tetano
Editor, Senior Moderator
Lancet HIV
. 2020 May 28;S2352-3018(20)30164-8.
doi: 10.1016/S2352-3018(20)30164-8. Online ahead of print.
Description of COVID-19 in HIV-infected Individuals: A Single-Centre, Prospective Cohort
Pilar Vizcarra[SUP] 1 [/SUP], Mar?a J P?rez-El?as[SUP] 2 [/SUP], Carmen Quereda[SUP] 2 [/SUP], Ana Moreno[SUP] 2 [/SUP], Mar?a J Vivancos[SUP] 2 [/SUP], Fernando Dronda[SUP] 2 [/SUP], Jos? L Casado[SUP] 2 [/SUP], COVID-19 ID Team
Collaborators, Affiliations
Abstract
Background: Information about incidence, clinical characteristics, and outcomes of HIV-infected individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is scarce. We characterised individuals with COVID-19 among a cohort of HIV-infected adults in Madrid.
Methods: In this observational prospective study, we included all consecutive HIV-infected individuals (aged ≥18 years) who had suspected or confirmed COVID-19 as of April 30, 2020, at the Hospital Universitario Ram?n y Cajal (Madrid, Spain). We compared the characteristics of HIV-infected individuals with COVID-19 with a sample of HIV-infected individuals assessed before the COVID-19 pandemic, and described the outcomes of individuals with COVID-19.
Findings: 51 HIV-infected individuals were diagnosed with COVID-19 (incidence 1?8%, 95% CI 1?3-2?3). Mean age of patients was 53?3 years (SD 9?5); eight (16%) were women, and 43 (84%) men. 35 (69%) cases of co-infection had laboratory confirmed COVID-19, and 28 (55%) required hospital admission. Age and CD4 cell counts in 51 patients diagnosed with COVID-19 were similar to those in 1288 HIV-infected individuals without; however, 32 (63%) with COVID-19 had at least one comorbidity (mostly hypertension and diabetes) compared with 495 (38%) without COVID-19 (p=0?00059). 37 (73%) patients had received tenofovir before COVID-19 diagnosis compared with 487 (38%) of those without COVID-19 (p=0?0036); 11 (22%) in the COVID-19 group had previous protease inhibitor use (mostly darunavir) compared with 175 (14%; p=0?578). Clinical, analytical, and radiological presentation of COVID-19 in HIV-infected individuals was similar to that described in the general population. Six (12%) individuals were critically ill, two of whom had CD4 counts of less than 200 cells per μL, and two (4%) died. SARS-CoV-2 RT-PCR remained positive after a median of 40 days from symptoms onset in six (32%) individuals, four of whom had severe disease or low nadir CD4 cell counts.
Interpretation: HIV-infected individuals should not be considered to be protected from SARS-CoV-2 infection or to have lower risk of severe disease. Generally, they should receive the same treatment approach applied to the general population.
Funding: None.
. 2020 May 28;S2352-3018(20)30164-8.
doi: 10.1016/S2352-3018(20)30164-8. Online ahead of print.
Description of COVID-19 in HIV-infected Individuals: A Single-Centre, Prospective Cohort
Pilar Vizcarra[SUP] 1 [/SUP], Mar?a J P?rez-El?as[SUP] 2 [/SUP], Carmen Quereda[SUP] 2 [/SUP], Ana Moreno[SUP] 2 [/SUP], Mar?a J Vivancos[SUP] 2 [/SUP], Fernando Dronda[SUP] 2 [/SUP], Jos? L Casado[SUP] 2 [/SUP], COVID-19 ID Team
Collaborators, Affiliations
- PMID: 32473657
- PMCID: PMC7255735
- DOI: 10.1016/S2352-3018(20)30164-8
Abstract
Background: Information about incidence, clinical characteristics, and outcomes of HIV-infected individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is scarce. We characterised individuals with COVID-19 among a cohort of HIV-infected adults in Madrid.
Methods: In this observational prospective study, we included all consecutive HIV-infected individuals (aged ≥18 years) who had suspected or confirmed COVID-19 as of April 30, 2020, at the Hospital Universitario Ram?n y Cajal (Madrid, Spain). We compared the characteristics of HIV-infected individuals with COVID-19 with a sample of HIV-infected individuals assessed before the COVID-19 pandemic, and described the outcomes of individuals with COVID-19.
Findings: 51 HIV-infected individuals were diagnosed with COVID-19 (incidence 1?8%, 95% CI 1?3-2?3). Mean age of patients was 53?3 years (SD 9?5); eight (16%) were women, and 43 (84%) men. 35 (69%) cases of co-infection had laboratory confirmed COVID-19, and 28 (55%) required hospital admission. Age and CD4 cell counts in 51 patients diagnosed with COVID-19 were similar to those in 1288 HIV-infected individuals without; however, 32 (63%) with COVID-19 had at least one comorbidity (mostly hypertension and diabetes) compared with 495 (38%) without COVID-19 (p=0?00059). 37 (73%) patients had received tenofovir before COVID-19 diagnosis compared with 487 (38%) of those without COVID-19 (p=0?0036); 11 (22%) in the COVID-19 group had previous protease inhibitor use (mostly darunavir) compared with 175 (14%; p=0?578). Clinical, analytical, and radiological presentation of COVID-19 in HIV-infected individuals was similar to that described in the general population. Six (12%) individuals were critically ill, two of whom had CD4 counts of less than 200 cells per μL, and two (4%) died. SARS-CoV-2 RT-PCR remained positive after a median of 40 days from symptoms onset in six (32%) individuals, four of whom had severe disease or low nadir CD4 cell counts.
Interpretation: HIV-infected individuals should not be considered to be protected from SARS-CoV-2 infection or to have lower risk of severe disease. Generally, they should receive the same treatment approach applied to the general population.
Funding: None.