Outcomes from COVID-19 in French cohort of 54 HIV positive people on ART

14 October 2020. Related: COVID-19: HIV and COVID-19 coinfection, COVID-19.

Simon Collins, HIV i-Base

A research letter published in the 1 October 2020 edition of AIDS reported results from a prospective observational study in Paris in HIV positive people who were on ART with generally good CD4 counts. [1]

The study included 54 HIV positive adults (60% men) diagnosed with COVID-19 from 1 March to 30 April 2020.

Median age was 54 years (IQR: 47 to 60) and median CD4 counts was 583  cells/mm³ (IQR: 474 to 773). All were on ART and nearly all (51/53) had viral load <40  copies/mL. 

Over median of 29 days (IQR: 29 to 45 days), all for at least 14 days, 35/54 (65%) developed moderate disease, 14/54 severe (26%) and 5/54 were critical (9%). One person died.

Participants from Sub Saharan Africa were disproportionally affected compared to the clinic population overall (45% vs 30%), with higher rates of severe disease (13/19 vs 13/35).

By multivariate analysis, age , male gender, ethnic origin from Sub Saharan Africa, and metabolic disorder, were associated with severe or critical forms of COVID-19. 

Prior CD4 T cell counts did not differ between groups.

comment

The disproportionate impact of ethnicity on COVID-19 infection and outcomes is increasingly reported, including in the US and UK. [2, 3]

Reference

1. Etienne N et al. HIV infection and COVID-19 risk factors for severe disease. Research letter. AIDS: 2020; 34(12):1771-1774. DOI: 10.1097/QAD.0000000000002651. (1 October 2020).
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493770
2. Meyerowitz EA et al. Disproportionate burden of COVID-19 among racial minorities and those in congregate settings among a large cohort of people with HIV. AIDS. 2020 Oct 1; 34(12): 1781–1787.
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7499878
3. Coronavirus (COVID-19) related deaths by ethnic group, England and Wales – Office for National Statistics.
   https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles