HIV infection and Long COVID: A RECOVER Program, electronic health record based cohort study
Hawkins, KL; Dandachi, D; Verzani, Z; et al., Clinical Infectious Diseases
Published
May 2025
Journal
Clinical Infectious Diseases
Abstract
People with HIV may be at increased risk for long COVID after acute SARS-CoV-2 infection. We investigated the association between HIV and long COVID in two large electronic health record databases. Using data from the Patient-Centered Clinical Research Network (PCORnet) and the National Clinical Cohort Collaborative (N3C) from 1/1/2018 to 4/30/2024, our analytic sample included individuals aged ≥21 years with SARS-CoV-2. All individuals were classified as having HIV or not. We estimated the adjusted odds ratio (aOR) of long COVID by HIV status using logistic regression. Multivariable models controlled for potential associated factors and used 2 cohort definitions: a computed phenotype definition or ICD-10 code-based definition. We included 1,369,896 patients from PCORnet (11,964 with and 1,357,932 without HIV) and 3,312,355 patients from N3C (23,931 with and 3,288,424 without HIV). Using the computed phenotype definition of long COVID, we noted a small, but significant, increase in odds of developing long COVID among people with compared to those without HIV (PCORnet aOR 1.09 [CI 1.04-1.14] and N3C aOR 1.18 [CI 1.13-1.23]). Using the ICD-10 definition of long COVID, there was no association between HIV and long-COVID (PCORnet aOR 1.01 [CI 0.88-1.16] and N3C aOR 1.07 [CI 0.97-1.18], respectively). In this large multicenter study, people with HIV had a modestly increased risk of long COVID when defined by a computed phenotype, but not when using ICD-10 codes. These findings suggest that long COVID may be under-recognized in people with HIV and underscore challenges in diagnosing long COVID in populations with baseline chronic conditions.
Authors
Kellie L Hawkins, Dima Dandachi, Zoe Verzani, M Daniel Brannock, Colby Lewis, Sajjad Abedian, Sohrab Jaferian, Shannon Wuller, Jennifer Truong, Margot Gage Witvliet, Gretchen Dymond, Hemalkumar B Mehta, Payal B Patel, Elaine Hill, Mark G Weiner, Thomas W Carton, Rainu Kaushal, Elen Feuerriegel, Huong G Tran, Kristen Marks, Carlos R Oliveira, Edward M Gardner, Igho Ofotokun, Roy M Gulick, Kristine M Erlandson; RECOVER Consortium, the N3C Consortium; PCORnet Consortium
Keywords
HIV; Long COVID; SARS-CoV-2
Short Summary
This RECOVER study looked at whether people with Human Immunodeficiency Virus (HIV) are more likely to get Long COVID after having COVID-19. HIV is a virus that attacks the body’s immune system. Researchers used electronic health records (EHRs) from 2 nationwide research networks of people ages 21 and older who had COVID-19. They divided them into 2 groups: people with HIV and people without HIV. Researchers used 2 methods to find people in the groups who might have Long COVID. One used a computer system that looked for Long COVID symptoms in medical records. The other looked for official diagnosis codes that doctors enter when they think someone has Long COVID. They found that people with HIV may have a slightly higher risk of being diagnosed with Long COVID when looking for Long COVID symptoms in medical records. However, they found that there was no clear link between having HIV and receiving the official diagnosis code for Long COVID. This suggests that Long COVID may be missed in people with long-term health problems like HIV.