Abstract
Background
COVID-19 infection amongst persons living with HIV (PLWH) at Federally Qualified Healthcare Centers (FQHC) is not yet well understood. FQHC patients are frequently impoverished and marginalized due to socioeconomic instability and structural inequities. The virus has a wide-ranging clinical presentation, and little is known about how it affects specific populations such as PLWH and whether specific patterns of immunocompromise confer increased risk. Patients in community health centers and those living with HIV are often underrepresented from clinical trials. Patients seen at FQHC’s are more likely to be uninsured or living in poverty, or of Black or Latinx racial and ethnic backgrounds. Sun River Health is a not-for-profit, New York State licensed Article 28 Diagnostic & Treatment Center and FQHC. Sun River Health provides HIV primary care and supportive services caring for more than 2,500 PLWH primarily concentrated in 16 sites throughout the region. This study is a retrospective analysis of a vulnerable community at the heart of this pandemic.
Methods
We gathered COVID-19 diagnosis related data from the clinic’s electronic medical record and the New York State Health Information Exchange (HIE). We did chart reviews on 122 PLWH who had positive COVID PCR or antibody test between March 10 2020 and June 10 2020. Data collected included presence of symptoms, presence of comorbidities, CD4 counts, Hospitalization rate, ICU admission, and number of deaths.
Results
71.3% of cases occurred between the ages of 40-69 years. There were 85 cases (69.7%) in men and 37 cases (30.3%) in women. 54 cases (44.3%) occurred in African Americans, and 46 cases (37.7%) in Caucasians. 48 cases (39.3%) occurred in Latinx individuals, and 68 cases (55.7%) in Non-Hispanics. 91 cases (74.6%) were symptomatic and had either a positive COVID-19 PCR or antibody test. Symptomatic COVID-19 was present at higher rates in those with multiple predisposing comorbidities. 101 cases (82.8%) were virally suppressed. 89 cases (72.9%) were not hospitalized while 27 cases (22.1%) were hospitalized.
Conclusion
Most PLWH with COVID-19 were managed on an outpatient basis. PLWH with COVID-19 are not at a greater risk of severe disease or death as compared to HIV negative patients.
Disclosures
Christine A. Kerr, MD, Galileo Health (Employee, Shareholder)
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