Risk of mortality in HIV-infected COVID-19 patients: A systematic review and meta-analysis

Dzinamarira, Tafadzwa; Murewanhema, Grant; Chitungo, Itai; Ngara, Bernard; Nkambule, Sphamandla Josias; Madziva, Roda; Herrera, Helena; Mukwenha, Solomon; Cuadros, Diego F.; Iradukunda, Patrick Gad; Mashora, Moreblessing Chipo; Tungwarara, Nigel; Rwibasira, Gallican Nshogoza; Musuka, Godfrey

doi:10.1016/j.jiph.2022.05.006

Cited by 27 publications

(22 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…All women in the analysis also delivered a healthy infant, another marker of maternal health. Thus, in this cohort of healthy postpartum women, we did not observe a significant effect of HIV co-infection on SARS-CoV-2 infection and few symptoms of COVID-19 overall, as compared to other populations living with HIV, in whom HIV has been associated with increased COVID-19 severity and death [8][9][10][11][12][13][14].…”

Section: Plos Onecontrasting

confidence: 57%

“…Kenya has an estimated 1.5 million adults and children living with HIV [5], and there are limited data on the epidemiology of SARS-CoV-2 infection in this population. Several studies and meta-analyses suggest people living with HIV may have an increased risk of COVID-19 mortality, which is higher among those not on ART [6][7][8][9][10][11][12][13][14][15]. Persistent inflammation and immune dysregulation are hallmarks of HIV that are only partially resolved by suppressive antiretroviral therapy (ART) [16], and can result in pulmonary, cardiac, and other comorbidities that are risk factors for severe COVID-19 [17].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

HIV and SARS-CoV-2 infection in postpartum Kenyan women and their infants

et al. 2023

View full text Add to dashboard Cite

Background HIV may increase SARS-CoV-2 infection risk and COVID-19 severity generally, but data are limited about its impact on postpartum women and their infants. As such, we characterized SARS-CoV-2 infection among mother-infant pairs in Nairobi, Kenya. Methods We conducted a nested study of 62 HIV-uninfected and 64 healthy women living with HIV, as well as their HIV-exposed uninfected (N = 61) and HIV-unexposed (N = 64) infants, participating in a prospective cohort. SARS-CoV-2 serology was performed on plasma collected between May 1, 2020-February 1, 2022 to determine the incidence, risk factors, and symptoms of infection. SARS-CoV-2 RNA PCR and sequencing was also performed on available stool samples from seropositive participants. Results SARS-CoV-2 seropositivity was found in 66% of the 126 mothers and in 44% of the 125 infants. There was no significant association between SARS-CoV-2 infection and maternal HIV (Hazard Ratio [HR] = 0.810, 95% CI: 0.517–1.27) or infant HIV exposure (HR = 1.47, 95% CI: 0.859–2.53). Maternal SARS-CoV-2 was associated with a two-fold increased risk of infant infection (HR = 2.31, 95% CI: 1.08–4.94). Few participants (13% mothers, 33% infants) had symptoms; no participant experienced severe COVID-19 or death. Seroreversion occurred in about half of mothers and infants. SARS-CoV-2 sequences obtained from stool were related to contemporaneously circulating variants. Conclusions These data indicate that postpartum Kenyan women and their infants were at high risk for SARS-CoV-2 infection and that antibody responses waned over an average of 8–10 months. However, most cases were asymptomatic and healthy women living with HIV did not have a substantially increased risk of infection or severe COVID-19.

show abstract

Section: Plos Onecontrasting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

HIV and SARS-CoV-2 infection in postpartum Kenyan women and their infants

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Another study in New York showed that HIV infection alone is associated with an increased risk for severe disease and hospitalization, while the risk of hospitalization was even higher among those with advanced HIV disease [ 29 , 33 ]. Furthermore, meta-analyses have had inconsistent findings, with some showing increased odds of mortality among PWH [ 34 , 35 , 36 , 37 ] and others showing no differences in outcomes between HIV and non-HIV populations [ 38 ].…”

