Individuals With HIV and Cognitive Impairment at Increased Risk for COVID-19 Mortality

Dementia and cognitive impairment among people living with HIV were associated with risk for COVID-19 mortality.

People living with HIV (PLWH) and cognitive impairment are at increased risk for COVID-19 mortality, according to study results presented at IDWeek 2022, held from October 19 to 23, in Washington, DC.

Research has shown that PLWH are at increased risk for cognitive disorders, including dementia. In addition, dementia is known to be a risk factor for COVID-19 mortality. However, it is unclear whether PLWH with cognitive impairment are at increased risk for adverse COVID-19 outcomes.

Data for the study were collected from Massachusetts General Hospital, Boston. Patients with confirmed SARS-CoV-2 infection between March 2020 and 2021 were included. The PLWH were matched, by age, sex, race, and zip code, 1:10 with those without HIV. Risk for mortality was evaluated on the basis of evidence of cognitive impairment 12 months prior to the onset of COVID-19.

Primary exposures included dementia and cognitive impairment.

A total of 14,129 PLWH, among whom 64 (0.45%) had COVID-19, and 463 control participants were enrolled in the study. In the HIV cohort, 59% had viral suppression and 14% had a CD4 T-cell count of fewer than 200 cells/mL.

Researchers noted that PLWH vs control participants had higher rates of dementia (16% vs 6%, respectively; P =.01) and cognitive impairment (22% vs 16%, respectively; P =.04).

The rate of mortality was increased (17% vs 6%; P <.01) and occurred more frequently at a younger median age (58 vs 66 years; P =.03) among patients in the HIV group vs those in the control group.

Overall, mortality risk was significantly associated with dementia (adjusted odds ratio [aOR], 3.4; 95% CI, 1.3-8.1; P =.01) and cognitive impairment (aOR, 2.5; 95% CI, 1.1-5.9; P =.03). In the HIV cohort, both cognitive impairment and dementia were associated with COVID-19 mortality (aOR, 7.2; 95% CI, 1.1-48.0; P =.04 and aOR, 6.0; 95% CI, 0.8-43.8; P =.08, respectively).

Based on the study findings, the authors noted that “Assessment of cognitive status is an important component to care for aging [PLWH] in the COVID-19 era.”


Mukerji SS, Wilcox DR, Rudmann EA, et al. Dementia and cognitive concerns are risk factors for mortality in people with human immunodeficiency virus and COVID-19. Presented at: IDWeek 2022; October 19-23; Washington, DC. Abstract 2358.