Over 5,300 people living with HIV (PLWHIV) were involved in this study, of whom only 0.5% were positive for the virus that caused COVID-19; and among these 30 patients, 70% were hospitalized while 30% were outpatients.
The median patient age was 54 years and over three-quarters were born outside of France, 60% of the patients were men, 33% were women and 7% were transgendered. Around one-third of the patients had cardiovascular disease, diabetes and obesity. Around one-fifth had chronic kidney disease and two-thirds were overweight and 5 had a Charlson comorbidity index of three or more; this reflects the comorbidities most commonly seen in serve/critical COVID-19 infection.
At the study conclusion, 2 patients had died while 4 were still in the hospital, and the worst outcomes were in those with a higher CCI score. 3 patients needed ventilation which is similar to other studies, but the mortality in this study was lower compared to 21% in other studies.
HIV infection was dormant in 90% of the patients and in the remaining 3 two had a low HIV viral load, and three-quarters of the patients had a CD4 cell count above 500 cells/mm3; this suggests that other risk factors than HIV-induced immunosuppression were driving COVID-19 infection.
80% of the patients were positive for the viral RNA polymerase chain reaction testing, 2 were negative but had typical findings of COVID-19 on chest CT scanning. IN three patients diagnosis was made based on anosmia or ageusia without a nasal swab at a median of 7 days from the onset of symptoms.
Only one patient required the treatment regimen to be altered due to the critical medical condition, 16% required additional antiviral treatment due to the severity of the disease; requiring an oxygen flow of over 3 litres per minute, and around the same number of patients needed tocilizumab and dexamethasone.
Most of these patients were on effective anti-retroviral treatment and were virologically suppressed, with a high CD4 count. Additional studies are required to establish the risk factors, the clinical outcomes, and treatment options in PLWHIV who contract COVID-19.
“The study concludes, risk factors were the same as those described in other SARS-COV2 series, suggesting that HIV infection is probably not an independent risk factor for COVID-19 infection.”
