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© 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Introduction

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) has infected >6 million people worldwide since December 2019. Global reports of HIV/SARS‐CoV‐2 coinfection are limited. To better understand the impact of the coronavirus disease 2019 (COVID‐19) pandemic on persons with HIV and improve their care, we present an outpatient and inpatient clinical experience of HIV/SARS‐CoV‐2 coinfection from Rhode Island, US.

Methods

We describe outpatient and inpatient preparedness for the COVID‐19 pandemic, and present a case series of all known patients with HIV/SARS‐CoV‐2 coinfection at The Miriam Hospital and Rhode Island Hospital, and The Miriam Hospital Infectious Diseases and Immunology Center, in Providence, Rhode Island, US.

Results and discussion

The Infectious Diseases and Immunology Center rapidly prepared for outpatient and inpatient care of persons with HIV and SARS‐CoV‐2. Between 30 March and 20 May 2020, 27 patients with HIV were diagnosed with SARS‐CoV‐2. Twenty were male, six female and one transgender female; average age was 49 years; 13/27 were Hispanic and 6/27 were African American. All had HIV viral load <200 copies/mL and were on antiretroviral therapy with CD4 count range 87 to 1441 cells/µL. Twenty‐six of the 27 had common COVID‐19 symptoms for one to twenty‐eight days and most had other co‐morbidities and/or risk factors. Nine of the 27 were hospitalized for one to thirteen days; of those, three lived in a nursing home, six received remdesivir through a clinical trial or emergency use authorization and tolerated it well; eight recovered and one died. Overall, 17% of known Center people had HIV/SARS‐CoV‐2 coinfection, whereas the comparable state‐wide prevalence was 9%.

Conclusions

We highlight challenges of outpatient and inpatient HIV care in the setting of the COVID‐19 pandemic and present the largest detailed case series to date from the United States on HIV/SARS‐CoV‐2 coinfection, adding to limited global reports. The aggregated clinical findings suggest that the clinical presentation and outcomes of COVID‐19 appear consistent with those without HIV. Whether SARS‐CoV‐2 infection is more frequent among persons with HIV remains to be determined. More data are needed as we develop our understanding of how HIV and antiretroviral therapy are affected by or have an impact on this pandemic.

Details

Title
SARS‐CoV‐2 and HIV coinfection: clinical experience from Rhode Island, United States
Author
Byrd, Katrina M 1   VIAFID ORCID Logo  ; Beckwith, Curt G 1 ; Garland, Joseph M 1 ; Johnson, Jennie E 1 ; Su Aung 1   VIAFID ORCID Logo  ; Susan Cu‐Uvin 1 ; Farmakiotis, Dimitrios 1 ; Flanigan, Timothy 1 ; Gillani, Fizza S 1 ; Raul Macias‐Gil 1 ; Mileno, Maria 1 ; Ramratnam, Bharat 1 ; Rybak, Natasha R 1 ; Sanchez, Martha 1 ; Tashima, Karen 1 ; Mylonakis, Eleftherios 1 ; Kantor, Rami 1 

 Division of Infectious Diseases, Department of Medicine, The Brown Alpert Medical School and The Miriam Hospital, Providence, RI, USA 
Section
Short Reports
Publication year
2020
Publication date
Jul 2020
Publisher
John Wiley & Sons, Inc.
e-ISSN
1758-2652
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2427617617
Copyright
© 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.