SARS-CoV-2 infection in persons living with HIV: A single center prospective cohort

J Med Virol. 2021 Feb;93(2):1145-1149. doi: 10.1002/jmv.26352. Epub 2020 Oct 8.

Abstract

Information about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in HIV-infected individuals is scarce. In this prospective study, we included HIV (human immunodefeciency virus)-infected individuals (people living with HIV [PLWHIV]) with confirmed SARS-CoV-2 infection and compared them with PLWHIV negative for SARS-CoV-2. We compared 55 cases of SARS-CoV-2 infection with 69 asymptomatic PLWHIV negative for SARS-CoV-2 reverse transcription-polymerase chain reaction and/or serology. There was no significant difference between SARS-CoV-2 positive or negative patients for age distribution, gender, time with HIV infection, nadir CD4-cell counts, type and number of co-morbidities, current CD4 and CD8 counts and type of anti-HIV therapy. Positive patients presented with a median of three symptoms (interquartile range, 1-3). Most common symptoms were fever (76%), dyspnea (35%), anosmia (29%) non-productive cough (27%), fatigue 22%), and ageusia (20%). Ten patients (18%) were completely asymptomatic. Four (7.2%) subjects died of coronavirus disease 2019. Factors significantly (P < .05) associated with death included age and number of co-morbidities, while time from HIV infection and lower current CD4 counts were significant only in univariate analysis. HIV-infected individuals are not protected from SARS-CoV-2 infection or have a lower risk of severe disease. Indeed, those with low CD4 cell counts might have worse outcomes. Infection is asymptomatic in a large proportion of subjects and this is relevant for epidemiological studies.

Keywords: CD4; CNS; COVID-19; HIV; SARS-CoV-2; asymptomatic; co-morbidities; cohort; mortality; risk factors; symptoms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • CD4 Lymphocyte Count / statistics & numerical data
  • CD8-Positive T-Lymphocytes / immunology
  • COVID-19 / epidemiology*
  • COVID-19 / mortality
  • COVID-19 / virology*
  • Comorbidity
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / virology
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors