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. 2020 Oct;21(5):130-139.
doi: 10.1080/25787489.2020.1844521. Epub 2020 Nov 19.

COVID-19 symptoms and SARS-CoV-2 infection among people living with HIV in the US: the MACS/WIHS combined cohort study

Gypsyamber D'Souza  1 , Gayle Springer  1 , Deborah Gustafson  2 , Seble Kassaye  3 , Maria L Alcaide  4 , Catalina Ramirez  5 , Anjali Sharma  6 , Frank J Palella  7 , Phyllis C Tien  8 , Roger Detels  9 , Mirjam-Colette Kempf  10 , Cecile D Lahiri  11 , Charles R Rinaldo  12 , Audrey L French  13 , Joseph B Margolick  14 , Ada A Adimora  5   15
Affiliations

COVID-19 symptoms and SARS-CoV-2 infection among people living with HIV in the US: the MACS/WIHS combined cohort study

Gypsyamber D'Souza et al. HIV Res Clin Pract. 2020 Oct.

Abstract

Background: SARS-CoV-2 infection among People Living With HIV (PLWH) is not well-described.

Objective: To study COVID-19 symptoms and SARS-CoV-2 PCR-based swab testing among participants of the Multicenter AIDS Cohort Study (MACS) and Women's Interagency HIV Study (WIHS).

Methods: A telephone survey was collected April-June 30, 2020. Symptom and testing prevalence were explored. Multivariable logistic regression was used to examine the factors associated with SARS-CoV-2 positivity.

Results: The survey was completed by 3411 participants, including 2078 (61%) PLWH and 1333 HIV-seronegative (SN) participants from across the US. Thirteen percent (n = 441) were tested for SARS-CoV-2 infection (13.4% of PLWH vs 12.2% of SN). Among those tested, positivity was higher in PLWH than SN (11.2% vs 6.1%, p = 0.08). Reasons for not being tested included testing not being available (30% of participants) and not knowing where to get tested (16% of participants). Most symptoms reported since January 2020 were similar in PLWH and SN, including headache (23% vs. 24%), myalgias (19% vs 18%), shortness of breath (14% vs 13%), chills (12% vs 10%), fever (6% vs 6%) and loss of taste or smell (6% vs 7%). Among PLWH who tested positive for SARS-CoV-2 DNA, the most common symptoms were headache (71%), myalgia (68%), cough (68%) and chills (65%). In multivariable analysis among those tested, the odds of SARS-CoV-2 positivity were higher among PLWH than SN (aOR = 2.22 95%CI = 01.01-4.85, p = 0.046) and among those living with others versus living alone (aOR = 2.95 95%CI = 1.18-7.40).

Conclusion: Prevalence and type of COVID-19 symptoms were similar in PLWH and SN. SARS-CoV-2 infection may be elevated among PLWH.

Keywords: COVID-19; HIV; MWCCS; PLWH; SARS-CoV-2; epidemiology; symptoms; testing.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Palella FJ has been a consultant and/or has provided lectures for the following: Gilead Sciences, Janssen Pharmaceuticals, ViiV Healthcare and Merck. Sharma A has received grant funding from Gilead Sciences, Inc. PCT has received grant support from Merck. Aadimora AA has received consulting fees from Viiv, and Gilead and her institution has received funding from Gilead for her research. All other authors have no conflicts to report.

Figures

Figure 1
Figure 1
Prevalence of SARS-CoV-2 positivity among MWCCS participants tested by study site and HIV serostatus∼ ∼Number tested at each site is shown below each bars, by HIV status. There were 41 SARS-CoV-2 positive cases, this included 16 cases in New York (11 PLWH and 5 SN), 2 PLWH cases in Pennsylvania, 4 cases in Georgia (3 PLWH and 1 SN), 1 PLWH case in Florida, 7 PLWH cases in Illinois, 4 cases in Maryland (2 PLWH and 2 SN), 6 cases in California (4 PLWH and 2 SN), and 1 PLWH case in Washington DC. Fischer’s Exact test was used for the p-value for the difference in percent positive by site.
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