Associations between HIV infection and clinical spectrum of COVID-19: a population level analysis based on US National COVID Cohort Collaborative (N3C) data

Yang, Xueying; Sun, Jing; Patel, Rena C; Zhang, Jiajia; Guo, Siyuan; Zheng, Qulu; Olex, Amy L.; Olatosi, Bankole; Weissman, Sharon; Islam, Jessica Y.; Chute, Christopher G.; Haendel, Melissa; Kirk, Gregory D.; Li, Xiaoming; Moffitt, Richard A.; Akelsrod, Hana; Crandall, Keith A.; Francheschini, Nora; French, Evan; Chiang, Teresa Po‐Yu; Caleb-Alexander, G; Andersen, Kathleen M.; Vinson, Amanda J.; Brown, Todd T.; Mannon, Roslyn B.

doi:10.1016/s2352-3018(21)00239-3

Cited by 130 publications

(144 citation statements)

References 24 publications

(38 reference statements)

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“…A higher total T cell count, including both CD4+ and CD8+, has been shown to be a predictor of a less severe disease and a more favorable clinical outcome in patients with COVID-19 [34]. In The Lancet HIV, two studies demonstrated worse outcomes in HIV patients with CD4 counts less than 200 cells per µL [35,36]. Overall, 70-80% of circulating lymphocytes are T lymphocytes and the underlying cause of lymphopenia in severe cases of COVID-19 has previously been attributed to apoptosis of T lymphocytes [37][38][39].…”

Section: Discussionmentioning

confidence: 99%

Lymphopenia as a Predictor for Adverse Clinical Outcomes in Hospitalized Patients with COVID-19: A Single Center Retrospective Study of 4485 Cases

Niu

Sareli

Mayer

et al. 2022

JCM

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Lymphopenia is commonly present in patients with COVID-19. We sought to determine if lymphopenia on admission predicts COVID-19 clinical outcomes. A retrospective chart review was performed on 4485 patients with laboratory-confirmed COVID-19, who were admitted to the hospital. Of those, 2409 (57.3%) patients presented with lymphopenia (absolute lymphocyte count < 1.1 × 109/L) on admission, and had higher incidences of ICU admission (17.9% versus 9.5%, p < 0.001), invasive mechanical ventilation (14.4% versus 6.5%, p < 0.001), dialysis (3.4% versus 1.8%, p < 0.001) and in-hospital mortality (16.6% versus 6.6%, p < 0.001), with multivariable-adjusted odds ratios of 1.86 (95% confidence interval [CI], 1.55–2.25), 2.09 (95% CI, 1.69–2.59), 1.77 (95% CI, 1.19–2.68), and 2.19 (95% CI 1.76–2.72) for the corresponding outcomes, respectively, compared to those without lymphopenia. The restricted cubic spline models showed a non-linear relationship between lymphocyte count and adverse outcomes, with an increase in the risk of adverse outcomes for lower lymphocyte counts in patients with lymphopenia. The predictive powers of lymphopenia, expressed as areas under the receiver operating characteristic curves, were 0.68, 0.69, 0.78, and 0.79 for the corresponding adverse outcomes, respectively, after incorporating age, gender, race, and comorbidities. In conclusion, lymphopenia is a useful metric in prognosticating outcomes in hospitalized COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

Lymphopenia as a Predictor for Adverse Clinical Outcomes in Hospitalized Patients with COVID-19: A Single Center Retrospective Study of 4485 Cases

Niu

Sareli

Mayer

et al. 2022

JCM

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“…As of November 2021, more than 250 million people have been infected by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) (1). Information regarding COVID-19 prognosis in the 38 million people living with HIV (PLWH) suggests that they are at higher risk of a more severe clinical course of the disease (2)(3)(4)(5)(6). A strong protection is therefore warranted in this specific population.…”

