ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Risk Factors for Coronavirus Disease 2019 (COVID-19) Death in a Population Cohort Study from the Western Cape Province, South Africa.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 376 papers, 11 of them syntheses that pooled it.
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Who cites it
376 citing papers in PubMed, 11 syntheses or guidelines pooled it, 597 citations in OpenAlex.
- Efficacy of tenofovir on clinical outcomes of COVID-19 patients: a systematic review.BMC infectious diseases · 2025Pooled it
- Systematic review and meta-analysis of Tuberculosis and COVID-19 Co-infection: Prevalence, fatality, and treatment considerations.PLoS neglected tropical diseases · 2024Pooled it
- Disparities in COVID-19 mortality amongst the immunosuppressed: A systematic review and meta-analysis for enhanced disease surveillance.The Journal of infection · 2024Pooled it
- The impact of COVID-19 on non-communicable disease patients in sub-Saharan African countries: A systematic review.PloS one · 2024Pooled it
- Serological response following COVID-19 vaccines in patients living with HIV: a dose-response meta-analysis.Scientific reports · 2023Pooled it
- Usefulness of linked data for infectious disease events: a systematic review.Epidemiology and infection · 2023Pooled it
- Immunogenicity and effectiveness of COVID-19 booster vaccination among people living with HIV: a systematic review and meta-analysis.Frontiers in medicine · 2023Pooled it
- The effects of hypertension on the prognosis of coronavirus disease 2019: a systematic review and meta-analysis on the interactions with age and antihypertensive treatment.Journal of hypertension · 2022Pooled it
- HIV infection does not affect the risk of death of COVID-19 patients: A systematic review and meta-analysis of epidemiological studies.Journal of global health · 2022Pooled it
- The Social, Behavioral, and Ethical Modalities of COVID-19 on HIV Care in South Africa: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Pooled it
- Daily tenofovir disoproxil fumarate/emtricitabine and hydroxychloroquine for pre-exposure prophylaxis of COVID-19: a double-blind placebo-controlled randomized trial in healthcare workers.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2023Trial
- Stay-at-Home: The Impact of the COVID-19 Lockdown on Household Functioning and ART Adherence for People Living with HIV in Three Sub-districts of Cape Town, South Africa.AIDS and behavior · 2022Trial
- Impact of the COVID-19 Pandemic on Treatment Outcomes and Healthcare Utilization Among People Living With HIV in Korea: A Multicenter Cohort Study.Journal of Korean medical science · 2026Observational
- High Mortality in Adults With Community-Acquired Pneumonia Admitted to Hospitals in South Africa Before and During the COVID-19 Pandemic, Stratified by HIV Serostatus and Viral Load: Data From a Prospective Cohort Study (2019-2021).Open forum infectious diseases · 2026Article
- Relative efficacy, safety and immunogenicity of bivalent versus monovalent COVID-19 mRNA booster vaccines: a randomized trial.Research square · 2026Article
- High risk of COVID-19 mortality in people living with advanced HIV disease in South Africa: A retrospective cohort study.Medicine · 2026Article
- Profile of SARS-CoV-2/HIV-1 coinfection in patients from the extreme south of Brazil.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2026Article
- Article
- Host proteins associated with strong neutralizing SARS-CoV-2 antibody responses in a South African cohort.Communications medicine · 2026Article
316 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
1 author at 16 institutions in 4 countries.
Funding
Abstract
backgroundRisk 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.
methodsWe 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.
resultsAmong 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).
conclusionsWhile 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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