Outcomes among HIV-positive patients hospitalized with COVID-19

Abstract

Background: SARS-CoV-2 infection continues to cause significant morbidity and mortality worldwide. Preliminary data on SARS-CoV-2 infection suggests that some immunocompromised hosts experience worse outcomes. We performed a retrospective matched cohort study to characterize outcomes in HIV-positive patients with SARS-CoV-2 infection. Methods: Leveraging data collected from electronic medical records for all patients hospitalized at NYU Langone Health with COVID-19 between March 2, 2020 and April 23, 2020, we matched 21 HIV-positive patients to 42 non-HIV patients using a greedy nearest neighbor algorithm. Admission characteristics, laboratory results, and hospital outcomes were recorded and compared between the two groups. Results: While there was a trend toward increased rates of ICU admission, mechanical ventilation, and mortality in HIV-positive patients, these differences were not statistically significant. Rates for these outcomes in our cohort are similar to those previously published for all patients hospitalized with COVID-19. HIV-positive patients had significantly higher admission and peak CRP values. Other inflammatory markers did not differ significantly between groups, though HIV-positive patients tended to have higher peak values during their clinical course. Three HIV-positive patients had superimposed bacterial pneumonia with positive sputum cultures, and all three patients expired during hospitalization. There was no difference in frequency of thrombotic events or myocardial infarction between these groups. Conclusion: This study provides evidence that HIV coinfection does not significantly impact presentation, hospital course, or outcomes of patients infected with SARS-CoV-2, when compared to matched non-HIV patients. A larger study is required to determine if the trends we observed apply to all HIV-positive patients.

COVID-19 in Hospitalized Adults With HIV

“…This is despite no differences in initial chest x-ray findings, presenting symptoms, time of illness onset, prognostic markers such as lymphopenia or elevated D-dimer, or code status. Other case reports and studies have found similarly low morbidity in patients with HIV and SARS-CoV-2 co-infection [ 27 , 28 ]. In our study, the PWH group had very well-controlled disease.…”

COVID-19 in people living with HIV: A multicenter case-series study

“…Härter's cohort [26] has a similar mean age but showed higher severity, hospitalization, admission to ICU and mortality rates. However, differences are more difficult to assess with a smaller sample and in the absence of data related to subject comorbidities; the same limitations were found when comparing with the Wuhan [27] and New York [28] , [29] cohorts, both with a significantly higher median age. Finally, we found several similarities in our data with a recent systematic review [30] ; then, we suspect that the differences observed between the different cohorts are probably not significant.…”

Increased IL‐10‐producing regulatory T cells are characteristic of severe cases of COVID‐19

“…This is tentatively supported by results showing HIV-positive patients with a slight trend towards poorer COVID-19 outcome. [36][37][38] In addition, patients who received haematopoietic stem cell transplantation (HSCT), which leads to profound T-cell lymphopenia, 39 seem to have a worse outcome after SARS-CoV-2 infection, since preliminary data suggest 30% mortality according to an ongoing European Society for Blood and Marrow Transplantation survey. 40 The loss of B cells is less likely to contribute to disease, with patients who are genetically depleted of B cells showing normal outcomes.…”