ABSTRACT Background: This study aimed to identify COVID-19 cases among people living with HIV (PLWH) in Brazil in 2020, describe their clinical, sociodemographic, and epidemiological profiles, and evaluate the factors associated with disease severity. Methods: This cross-sectional study used secondary data obtained from the Brazilian healthcare system. Probabilistic and deterministic data linkage methods were used to identify coinfected patients. Descriptive statistical analysis was conducted, and factors associated with severe cases were evaluated using Pearson's chi-squared test, Student's t-test, and logistic regression. Results: In 2020, 36,746 coinfections were identified, making it one of the largest coinfection databases described worldwide. In total, 4,502 (12.25%) patients had severe cases and 32,244 (87.75%) had non-severe cases. The covariates age (OR=1.05; 95% CI: 1.05-1.06), nonwhite ethnicity (OR=1.68; 95% CI: 1.56-1.81), history of AIDS diagnosis (OR=1.17; 95% CI: 1.08-1.28), recent HIV diagnosis (OR=5.47; 95% CI: 4.25-7.02), absence of antiretroviral therapy (OR=1.70; 95% CI: 1.57-1.84), CD4+ < 200 (OR=6.41; 95% CI: 5.09-8.08), detectable HIV viral load (OR=2.61; 95% CI: 2.21-3.05), ≥ 1 comorbidity (OR=4.09; 95% CI: 3.79-4.41), and ≥ 4 symptoms were associated with increased severity. Conclusions: Multiple factors were linked to severe COVID-19, including uncontrolled HIV infection, age > 50 years, comorbidities, and racial disparities. This study reinforces the importance of maintaining public policies focused on early HIV diagnosis, access and adherence to treatment, especially for minority ethnic groups, and focusing on premature aging in PLWH. Background COVID19 COVID 19 COVID-1 PLWH (PLWH 2020 clinical sociodemographic profiles severity Methods crosssectional cross sectional system conducted Pearsons Pearson s chisquared chi squared test Students Student ttest, ttest t t-test regression Results 36746 36 746 36,74 identified worldwide total 4502 502 4,50 12.25% 1225 12 25 (12.25% 32244 32 244 32,24 87.75% 8775 87 75 (87.75% nonsevere non OR=1.05 OR105 OR 05 (OR=1.05 95 CI 1.051.06, 105106 1.05 1.06 , 06 1.05-1.06) OR=1.68 OR168 68 (OR=1.68 1.561.81, 156181 1.56 1.81 56 81 1.56-1.81) OR=1.17 OR117 17 (OR=1.17 1.081.28, 108128 1.08 1.28 08 28 1.08-1.28) OR=5.47 OR547 5 47 (OR=5.47 4.257.02, 425702 4.25 7.02 7 02 4.25-7.02) OR=1.70 OR170 70 (OR=1.70 1.571.84, 157184 1.57 1.84 57 84 1.57-1.84) CD4 CD 20 OR=6.41 OR641 6 41 (OR=6.41 5.098.08, 509808 5.09 8.08 09 8 5.09-8.08) OR=2.61 OR261 2 61 (OR=2.61 2.213.05, 221305 2.21 3.05 21 3 2.21-3.05) OR=4.09 OR409 (OR=4.09 3.794.41, 379441 3.79 4.41 79 3.79-4.41) Conclusions COVID19, 19, infection years comorbidities disparities treatment groups COVID1 COVID- 202 3674 74 36,7 450 4,5 12.25 122 (12.25 3224 24 32,2 87.75 877 (87.75 OR=1.0 OR10 0 (OR=1.0 9 051 1.051.06 10510 105 1.0 106 1.05-1.06 OR=1.6 OR16 (OR=1.6 561 1.561.81 15618 156 1.5 181 1.8 1.56-1.81 OR=1.1 OR11 (OR=1.1 081 1.081.28 10812 108 128 1.2 1.08-1.28 OR=5.4 OR54 (OR=5.4 257 4.257.02 42570 425 4.2 702 7.0 4.25-7.02 OR=1.7 OR17 (OR=1.7 571 1.571.84 15718 157 184 1.57-1.84 OR=6.4 OR64 (OR=6.4 098 5.098.08 50980 509 5.0 808 8.0 5.09-8.08 OR=2.6 OR26 (OR=2.6 213 2.213.05 22130 221 2.2 305 3.0 2.21-3.05 OR=4.0 OR40 (OR=4.0 794 3.794.41 37944 379 3.7 441 4.4 3.79-4.41 367 36, 45 4, 12.2 (12.2 322 32, 87.7 (87.7 OR=1. OR1 (OR=1. 1.051.0 1051 10 1. 1.05-1.0 1.561.8 1561 15 18 1.56-1.8 1.081.2 1081 1.08-1.2 OR=5. OR5 (OR=5. 4.257.0 4257 42 4. 7. 4.25-7.0 1.571.8 1571 1.57-1.8 OR=6. OR6 (OR=6. 5.098.0 5098 5. 80 8. 5.09-8.0 OR=2. OR2 (OR=2. 2.213.0 2213 22 2. 30 3. 2.21-3.0 OR=4. OR4 (OR=4. 3.794.4 3794 37 44 3.79-4.4 12. (12. 87. (87. OR=1 (OR=1 1.051. 1.05-1. 1.561. 1.56-1. 1.081. 1.08-1. OR=5 (OR=5 4.257. 4.25-7. 1.571. 1.57-1. OR=6 (OR=6 5.098. 5.09-8. OR=2 (OR=2 2.213. 2.21-3. OR=4 (OR=4 3.794. 3.79-4. (12 (87 OR= (OR= 1.051 1.05-1 1.561 1.56-1 1.081 1.08-1 4.257 4.25-7 1.571 1.57-1 5.098 5.09-8 2.213 2.21-3 3.794 3.79-4 (1 (8 (OR 1.05- 1.56- 1.08- 4.25- 1.57- 5.09- 2.21- 3.79- (