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By grants COV20/01112 and RD16/0002 from Instituto de Salud Carlos III and grant R37 AI102634 from the National Institutes of Health.

Analysis of institutional authors

Velasco Arribas, MariaAuthor

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January 23, 2023
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Incidence and Severity of COVID-19 in HIV-Positive Persons Receiving Antiretroviral Therapy A Cohort Study

Publicated to:Annals Of Internal Medicine. 173 (7): 536-+ - 2020-10-06 173(7), DOI: 10.7326/M20-3689

Authors: del Amo, Julia; Polo, Rosa; Moreno, Santiago; Diaz, Asuncion; Martinez, Esteban; Ramon Arribas, Jose; Jarrin, Inma; Hernan, Miguel A

Affiliations

Harvard Mit Div Hlth Sci & Technol, 677 Huntington Ave, Boston, MA 02115 USA - Author
Harvard TH Chan Sch Publ Hlth, 677 Huntington Ave, Boston, MA 02115 USA - Author
Inst Hlth Carlos III, Natl Ctr Epidemiol, Av Monforte de Lemos 5, Madrid 28029, Spain - Author
Minist Hlth, Natl Plan AIDS, Paseo Prado 19, Madrid 28004, Spain - Author
Univ Hosp Clin, Carrer Villarroel 170, Barcelona 08036, Spain - Author
Univ Hosp La Paz, IdiPAZ, Paseo Castellana 261, Madrid 28046, Spain - Author
Univ Hosp Ramon Y Cajal, M-607,Km 9,100, Madrid 28034, Spain - Author
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Abstract

Background: The incidence and severity of coronavirus disease 2019 (COVID-19) among HIV-positive persons receiving anti-retroviral therapy (ART) have not been characterized in large populations.Objective: To describe the incidence and severity of COVID-19 by nucleos(t)ide reverse transcriptase inhibitor (NRTI) use among HIV-positive persons receiving ART.Design: Cohort study. Setting: HIV clinics in 60 Spanish hospitals between 1 February and 15 April 2020.Participants: 77 590 HIV-positive persons receiving ART.Measurements: Estimated risks (cumulative incidences) per 10 000 persons and 95% CIs for polymerase chain reaction-confirmed COVID-19 diagnosis, hospitalization, intensive care unit (ICU) admission, and death. Risk and 95% CIs for COVID-19 diagnosis and hospital admission by use of the NRTIs tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC), tenofovir alafen-amide (TAF)/FTC, abacavir (ABC)/lamivudine (3TC), and others were estimated through Poisson regression models.Results: Of 77 590 HIV-positive persons receiving ART, 236 were diagnosed with COVID-19, 151 were hospitalized, 15 were admitted to the ICU, and 20 died. The risks for COVID-19 diag-nosis and hospitalization were greater in men and persons older than 70 years. The risk for COVID-19 hospitalization was 20.3 (95% CI, 15.2 to 26.7) among patients receiving TAF/FTC, 10.5 (CI, 5.6 to 17.9) among those receiving TDF/FTC, 23.4 (CI, 17.2 to 31.1) among those receiving ABC/3TC, and 20.0 (CI, 14.2 to 27.3) for those receiving other regimens. The corresponding risks for COVID-19 diagnosis were 39.1 (CI, 31.8 to 47.6), 16.9 (CI, 10.5 to 25.9), 28.3 (CI, 21.5 to 36.7), and 29.7 (CI, 22.6 to 38.4), respectively. No patient receiving TDF/FTC was admitted to the ICU or died.Limitation: Residual confounding by comorbid conditions cannot be completely excluded.Conclusion: HIV-positive patients receiving TDF/FTC have a lower risk for COVID-19 and related hospitalization than those receiving other therapies. These findings warrant further investigation in HIV preexposure prophylaxis studies and randomized trials in persons without HIV.

Keywords

AgeInfection

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Annals Of Internal Medicine due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2020, it was in position 6/167, thus managing to position itself as a Q1 (Primer Cuartil), in the category Medicine, General & Internal. Notably, the journal is positioned above the 90th percentile.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 6.61. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Field Citation Ratio (FCR) from Dimensions: 90.08 (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-16, the following number of citations:

  • WoS: 250

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-16:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 464.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 478 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 461.85.
  • The number of mentions on the social network Facebook: 4 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 526 (Altmetric).
  • The number of mentions in news outlets: 13 (Altmetric).

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: United States of America.