COVID-19 in people living with HIV: A multicenter case-series study

Graphical Abstract
Highlights • Lower mortality rate was observed in HIV patients. • Similar hospitalization and ICU admission rate were observed in HIV patients. • Age and comorbidities also represent the main poor prognostic factors for PLHIV. • HIV severity or the type of antiretroviral does not influence the Covid-19 outcome.
Objectives The information of how COVID-19 infection affects people living with HIV (PLHIV) is still scarce. Methods Observational study was conducted in four of public hospitals in Madrid. All HIV patients with confirmed or suspected COVID-19 disease were included and compared with COVID-19 infected patients without HIV infection. Results Sixty-three patients with HIV infection were analysed. The median age was 46 years (IQR: 37-56 years), 88.9% were men. The median time of HIV infection was 10.8 years (IQR: 6.5 - 16.8 years), 96.8% were on antiretroviral therapy. 84.1% had previous comorbidities. The most common symptoms were fever(66.1%), cough(66.1%) and dyspnea(46.8%). Pneumonia was found in 47.5%, 28.6% of patients had severe disease and 32.3% was admitted to hospital. The ICU admission rate and the mortality rate were both 3.17%. Significant association was observed between age, arterial hypertension, overweight, diabetes mellitus and the severity of COVID-19 disease. No association was observed between HIV-related factors. The rate of COVID-19 disease in HIV-patients was 1,68%. A similar hospitalization (31.74% vs 32.57%) and ICU admission rate (3.17% vs 2%) was observed with non-HIV infected patients. A lower mortality rate during hospitalization (10% vs 21.37%) and global mortality rate (3.17% vs 6.96%) were observed. Conclusions Established poor prognostic factors, such as age and comorbidities, represent also the main determinants for PLHIV. Neither the HIV severity, nor the type of ARV treatment seem to influence the outcome of COVID-19 infection. Large prospective cohorts are needed in order to establish the differences between HIV positive and negative patients.