Table 4.
Associations with Coronavirus Disease 2019 Death from Cox Proportional Hazards Models
| All public-sector SARS-CoV-2 cases diagnosed before 1 June 2020,a n = 15 203 | Hospitalized public-sector SARS-CoV-2 cases, n = 2978 | |||||
|---|---|---|---|---|---|---|
| Adjusted HR | 95% CI | P value | Adjusted HR | 95% CI | P value | |
| Sex | ||||||
| Female | Ref | … | Ref | … | ||
| Male | 1.45 | 1.22–1.74 | <.001 | 1.29 | 1.09–1.53 | .003 |
| Age | ||||||
| 20–39 years | Ref | … | Ref | … | ||
| 40–49 years | 3.19 | 2.06–4.93 | <.001 | 1.83 | 1.23–2.72 | .003 |
| 50–59 years | 10.84 | 7.34–16.01 | <.001 | 3.81 | 2.68–5.42 | <.001 |
| 60–69 years | 24.87 | 16.67–37.11 | <.001 | 6.11 | 4.27–8.75 | <.001 |
| ≥70 years | 38.32 | 25.47–57.64 | <.001 | 7.53 | 5.23–10.84 | <.001 |
| Diabetes | ||||||
| None | Ref | … | Ref | … | ||
| Diabetes HbA1c <7% | 2.21 | 1.57–3.12 | <.001 | 1.44 | 1.06–1.96 | .020 |
| Diabetes HbA1c 7–8.9% | 3.41 | 2.59–4.51 | <.001 | 1.81 | 1.39–2.35 | <.001 |
| Diabetes HbA1c ≥9% | 3.62 | 2.85–4.59 | <.001 | 1.60 | 1.27–2.0 | <.001 |
| Diabetes, no HbA1c measurement | 2.02 | 1.47–2.76 | <.001 | 1.13 | .83–1.55 | <.001 |
| Other noncommunicable diseases | ||||||
| Hypertension | 1.02 | .84–1.24 | .843 | 1.05 | .88–1.27 | .574 |
| Chronic kidney disease | 1.92 | 1.51–2.45 | <.001 | 1.51 | 1.20–1.89 | <.001 |
| Chronic pulmonary disease/asthma | .92 | .72–1.18 | .512 | .68 | .53–.86 | .002 |
| Tuberculosis | ||||||
| Never tuberculosis | Ref | … | Ref | … | ||
| Previous tuberculosis | 1.55 | 1.19–2.02 | .001 | 1.40 | 1.08–1.82 | .011 |
| Current tuberculosis | 1.62 | 1.04–2.51 | .031 | 1.09 | .72–1.65 | .683 |
| HIV | ||||||
| Negative | Ref | … | Ref | … | ||
| Positive | 1.70 | 1.32–2.18 | <.001 | 1.45 | 1.14–1.84 | .002 |
| VL <1000 copies/ml (last 15 mo) and ART script (last 6 mo)b | 1.60 | 1.19–2.17 | .002 | 1.57 | 1.18–2.07 | .002 |
| VL <1000 copies/ml (2yr to 15 mo prior), or ART script (last 6 mo) and VL <1000 copies/ml >2yr prior | 1.56 | .80–3.07 | .193 | 1.33 | .72–2.46 | .357 |
| VL ≥1000 copies/ml (last 15 mo) or CD4 count <200 cells/µl (last 18 mo) | 3.39 | 1.14–3.62 | <.001 | 1.60 | .79–3.25 | .190 |
| No VL (last 15 mo); CD4 count ≥200 cells/µl or unknown (last 18 mo) | 1.73 | 1.10–2.71 | .017 | 1.17 | .73–1.87 | .506 |
| ART in PLWH with script issued in last 12 monthsc | ||||||
| Abacavir or zidovudine | Ref | … | Ref | … | ||
| Tenofovir disoproxil fumarate | .41 | .21–.78 | .007 | .57 | .31–1.04 | .067 |
| Efavirenz | Ref | … | Ref | … | ||
| Lopinavir | .91 | .37–2.25 | .846 | .68 | .29–1.63 | .392 |
| Atazanavir | .38 | .05–2.92 | .352 | 1.09 | .25–4.82 | .911 |
| Dolutegravir | .57 | .16–2.01 | .380 | .62 | .17–2.22 | .461 |
| ART duration | ||||||
| <1 year | Ref | … | Ref | … | ||
| 1–2 years | .78 | .21–2.94 | .719 | 1.28 | .37–4.42 | .701 |
| ≥2 years | .54 | .19–1.48 | .230 | .55 | .21–1.42 | .213 |
| CD4 count during COVID-19d | ||||||
| >350 cells/µl | … | … | 1.24 | .95–1.63 | .112 | |
| 200–349 cells/µl | … | … | 1.65 | .94–2.88 | .080 | |
| <200 cells/µl | … | … | 2.36 | 1.47–3.78 | <.001 | |
Data are multivariate HRs and 95% CIs among (1) all adult COVID-19 cases diagnosed before 1 June 2020 (n = 15 203) and (2) all hospitalized adult COVID-19 cases (n = 2978).
Abbreviations: ART, antiretroviral therapy; CI, confidence interval; COVID-19, coronavirus disease 2019; HbA1c, glycosylated haemoglobin; HIV, human immunodeficiency virus; HR, hazard ratio; PLWH, people living with HIV; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; VL, viral load.
aAnalysis limited to cases diagnosed before 1 June 2020, when testing criteria changed, with public-sector tests being limited to patients >55 year of age or with comorbidities.
bReference category is HIV negative; adjusted for all other variables listed in this table in a model that included the listed categories of HIV VL, CD4 count, and ART instead of the binary variable of testing HIV positive vs negative; the effect of the other variables on mortality was similar to those presented here.
cRestricted to patients with documented antiretrovirals dispensed in the last 12 months, adjusted for all other variables listed in this table in a model that included the relevant antiretrovirals and ART duration; the effect of the other variables on mortality was similar to those presented here.
dReference category is HIV negative, restricted to patients living without HIV and 199 of 601 PLWH with a CD4 count measurement at the time of COVID-19 diagnosis or admission and adjusted for all other variables listed in this table in a model that included the listed categories of CD4 count instead of the binary variable of testing HIV positive vs negative; the effect of the other variables on mortality was similar to those presented here.