Factors associated with hospital admission for COVID-19 in HIV patients

Biagio, Antonio Di; Ricci, Elena; Calza, Leonardo; Squillace, Nicola; Menzaghi, Barbara; Rusconi, Stefano; Orofino, Giancarlo; Bargiacchi, Olivia; Molteni, Chiara; Valsecchi, Laura; Cenderello, Giovanni; Ferrara, S.; Saracino, Annalisa; Maggi, Paolo; Falasca, Katia; Taramasso, Lucia; Bonfanti, Paolo

doi:10.1097/qad.0000000000002663

Cited by 29 publications

(31 citation statements)

References 6 publications

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“…21 23 28 32 34 37 38 40 41 while other studies found that PLHIV with COVID-19 were more likely to have comorbidities such as diabetes and hypertension.26 29 31 35 36 …”

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confidence: 99%

Sexual health (excluding reproductive health, intimate partner violence and gender-based violence) and COVID-19: a scoping review

et al. 2021

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ObjectivesThe COVID-19 pandemic has exposed and exacerbated existing socioeconomic and health disparities, including disparities in sexual health and well-being. While there have been several reviews published on COVID-19 and population health disparities generally—including some with attention to HIV—none has focused on sexual health (ie, STI care, female sexual health, sexual behaviour). We have conducted a scoping review focused on sexual health (excluding reproductive health (RH), intimate partner violence (IPV) and gender-based violence (GBV)) in the COVID-19 era, examining sexual behaviours and sexual health outcomes.MethodsA scoping review, compiling both peer-reviewed and grey literature, focused on sexual health (excluding RH, IPV and GBV) and COVID-19 was conducted on 15 September 2020. Multiple bibliographical databases were searched. Study selection conformed to Joanna Briggs Institute (JBI) Reviewers’ Manual 2015 Methodology for JBI Scoping Reviews. We only included English-language original studies.ResultsWe found that men who have sex with men may be moving back toward pre-pandemic levels of sexual activity, and that STI and HIV testing rates seem to have decreased. There was minimal focus on outcomes such as the economic impact on sexual health (excluding RH, IPV and GBV) and STI care, especially STI care of marginalised populations. In terms of population groups, there was limited focus on sex workers or on women, especially women’s sexual behaviour and mental health. We noticed limited use of qualitative techniques. Very few studies were in low/middle-income countries (LMICs).ConclusionsSexual health research is critical during a global infectious disease pandemic and our review of studies suggested notable research gaps. Researchers can focus efforts on LMICs and under-researched topics within sexual health and explore the use of qualitative techniques and interventions where appropriate.

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“…21 23 28 32 34 37 38 40 41 while other studies found that PLHIV with COVID-19 were more likely to have comorbidities such as diabetes and hypertension.26 29 31 35 36 …”

mentioning

confidence: 99%

Sexual health (excluding reproductive health, intimate partner violence and gender-based violence) and COVID-19: a scoping review

et al. 2021

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“…Four of these reported all-cause mortality among people diagnosed with COVID-19 [10,16,18,28] and one reported mortality due to COVID-19 as recorded on death certificates [27]. Of the remaining fourteen studies, seven made multiple comparisons between PLWH with COVID-19 and HIV-negative cohorts, and/or the general population, and/or PLWH without COVID-19, [11,12,14,15,23,25,26], two studies compared only to a HIV-negative cohort [13,19], two studies compared only cohorts of PLWH with and without COVID-19 [17,22] and three studies compared only the characteristics of PLWH with different COVID-19 disease severity [20,21,24].…”

Section: Resultsmentioning

confidence: 99%

“…We identified 1,908 records and included 19 studies in our final qualitative analysis ( Figure 1). Seventeen studies [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] were peer-reviewed and two were preprints [27,28]. Quality appraisal is included in Tables 1, S2 and S3.…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

“…CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint and/or PLWH without COVID-19, [11,12,14,15,23,25,26], two studies compared only to a HIV-negative cohort [13,19], two studies compared only cohorts of PLWH with and without COVID-19 [17,22] and three studies compared only the characteristics of PLWH with different COVID-19 disease severity [20,21,24].…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

“…A US hospital study found that PLWH and COVID-19 who survived were more likely to have been treated with NRTIs that those PLWH who died (99% vs 89%, p=0.04) in univariate analysis [13]. Seven smaller studies (n=18-93 PLWH with COVID- 19) reported no significant association between ART-regimen and COVID-19 severity amongst PLWH [14,15,17,[20][21][22][23][24].…”

