COVID-19 in patients with HIV: clinical case series

Abstract

As of March 24, 2020, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has affected almost 400 000 people in 168 countries on five continents. Older patients (>60 years) and those with comorbidities (eg, hypertension, diabetes, cardiovascular disease, lung disease, and chronic kidney disease) present with more severe infection and worse prognosis. Coronavirus disease 2019 (COVID-19) has been described in only one patient with HIV in Wuhan, China, but case series in patients with HIV are lacking despite 37·9 million people having HIV globally. Here we describe, to our knowledge, the first single-centre experience of COVID-19 in patients infected with HIV-1, including clinical characteristics, antiviral and antiretroviral treatment, and outcomes. All patients gave informed consent for publishing their clinical data. We used nasopharyngeal swab samples for all diagnoses, amplifying the betacoronavirus E gene and the specific SARS-CoV-2 RdRp gene by PCR. On March 9, 2020, 2 weeks into the COVID-19 outbreak in Spain, 543 consecutive patients with SARSCoV-2 infection had been admitted to hospital at Hospital Clínic Barcelona, Barcelona, Spain. We admitted 62 (12%) into intensive care units and we discharged 208 (38%) with supervised outpatient care. Of all patients, five (0·92%; 95% 0·39–2·14) were HIV positive (table), of whom three were male and two were transgender, and four identified as men who Lancet HIV 2020