Mortality COVID-19 in people living with HIV in a private insurance carrier in Colombia

BACKGROUND: On March 06,2020, the first case of COVID-19 infection was confirmed in Colombia. Since then, more than 2 million new cases and 57000 deaths have been reported due to COVID-19 up to the time of this article. There are more than 103000 people living with HIV in Colombia, from whom 129 have died due to COVID-19 so far as reported by the Colombian National Institute of Health. Here we describe a cohort of HIV patients cared under a private insurance carrier in Colombia who developed COVID-19 and evaluate predictors of death.
METHODS: Prospective Cohort Study following patients affiliated with a health plan insurance carrier in Colombia, with presence in 16 cities and covering more than 11000 people living with HIV. Data was collected for 90 days or until death from new or existing HIV infected individuals diagnosed with COVID-19 confirmed by PCR between March 06,2020 and September 30,2020.
RESULTS: Of 11088 people living with HIV covered by the insurance carrier, 429 were diagnosed with COVID-19 infection. Data was accrued up until December 31,2020, with a total of 334 person-years of follow-up. Among this cohort there were 12 deaths reported. The presence of chronic diseases was found to be significantly associated with death for Hypertension ( p- value=0.004) and Diabetes ( p-value= 0,003). As for HIV-related predictors, presence of Anti Retroviral Therapy (ART) at the time of the COVID-19 infection showed significant association (p- value<,0001): 1.7% of those on ART at the time of COVID-19 infection died, compared to 21.7% of those not receiving ART. ART was significantly associated with recovery (p- value<0,0001). There were no significative differences in outcomes according to ART type.
CONCLUSIONS: In this cohort of patients living with HIV affiliated with a private Health Care insurance carrier in Colombia, the relative risk of death due to confirmed COVID-19 was 10 times higher among those not received ART at the time of COVID-19 diagnosis, compared to those receiving ART, after adjusting for comorbidities such as Hypertension and Diabetes. There were no significant differences related to the type of ART received.