Section: Clinical Outcomesmentioning

confidence: 99%

HIV and COVID-19 Co-Infection: Epidemiology, Clinical Characteristics, and Treatment

Basoulis

Mastrogianni

Voutsinas

et al. 2023

Viruses

View full text Add to dashboard Cite

The COVID-19 pandemic has been a global medical emergency with a significant socio-economic impact. People with HIV (PWH), due to the underlying immunosuppression and the particularities of HIV stigma, are considered a vulnerable population at high risk. In this review, we report what is currently known in the available literature with regards to the clinical implications of the overlap of the two epidemics. PWH share the same risk factors for severe COVID-19 as the general population (age, comorbidities), but virological and immunological status also plays an important role. Clinical presentation does not differ significantly, but there are some opportunistic infections that can mimic or co-exist with COVID-19. PWH should be prime candidates for preventative COVID-19 treatments when they are available, but in the setting of resistant strains, this might be not easy. When considering small-molecule medications, physicians need to always remember to address potential interactions with ART, and when considering immunosuppressants, they need to be aware of potential risks for opportunistic infections. COVID-19 shares similarities with HIV in how the public perceives patients—with fear of the unknown and prejudice. There are opportunities for HIV treatment hidden in COVID-19 research with the leaps gained in both monoclonal antibody and vaccine development.

show abstract

“…Literature published since the beginning of the pandemic have documented higher COVID-19 related mortality in PLHIV; however, these reports did not provide conclusive evidence [4,5]. Recently, a metaanalysis published by Dzinamarira and colleagues which included 16 studies of PLHIV with concomitant SARS-CoV-2 infection concluded that there is no significant higher risk of mortality in PLHIV (RR 1.07, 95% CI 0.86-1.32) which leads to more questions due to the lack of concrete evidence [6].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 in people living with HIV: a single-center descriptive study

Pérez-Barragán

Castillo-Flores²,

Mata‐Marín³

et al. 2022

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: People living with human immunodeficiency virus (PLHIV) may suffer more severe symptoms of coronavirus disease 2019 (COVID-19) due to their immunocompromised status, even if they are undetectable. Human immunodeficiency virus (HIV) infection has been reported as an independent factor associated with higher mortality in patients with COVID-19. The present study aims to describe the clinical characteristics of PLHIV and COVID-19 in one center in Mexico. Methodology: We conducted an observational retrospective monocentric cohort study of PLHIV diagnosed with COVID-19 between 1 March 2020 and 30 April 2021. SARS-CoV-2 was detected by polymerase chain reaction (PCR) of a nasopharyngeal swab sample, clinical features, and epidemiological characteristics. Results: We identified 55 PLHIV with COVID-19. The median age was 36 years (IQR 25–41.5 years), and 54 patients were men. The median duration of HIV-1 infection was 4.3 years (Interquartile range, IQR 2.6–7.2 years), and 100% were on antiretroviral therapy (ART). The last HIV-1 RNA viral load analysis of the patients was 52/55 (94.5%) indicating that they were in virological suppression. The median CD4+ T-cell count was 734/mm3 (IQR 541.5-921/mm3). The most frequent pre-existing comorbidities found were obesity (21.8%), hypertension (7.2%), and diabetes (5.4%). Only one death was reported (1.8%). Conclusions: It has been reported that COVID-19/HIV/AIDS co-infection has a higher risk of mortality, admission to intensive care, and complications. However, our study found that people living with HIV-1 with adequate virological control did not present a severe course of COVID -19.

show abstract

Risk of mortality in HIV-infected COVID-19 patients: A systematic review and meta-analysis

Cited by 27 publications

References 60 publications

HIV and SARS-CoV-2 infection in postpartum Kenyan women and their infants

HIV and SARS-CoV-2 infection in postpartum Kenyan women and their infants

HIV and COVID-19 Co-Infection: Epidemiology, Clinical Characteristics, and Treatment

COVID-19 in people living with HIV: a single-center descriptive study

Contact Info

Product

Resources

About