| dc.description.abstract | Background Information about incidence, clinical characteristics, and outcomes of HIV-infected individuals with
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is scarce. We characterised individuals with
COVID-19 among a cohort of HIV-infected adults in Madrid.
Methods In this observational prospective study, we included all consecutive HIV-infected individuals (aged ≥18 years)
who had suspected or confirmed COVID-19 as of April 30, 2020, at the Hospital Universitario Ramón y Cajal (Madrid,
Spain). We compared the characteristics of HIV-infected individuals with COVID-19 with a sample of HIV-infected
individuals assessed before the COVID-19 pandemic, and described the outcomes of individuals with COVID-19.
Findings 51 HIV-infected individuals were diagnosed with COVID-19 (incidence 1·8%, 95% CI 1·3–2·3). Mean age of
patients was 53·3 years (SD 9·5); eight (16%) were women, and 43 (84%) men. 35 (69%) cases of co-infection had
laboratory confirmed COVID-19, and 28 (55%) required hospital admission. Age and CD4 cell counts in 51 patients
diagnosed with COVID-19 were similar to those in 1288 HIV-infected individuals without; however, 32 (63%) with
COVID-19 had at least one comorbidity (mostly hypertension and diabetes) compared with 495 (38%) without
COVID-19 (p=0·00059). 37 (73%) patients had received tenofovir before COVID-19 diagnosis compared with
487 (38%) of those without COVID-19 (p=0·0036); 11 (22%) in the COVID-19 group had previous protease inhibitor
use (mostly darunavir) compared with 175 (14%; p=0·578). Clinical, analytical, and radiological presentation of
COVID-19 in HIV-infected individuals was similar to that described in the general population. Six (12%) individuals
were critically ill, two of whom had CD4 counts of less than 200 cells per µL, and two (4%) died. SARS-CoV-2 RT-PCR
remained positive after a median of 40 days from symptoms onset in six (32%) individuals, four of whom had severe
disease or low nadir CD4 cell counts.
Interpretation HIV-infected individuals should not be considered to be protected from SARS-CoV-2 infection or to
have lower risk of severe disease. Generally, they should receive the same treatment approach applied to the general
population. | |
