Clinical characteristics of COVID-19 patients with HIV coinfection in Wuhan, China

ABSTRACT

Background

Information about the impact of HIV coinfection on clinical characteristics of COVID-19 patients remains limited.

Methods

Maximum body temperatures, fever duration, chest CT and viral shedding, lymphocyte counts, and titer of SARS-CoV-2 antibody were compared between COVID-19 patients with and without HIV infection in Zhongnan Hospital of Wuhan University from January 20th to February 14th, 2020.

Results

Compared with 53 COVID-19 patients without HIV infection, the patients with SARS-CoV-2 and HIV coinfection had higher maximum body temperatures (38.7°C vs 37.6°C, P = 0.044), longer duration of fever (8.7 ± 4.5 vs 4.2 ± 2.1 days, P = 0.038), longer time to have improvement of chest CT images (22 vs 15 days from the onset of illness, P = 0.011), lower level of SARS-CoV-2 IgG (5.11 ± 32.33 vs 37.45 ± 15.48 AU/ml, P = 0.042). However, no statistically significant difference of duration of SARS-CoV-2 shedding in the two groups was found (12.3 ± 2.6 vs 13.4 ± 2.4 days, , P = 0.813).

Conclusion

Lower level of CD4⁺ T lymphocyte counts caused by HIV infection itself might be one of reasons for relatively weak ability to produce SARS-CoV-2 specific antibodies. The effects of anti-HIV drugs in prevention and treatment of COVID-19 appears to be limited.

KEYWORDS:

• COVID-19
• SARS-CoV-2
• AIDS
• viral shedding

Author contributions

All authors collected the clinical data. Rongrong Yang, Yongxi Zhang, Yong Xiong and Shicheng Gao drafted the manuscript. Xien Gui and Hengning Ke supervised the final manuscript. All authors were responsible for summarising all data related to this study.

Article highlights

• HIV coinfection does not affect the diagnosis and clinical typing of COVID-19.

• Patients coinfection with SARS-CoV-2 and HIV had longer duration of fever and lung imaging recovery.

• Lymphocytopenia associated with SARS-CoV-2 infection can return to normal along with the improvement of the disease, which is different from lymphocytopenia caused by HIV infection which requires ART for a long time to recovery.

• No statistically significant difference in the duration of SARS-CoV-2 shedding was found between COVID-19 patients with and without HIV coinfection in this study.

• For HIV-infected patients with severe immune deficiency, the ability to produce SARS-CoV-2 antibodies could also be weakened.

Acknowledgments

We thank the patients, the nurses and physicians who provided care for the patients, and the investigators at Zhongnan Hospital of Wuhan University.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Consent for publication

Written informed consent for publication can be obtained from all participants.

Availability of data and materials

All data analyzed during this study are included in this article.

Additional information

Funding

This project was supported by National Natural Science Foundation of China (Grant No. 81572902).