Comparative analyses of COVID-19 in-hospital mortality in people with HIV during SARS-CoV-2 pre-Delta, Delta, and Omicron waves
Bibliographic record
Abstract
BACKGROUND: We investigated in-hospital mortality trends across waves of different SARS-CoV-2 variants and assessed the effect of COVID-19 immunization among people with HIV (PWH). METHOD: We analyzed individual-level data from the WHO Global Clinic Platform comprising 823 845 hospitalized children and adults from 61 countries. Survival analyses were used to assess the association of HIV co-infection with in-hospital mortality across SARS-CoV-2 pre-Delta, Delta, and Omicron variant waves. FINDINGS: PWH experienced significantly higher in-hospital mortality compared to HIV-negative individuals across all variant waves. Adjusted hazard ratios (aHRs) for PWH mortality were 1.85 [95% confidence interval (CI) 1.76-1.93] during the pre-Delta wave, 1.58 (95% CI 1.42-1.74) during the Delta wave, and 3.07 (95% CI 2.75-3.42) during the Omicron wave. In-hospital mortality risk was notably higher in PWH with CD4 + cell count 200 cells/μl or less. While mortality declined modestly between pre-Delta and Delta waves in both HIV-negative (10% reduction) and HIV-positive populations (9% reduction), the decline was more substantial for HIV-negative individuals during the Omicron wave (from 18.9 to 8%) than for PWH (from 24.2 to 19.3%) relative to the Delta wave. INTERPRETATION: Although in-hospital mortality among HIV-negative individuals declined markedly during the Omicron wave, reduction in PWH was less pronounced, leading to a relatively higher mortality risk for this group. These findings highlight the need for adherence to WHO recommendations on booster vaccinations and therapeutics for populations at elevated risk of severe COVID-19 outcomes, including PWH.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".