Influence of Novel Coronavirus COVID – 19 and HIV: A Scoping Review of Hospital Course and Symptomatology

  1. Mona Sheikh
  2. Shavy Nagpal
  3. Madiha Zaidi
  4. Rupalakshmi Vijayan
  5. Wanessa Matos
  6. Neguemadji Nagardig Ngaba
  7. Lordstrong Akano
  8. Samia Jahan
  9. Shazia Q. Shah
  10. Camille Celeste Go
  11. Sindhu Thevuthasan
  12. George Michel

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Abstract

Background

An outbreak of novel coronavirus (SARS- CoV-2) was observed on December 2019 in Wuhan, China which led to a global pandemic declared in March 2020. As a consequence, it imposed delirious consequences in patients with underlying co – morbid conditions that make them immunocompromised. The purpose of this paper is to provide an in - depth review of influence of COVID – 19 in patients with underlying HIV in terms of mortality and hospitalization.

Authors also aim to provide a thorough risk analysis of hospitalization, ICU admission and mortality of PLWH and COVID-19. The secondary objective was to analyze the CD4+ count variations and outcome of COVID - 19 and to correlate if ART provided a protective role. Authors also aim to provide an evaluation of typical clinical presentation of COVID-19 in PLWH. ART is found to show activity against SARS-CoV-2 in vitro, and there is some similarity in the structure of HIV-1 gp41 and S2 proteins of SARS-CoV since they both belong to +ssRNA type.

Methods

We conducted a literature review using search engines namely, Cochrane, PubMed and Google Scholar. The following keywords were targeted: “COVID-19,” “SARS-CoV-2,” and “HIV.” We included case reports, case series, and cohort (retrospective and prospective) studies. We excluded clinical trials and review articles. We came across 23 articles that met the inclusion criteria. PRISMA guidelines were followed for study acquisition (Fig. 9).

Results

From the 23 studies, we found a total of 651 PLWH with confirmed COVID-19 (549, 91, and 11 in cohorts, case series, and case reports, respectively). The overall risk of hospital admission from pooled data of the 23 reviewed articles was 69.13% (450/651), ICU admission was 12.90% (84/651) in total infected patients, and 18.67% (84/450) among hospitalized patients. The overall case fatality rate from the 23 reviewed articles was 11.21 (73/651).A weak positive correlation was found between CD4+ counts and hospital admissions in case series and case reports, while the weak negative correlation was found in cohorts. For mortality, there was a negative weak association in the cohorts and in case series, while a weak positive was seen in case reports (Fig.7). We assessed the presenting symptoms of PLWH with COVID-19, and our review demonstrated this group does not greatly differ from the rest of the population, as their common presenting symptoms were cough, fever, and SOB.

Conclusion

Our results indicated that there was a high rate of hospitalization, ICU admission, and mortality among patients living with HIV and COVID-19. PLWH needs to be noted as a high-risk group for COVID-19 complications and severity. We recommend that PLWH be closely monitored by their physicians and strictly adhere to antiretroviral therapy and standard universal COVID-19 precautions.

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  1. ScreenIT

    SciScore for 10.1101/2021.07.25.21260967: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Literature search: A literature search was conducted with PubMed, Cochrane, and Google scholars using the following keywords: “COVID-19”, “HIV,” “SARS-CoV-2”, and “AIDS” from January 2020 until August 31st, 2020.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Cochrane
    suggested: (Cochrane Library, RRID:SCR_013000)
    Google
    suggested: (Google, RRID:SCR_017097)
    The data were tabulated using Microsoft Excel.
    Microsoft Excel
    suggested: (Microsoft Excel, RRID:SCR_016137)

    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:
    Despite the fact that this review was done following a standardized methodology, it presents with specific limitations. Cohort studies that we reviewed, such as Del Amo et al. and Meyerowitz et al. did not report an HIV viral load which makes it difficult to assess in relation to the other cohorts. Del Amo et al. also did not disclose a CD4+ count. Among the case reports, the HIV viral load and the total number of patients on IMV were not reported by Maomao et al. Lastly, Byrd et al. did not present the total number of patients admitted in the ICU and the number of patients on IMV. We did not run a study assessment because these limitations create barriers which make it hard to assess and compare the studies with one another.

    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.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.07.25.21260967v1 on medRxiv