Influence of HIV infection on clinical course of the new coronavirus infection (COVID-19)

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Abstract

BACKGROUND: Human immunodeficiency virus (HIV)-associated severe immunosuppression, high viral load, non-HIV-related comorbidities and conditions, and lack of antiretroviral therapy may exacerbate the clinical course of coronavirus disease 2019 (COVID-19).

AIM: To assess the effect of HIV infection on the clinical course of COVID-19, disease severity, and its outcomes.

MATERIALS AND METHODS: Medical records of 35,328 patients who had COVID-19 in 2020 were analyzed, including 46 cases of COVID-19 in individuals with HIV infection. Clinical variants and COVID-19 severity, frequency of COVID-19 detection by polymerase chain reaction, CD4 lymphocyte count, viral load in individuals with HIV infection, and mortality rates were assessed.

RESULTS: In 76% of patients with coinfection, signs of HIV infection progression, opportunistic infections, and concomitant diseases were noted. Moreover, 52.2% of the patients analyzed were users of psychoactive substances. Among patients with HIV and COVID-19, men predominated in groups aged >30 years, whereas among the HIV-negative population, women were predominant in groups aged >18 years. The proportion of severe COVID-19 in individuals with HIV infection (47.8%) exceeds that in the group without HIV (12.3%). The mortality rate from COVID-19 in the HIV-infected group was more than seven times higher than that in the HIV-negative group (t=1.81; p=0.01).

CONCLUSIONS: In the HIV-infected group, extremely severe COVID-19 was more common. Weakness, cough, shortness of breath, and myalgia were significantly more common in the HIV-infected group. Moreover, the HIV-infected group with an undetectable viral load and adequate CD4 lymphocyte count in the blood was exposed to the same risks of the disease and its progression as the HIV-negative group.

About the authors

Alexey N. Danilov

Razumovsky Saratov State Medical University; Saratov Regional Clinical Center for AIDS Prevention and Control

Email: docvol@yandex.ru
ORCID iD: 0000-0002-9808-8471
SPIN-code: 4501-2565

MD, Dr Sci. (Med.), Professor

Russian Federation, 69, Melnichnaya St., Saratov, 410009; Saratov

Viacheslav I. Eremin

Razumovsky Saratov State Medical University

Email: epidem2012@yandex.ru
ORCID iD: 0000-0003-4703-0293
SPIN-code: 4871-0785

MD, Dr Sci. (Med.), Professor

Russian Federation, 69, Melnichnaya St., Saratov, 410009

Tatyana L. Abramyan

Saratov Regional Clinical Center for AIDS Prevention and Control

Email: tlabramyan@mail.ru
ORCID iD: 0000-0001-9977-0432
SPIN-code: 1207-3734

MD

Russian Federation, 69, Melnichnaya St., Saratov, 410009

Svetlana I. Yaroshevskaya

Saratov Regional Clinical Center for AIDS Prevention and Control

Email: centr_spid@overta.ru
ORCID iD: 0000-0002-2059-2619

MD

Russian Federation, 69, Melnichnaya St., Saratov, 410009

Anna V. Sofina

Saratov Regional Clinical Center for AIDS Prevention and Control

Email: dr.sofy@yandex.ru
ORCID iD: 0000-0001-5317-5590
SPIN-code: 2053-3478

MD

Russian Federation, 69, Melnichnaya St., Saratov, 410009

Irina A. Mamonova

Saratov Regional Clinical Center for AIDS Prevention and Control

Email: ira-mamonova@yandex.ru
ORCID iD: 0000-0003-3941-4334

MD

Russian Federation, 69, Melnichnaya St., Saratov, 410009

Elena A. Vodina

Saratov Regional Clinical Center for AIDS Prevention and Control

Email: centr_spid@overta.ru
ORCID iD: 0000-0003-2422-2727

MD

Russian Federation, 69, Melnichnaya St., Saratov, 410009

Natalya A. Philippova

Saratov Regional Clinical Center for AIDS Prevention and Control

Email: flp-na@yandex.ru
ORCID iD: 0000-0003-1698-1141

MD

Russian Federation, 69, Melnichnaya St., Saratov, 410009

Darya A. Teisherskaya

Saratov Regional Clinical Center for AIDS Prevention and Control

Author for correspondence.
Email: teyshdarya97@gmail.com
ORCID iD: 0000-0002-6742-5025
SPIN-code: 2461-5262

MD

Russian Federation, 69, Melnichnaya St., Saratov, 410009

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2. Fig. 1. Age structure among PLHIV and HIV-negative who have had COVID-19.

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