Coronavirus disease 2019 (COVID-19) outcomes in HIV/AIDS patients: a systematic review

HIV Med. 2020 Oct;21(9):567-577. doi: 10.1111/hiv.12911. Epub 2020 Jul 15.

Abstract

Objectives: The aim of the study was to systematically review current studies reporting on clinical outcomes in people living with HIV (PLHIV) infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods: We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A comprehensive literature search was conducted in Global Health, SCOPUS, Medline and EMBASE using pertinent key words and Medical Subject Headings (MeSH) terms relating to coronavirus disease 2019 (COVID-19) and HIV. A narrative synthesis was undertaken. Articles are summarized in relevant sections.

Results: Two hundred and eighty-five articles were identified after duplicates had been removed. After screening, eight studies were analysed, totalling 70 HIV-infected patients (57 without AIDS and 13 with AIDS). Three themes were identified: (1) controlled HIV infection does not appear to result in poorer COVID-19 outcomes, (2) more data are needed to determine COVID-19 outcomes in patients with AIDS and (3) HIV-infected patients presenting with COVID-19 symptoms should be investigated for superinfections.

Conclusions: Our findings suggest that PLHIV with well-controlled disease are not at risk of poorer COVID-19 disease outcomes than the general population. It is not clear whether those with poorly controlled HIV disease and AIDS have poorer outcomes. Superimposed bacterial pneumonia may be a risk factor for more severe COVID-19 but further research is urgently needed to elucidate whether PLHIV are more at risk than the general population.

Keywords: AIDS; HIV; coronavirus disease 2019; severe acute respiratory syndrome coronavirus.

Publication types

  • Systematic Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Acquired Immunodeficiency Syndrome / mortality
  • Acquired Immunodeficiency Syndrome / pathology
  • Acquired Immunodeficiency Syndrome / virology
  • COVID-19 / complications*
  • COVID-19 / mortality
  • COVID-19 / pathology
  • COVID-19 / virology
  • Coinfection*
  • Disease Progression
  • Female
  • Humans
  • MEDLINE
  • Male
  • Medical Informatics Applications
  • Risk Factors