Comparison of outcomes in HIV-positive and HIV-negative patients with COVID-19. Issue 2 (August 2021)

• Record Type: Journal Article
• Authors: Venturas, Jacqui; Zamparini, Jarrod; Shaddock, Erica; Stacey, Sarah; Murray, Lyle; Richards, Guy A; Kalla, Ismail; Mahomed, Adam; Mohamed, Farzahna; Mer, Mervyn; Maposa, Innocent; Feldman, Charles
• Is Part Of: Journal of infection. Volume 83:Issue 2(2021)
• Page Start: 217
• Page End: 227
• Publication Date: 2021-08
• Subjects: HIV -- COVID-19 -- Mortality -- South Africa; Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2021.05.020
• Languages: English
• ISSNs: 0163-4453

Abstract

Highlights: HIV is not a risk factor for moderate or severe COVID-19. HIV-positive patients do not have higher a mortality than HIV negative patients with COVID-19. HIV-positive patients with COVID-19 requiring admission to hospital are younger. Abstract: Background: South Africa has the highest prevalence of HIV in the world and to date has recorded the highest number of cases of COVID-19 in Africa. There is uncertainty as to what the significance of this dual infection is, and whether people living with HIV (PLWH) have worse outcomes compared to HIV-negative patients with COVID-19. This study compared the outcomes of COVID-19 in a group of HIV-positive and HIV-negative patients admitted to a tertiary referral centre in Johannesburg, South Africa. Methods: Data was collected on all adult patients with known HIV status and COVID-19, confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR), admitted to the medical wards and intensive care unit (ICU) between 6 March and 11 September 2020. The data included demographics, co-morbidities, laboratory results, severity of illness scores, complications and mortality, and comparisons were made between the HIV-positive and HIV negative groups. Results: Three-hundred and eighty-four patients, 108 HIV-positive and 276 HIV-negative, were included in the study. Median 4C score was significantly higher in the HIV-positive patients compared to the HIV-negative patients, but there was no significant difference in mortality between the HIV-positive and HIV-negative groups (15% vs 20%, p = 0.31). In addition, HIV-positive patients who died were younger than their HIV-negative counterparts, but this was not statistically significant (47.5 vs 57 years, p = 0.06). Conclusion: Our findings suggest that HIV is not a risk factor for moderate or severe COVID-19 disease neither is it a risk factor for mortality. However, HIV-positive patients with COVID-19 requiring admission to hospital are more likely to be younger than their HIV-negative counterparts. These findings need to be confirmed in future, prospective, studies.