Low risk of bacterial co-infection, opportunistic diseases, and persistent immunosuppression in people living with HIV and COVID-19

• Published in: Infection Vol. 50; no. 4; pp. 1013 - 1017
• Main Authors: Casado, José L., Vizcarra, Pilar, Vivancos, María J., Martinez-Sanz, Javier, Perez-Elías, María J., Moreno, Ana, Vallejo, Alejandro
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2022; Springer Nature B.V
• Subjects: Acquired immune deficiency syndrome; AIDS; Antibiotics; Antigens; Bacteria; Bacterial infections; Brief Report; CD4 antigen; CD8 antigen; Coronaviruses; COVID-19; Evolution; Family Medicine; General Practice; Health risks; HIV; Hospitalization; Human immunodeficiency virus; Immunology; Immunosuppression; Infections; Infectious Diseases; Internal Medicine; Laboratories; Leukocytosis; Lymphocytes T; Lymphopenia; Medicine; Medicine & Public Health; Pathogens; Pneumonia; Procalcitonin; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Superinfection; Viral diseases; Viral infections; COVID-19; Superinfection; Co-infection; HIV; Lymphopenia; CD4/CD8 ratio
• ISSN: 0300-8126; 1439-0973
• DOI: 10.1007/s15010-022-01811-0

Purpose SARS-CoV-2 infection produces lymphopenia and CD4+ T-cell decrease, which could lead to a higher risk of bacterial co-infection or impair immunological evolution in people living with HIV (PLWH). Methods We investigated the rate of co-infection and superinfection, and the evolution of CD4+ count and CD4+/CD8+ ratio, in hospitalized PLWH with COVID-19. Results From March to December 2020, 176 PLWH had symptomatic COVID-19 and 62 required hospitalization (median age, 56 years, 89% males). At admission, 7% and 13% of patients had leukocytosis or increased procalcitonin values and 37 (60%) received empiric antibiotic therapy, but no bacterial co-infection was diagnosed. There were seven cases of superinfection (12%), and one case of P. jiroveci pneumonia during ICU stay. No significant change in CD4+ count or CD4+/CD8+ ratio was observed after discharge. Conclusion Bacterial co-infection is not frequent in PLWH with COVID-19. Immune recovery is observed in most of patients after the disease.