COVID-19 and HIV co-infection

Jump to navigation Jump to search

COVID-19 Microchapters

Home

Long COVID

Frequently Asked Outpatient Questions

Frequently Asked Inpatient Questions

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating COVID-19 from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Vaccines

Secondary Prevention

Future or Investigational Therapies

Ongoing Clinical Trials

Case Studies

Case #1

COVID-19 and HIV co-infection On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of COVID-19 and HIV co-infection

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on COVID-19 and HIV co-infection

CDC on COVID-19 and HIV co-infection

COVID-19 and HIV co-infection in the news

Blogs on COVID-19 and HIV co-infection

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for COVID-19 and HIV co-infection

For COVID-19 frequently asked inpatient questions, click here

For COVID-19 frequently asked outpatient questions, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Harmeet Kharoud M.D.[2]

Synonyms and keywords:

Overview

  • An observational prospective study found out that the incidence of HIV-infected individuals to be affected by SARS-CoV-2 was similar to the general population.
  • Specific antiretroviral therapy did not affect COVID-19 severity.
  • Immunosuppression(low CD4 cell counts) was associated with COVID-19 severity.
  • Patients with HIV infection often have other comorbidities(lung disease, cardiovascular disease) therefore, increasing the risk for severe-COVID-19 disease.
  • Patients with HIV infection with CD4 cell count<200/mm3 are at increased risk for complications from other respiratory infections. However, we do not know if this is the scenario with COVID-19.

Epidemiology and Demographics

Risk

  • At present people with HIV who are at greatest risk of Severe COVID-19 infection are people -
    • who have lowCD4 cell count.
    • not on antiretroviral therapy.

Specific Populations with HIV 'Pregnancy'

  • Pregnant individuals with HIV are at greater risk for severe illness, morbidity, or mortality as compared with the general population due to coronavirus infections(SARS-CoV and MERS-CoV) and other viral respiratory infections like influenza. [1]Data related to COVID-19 is limited but pregnant individuals with HIV are suspected to be at greater risk due to SARS-COV-2 similarity with other coronaviruses (SARS-CoV and MERS).[2][3]
  • They are suspected to be at increased risk of preterm delivery, adverse neonatal outcomes.[4] In a small series of pregnant women with COVID-19 adverse outcomes such as fetal distress and preterm delivery have been noted. They have also been reported with SARS-CoV and MERS.[5][6][7]
  • Vertical Transmission of COVID-19 has not been found.[8][9][10][11]


'Older Adults'

Presentation

  • There hasn't been any observable difference in clinical presentation among people with HIV infection as compared to the general population.
  • Common symptoms for COVID-19 are
    • Fever or chills
    • Cough[12]
    • Shortness of Breath or difficulty breathing
    • Fatigue
    • Muscle or Body aches
    • Headache
    • New loss of taste or smell
    • Sore Throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea


Recommendations for Patients with HIV

  • Maintain the supply for antiretroviral therapy for a minimum of 30 days.
  • Virtual visit and telemedicine should be considered for non-urgent care and non-adherence counseling
  • People with suppressed HIV viral load and in stable health, should postpone their routine medical care and laboratory visits to the extent possible.
  • If they develop symptoms of COVID-19 like fever, cough, shortness of breath, etc they should seek medical advice.
  • They should make sure their vaccination status is updated.

Screening

Natural History, Complications, and Prognosis

Natural History

Complications

Prognosis

Diagnosis

Diagnostic Study of Choice

Physical Examination

Laboratory Findings

Medical Therapy

References

  1. "Interim Guidance for COVID-19 and Persons with HIV".
  2. "Society for Maternal-Fetal Medicine, Dotters-Katz S, Hughes BL. Coronavirus (COVID-19) and Pregnancy: What Maternal-Fetal Medicine Subspecialists Need to Know. 2020" (PDF).
  3. "Interim Guidance for COVID-19 and Persons with HIV".
  4. "Society for Maternal-Fetal Medicine, Dotters-Katz S, Hughes BL. Coronavirus (COVID-19) and Pregnancy: What Maternal-Fetal Medicine Subspecialists Need to Know. 2020" (PDF).
  5. Siston, Alicia M. (2010). "Pandemic 2009 Influenza A(H1N1) Virus Illness Among Pregnant Women in the United States". JAMA. 303 (15): 1517. doi:10.1001/jama.2010.479. ISSN 0098-7484.
  6. Alfaraj, Sarah H.; Al-Tawfiq, Jaffar A.; Memish, Ziad A. (2019). "Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: Report of two cases & review of the literature". Journal of Microbiology, Immunology and Infection. 52 (3): 501–503. doi:10.1016/j.jmii.2018.04.005. ISSN 1684-1182.
  7. Wong, Shell F; Chow, Kam M; Leung, Tse N; Ng, Wai F; Ng, Tak K; Shek, Chi C; Ng, Pak C; Lam, Pansy W.Y; Ho, Lau C; To, William W.K; Lai, Sik T; Yan, Wing W; Tan, Peggy Y.H (2004). "Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome". American Journal of Obstetrics and Gynecology. 191 (1): 292–297. doi:10.1016/j.ajog.2003.11.019. ISSN 0002-9378.
  8. "Interim Guidance for COVID-19 and Persons with HIV".
  9. Chen, Huijun; Guo, Juanjuan; Wang, Chen; Luo, Fan; Yu, Xuechen; Zhang, Wei; Li, Jiafu; Zhao, Dongchi; Xu, Dan; Gong, Qing; Liao, Jing; Yang, Huixia; Hou, Wei; Zhang, Yuanzhen (2020). "Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records". The Lancet. 395 (10226): 809–815. doi:10.1016/S0140-6736(20)30360-3. ISSN 0140-6736.
  10. Wang, Dawei; Hu, Bo; Hu, Chang; Zhu, Fangfang; Liu, Xing; Zhang, Jing; Wang, Binbin; Xiang, Hui; Cheng, Zhenshun; Xiong, Yong; Zhao, Yan; Li, Yirong; Wang, Xinghuan; Peng, Zhiyong (2020). "Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China". JAMA. 323 (11): 1061. doi:10.1001/jama.2020.1585. ISSN 0098-7484.
  11. Feng, Ling; Zhang, Jingyi; Cao, Yong; Liu, Weiyong; Chen, Ling; Guo, Lili; Wang, Shaoshuai (2020). "A Case Report of Neonatal 2019 Coronavirus Disease in China". Clinical Infectious Diseases. doi:10.1093/cid/ciaa225. ISSN 1058-4838.
  12. {{cite web |url://www.chkd.org/uploadedFiles/Documents/COVID-19/CHKD%20MIS-C%20Guideline%20D2.pdf >