Section: Impact Of Art Regimen On Covid-19 Outcomesmentioning

confidence: 99%

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Risk of adverse COVID-19 outcomes for people living with HIV: a rapid review and meta-analysis

Mellor

Bast

Jones

et al. 2020

Preprint

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Objective: To assess whether people living with HIV (PLWH) are at increased risk of COVID-19 mortality or adverse outcomes, and whether antiretroviral therapy (ART) influences this risk. Design: Rapid review with meta-analysis and narrative synthesis. Methods: We searched databases including Embase, Medline, medRxiv, and Google Scholar up to 26th August 2020 for studies describing COVID-19 outcomes in PLWH and conducted a meta-analysis of higher quality studies. Results: We identified 1,908 studies and included 19 in the review. In a meta-analysis of five studies, PLWH had a higher risk of COVID-19 mortality (hazard ratio (HR) 1.93, 95% Confidence Interval (CI): 1.59-2.34) compared to people without HIV. Risk of death remained elevated for PLWH in a subgroup analysis of hospitalised cohorts (HR 1.54, 95% CI: 1.05-2.24) and studies of PLWH across all settings (HR 2.08, 95%CI: 1.69-2.56). Eight other studies assessed the association between HIV and COVID-19 outcomes, but provided inconclusive, lower-quality evidence due to potential confounding and selection bias. There were insufficient data on the effect of CD4+ T cell count and HIV viral load on COVID-19 outcomes. Eleven studies reported COVID-19 outcomes by ART-regimen. In the two largest studies, tenofovir-disoproxil-fumarate (TDF)-based regimens were associated with a lower risk of adverse COVID-19 outcomes, although these analyses are susceptible to confounding by comorbidities. Conclusion: Evidence is emerging that suggests a moderately increased risk of COVID-19 mortality amongst PLWH. Further investigation into the relationship between COVID-19 outcomes and CD4+ T cell count, HIV viral load, ART and the use of TDF is warranted.

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Mitigation strategies to safely conduct HIV treatment research in the context of COVID‐19

et al. 2022

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Introduction The International AIDS Society convened a multidisciplinary committee of experts in December 2020 to provide guidance and key considerations for the safe and ethical management of clinical trials involving people living with HIV (PLWH) during the SARS‐CoV‐2 pandemic. This consultation did not discuss guidance for the design of prevention studies for people at risk of HIV acquisition, nor for the programmatic delivery of antiretroviral therapy (ART). Discussion There is strong ambition to continue with HIV research from both PLWH and the research community despite the ongoing SARS‐CoV‐2 pandemic. How to do this safely and justly remains a critical debate. The SARS‐CoV‐2 pandemic continues to be highly dynamic. It is expected that with the emergence of effective SARS‐CoV‐2 prevention and treatment strategies, the risk to PLWH in clinical trials will decline over time. However, with the emergence of more contagious and potentially pathogenic SARS‐CoV‐2 variants, the effectiveness of current prevention and treatment strategies may be compromised. Uncertainty exists about how equally SARS‐CoV‐2 prevention and treatment strategies will be available globally, particularly for marginalized populations, many of whom are at high risk of reduced access to ART and/or HIV disease progression. All of these factors must be taken into account when deciding on the feasibility and safety of developing and implementing HIV research. Conclusions It can be assumed for the foreseeable future that SARS‐CoV‐2 will persist and continue to pose challenges to conducting clinical research in PLWH. Guidelines regarding how best to implement HIV treatment studies will evolve accordingly. The risks and benefits of performing an HIV clinical trial must be carefully evaluated in the local context on an ongoing basis. With this document, we hope to provide a broad guidance that should remain viable and relevant even as the nature of the pandemic continues to develop.

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Factors associated with hospital admission for COVID-19 in HIV patients

Cited by 29 publications

References 6 publications

Sexual health (excluding reproductive health, intimate partner violence and gender-based violence) and COVID-19: a scoping review

Sexual health (excluding reproductive health, intimate partner violence and gender-based violence) and COVID-19: a scoping review

Risk of adverse COVID-19 outcomes for people living with HIV: a rapid review and meta-analysis

Mitigation strategies to safely conduct HIV treatment research in the context of COVID‐19

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