Outcomes Among HIV-Positive Patients Hospitalized With COVID-19

Karmen-Tuohy, Savannah; Carlucci, Philip M.; Zervou, Fainareti N.; Zacharioudakis, Ioannis M.; Rebick, Gabriel; Klein, Elizabeth J.; Reich, Jenna; Jones, Simon; Rahimian, Joseph

doi:10.1097/qai.0000000000002423

Cited by 167 publications

(189 citation statements)

References 17 publications

Supporting

Mentioning

172

Contrasting

Unclassified

Order By: Relevance

“…While lymphopenia may remain an epiphenomenon, the paucity of T cells may equally be contributing to disease. This is tentatively supported by results showing HIV‐positive patients with a slight trend towards poorer COVID‐19 outcome 36–38 . In addition, patients who received haematopoietic stem cell transplantation (HSCT), which leads to profound T‐cell lymphopenia, 39 seem to have a worse outcome after SARS‐CoV‐2 infection, since preliminary data suggest 30% mortality according to an ongoing European Society for Blood and Marrow Transplantation survey 40 .…”

Section: Discussionmentioning

confidence: 90%

Increased IL‐10‐producing regulatory T cells are characteristic of severe cases of COVID‐19

et al. 2020

View full text Add to dashboard Cite

Objectives The pandemic spread of the coronavirus SARS‐CoV‐2 is due, in part, to the immunological properties of the host–virus interaction. The clinical presentation varies from individual to individual, with asymptomatic carriers, mild‐to‐moderate‐presenting patients and severely affected patients. Variation in immune response to SARS‐CoV‐2 may underlie this clinical variation. Methods Using a high‐dimensional systems immunology platform, we have analysed the peripheral blood compartment of 6 healthy individuals, 23 mild‐to‐moderate and 20 severe COVID‐19 patients. Results We identify distinct immunological signatures in the peripheral blood of the mild‐to‐moderate and severe COVID‐19 patients, including T‐cell lymphopenia, more consistent with peripheral hypo‐ than hyper‐immune activation. Unique to the severe COVID‐19 cases was a large increase in the proportion of IL‐10‐secreting regulatory T cells, a lineage known to possess anti‐inflammatory properties in the lung. Conclusion As IL‐10‐secreting regulatory T cells are known to possess anti‐inflammatory properties in the lung, their proportional increase could contribute to a more severe COVID‐19 phenotype. We openly provide annotated data ( https://flowrepository.org/experiments/2713 ) with clinical correlates as a systems immunology resource for the COVID‐19 research community.

show abstract

Section: Discussionmentioning

confidence: 90%

Increased IL‐10‐producing regulatory T cells are characteristic of severe cases of COVID‐19

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The single patient affected by HIV reported by Molina et al 30 was included among patients with a median age of 58.7 years (20–77) and the one reported by Wang et al 17 was among those with a median age of 38.76 years. Last, Gervasoni et al included 47 patients with a mean age of 51 ± 11 years, 27 while Karmen‐Tuohy et al reported 21 patients with a mean age of 60.04 ± 11.77 24 …”

Section: Resultsmentioning

confidence: 99%

SARS‐CoV‐2 infection in people living withHIV: a systematic review

Costenaro

Minotti

Barbieri

et al. 2020

Reviews in Medical Virology

View full text Add to dashboard Cite

Summary Background and setting Little is known about SARS‐CoV‐2 impact on some vulnerable subgroups, such as people living with HIV/AIDS (PLWHA). In our study we reviewed the current knowledge on SARS‐CoV‐2 cases in PLWHA. Methods A systematic review was conducted by searching the MEDLINE, EMBASE and Google Scholar databases. Studies reporting data on PLWHA affected by SARS‐CoV‐2 were considered for inclusion. The aim of this study was the systematic characterization of cases of SARS‐CoV‐2 infection among PLWHA, particularly focusing on age, clinical findings at diagnosis, radiological features, therapeutic management and clinical outcomes. Results Twenty three relevant articles were identified, which reported 164 adults with both HIV and SARS‐CoV‐2 infection. Of those, the large majority were males (120/142, 84.5%), often with one or more comorbidities. Fifteen cases needed intensive care treatment and 16 died. For each group, respectively three patients had underlying comorbidities. There were no studies on children. The included studies were mostly retrospective or case series/reports (19 studies). The overall risk of bias was moderate, due to the study types and characteristics. Conclusion It is still unclear if HIV infection may influence SARS‐CoV‐2 infection and disease course, however some PLWHA and particularly males affected by ARV‐related complications may be at greater risk of severe Covid‐19 course.

