Description of COVID-19 in HIV-infected individuals: a single-centre, prospective cohort. Issue 8 (August 2020)

• Record Type: Journal Article
• Authors: Vizcarra, Pilar; Pérez-Elías, María J; Quereda, Carmen; Moreno, Ana; Vivancos, María J; Dronda, Fernando; Casado, José L; Moreno, Santiago; Pérez-Elías, Maria Jesús; Fortún, Jesús; Navas, Enrique; Quereda, Carmen; Dronda, Fernando; Del Campo, Santos; López-Vélez, Rogelio; Cobo Reinoso, Javier; Casado, José Luis; Moreno, Ana; Norman, Franceca; Martín-Dávila, Pilar; Hermida, José Manuel; Pérez Molina, José Antonio; Monge, Begoña; Pintado, Vicente; Serrano-Villar, Sergio; Sánchez-Conde, Matilde; Chamorro, Sandra; Escudero, Rosa; Gioia, Francesca; Comeche, Belén; Crespillo, Clara; Herrera, Sabina; Ron, Raquel; Martínez-Sanz, Javier; Pons-Guillén, Mario; Vivancos, María Jesús; Vizcarra, Pilar;
• Is Part Of: Lancet. Volume 7:Issue 8(2020)
• Page Start: e554
• Page End: e564
• Publication Date: 2020-08
• Subjects: HIV (Viruses) -- Periodicals; HIV infections -- Periodicals; AIDS (Disease) -- Periodicals; 616.9792
• DOI: 10.1016/S2352-3018(20)30164-8
• Languages: English
• ISSNs: 2405-4704

Abstract

Summary: 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 Ramón 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.