How many are at increased risk of severe COVID-19 disease? Rapid global, regional and national estimates for 2020

Andrew Clark; Mark Jit; Charlotte Warren-Gash; Bruce Guthrie; Harry HX Wang; Stewart W Mercer; Colin Sanderson; Martin McKee; Christopher Troeger; Kanyin I Ong; Francesco Checchi; Pablo Perel; Sarah Joseph; Hamish P Gibbs; Amitava Banerjee; Rosalind M Eggo

With the exception of HIV/AIDS our estimates do not account for the role of treatment or control of the underlying condition: for example, while some conditions are less prevalent in Africa than Europe, African patients may on average be at higher risk as they have less access to diagnosis and effective treatment. It is not yet known whether those with HIV are at increased risk of severe disease with COVID-19. Whilst it has been shown that widespread introduction of ART reduced the risk of hospitalisation and death associated with seasonal influenza, 36 a substantial proportion of those on ART remain somewhat immunocompromised. 37, 38 Recent evidence from South Africa has shown that individuals living with HIV have an eight-fold higher risk of pneumonia hospitalisation associated with seasonal influenza, and a three-fold higher risk of pneumonia death. 39 Until more evidence emerges, it may be necessary to include these individuals in shielding strategies, irrespective of ART status, with priority given to those not yet receiving treatment. 40 . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.