show abstract

“…Evidence about the interplay between HIV and COVID-19 is not entirely consistent [8,9,[13][14][15][16][17][18][19][20][21][22][23]. A case-control study from New York compared 88 PWH, all of whom were receiving ART, and 405 HIV-negative controls matched by age, gender, ethnicity, and calendar week of infection [21].…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

“…Several case series and observational cohort studies have described the outcomes of in PWH across Europe [9,[13][14][15][16][17][18][19], Asia [18,19], and the United States [8,[18][19][20][21][22]. These studies have often been limited by small sample sizes, lack of direct comparative data from people without HIV, or inability to adjust for comorbidities.…”

Section: Introductionmentioning

confidence: 99%

“…These studies have often been limited by small sample sizes, lack of direct comparative data from people without HIV, or inability to adjust for comorbidities. Some reports indicated that PWH did not experience higher rates of COVID-19 related hospitalization or mortality than people without HIV [14,21], whereas others suggested increased disease severity [9,20]. Importantly, preliminary data from South Africa indicated that despite effective ART, HIV infection more than doubled the risk of COVID-19 related mortality [23].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of Coronavirus Disease 2019 (COVID-19) Related Hospitalization Among People With Human Immunodeficiency Virus (HIV) in the ISARIC World Health Organization (WHO) Clinical Characterization Protocol (UK): A Prospective Observational Study

Geretti

Stockdale

Kelly

et al. 2020

Clinical Infectious Diseases

238

244

View full text Add to dashboard Cite

Background Evidence is conflicting about how HIV modulates COVID-19. We compared the presentation characteristics and outcomes of adults with and without HIV who were hospitalized with COVID-19 at 207 centers across the United Kingdom and whose data were prospectively captured by the ISARIC WHO CCP study. Methods We used Kaplan-Meier methods and Cox regression to describe the association between HIV status and day-28 mortality, after separate adjustment for sex, ethnicity, age, hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, ten individual comorbidities, and disease severity at presentation (as defined by hypoxia or oxygen therapy). Results Among 47,592 patients, 122 (0.26%) had confirmed HIV infection and 112/122 (91.8%) had a record of antiretroviral therapy. At presentation, HIV-positive people were younger (median 56 versus 74 years; p<0.001) and had fewer comorbidities, more systemic symptoms and higher lymphocyte counts and C-reactive protein levels. The cumulative day-28 mortality was similar in the HIV-positive vs. HIV-negative groups (26.7% vs. 32.1%; p=0.16), but in those under 60 years of age HIV-positive status was associated with increased mortality (21.3% vs. 9.6%; p<0.001 [log-rank test]). Mortality was higher among people with HIV after adjusting for age (adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.01-2.14; p=0.05), and the association persisted after adjusting for the other variables (aHR 1.69; 95% CI 1.15-2.48; p=0.008) and when restricting the analysis to people aged <60 years (aHR 2.87; 95% CI 1.70-4.84; p<0.001). Conclusions HIV-positive status was associated with an increased risk of day-28 mortality among patients hospitalized for COVID-19.

show abstract

Outcomes Among HIV-Positive Patients Hospitalized With COVID-19

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 167 publications

References 17 publications

Increased IL‐10‐producing regulatory T cells are characteristic of severe cases of COVID‐19

Increased IL‐10‐producing regulatory T cells are characteristic of severe cases of COVID‐19

SARS‐CoV‐2 infection in people living withHIV: a systematic review

Outcomes of Coronavirus Disease 2019 (COVID-19) Related Hospitalization Among People With Human Immunodeficiency Virus (HIV) in the ISARIC World Health Organization (WHO) Clinical Characterization Protocol (UK): A Prospective Observational Study

Contact Info

Product

Resources

About