Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis
Abstract Susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the risk of mortality among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) is largely unknown. PLWHA are unique due to their altered immune s...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2021-03-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-85359-3 |
| _version_ | 1818402824062500864 |
|---|---|
| author | Paddy Ssentongo Emily S. Heilbrunn Anna E. Ssentongo Shailesh Advani Vernon M. Chinchilli Jonathan J. Nunez Ping Du |
| author_facet | Paddy Ssentongo Emily S. Heilbrunn Anna E. Ssentongo Shailesh Advani Vernon M. Chinchilli Jonathan J. Nunez Ping Du |
| author_sort | Paddy Ssentongo |
| collection | DOAJ |
| description | Abstract Susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the risk of mortality among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) is largely unknown. PLWHA are unique due to their altered immune system from their history of chronic HIV infection and their use of antiretroviral therapy, some of which have been used experimentally to treat coronavirus disease 2019 (COVID-19). Therefore, we conducted a systematic review and meta-analysis to assess the epidemiology of SARS-COV-2/HIV coinfection and estimate associated mortality from COVID-19 (Prospero Registration ID: CRD42020187980). PubMed, SCOPUS, OVID and Cochrane Library databases, and medRxiv preprint repositories were searched from January 1, 2020, to December 12, 2020. Data were extracted from studies reporting COVID-19 attack and mortality rates in PLWHA compared to their HIV-negative counterparts. Pooled attack and mortality risks were quantified using random-effects models. We identified 22 studies that included 20,982,498 participants across North America, Africa, Europe, and Asia. The median age was 56 years, and 50% were male. HIV-positive persons had a significantly higher risk of SARS-CoV-2 infection [risk ratio (RR) 1.24, 95% CI 1.05–1.46)] and mortality from COVID-19 (RR 1.78, 95% CI 1.21–2.60) than HIV-negative individuals. The beneficial effects of tenofovir and protease-inhibitors in reducing the risk of SARS-CoV-2 infection and death from COVID-19 in PLWHA remain inconclusive. HIV remains a significant risk factor for acquiring SARS-CoV-2 infection and is associated with a higher risk of mortality from COVID-19. In support of the current Centers for Disease Control and Prevention (CDC) guidelines, persons with HIV need priority consideration for the SARS-CoV-2 vaccine. |
| first_indexed | 2024-12-14T08:14:30Z |
| format | Article |
| id | doaj.art-ba4c0e45ea1344c29e635af9dd70afe9 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T08:14:30Z |
| publishDate | 2021-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-ba4c0e45ea1344c29e635af9dd70afe92022-12-21T23:09:58ZengNature PortfolioScientific Reports2045-23222021-03-0111111210.1038/s41598-021-85359-3Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysisPaddy Ssentongo0Emily S. Heilbrunn1Anna E. Ssentongo2Shailesh Advani3Vernon M. Chinchilli4Jonathan J. Nunez5Ping Du6Department of Public Health Sciences, Penn State College of Medicine and Milton S. Hershey Medical CenterDepartment of Public Health Sciences, Penn State College of Medicine and Milton S. Hershey Medical CenterDepartment of Public Health Sciences, Penn State College of Medicine and Milton S. Hershey Medical CenterDepartment of Oncology, Georgetown University School of Medicine, Georgetown UniversityDepartment of Public Health Sciences, Penn State College of Medicine and Milton S. Hershey Medical CenterDepartment of Medicine, Penn State College of Medicine and Milton S. Hershey Medical CenterDepartment of Public Health Sciences, Penn State College of Medicine and Milton S. Hershey Medical CenterAbstract Susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the risk of mortality among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) is largely unknown. PLWHA are unique due to their altered immune system from their history of chronic HIV infection and their use of antiretroviral therapy, some of which have been used experimentally to treat coronavirus disease 2019 (COVID-19). Therefore, we conducted a systematic review and meta-analysis to assess the epidemiology of SARS-COV-2/HIV coinfection and estimate associated mortality from COVID-19 (Prospero Registration ID: CRD42020187980). PubMed, SCOPUS, OVID and Cochrane Library databases, and medRxiv preprint repositories were searched from January 1, 2020, to December 12, 2020. Data were extracted from studies reporting COVID-19 attack and mortality rates in PLWHA compared to their HIV-negative counterparts. Pooled attack and mortality risks were quantified using random-effects models. We identified 22 studies that included 20,982,498 participants across North America, Africa, Europe, and Asia. The median age was 56 years, and 50% were male. HIV-positive persons had a significantly higher risk of SARS-CoV-2 infection [risk ratio (RR) 1.24, 95% CI 1.05–1.46)] and mortality from COVID-19 (RR 1.78, 95% CI 1.21–2.60) than HIV-negative individuals. The beneficial effects of tenofovir and protease-inhibitors in reducing the risk of SARS-CoV-2 infection and death from COVID-19 in PLWHA remain inconclusive. HIV remains a significant risk factor for acquiring SARS-CoV-2 infection and is associated with a higher risk of mortality from COVID-19. In support of the current Centers for Disease Control and Prevention (CDC) guidelines, persons with HIV need priority consideration for the SARS-CoV-2 vaccine.https://doi.org/10.1038/s41598-021-85359-3 |
| spellingShingle | Paddy Ssentongo Emily S. Heilbrunn Anna E. Ssentongo Shailesh Advani Vernon M. Chinchilli Jonathan J. Nunez Ping Du Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis Scientific Reports |
| title | Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis |
| title_full | Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis |
| title_fullStr | Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis |
| title_full_unstemmed | Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis |
| title_short | Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis |
| title_sort | epidemiology and outcomes of covid 19 in hiv infected individuals a systematic review and meta analysis |
| url | https://doi.org/10.1038/s41598-021-85359-3 |
| work_keys_str_mv | AT paddyssentongo epidemiologyandoutcomesofcovid19inhivinfectedindividualsasystematicreviewandmetaanalysis AT emilysheilbrunn epidemiologyandoutcomesofcovid19inhivinfectedindividualsasystematicreviewandmetaanalysis AT annaessentongo epidemiologyandoutcomesofcovid19inhivinfectedindividualsasystematicreviewandmetaanalysis AT shaileshadvani epidemiologyandoutcomesofcovid19inhivinfectedindividualsasystematicreviewandmetaanalysis AT vernonmchinchilli epidemiologyandoutcomesofcovid19inhivinfectedindividualsasystematicreviewandmetaanalysis AT jonathanjnunez epidemiologyandoutcomesofcovid19inhivinfectedindividualsasystematicreviewandmetaanalysis AT pingdu epidemiologyandoutcomesofcovid19inhivinfectedindividualsasystematicreviewandmetaanalysis |