New Yorkers with HIV experienced elevated risk for poor COVID-19 outcomes compared to those without HIV during 2020. PWH, particularly those with low CD4 counts or underlying conditions, should be an ongoing focus for COVID-19 vaccination and rigorous identification and treatment of SARS-CoV-2 infections to prevent adverse outcomes.