by Jeffrey T. Kirchner, DO, AAHIVS, AAHIVM Chief Medical Officer

September 1, 2020

Featured Literature:
Karmen-Tuohy, S. et al. Outcomes Among HIV-Positive Patients Hospitalized With COVID-19
JAIDS: September 1, 2020; 85(1):6-10; doi: 10.1097/QAI.0000000000002423

The coronavirus pandemic continues to cause significant morbidity and mortality worldwide. Early data suggested that persons who are immunocompromised, such as those with HIV may have worse outcomes if infected by SARS-CoV-2. This study is a retrospective matched cohort to characterize outcomes in HIV-positive patients in New York with SARS-CoV-2 infection. The authors extracted data via the EHR for all patients hospitalized at Langone Medical Center with COVID-19 between March 2 and April 23, 2020. They matched 42 non-HIV patients with 21 HIV-positive patients with admission characteristics, various test results, and hospital outcomes compared between the two groups. There was an observed trend towards increased ICU admissions, need for ventilator support and mortality in persons with HIV however none of the differences were statistically significant. There was no difference in frequency of myocardial infarction or thrombotic events between the two groups of patients. Other observations in this study included higher peak CRP values in PWH but not other markers of inflammation. Three of the 21 HIV-positive patients had secondary bacterial pneumonia and died during hospitalization.

Author’s Commentary:

This study provides reassuring evidence that HIV-coinfection does not appear to impact presentation or clinical course including morbidity and mortality in patients infected with SARS-CoV-2 when compared with matched non-HIV patients. This is similar to data from China, Italy and Spain. Of interest, with HIV-positive patients in the Spanish cohort it was found that those taking TDF/FTC had a lower risk for COVID-19 and related hospitalization. I believe the most prudent advice we can give to our patients is to stay on their ART regimens to maintain and preserve immunity while continuing to maximize health including immunization updates as indicated. 

The author has no conflicts of interest to disclose.

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