Artigo Acesso aberto Revisado por pares

Risk Factors for Coronavirus Disease 2019 (COVID-19) Death in a Population Cohort Study from the Western Cape Province, South Africa

2020; Oxford University Press; Volume: 73; Issue: 7 Linguagem: Inglês

10.1093/cid/ciaa1198

ISSN

1537-6591

Autores

Andrew Boulle, Mary‐Ann Davies, Hannah Hussey, Muzzammil Ismail, Erna Morden, Ziyanda Vundle, Virginia Zweigenthal, Hassan Mahomed, Masudah Paleker, David Pienaar, Yamanya Tembo, Charlene Lawrence, Washiefa Isaacs, Hlengani Mathema, Derick Allen, Taryn Allie, Jamy‐Lee Bam, Kasturi Buddiga, Pierre Dane, Alexa Heekes, Boitumelo Matlapeng, Themba Mutemaringa, Luckmore Muzarabani, Florence Phelanyane, R. Pienaar, Catherine Rode, Mariette Smith, Nicki Tiffin, Nesbert Zinyakatira, Carol Cragg, Frederick Marais, Vanessa Mudaly, Jacqueline Voget, Jody Davids, F Roodt, Nellis van Zyl Smit, Alda Vermeulen, Kevin Adams, Gordon Audley, Kathleen Bateman, Peter Beckwith, M. Bernon, Dirk Blom, Linda Boloko, Jean Botha, Adam Boutall, S. Burmeister, Lydia Cairncross, G Calligaro, Cecilia Coccia, Chadwin Corin, Remy Daroowala, Joel A. Dave, Elsa De Bruyn, Martin De Villiers, Mimi Deetlefs, Sipho Dlamini, Thomas Du Toit, Wilhelm Endres, Tarin A. Europa, Graham Fieggan, Anthony Figaji, Petro Frankenfeld, Elizabeth Gatley, Phindile Gina, Evashan Govender, Rochelle Grobler, M V Gule, Christoff Hanekom, Michael Held, Alana Heynes, Sabelo Hlatswayo, Bridget Hodkinson, J. A. Holtzhausen, Shakeel Hoosain, Ashely Jacobs, Miriam Kahn, Thania Kahn, Arvin Khamajeet, Joubin Khan, Riaasat Khan, Alicia Khululwa Khwitshana, Lauren Knight, S Kooverjee, Rene Krogscheepers, Jean Jacque Kruger, Suzanne Kuhn, Kim Laubscher, J. Michael Lazarus, Jacque Le Roux, Scott Lee Jones, Dion Levin, Gary Maartens, Thina Majola, Rodgers Manganyi, David Marais, Suzaan Marais, F J Maritz, Deborah Maughan, Simthandile Mazondwa, Luyanda Mbanga, Nomonde Mbatani, Bulewa Mbena, Graeme Meintjes, Marc Mendelson, Ernst Lodewicus Möller, Allison Moore, Babalwa Ndebele, Marc Nortje, Ntobeko Ntusi, Funeka Nyengane, Chima Ofoegbu, Nectarios Papavarnavas, Jonny Peter, H Pickard, Kent Pluke, Jonny Peter, Gordon Robertson, Julius Rozmiarek, Abdul‐Rauf Sayed, Matthias Scriba, Hennie Sekhukhune, Prasun Singh, Elsabe Smith, Vuyolwethu Soldati, Cari Stek, Robert van den berg, Le Roux van der Merwe, P.A. Venter, Barbra Vermooten, Gerrit Viljoen, Santhuri Viranna, J. Vogel, Nokubonga Vundla, Sean Wasserman, Eddy Zitha, Vanessa Lomas-Marais, Annie Lombard, Katrin Stuve, Werner Viljoen, De Vries Basson, Sue Le Roux, Ethel Linden-Mars, López López Víctor, Mark Wates, Elbe Zwanepoel, Nabilah Ebrahim, Sa’ad Lahri, Ayanda Trevor Mnguni, Thomas Crede, Martin de Man, Katya Evans, Clint Hendrikse, Jonathan Naudé, Moosa Parak, Patrick Szymanski, Candice Van Koningsbruggen, Riezaah Abrahams, Brian Allwood, Christoffel Botha, Matthys Henndrik Botha, Alistair G.B. Broadhurst, Dirkie Claasen, Che Daniel, R Dawood, Marié Du Preez, Nicolene du Toit, Kobie Erasmus, Coenraad F.N. Koegelenberg, Shiraaz Gabriel, Susan Hugo, Thabiet Jardine, Clint Johannes, Sumanth Karamchand, Usha Lalla, Eduard Langenegger, Eize Louw, Boitumelo Mashigo, Nonte Mhlana, Chizama Mnqwazi, Ashley Moodley, Desiree Moodley, Muhammad Moolla, Abdurasiet Mowlana, André Nortje, Elzanne Olivier, Arifa Parker, Chané Paulsen, Hans Prozesky, J W Rood, Tholakele Sabela, Neshaad Schrueder, Nokwanda Sithole, Sthembiso Sithole, Jantjie Taljaard, Gideon Titus, Tian Van Der Merwe, Marije Van Schalkwyk, Luthando Vazi, Abraham Viljoen, Mogamat‐Yazied Chothia, Vanessa Naidoo, Lee Wallis, Mumtaz Abbass, Juanita Arendse, Rizqa Armien, Rochelle Bailey, Muideen Bello, Rachel Carelse, Sheron Forgus, Nosi Kalawe, Saadiq Kariem, Mariska Kotze, Jonathan Lucas, Juanita McClaughlin, Kathleen Murie, Leilah Najjaar, Liesel Petersen, James Porter, Melanie Shaw, Dusica Stapar, Michelle Williams, Linda Aldum, Natacha Berkowitz, Raakhee Girran, Kevin Lee, Lenny Naidoo, Caroline Neumuller, Kim Anderson, Kerrin Begg, Lisa Boerlage, Morna Cornell, Renée de Waal, Lilian Dudley, René English, Jonathan Euvrard, Pam Groenewald, Nisha Jacob, Heather B. Jaspan, Emma Kalk, Naomi Levitt, Thokozile R. Malaba, Patience Nyakato, Gabriela Patten, Helen Schneider, Maylene Shung King, Priscilla Ruvimbo Tsondai, James Van Duuren, Nienke van Schaik, Lucille Blumberg, Cheryl Cohen, Nelesh P. Govender, Waasila Jassat, Tendesayi Kufa, Kerrigan McCarthy, Lynn Morris, Marvin Hsiao, Ruan Marais, Jon Ambler, Olina Ngwenya, Richard Osei‐Yeboah, Leigh F. Johnson, Reshma Kassanjee, Tsaone Tamuhla,

