The characteristics of HIV-positive patients with mild/asymptomatic and moderate/severe course of COVID-19 disease—A report from Central and Eastern Europe

• Main Authors: Justyna D. Kowalska, Kerstin Kase, Anna Vassilenko, Arjan Harxhi, Botond Lakatos, Gordana Dragović Lukić, Antonija Verhaz, Nina Yancheva, Florentina Dumitrescu, David Jilich, Ladislav Machala, Agata Skrzat-Klapaczyńska, Raimonda Matulionyte
• Format: Article
• Language: English
• Published: Elsevier 2021-03-01
• Series: International Journal of Infectious Diseases
• Subjects: HIV; SARS-CoV-2; COVID-19; Antiretroviral therapy; Protease inhibitors
• Online Access: http://www.sciencedirect.com/science/article/pii/S1201971220325480

Background: There is currently no evidence suggesting that COVID-19 takes a different course in HIV-positive patients on antiretroviral treatment compared to the general population. However, little is known about the relation between specific HIV-related factors and the severity of the COVID-19 disease. Methods: We performed a retrospective analysis of cases collected through an on-line survey distributed by the Euroguidelines in Central and Eastern Europe Network Group. In statistical analyses characteristics of HIV-positive patients, asymptomatic/moderate and moderate/severe course were compared. Results: In total 34 HIV-positive patients diagnosed with COVID-19 were reported by 12 countries (Estonia, Czech Republic, Lithuania, Albania, Belarus, Romania, Serbia, Bosnia and Herzegovina, Poland, Russia, Hungary, Bulgaria). Asymptomatic courses of COVID-19 were reported in four (12%) cases, 11 (32%) patients presented with mild disease not requiring hospitalization, moderate disease with respiratory and/or systemic symptoms was observed in 14 (41%) cases, and severe disease with respiratory failure was found in five (15%) patients. The HIV-related characteristics of patients with an asymptomatic/mild course of COVID-19 were comparable to those with a moderate/severe course of COVID-19, except for the use of non-nucleoside reverse transcriptase inhibitors (NNRTIs) in cART regimen (0.0% vs. 31.6% respectively, p = 0.0239). Conclusions: In our analyses HIV viral suppression and immunological status were not associated with the course of COVID-19 disease. On the contrary the cART regimen could contribute to severity of SARS-CoV-2 infection. Large and prospective studies are necessary to further investigate this relationship.