SARS-CoV-2 (COVID-19) infection in patients with HTLV-1 infection in Peru - case series

Abstract

Introduction: Peru has suffered a prolonged sanitary emergency and has the highest COVID – 19 mortalities per capita in the world. Some risk factors (diabetes, HIV, cardiovascular diseases, etc.) are currently considered by the CDC to develop severe COVID-19 infection. CDC considers as possible risk factors (evidence is mixed), other immunodeficiency conditions, one of them would be infection by HTLV-1 (human T-cell lymphotropic virus type 1). It is not known whether subjects with HTLV – 1 infection have a higher risk for severe COVID – 19 disease. Materials and methods: We identified 51 patients with HTLV-1 and COVID-19. The patients recruited for this article belong to the HTLV-1 cohort of the Institute of Tropical Medicine Alexander von Humboldt - Cayetano Heredia Hospital and to the study cohort: "The effect of Strongyloides Stercoralis on HTLV-1 disease progression”. Periodic telemedicine follow-up was carried out on our patients during the lockdown from April 2020 to November 2021, and information related to SARS-CoV-2 infection was recorded. Results: 51 patients from cohorts were diagnosed with COVID-19 during the pandemic between April 2020 and October 2021. The majority are female (29 patients, 56.85%). 76.47% (39 patients) underwent a molecular/PCR, antigenic or serological test; while 23.53% (12 patients) developed symptoms compatible with COVID-19 in a context of family outbreak and positive direct contact. 74.51% (38 patients) developed a mild form of the disease, 15.69% (8 patients) a moderate form and 9.80% (5 patients) were asymptomatic. The most frequent symptoms were general malaise and/or fever (82.35%), headache (80.39%) and cough (76.47%). Discussion: the course of SARS-CoV-2 in patients infected with HTLV-1 follows similar patterns in percentage and symptoms compared to the general population. 81% usually develop a mild condition, while for our data 74.51% did. 14% usually develop moderate to severe disease worldwide, in our cohort, 15.69% developed moderate disease. The patients show a clinical picture similar to what is described in the literature as a common presentation of SARS-CoV-2. American studies show that the most frequent symptoms are headache (76%) and sore throat (65%); in our cohort, 80.39% reported headache and 35.29% sore throat. Conclusion: Patients with HTLV-1 who become infected with SARS-CoV-2 develop mild or moderate disease in similar proportions to the general population. More studies are needed to elucidate the risk of developing severe SARS-CoV-2 disease in patients infected with HTLV-1 and its associated comorbidities.