COVID-19 symptoms and SARS-CoV-2 infection among people living with HIV in the US: the MACS/WIHS combined cohort study

HIV Res Clin Pract. 2020 Oct;21(5):130-139. doi: 10.1080/25787489.2020.1844521. Epub 2020 Nov 19.

Abstract

Background: SARS-CoV-2 infection among People Living With HIV (PLWH) is not well-described.

Objective: To study COVID-19 symptoms and SARS-CoV-2 PCR-based swab testing among participants of the Multicenter AIDS Cohort Study (MACS) and Women's Interagency HIV Study (WIHS).

Methods: A telephone survey was collected April-June 30, 2020. Symptom and testing prevalence were explored. Multivariable logistic regression was used to examine the factors associated with SARS-CoV-2 positivity.

Results: The survey was completed by 3411 participants, including 2078 (61%) PLWH and 1333 HIV-seronegative (SN) participants from across the US. Thirteen percent (n = 441) were tested for SARS-CoV-2 infection (13.4% of PLWH vs 12.2% of SN). Among those tested, positivity was higher in PLWH than SN (11.2% vs 6.1%, p = 0.08). Reasons for not being tested included testing not being available (30% of participants) and not knowing where to get tested (16% of participants). Most symptoms reported since January 2020 were similar in PLWH and SN, including headache (23% vs. 24%), myalgias (19% vs 18%), shortness of breath (14% vs 13%), chills (12% vs 10%), fever (6% vs 6%) and loss of taste or smell (6% vs 7%). Among PLWH who tested positive for SARS-CoV-2 DNA, the most common symptoms were headache (71%), myalgia (68%), cough (68%) and chills (65%). In multivariable analysis among those tested, the odds of SARS-CoV-2 positivity were higher among PLWH than SN (aOR = 2.22 95%CI = 01.01-4.85, p = 0.046) and among those living with others versus living alone (aOR = 2.95 95%CI = 1.18-7.40).

Conclusion: Prevalence and type of COVID-19 symptoms were similar in PLWH and SN. SARS-CoV-2 infection may be elevated among PLWH.

Keywords: COVID-19; HIV; MWCCS; PLWH; SARS-CoV-2; epidemiology; symptoms; testing.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acquired Immunodeficiency Syndrome / epidemiology
  • Adult
  • Aged
  • Aged, 80 and over
  • Ageusia / epidemiology
  • Ageusia / virology
  • Anosmia / epidemiology
  • Anosmia / virology
  • COVID-19 / epidemiology
  • COVID-19 / physiopathology*
  • COVID-19 / virology*
  • Chills / epidemiology
  • Chills / virology
  • Coinfection
  • Cough / epidemiology
  • Cough / virology
  • Dyspnea / epidemiology
  • Dyspnea / virology
  • Female
  • Fever / epidemiology
  • Fever / virology
  • HIV Infections / epidemiology
  • HIV Infections / physiopathology*
  • HIV Infections / virology*
  • Headache / epidemiology
  • Humans
  • Middle Aged
  • Prevalence
  • SARS-CoV-2 / isolation & purification
  • United States / epidemiology