Significant association between HIV infection and increased risk of COVID-19 mortality: a meta-analysis based on adjusted effect estimates

Abstract

To investigate the relationship between human immunodeficiency virus (HIV) infection and the risk of mortality among coronavirus disease 2019 (COVID-19) patients based on adjusted effect estimate by a quantitative meta-analysis. A randomeffects model was used to estimate the pooled effect size (ES) with corresponding 95% confidence interval (CI). I 2 statistic, sensitivity analysis, Begg's test, meta-regression and subgroup analyses were also conducted. This meta-analysis presented that HIV infection was associated with a significantly higher risk of COVID-19 mortality based on 40 studies reporting risk factors-adjusted effects with 131,907,981 cases (pooled ES 1.43, 95% CI 1.25-1.63). Subgroup analyses by male proportion and setting yielded consistent results on the significant association between HIV infection and the increased risk of COVID-19 mortality. Allowing for the existence of heterogeneity, further meta-regression and subgroup analyses were conducted to seek the possible source of heterogeneity. None of factors might be possible reasons for heterogeneity in the further analyses. Sensitivity analysis indicated the robustness of this meta-analysis. The Begg's test manifested that there was no publication bias (P = 0.2734). Our findings demonstrated that HIV infection was independently associated with a significantly increased risk of mortality in COVID-19 patients. Further well-designed studies based on prospective study estimates are warranted to confirm our findings.

Six-month immune responses to mRNA-1273 Vaccine in cART-treated late presenter people living with HIV according to previous SARS-CoV-2 Infection

“…The incidence of coronavirus disease 2019 (COVID- 19) among people with HIV (PWH) has been reported similar [1][2][3] or even lower [4][5][6] than in the general population, suggesting that HIV per se is not a risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Likewise, studies evaluating COVID-19 outcome in PWH have yielded conflicting results due to multiple confounding factors [7,8], displaying similar [9,10] or higher [3,[11][12][13] disease severity and mortality compared to people without HIV.…”

Relevance of comorbidities for main outcomes during different periods of the COVID‐19 pandemic

“…28 Some other cardiovascular diseases (peripheral vascular disease, cerebrovascular disease, and ischemic heart disease) also played an important role in the first wave, 29 with HIV featuring only in this period. 30 The second and third periods had fewer comorbidities related to death, with liver disease and diabetes appearing in all periods, 31,32 while in the Omicron variant the number of predictive comorbidities increased slightly, with hemiplegia/paraplegia added to the previous predictive variables. The profile for adverse evolution was similar to that previously described, with the addition of diabetes.…”

COVID‐19 hospitalization outcomes in adults by HIV status; a nation‐wide register‐based study

“…A recent meta‐analysis also found an increased risk of COVID‐19 in‐hospital mortality in PWH. However, this analysis did not take HIV‐related variables into account, and the risk differed between regions (Africa, Asia, Europe and America), highlighting the possible effect of differences in viral load, CD4 count, ART and socio‐economic factors [27].…”