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Description of COVID-19 in HIV-infected individuals: a single-centre, prospective cohort
Open accessAbstract
Background Information about incidence, clinical characteristics, and outcomes of HIV-infected individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is scarce. We characterised individuals with COVID-19 among a cohort of HIV-infected adults in Madrid. Methods In this observational prospective study, we included all consecutive HIV-infected individuals (aged ≥18 years) who had suspected or confirmed COVID-19 as of April 30, 2020, at the Hospital Universitario Ramón y Cajal (Madrid, Spain). We compared the characteristics of HIV-infected individuals with COVID-19 with a sample of HIV-infected individuals assessed before the COVID-19 pandemic, and described the outcomes of individuals with COVID-19. Findings 51 HIV-infected individuals were diagnosed with COVID-19 (incidence 1·8%, 95% CI 1·3–2·3). Mean age of patients was 53·3 years (SD 9·5); eight (16%) were women, and 43 (84%) men. 35 (69%) cases of co-infection had laboratory confirmed COVID-19, and 28 (55%) required hospital admission. Age and CD4 cell counts in 51 patients diagnosed with COVID-19 were similar to those in 1288 HIV-infected individuals without; however, 32 (63%) with COVID-19 had at least one comorbidity (mostly hypertension and diabetes) compared with 495 (38%) without COVID-19 (p=0·00059). 37 (73%) patients had received tenofovir before COVID-19 diagnosis compared with 487 (38%) of those without COVID-19 (p=0·0036); 11 (22%) in the COVID-19 group had previous protease inhibitor use (mostly darunavir) compared with 175 (14%; p=0·578). Clinical, analytical, and radiological presentation of COVID-19 in HIV-infected individuals was similar to that described in the general population. Six (12%) individuals were critically ill, two of whom had CD4 counts of less than 200 cells per μL, and two (4%) died. SARS-CoV-2 RT-PCR remained positive after a median of 40 days from symptoms onset in six (32%) individuals, four of whom had severe disease or low nadir CD4 cell counts. Interpretation HIV-infected individuals should not be considered to be protected from SARS-CoV-2 infection or to have lower risk of severe disease. Generally, they should receive the same treatment approach applied to the general population. Funding None.
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Piroth, L., Cottenet, J., Mariet, A.-S., Bonniaud, P., Blot, M., Tubert-Bitter, P., & Quantin, C. (2021) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(20)30527-0 · Cited by 600
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Mulenga, L. B., Hines, J. Z., Fwoloshi, S., Chirwa, L., Siwingwa, M., Yingst, S., Wolkon, A., Barradas, D. T., Favaloro, J., Zulu, J. E., et al. (2021) · The Lancet Global Health · doi:10.1016/s2214-109x(21)00053-x · Cited by 149
Metadata
- Authors
- Vizcarra, P., Pérez-Elías, M. J., Quereda, C., Moreno, A., Vivancos, M. J., Dronda, F., Casado, J. L., Moreno, S., Pérez-Elías, M. J., Fortún, J., Navas, E., Quereda, C., Dronda, F., Del Campo, S., López-Vélez, R., Cobo Reinoso, J., Casado, J. L., Moreno, A., Norman, F., Martín-Dávila, P., Hermida, J. M., Pérez Molina, J. A., Monge, B., Pintado, V., Serrano-Villar, S., Sánchez-Conde, M., Chamorro, S., Escudero, R., Gioia, F., Comeche, B., Crespillo, C., Herrera, S., Ron, R., Martínez-Sanz, J., Pons-Guillén, M., Vivancos, M. J., & Vizcarra, P.
- Venue
- The Lancet HIV
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 7
- Issue
- 8
- Pages
- e554-e564
- ISSN
- 2352-3018 (ISSN-L)
- OpenAlex
- W3029194236
- Cited by
- 373
- References
- 20
- FWCI
- 9.75
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Vizcarra, P., Pérez-Elías, M. J., Quereda, C., Moreno, A., Vivancos, M. J., Dronda, F., Casado, J. L., Moreno, S., Pérez-Elías, M. J., Fortún, J., Navas, E., Quereda, C., Dronda, F., Del Campo, S., López-Vélez, R., Cobo Reinoso, J., Casado, J. L., Moreno, A., Norman, F., . . . Vizcarra, P. (2020). Description of COVID-19 in HIV-infected individuals: a single-centre, prospective cohort. The Lancet HIV. https://doi.org/10.1016/s2352-3018(20)30164-8
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