text: Impact of HIV Infection on COVID 19 Outcomes Among Hospitalized Adults in the U S Whether HIV infection is associated with differences in clinical outcomes among people hospitalized with COVID 19 is uncertain To evaluate the impact of HIV infection on COVID 19 outcomes among hospitalized patients Using the American Heart Associations COVID 19 Cardiovascular Disease registry we used hierarchical mixed effects models to assess the association of HIV with in hospital mortality accounting for patient demographics and comorbidities and clustering by hospital Secondary outcomes included major adverse cardiac events MACE severity of illness and length of stay LOS The registry included 21 528 hospitalization records of people with confirmed COVID 19 from 107 hospitals in 2020 including 220 people living with HIV PLWH PLWH were younger 56 0 13 0 versus 61 3 17 9 years old and more likely to be male 72 3 vs 52 7 Non Hispanic Black 51 4 vs 25 4 on Medicaid 44 5 vs 24 5 and active tobacco users 12 7 versus 6 5 Of the study population 36 PLWH 16 4 had in hospital mortality compared with 3 290 15 4 without HIV Risk ratio 1 06 95 CI 0 79 1 43 risk difference 0 9 95 CI 4 2 to 6 1 p 0 71 After adjustment for age sex race and insurance HIV was not associated with in hospital mortality aOR 1 13 95 CI 0 77 1 6 p 0 54 even after adding body mass index and comorbidities aOR 1 15 95 CI 0 78 1 70 p 0 48 HIV was not associated with MACE aOR 0 99 95 CI 0 69 1 44 p 0 91 severity of illness aOR 0 96 95 CI 0 62 1 50 p 0 86 or LOS aOR 1 03 95 CI 0 76 1 66 p 0 21 HIV was not associated with adverse outcomes of COVID 19 including in hospital mortality MACE or severity of illness We studied 21 528 patients hospitalized with COVID 19 at 107 hospitals in AHAs COVID 19 registry to examine the association between HIV and COVID 19 outcomes More patients with HIV were younger male non Hispanic Black on Medicaid and current smokers HIV was not associated with worse COVID 19 in hospital mortality Risk ratio 1 06 95 CI 0 79 1 43 p 0 71 even after adjustment aOR 1 15 95 CI 0 78 1 70 p 0 48 HIV was also not associated with MACE aOR 0 99 95 CI 0 69 1 44 p 0 91 or severity of illness aOR 0 96 95 CI 0 62 1 50 p 0 86 Our findings do not support that HIV is a major risk factor for adverse COVID 19 outcomes 