Section: Introductionmentioning

confidence: 99%

Impact on HIV-1 RNA Levels and Antibody Responses Following SARS-CoV-2 Vaccination in HIV-Infected Individuals

et al. 2022

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This study aims to assess the immunological response and impact on virological control of the mRNA vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among people living with HIV (PLWH). In this single-center observational study, all PLWH were offered vaccination with mRNA1273 or BNT162b2. Both anti-N and anti-S1-receptor binding domain (RBD) antibodies were measured together with HIV-1 RNA levels after the first dose (M0) and then at 1 (M1), 2 (M2) and 6 (M6) months later. A total of 131 individuals (median age: 54 years [IQR: 47.0-60.5]; male: 70.2%; median baseline CD4 T-cell: 602/µl [IQR 445.0-825.5]; median nadir CD4 T-cells 223/µl [IQR 111.0-330.0]) were included. All participants were positive for anti-RBD antibodies at 30 days, 60 days and 6 months after the first dose, with no statistical difference between those with HIV-1 RNA below or >20 copies/ml. HIV-1 RNA data were collected for 128 patients at baseline and 30 days after the first dose; for 124 individuals, 30 days after the second dose; and for 83 patients, 6 months after the first dose. Nineteen (14.8%) of 128 had detectable HIV-1 RNA (>20 copies/ml) at M0, 13/128 (10.2%) at M1 (among which 5 were newly detectable), 15/124 (12.1%) at M2 (among which 5 were newly detectable), and 8/83 (9.6%) at M6. No serious adverse effects were reported. All participants elicited antibodies after two doses of mRNA vaccines, with only a minor impact on HIV-1 RNA levels over a 6-month period.

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“…The COVID-19 pandemic has led to decreased access to HIV-prevention services, HIV testing, HIV treatment and viral suppression, which could lead to less control over the HIV epidemic [2]. People living with HIV (PLWH) have been disproportionately affected by COVID-19 and are at increased risk for severe clinical symptoms and mortality due to SARS-CoV-2 infection, especially among those with lower CD4 + T cell counts or unsuppressed HIV viral replication [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Vaccination in People Living with HIV (PLWH) in China: A Cross Sectional Study of Vaccine Hesitancy, Safety, and Immunogenicity

Liu

Han

et al. 2021

Vaccines

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The administration of COVID-19 vaccines is the primary strategy used to prevent further infections by COVID-19, especially in people living with HIV (PLWH), who are at increased risk for severe symptoms and mortality. However, the vaccine hesitancy, safety, and immunogenicity of COVID-19 vaccines among PLWH have not been fully characterized. We estimated vaccine hesitancy and status of COVID-19 vaccination in Chinese PLWH, explored the safety and impact on antiviral therapy (ART) efficacy and compared the immunogenicity of an inactivated vaccine between PLWH and healthy controls (HC). In total, 27.5% (104/378) of PLWH hesitated to take the vaccine. The barriers included concerns about safety and efficacy, and physician counselling might help patients overcome this vaccine hesitancy. A COVID-19 vaccination did not cause severe side effects and had no negative impact on CD4+ T cell counts and HIV RNA viral load. Comparable spike receptor binding domain IgG titer were elicited in PLWH and HC after a second dose of the CoronaVac vaccine, but antibody responses were lower in poor immunological responders (CD4+ T cell counts < 350 cells/µL) compared with immunological responders (CD4+ T cell counts ≥ 350 cells/µL). These data showed that PLWH have comparable safety and immune response following inactivated COVID-19 vaccination compared with HC, but the poor immunological response in PLWH is associated with impaired humoral response.

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Associations between HIV infection and clinical spectrum of COVID-19: a population level analysis based on US National COVID Cohort Collaborative (N3C) data

Cited by 130 publications

References 24 publications

Lymphopenia as a Predictor for Adverse Clinical Outcomes in Hospitalized Patients with COVID-19: A Single Center Retrospective Study of 4485 Cases

Lymphopenia as a Predictor for Adverse Clinical Outcomes in Hospitalized Patients with COVID-19: A Single Center Retrospective Study of 4485 Cases

Impact on HIV-1 RNA Levels and Antibody Responses Following SARS-CoV-2 Vaccination in HIV-Infected Individuals

COVID-19 Vaccination in People Living with HIV (PLWH) in China: A Cross Sectional Study of Vaccine Hesitancy, Safety, and Immunogenicity

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