Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Lancet HIV. 2020 Aug;7(8):e554-e564. doi: 10.1016/S2352-3018(20)30164-8. Epub 2020 May 28.
Information about incidence, clinical characteristics, and outcomes of HIV-infected individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is scarce. We characterised individuals with COVID-19 among a cohort of HIV-infected adults in Madrid.
In this observational prospective study, we included all consecutive HIV-infected individuals (aged ≥18 years) who had suspected or confirmed COVID-19 as of April 30, 2020, at the Hospital Universitario Ramón y Cajal (Madrid, Spain). We compared the characteristics of HIV-infected individuals with COVID-19 with a sample of HIV-infected individuals assessed before the COVID-19 pandemic, and described the outcomes of individuals with COVID-19.
51 HIV-infected individuals were diagnosed with COVID-19 (incidence 1·8%, 95% CI 1·3-2·3). Mean age of patients was 53·3 years (SD 9·5); eight (16%) were women, and 43 (84%) men. 35 (69%) cases of co-infection had laboratory confirmed COVID-19, and 28 (55%) required hospital admission. Age and CD4 cell counts in 51 patients diagnosed with COVID-19 were similar to those in 1288 HIV-infected individuals without; however, 32 (63%) with COVID-19 had at least one comorbidity (mostly hypertension and diabetes) compared with 495 (38%) without COVID-19 (p=0·00059). 37 (73%) patients had received tenofovir before COVID-19 diagnosis compared with 487 (38%) of those without COVID-19 (p=0·0036); 11 (22%) in the COVID-19 group had previous protease inhibitor use (mostly darunavir) compared with 175 (14%; p=0·578). Clinical, analytical, and radiological presentation of COVID-19 in HIV-infected individuals was similar to that described in the general population. Six (12%) individuals were critically ill, two of whom had CD4 counts of less than 200 cells per μL, and two (4%) died. SARS-CoV-2 RT-PCR remained positive after a median of 40 days from symptoms onset in six (32%) individuals, four of whom had severe disease or low nadir CD4 cell counts.
HIV-infected individuals should not be considered to be protected from SARS-CoV-2 infection or to have lower risk of severe disease. Generally, they should receive the same treatment approach applied to the general population.
None.
关于感染严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 的艾滋病毒感染者的发病率、临床特征和结局的信息很少。我们描述了马德里一组艾滋病毒感染者中 COVID-19 患者的特征。
在这项观察性前瞻性研究中，我们纳入了截至 2020 年 4 月 30 日所有疑似或确诊 COVID-19 的连续 HIV 感染者（年龄≥18 岁）。我们比较了 HIV 感染者与 COVID-19 患者的特征，并描述了 COVID-19 患者的结局。
51 例 HIV 感染者被诊断为 COVID-19（发病率 1.8%，95%CI 1.3-2.3）。患者平均年龄为 53.3 岁（SD 9.5）；8 例（16%）为女性，43 例（84%）为男性。35 例（69%）合并感染有实验室确诊的 COVID-19，28 例（55%）需要住院治疗。51 例确诊 COVID-19 的患者的年龄和 CD4 细胞计数与 1288 例未感染 COVID-19 的患者相似；然而，32 例（63%）COVID-19 患者有至少一种合并症（主要为高血压和糖尿病），而 495 例（38%）未感染 COVID-19 的患者无合并症（p=0.00059）。与未感染 COVID-19 的患者相比，37 例（73%）患者在 COVID-19 诊断前接受过替诺福韦治疗（p=0.0036）；11 例（22%）COVID-19 组患者曾使用过蛋白酶抑制剂（主要为达芦那韦），而 175 例（14%）未感染 COVID-19 的患者使用过蛋白酶抑制剂（p=0.578）。与一般人群相比，HIV 感染者 COVID-19 的临床、分析和影像学表现相似。6 例（12%）患者病情严重，其中 2 例 CD4 计数低于 200 个细胞/μL，2 例（4%）死亡。6 例（32%）患者的 SARS-CoV-2 RT-PCR 检测结果仍为阳性，中位时间为症状出现后 40 天，其中 4 例患者病情严重或 CD4 细胞计数最低。
艾滋病毒感染者不应被视为免受 SARS-CoV-2 感染或发生严重疾病的风险较低。一般来说，他们应接受与一般人群相同的治疗方法。
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