Disparities in Coronavirus Disease 2019 Clinical Outcomes and Vaccination Coverage Among Migrants With Human Immunodeficiency Virus in the PISCIS Cohort : A Population-Based Propensity Score-Matched Analysis
Nomah, Daniel Kwakye (Institut Germans Trias i Pujol)
Díaz, Yesika (Institut Germans Trias i Pujol)
Bruguera Riera, Andreu (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Moreno-Fornés, Sergio (Institut Germans Trias i Pujol)
Aceitón, Jordi (Institut Germans Trias i Pujol)
Reyes-Urueña, Juliana (Institut Germans Trias i Pujol. Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya)
Llibre, Josep M (Institut Germans Trias i Pujol. Fundació Lluita Contra les Infeccions)
Falcó, Vicenç (Hospital Universitari Vall d'Hebron)
Imaz, Arkaitz (Hospital Universitari de Bellvitge)
Fanjul, Francisco Javier (Hospital Universitari Son Espases (Palma de Mallorca, Balears))
Peraire, Joaquim (Instituto de Salud Carlos III)
Deig, Elisabet (Hospital General de Granollers)
Domingo, Pere (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Inciarte, Alexy (Universitat de Barcelona)
Casabona-Barbarà, Jordi (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Miró, José M (Universitat de Barcelona)

Data:	2024
Resum:	Background. Coronavirus disease 2019 (COVID-19) disproportionately affects migrants and ethnic minorities, including those with human immunodeficiency virus (HIV). Comprehensive studies are needed to understand the impact and risk factors. Methods. Using data from the PISCIS cohort of people with HIV (PWH) in Catalonia, Spain, we investigated COVID-19 outcomes and vaccination coverage. Among 10 640 PWH we compared migrants and non-migrants assessing rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing, diagnosis, and associated clinical outcomes through propensity score matching and multivariable Cox regression. Results. The cohort (mean age, 43 years; 83. 5% male) included 57. 4% (3053) Latin American migrants. Migrants with HIV (MWH) had fewer SARS-CoV-2 tests (67. 8% vs 72. 1%, P <. 0001) but similar COVID-19 diagnoses (29. 2% vs 29. 4%, P =. 847) compared to Spanish natives. Migrants had lower complete vaccination (78. 9% vs 85. 1%, P <. 0001) and booster doses (63. 0% vs 65. 5%, P =. 027). COVID-19 hospitalizations (8. 1% vs 5. 1%, P <. 0001) and intensive care unit (ICU) admissions (2. 9% vs 1. 2%, P <. 0001) were higher among migrants, with similar hospitalization duration (5. 5 vs 4. 0 days, P =. 098) and mortality (3 [0. 2%] vs 6 [0. 4%], P =. 510). Age ≥40 years, CD4 counts <200 cells/μL, ≥2 comorbidities, and incomplete/nonreception of the SARS-CoV-2 vaccine increased the risk of severe COVID-19 among migrants. Conclusions. MWH had lower rates of SARS-CoV-2 testing and vaccination coverage, although the rates of COVID-19 diagnosis were similar between migrants and non-migrants. Rates of COVID-19-associated hospitalizations and ICU admissions were higher among migrants in comparison with non-migrants, with similar hospitalization duration and mortality. These findings can inform policies to address disparities in future pandemic responses for MWH.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COVID-19 ; HIV ; Migrants ; SARS-CoV-2 ; Vaccination
Publicat a:	Open Forum Infectious Diseases, Vol. 11 Núm. 1 (january 2024) , p. ofad693, ISSN 2328-8957

DOI: 10.1093/ofid/ofad693
PMID: 38221982

11 p, 755.4 KB

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