Major cardiovascular events after COVID-19 in people with HIV

• DOI: 10.1016/j.cmi.2024.02.006
• Publication Date: 2024-02-09T08:30:29Z
• Authors: Raquel Martín-Igu...; Sergio Moreno-Fornés; Andreu Bruguera; Jordi Aceitón; Daniel Kwakye Nomah; Ana González-Cordón; Pere Domingo; Adrian Curran; Arkaitz Imaz; David Dalmau Juanola; Joaquim Peraire; Beatriz Borjabad; Laia Arbones Fern...; Isik Somuncu Joha...; José M. Miró; Jordi Casabona; Josep M. Llibre
• Keywords: Male; Adult; Long-term risk; Heart failure; HIV Infections/complications; HIV Infections; Thrombotic disorders; Cardiovascular events; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; Humans; COVID-19/epidemiology; Hospitalization/statistics & numerical data; SARS-CoV-2; Cardiovascular Diseases/epidemiology; Incidence; HIV; COVID-19; Middle Aged; CD4 Lymphocyte Count; Hospitalization; Cardiovascular Diseases; Spain; Spain/epidemiology; Female

To assess the effect of COVID-19 on the postacute risk of cardiovascular events (CVEs) among people with HIV (PWH).Population-based matched cohort, including all PWH ≥16 years in the Catalan PISCIS HIV cohort. We estimated the incidence rate of the first CVE after COVID-19, analysed it a composite outcome (2020-2022). We adjusted for baseline differences using inverse probability weighting and used competing risk analysis.We included 4199 PWH with and 14 004 PWH without COVID-19. The median follow-up was 243 days (interquartile range [IQR]: 93-455), 82% (14 941/18 203) were men, with a median age of 47 years. Overall, 211 PWH with COVID-19 and 621 without developed CVE, with an incidence rate of 70.2 and 56.8/1000 person-years, respectively. During COVID-19 infection, 7.6% (320/4199) required hospitalization and 0.6% (25/4199) intensive care unit admission, 97% (4079/4199) had CD4+T-cell ≥200 cells/μL, 90% (3791/4199) had HIV-RNA<50 copies/mL and 11.8% (496/4199) had previous CVE at baseline. The cumulative CVE incidence was higher among PWH after COVID-19 compared with PWH without COVID-19 during the first year (log-rank p=0.011). The multivariable analysis identified significantly increased CVE risk with age, heterosexual men, previous cardiovascular disease (CVD), and chronic kidney or liver disease. COVID-19 was associated with increased subsequent risk of CVE (adjusted hazard ratio 1.30 [95% CI, 1.09-1.55]), also when only including individuals without previous CVD (1.60 [95% CI, 1.11-2.29]) or nonhospitalized patients (1.34 [95% CI, 1.11-1.62]).COVID-19 was associated with a 30% increased risk of major CVE in PWH during the subsequent year, suggesting that COVID-19 should be considered an additional CVD risk in PWH in the short term.