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Research Letter
Descriptive account of 18 adults with known HIV infection hospitalised with SARS-CoV-2 infection
  1. Sara Madge,
  2. Tristan J Barber,
  3. Alan Hunter,
  4. Sanjay Bhagani,
  5. Marc Lipman,
  6. Fiona Burns
  1. Department of HIV Medicine, Royal Free London NHS Foundation Trust, London, UK
  1. Correspondence to Dr Sara Madge, HIV Medicine, Royal Free London NHS Foundation Trust, London, UK; sara.madge{at}nhs.net

Abstract

Objective To report on the clinical characteristics and outcome of 18 people living with HIV (PLWH) hospitalised with SARS-CoV-2 infection in a London teaching hospital.

Methods The hospital notes of 18 PLWH hospitalised with SARS-CoV-2 infection were retrospectively reviewed alongside data concerning their HIV demographics from an established HIV Database.

Results The majority (16/18) had positive PCR swabs for SARS-CoV-2, and two had negative swabs but typical COVID-19 imaging and history. Most were male (14/18, 78%), median age 63 years (range 47–77 years). Two-thirds were migrants, nine (50%) of Black, Asian and minority ethnicity (BAME). All were diagnosed with HIV for many years (range 8–31 years), and all had an undetectable HIV viral load (<40 copies/mL). The median CD4 prior to admission was 439 (IQR 239–651), and 10/16 (63%) had a CD4 nadir below 200 cells/mm3. Almost all (17/18) had been diagnosed with at least one comorbidity associated with SARS-CoV-2 prior to admission. 3/18 patients died. None received mechanical ventilation. Hospital stay and clinical course did not appear prolonged (median 9 days).

Conclusions Our data suggest that PLWH may not necessarily have prolonged or complex admissions to hospital when compared with the general hospital and national population admitted with COVID-19. Many had low nadir CD4 counts and potentially impaired functional immune restoration. The PLWH group was younger than generally reported for COVID-19, and the majority were male with multiple complex comorbidities. These patients had frequent contact with hospital settings increasing potential for nosocomial acquisition and increased risk of severe COVID-19.

  • HIV
  • HIV clinical care
  • infection

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Footnotes

  • Handling editor Anna Maria Geretti

  • Twitter @Sara madge, @tristanjbarber

  • Contributors SM collected data and did inital draft of the letter, AH helped collect data for entry and collection, FB, TJP, ML and SB reviewed the data and drafts of the letter.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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