Background:: In their struggle with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, physicians are intensively focused on high-risk patient groups. One such group includes immunosuppressed people living with HIV (PLWH). This study considers the most vulnerable cohort of advanced HIV patients in order to identify potential risk factors for unfavorable SARS-CoV-2 disease (COVID-19) outcomes. Method:: This study analyzed data from a census-based sample of 500 patients. The sample en-compassed all consecutive patients during the study period (2020–2022) who met the inclusion and exclusion criteria. All selected patients, aged over 18 years, were hospitalized with confirmed advanced HIV and moderate to severe COVID-19 coinfection at the Infectious Disease Hospital (IDH) in Moscow from 2020 to 2022. Results:: The overall mortality rate reached 27.0% (135 deaths; 95% CI 23.3–30.9%). Primary analysis identified three key independent predictors of mortality: mechanical ventilation demon-strated the strongest association (aOR 4.29, 95% CI 3.15–5.84, p 500 cells/mm³; aOR 2.77, 95% CI 2.08–3.69, p = 0.03) and virological suppression (aOR 2.22, 95% CI 1.67–2.95, p = 0.001). Ferritin levels above 600 ng/mL emerged as an additional risk marker (aOR 1.73, 95% CI 1.32–2.27, p = 0.0006), though with less robust association than primary predictors. Conclusion:: These findings can provide physicians with a risk-based prioritization algorithm for patients with COVID-19 and advanced HIV coinfection. Identifying patients at highest risk for unfavorable outcomes ensures timely ICU admission, faster patient examination, and initiation of dedicated treatment.
Tsygankova et al. (Tue,) studied this question.