Clinical Outcomes and Immunologic Characteristics of Coronavirus Disease 2019 in People With Human Immunodeficiency Virus

Abstract

We performed a retrospective study of coronavirus disease 2019 (COVID-19) in people with human immunodeficiency virus (PWH). PWH with COVID-19 demonstrated severe lymphopenia and decreased CD4+ T cell counts. Levels of inflammatory markers, including C-reactive protein, fibrinogen, D-dimer, interleukin 6, interleukin 8, and tumor necrosis factor α were commonly elevated. In all, 19 of 72 hospitalized individuals (26.4%) died and 53 (73.6%) recovered. PWH who died had higher levels of inflammatory markers and more severe lymphopenia than those who recovered. These findings suggest that PWH remain at risk for severe manifestations of COVID-19 despite antiretroviral therapy and that those with increased markers of inflammation and immune dysregulation are at risk for worse outcomes.

Keywords: COVID-19; HIV; SARS-CoV-2; coronavirus; inflammation; people living with HIV.

Figure 1.

Changes in blood counts in the subset of patients with paired data from 2019 and the coronavirus disease 2019 (COVID-19) presentation available. A, CD4⁺ T-cell count. B, CD4⁺ T-cell percentage. C, Absolute lymphocyte count. Each connected pair represents 1 patient. Solid lines reflect medians for the sample. Medians are reported (M). P values calculated utilizing Wilcoxon matched-pairs signed-rank test.