Low Immunity Linked to Poor Outcomes in Patients with HIV, COVID-19

As patients with HIV are living longer, they are also being diagnosed with chronic conditions that have become increasingly common in recent decades, putting them at higher risk of COVID-19 hospitalization and death.

Despite earlier theories that medications used to treat HIV could provide some protection against the coronavirus disease 2019 (COVID-19), researchers have found that not only are individuals with HIV susceptible to COVID-19, but several factors could increase their risk of hospitalization and death.

Assistant professor of clinical medicine at the University of Missouri School of Medicine, Dima Dandachi, MD, examined data that included 286 adult patients with HIV who were diagnosed with COVID-19 across 36 institutions in 21 states. According to a press release, within 30 days of COVID-19 diagnosis, 57% of the patients required hospitalization, 16% required admission to the intensive care unit (ICU), and 9% did not survive. More than 94% of participants in the study were actively taking HIV medication.

“We were able to show that patients with HIV who are actively taking their medication are just as susceptible to COVID-19 as the general public,” Dandachi said in a press release. “And those with low immunity uncontrolled HIV or newly diagnosed HIV are at a higher risk of hospitalization or death. The key message for these patients is to take precautions against contracting the virus while ensuring they are compliant with their HIV medications to raise their immune cell count as high as possible.”

The team of researchers found people with HIV older than 60 years of age and those with chronic health issues also had a higher risk of being hospitalized or dying from COVID-19. Dandachi said that as patients with HIV are living longer, they are also being diagnosed with chronic conditions that have become increasingly common in recent decades, putting them at higher risk of COVID-19 hospitalization and death.

“The medications that prolong the lives of patients with HIV have improved life expectancy, but now we are seeing these patients develop other chronic conditions such as obesity, diabetes, and heart disease that we didn’t see 15 years ago,” Dandachi said in a statement. “And when we looked at the data from this study, we found that lung disease, kidney disease, hypertension, and older age were associated with higher hospitalization rates, higher ICU admissions, and increased mortality from COVID-19.”

Dandachi said she will use this study’s findings to counsel HIV-positive patients on the best ways to protect themselves against COVID-19 while also using it as proof that this patient population should be among those in early stages of vaccine rollouts.

“Patients with HIV should be a priority target when we are looking at any measure that could improve outcomes for patients at high risk for complications with COVID-19,” Dandachi concluded.

REFERENCE

Study Links Low Immunity to Poor Outcomes in Patients with HIV Who Contract COVID-19 [news release]. University of Missouri School of Medicine; September 30, 2020. https://medicine.missouri.edu/news/study-links-low-immunity-poor-outcomes-patients-hiv-who-contract-covid-19. Accessed January 11, 2021.