Impact of Underlying Chronic Medical Conditions on COVID-19 Outcomes Among People Living with HIV: A Retrospective Analysis from the Minnesota Fairview Network

(1) Background: The Coronavirus Disease 2019 (COVID-19) pandemic has raised concerns about the impact of underlying medical conditions on the health outcomes of people living with HIV (PLWH). This study aimed to assess how pre-existing chronic medical conditions affect the health outcomes of PLWH infected with COVID-19. (2) Methods: A retrospective study using data from the Minnesota Fairview network (1 January 2020–31 December 2022) was conducted. Fisher’s exact test, the Kruskal–Wallis rank-sum test, and ordinal logistic regressions with a Benjamini–Hochberg (BH) adjustment on p-values were used to assess the influence of chronic conditions on COVID-19 severity, adjusting for age and gender. (3) Results: Among 216 records, significant associations were found for a stroke, chronic kidney disease, lung disease, and neurologic conditions (p < 0.05). Type 1 diabetes was marginally significant (0.05 < p < 0.1). After adjusting for age and sex, a stroke (p = 0.0008, BH-adjusted p = 0.0044) and chronic kidney disease (p = 0.0003, BH-adjusted p = 0.0033) significantly increased the risk of severe COVID-19 outcomes. (4) Conclusions: Pre-existing medical conditions should be considered in the clinical management and public health interventions for PLWH infected with COVID-19. Tailored strategies are essential to mitigate the higher risk of severe outcomes in PLWH with specific chronic comorbidities.