Tópico(s)

Long-Term Effects of COVID-19

Resumo

Risk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) and tuberculosis on COVID-19 outcomes are unknown.We conducted a population cohort study using linked data from adults attending public-sector health facilities in the Western Cape, South Africa. We used Cox proportional hazards models, adjusted for age, sex, location, and comorbidities, to examine the associations between HIV, tuberculosis, and COVID-19 death from 1 March to 9 June 2020 among (1) public-sector "active patients" (≥1 visit in the 3 years before March 2020); (2) laboratory-diagnosed COVID-19 cases; and (3) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19, comparing adults living with and without HIV using modeled population estimates.Among 3 460 932 patients (16% living with HIV), 22 308 were diagnosed with COVID-19, of whom 625 died. COVID-19 death was associated with male sex, increasing age, diabetes, hypertension, and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR], 2.14; 95% confidence interval [CI], 1.70-2.70), with similar risks across strata of viral loads and immunosuppression. Current and previous diagnoses of tuberculosis were associated with COVID-19 death (aHR, 2.70 [95% CI, 1.81-4.04] and 1.51 [95% CI, 1.18-1.93], respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI, 1.96-2.86); population attributable fraction 8.5% (95% CI, 6.1-11.1).While our findings may overestimate HIV- and tuberculosis-associated COVID-19 mortality risks due to residual confounding, both living with HIV and having current tuberculosis were independently associated with increased COVID-19 mortality. The associations between age, sex, and other comorbidities and COVID-19 mortality were similar to those in other settings.

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