Prevalence, clinical characteristics and treatment outcomes of HIV and SARS-CoV-2 co-infection: a systematic review and meta-analysis
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Abstract
Objectives
To determine the prevalence, clinical characteristics and outcomes of HIV and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infection.
Methods
We searched Medline, Embase, Cochrane and Web of Science databases and grey literature for studies reporting epidemiological and clinical data of patients with HIV and SARS-CoV-2 co-infection. Eligible studies were all observational or interventional studies and commentaries in English language that reported patient data on HIV/SARS-CoV-2 co-infection. We used random effect meta-analysis to determine the pooled prevalence and mortality.
Results
Of the 17 eligible studies, there were 3 retrospective cohorts, 1 survey, 5 case series, 7 case reports and 1 commentary that reported on a total of 146 HIV infected individuals. The pooled prevalence of HIV among individuals with SARS-CoV-2 infection was 1.0% (95% CI: 0.0 – 3.0, I 2 = 79.3%, p = 0.01), whereas the prevalence of SARS-CoV-2 among HIV patients was 0.68% (95% CI: 0.34 – 1.34).There were 110 (83.8%) HIV/ SARS-CoV-2 co-infected males, and the age (range) of the co-infected was 30 – 60 years. A total of 129 (97.0%) were anti-retroviral therapy experienced, and 113 (85.6%) had a suppressed HIV viral load. The CD4 count (range) was 298 – 670 cells/mm 3 (n = 107). The commonest symptoms were fever (73.5%, n = 75) and cough (57.8%, n = 59). Sixty-two (65.3%) patients had at least one other comorbid condition, of which hypertension (26.4%, n = 38) was the commonest. Chest radiological imaging abnormalities were found in 46 (54.1%) cases. Twenty-eight cases (56.0%) were reported as mild. Recovery occurred in 120 (88.9%) cases, and the pooled mortality was 9% (95% CI: 3.0 – 15.0, I 2 = 25.6%, p = 0.24).
Conclusion
The prevalence of HIV/SARS-CoV-2 co-infection was low. The clinical characteristics and outcomes of HIV/SARS-CoV-2 co-infection are comparable to those reported among HIV negative SARS-CoV-2 cases.
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SciScore for 10.1101/2020.05.31.20118497: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources We searched for clinical studies from Medline, Embase, Cochrane and Web of Science databases published in English from inception to May 22 2020. Medlinesuggested: (MEDLINE, RRID:SCR_002185)Embasesuggested: (EMBASE, RRID:SCR_001650)Cochranesuggested: (Cochrane Library, RRID:SCR_013000)Analysis was performed using STATA 16.0. STATAsuggested: (Stata, RRID:SCR_012763)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to …
SciScore for 10.1101/2020.05.31.20118497: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources We searched for clinical studies from Medline, Embase, Cochrane and Web of Science databases published in English from inception to May 22 2020. Medlinesuggested: (MEDLINE, RRID:SCR_002185)Embasesuggested: (EMBASE, RRID:SCR_001650)Cochranesuggested: (Cochrane Library, RRID:SCR_013000)Analysis was performed using STATA 16.0. STATAsuggested: (Stata, RRID:SCR_012763)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are key limitations of our study. First, the findings are not generalizable to low resource settings where the highest burden of HIV is found. Also, the majority of the studies reviewed were case reports and case series which inherently have bias. Additionally, the sample size is small and inferences cannot be made with certainty. Lastly, most of the patients in these studies were inpatients and therefore the reported severity of COVID –19 may not be accurate for the entire population of PLHIV. Larger studies are still needed to characterise the HIV/SARS-CoV-2 co-infection. Nevertheless, we have provided a preliminary but comprehensive synthesis of the current literature on HIV/SARS-CoV-2 co-infection.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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