School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa; ICAP at Columbia University, Harare, Zimbabwe.
Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe.
J Infect Public Health. 2022 Jun;15(6):654-661. doi: 10.1016/j.jiph.2022.05.006. Epub 2022 May 16.
The relationship between HIV infection and COVID-19 clinical outcomes remains a significant public health research problem. We aimed to determine the association of HIV comorbidity with COVID-19 mortality.
We searched PubMed, Google Scholar and World Health Organization library databases for relevant studies. All searches were conducted from 1st to 7th December 2021. Title, abstract and full text screening was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relative risk of mortality in HIV-infected COVID-19 patients was computed using a random-effects model. All analyses were performed using Meta and Metasens statistical packages available in R version 4.2.1 software package. The quality of included studies was assessed using the GRADE approach, Egger's test was employed to determine the risk of bias.
A total of 16 studies were included in this review. Among the COVID-19 patients with HIV infection, the mortality rate due to COVID-19 was 7.97% (4 287/53,801), and among the COVID-19 patients without HIV infection, the mortality rate due to COVID-19 was 0.69% (127, 961/18, 513, 747). In the random effects model, we found no statistically significant relative risk of mortality in HIV-infected COVID-19 patients (RR 1.07, 95% CI 0.86-1.32). The between-studies heterogeneity was substantial (I = 91%, P < 0.01), while the risk of publication bias was not significant.
Findings did not link HIV infection with an increased risk of COVID-19 mortality. Our results add to the conflicting data on the relationship between COVID-19 and HIV infection.
HIV 感染与 COVID-19 临床结局之间的关系仍然是一个重大的公共卫生研究问题。我们旨在确定 HIV 合并症与 COVID-19 死亡率之间的关联。
我们在 PubMed、Google Scholar 和世界卫生组织图书馆数据库中搜索了相关研究。所有搜索均于 2021 年 12 月 1 日至 7 日进行。根据系统评价和荟萃分析的首选报告项目指南，对标题、摘要和全文进行筛选。使用随机效应模型计算 HIV 感染 COVID-19 患者的死亡率相对风险。所有分析均使用 R 版本 4.2.1 软件包中的 Meta 和 Metasens 统计软件包进行。使用 GRADE 方法评估纳入研究的质量，使用 Egger 检验确定偏倚风险。
本综述共纳入 16 项研究。在 HIV 感染的 COVID-19 患者中，COVID-19 死亡率为 7.97%（4287/53801），在未感染 HIV 的 COVID-19 患者中，COVID-19 死亡率为 0.69%（127/961）。在随机效应模型中，我们未发现 HIV 感染 COVID-19 患者死亡率的相对风险有统计学意义（RR 1.07，95%CI 0.86-1.32）。研究间异质性很大（I = 91%，P<0.01），但发表偏倚风险不显著。
研究结果并未将 HIV 感染与 COVID-19 死亡率增加联系起来。我们的结果增加了关于 COVID-19 与 HIV 感染之间关系的相互矛盾的数据。
