Descriptive account of 18 adults with known HIV infection hospitalised with SARS-CoV-2 infection

Abstract

ObjectiveTo report on the clinical characteristics and outcome of 18 people living with HIV (PLWH) hospitalised with SARS-CoV-2 infection in a London teaching hospital.MethodsThe hospital notes of 18 PLWH hospitalised with SARS-CoV-2 infection were retrospectively reviewed alongside data concerning their HIV demographics from an established HIV Database.ResultsThe majority (16/18) had positive PCR swabs for SARS-CoV-2, and two had negative swabs but typical COVID-19 imaging and history. Most were male (14/18, 78%), median age 63 years (range 47–77 years). Two-thirds were migrants, nine (50%) of Black, Asian and minority ethnicity (BAME). All were diagnosed with HIV for many years (range 8–31 years), and all had an undetectable HIV viral load (<40 copies/mL). The median CD4 prior to admission was 439 (IQR 239–651), and 10/16 (63%) had a CD4 nadir below 200 cells/mm3. Almost all (17/18) had been diagnosed with at least one comorbidity associated with SARS-CoV-2 prior to admission. 3/18 patients died. None received mechanical ventilation. Hospital stay and clinical course did not appear prolonged (median 9 days).ConclusionsOur data suggest that PLWH may not necessarily have prolonged or complex admissions to hospital when compared with the general hospital and national population admitted with COVID-19. Many had low nadir CD4 counts and potentially impaired functional immune restoration. The PLWH group was younger than generally reported for COVID-19, and the majority were male with multiple complex comorbidities. These patients had frequent contact with hospital settings increasing potential for nosocomial acquisition and increased risk of severe COVID-19.

HIV/SARS-CoV-2 co-infection: T cell profile, cytokine dynamics and role of exhausted lymphocytes

“…In International Journal of Infectious Diseases , Wang et al have recently reported a case of one HIV/COVID-19 patient with low CD4 + count who had a longer COVID-19 course and lower antibody amount ( Wang et al, 2020 ). Further, it has been detected that HIV/SARS-CoV-2 co-infection may lead to pneumonia complications oftener than COVID-19 itself ( Madge et al, 2020 , Okoh et al, 2020 ). The ability of HIV/SARS-CoV-2 co-infection to cause excessive T cell activation has been observed in sample sets little in size ( D’Ettorre et al, 2020 , Gao et al, 2020 ).…”

Enigma of the high prevalence of anti-SARS-CoV-2 antibodies in HIV-positive people with no symptoms of COVID-19 in Burkina Faso

“…This second scenario hypothesizes that co-infection with SARSCoV- 2 is more common among PLHIV as suggested by Byrd et al 29 The possibility of virus infection was due to the frequent contact of these participants with hospital settings, which increased the potential risk of exposure to the virus. 30 Indeed, Alharbi et al found a seroprevalence of SARS-CoV-2 of 24.24% among healthcare workers. 25 Antiretroviral treatment of PLHIV may also have had an effect in the asymptomatic presentation of COVID-19 in these infected subjects.…”