COVID-19 in People Living with HIV: A Systematic Review and Meta-Analysis.
Kai Wei LeeSook Fan YapYun Fong NgeowMunn Sann LyePublished in: International journal of environmental research and public health (2021)
COVID-19 is a global health emergency. People living with human immunodeficiency virus (PLHIV) have concerns about whether they have a higher risk of getting the infection and suffer worse COVID-19 outcomes. Findings from studies on these questions have largely been inconsistent. We aimed to determine the epidemiological characteristics, clinical signs and symptoms, blood parameters, and clinical outcomes among PLHIV who contracted COVID-19. Relevant studies were identified through Medline, Cinahl, and PubMed databases. A random-effects model was used in meta-analyses with a 95% confidence interval. Eighty-two studies were included in the systematic review and sixty-seven studies for the meta-analysis. The pooled incidence proportion of COVID-19 among PLHIV was 0.9% (95% CI 0.6%, 1.1%) based on the data from seven cohort studies. Overall, 28.4% were hospitalised, of whom, 2.5% was severe-critical cases and 3.5% needed intensive care. The overall mortality rate was 5.3%. Hypertension was the most commonly reported comorbidity (24.0%). Fever (71.1%) was the most common symptom. Chest imaging demonstrated a wide range of abnormal findings encompassing common changes such as ground glass opacities and consolidation as well as a spectrum of less common abnormalities. Laboratory testing of inflammation markers showed that C-reactive protein, ferritin, and interleukin-6 were frequently elevated, albeit to different extents. Clinical features as well as the results of chest imaging and laboratory testing were similar in highly active antiretroviral therapy (HAART)-treated and non-treated patients. PLHIV were not found to be at higher risk for adverse outcomes of COVID-19. Hence, in COVID-19 management, it appears that they can be treated the same way as HIV negative individuals. Nevertheless, as the pandemic situation is rapidly evolving, more evidence may be needed to arrive at definitive recommendations.
Keyphrases
- coronavirus disease
- sars cov
- systematic review
- human immunodeficiency virus
- meta analyses
- antiretroviral therapy
- hiv infected
- respiratory syndrome coronavirus
- hiv positive
- public health
- newly diagnosed
- case control
- hiv aids
- emergency department
- blood pressure
- machine learning
- south africa
- ejection fraction
- electronic health record
- radiation therapy
- weight loss
- depressive symptoms
- prognostic factors
- locally advanced
- open label
- insulin resistance
- mass spectrometry