Posted on Oct 05, 2020, 8 p.m.
A new study published in the International Journal of Infectious Diseases has reported that those with HIV infections are not at an increased risk for COVID-19 compared to the general population, according to the researchers at the Bichal University Hospital in Paris.
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.”
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