{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T02:40:39Z","timestamp":1773974439560,"version":"3.50.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T00:00:00Z","timestamp":1667347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","award":["221003\/Z\/20\/Z"],"award-info":[{"award-number":["221003\/Z\/20\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100020171","name":"Foreign, Commonwealth and Development Office","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100020171","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000030","name":"US Centers for Disease Control and Prevention","doi-asserted-by":"crossref","award":["NU51IP000930"],"award-info":[{"award-number":["NU51IP000930"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000030","name":"US Centers for Disease Control and Prevention","doi-asserted-by":"crossref","award":["U01IP001048"],"award-info":[{"award-number":["U01IP001048"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]},{"name":"CDC"},{"name":"African Field Epidemiology Network","award":["AF-NICD-001\/2021"],"award-info":[{"award-number":["AF-NICD-001\/2021"]}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"crossref","award":["96838"],"award-info":[{"award-number":["96838"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"crossref"}]},{"name":"African Society of Laboratory Medicine"},{"name":"Africa Centers for Disease Control and Prevention"},{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"crossref","award":["INV-018978"],"award-info":[{"award-number":["INV-018978"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institute for Communicable Diseases"},{"name":"National Health Laboratory Service, South Africa"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Data on risk factors for coronavirus disease 2019 (COVID-19)-associated hospitalization and mortality in high human immunodeficiency virus (HIV) prevalence settings are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using existing syndromic surveillance programs for influenza-like-illness and severe respiratory illness at sentinel sites in South Africa, we identified factors associated with COVID-19 hospitalization and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From April 2020 through March 2022, severe acute respiratory syndrome coronavirus 2 was detected in 24.0% (660 of 2746) of outpatient and 32.5% (2282 of 7025) of inpatient cases. Factors associated with COVID-19-associated hospitalization included the following: older age (25\u201344 [adjusted odds ratio {aOR}= 1.8, 95% confidence interval (CI) = 1.1\u20132.9], 45\u201364 [aOR = 6.8, 95% CI = 4.2\u201311.0] and \u226565 years [aOR = 26.6, 95% CI = 14.4\u201349.1] vs 15\u201324 years); black race (aOR, 3.3; 95% CI, 2.2\u20135.0); obesity (aOR, 2.3; 95% CI, 1.4\u20133.9); asthma (aOR, 3.5; 95% CI, 1.4\u20138.9); diabetes mellitus (aOR, 5.3; 95% CI, 3.1\u20139.3); HIV with CD4 \u2265200\/mm3 (aOR, 1.5; 95% CI, 1.1\u20132.2) and CD4 &amp;lt;200\/mm3 (aOR, 10.5; 95% CI, 5.1\u201321.6) or tuberculosis (aOR, 12.8; 95% CI, 2.8\u201358.5). Infection with Beta (aOR, 0.5; 95% CI, .3\u2013.7) vs Delta variant and being fully vaccinated (aOR, 0.1; 95% CI, .1\u2013.3) were less associated with COVID-19 hospitalization. In-hospital mortality was increased in older age (45\u201364 years [aOR, 2.2; 95% CI, 1.6\u20133.2] and \u226565 years [aOR, 4.0; 95% CI, 2.8\u20135.8] vs 25\u201344 years) and male sex (aOR, 1.3; 95% CI, 1.0\u20131.6) and was lower in Omicron-infected (aOR, 0.3; 95% CI, .2\u2013.6) vs Delta-infected individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Active syndromic surveillance encompassing clinical, laboratory, and genomic data identified setting-specific risk factors associated with COVID-19 severity that will inform prioritization of COVID-19 vaccine distribution. Elderly people with tuberculosis or people with HIV, especially severely immunosuppressed, should be prioritized for vaccination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofac578","type":"journal-article","created":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T04:38:28Z","timestamp":1667363908000},"source":"Crossref","is-referenced-by-count":9,"title":["Risk Factors for Severe Coronavirus Disease 2019 Among Human Immunodeficiency Virus-Infected and -Uninfected Individuals in South Africa, April 2020\u2013March 2022: Data From Sentinel Surveillance"],"prefix":"10.1093","volume":"9","author":[{"given":"Sibongile","family":"Walaza","sequence":"first","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Tempia","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"},{"name":"MassGenics , Atlanta, Georgia , USA"},{"name":"Influenza Program, Centers for Disease Control and Prevention , Pretoria , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"von Gottberg","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Wolter","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinal N","family":"Bhiman","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South 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Witwatersrand , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mignon","family":"du Plessis","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jocelyn","family":"Moyes","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meredith L","family":"McMorrow","sequence":"additional","affiliation":[{"name":"Influenza Program, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta , Georgia , USA"},{"name":"Influenza Program, Centers for Disease Control and Prevention , Pretoria , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Halima","family":"Dawood","sequence":"additional","affiliation":[{"name":"Department of Medicine, Greys Hospital , Pietermaritzburg , South Africa"},{"name":"Caprisa, University of KwaZulu - Natal , Pietermaritzburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebrahim","family":"Variava","sequence":"additional","affiliation":[{"name":"Department of Medicine, Klerksdorp-Tshepong Hospital Complex , Klerksdorp , South Africa"},{"name":"Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary","family":"Reubenson","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Rahima Moosa Mother and Child Hospital , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Nel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather J","family":"Zar","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Red Cross War Memorial Hospital, and South African-Medical Research Council on Child and Adolescent Health, University of Cape Town , South 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