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Ishizaka A, Koga M, Mizutani T, Yamayoshi S, Iwatsuki-Horimoto K, Adachi E, Suzuki Y, Kawaoka Y, Yotsuyanagi H. Association of gut microbiota with the pathogenesis of SARS-CoV-2 Infection in people living with HIV. BMC Microbiol 2024; 24:6. [PMID: 38172680 PMCID: PMC10763188 DOI: 10.1186/s12866-023-03157-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND People living with HIV (PLWH) with chronic inflammation may have an increasing risk for coronavirus disease 2019 (COVID-19) severity; however, the impact of their gut microbiota on COVID-19 is not fully elucidated. Here, we analyzed the temporal changes in the gut microbiota composition of hospitalized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected PLWH (PLWH-CoV) and their correlation with COVID-19 severity. RESULT The 16S rRNA analysis results using stool samples (along the timeline from disease onset) from 12 hospitalized PLWH-CoV, whose median CD4 + T cell count was 671 cells/µl, were compared to those of 19 healthy people and 25 PLWH. Bacterial diversity in PLWH-CoV is not significantly different from that of healthy people and SARS-CoV-2 non-infected PLWH, but a significant difference in the microbiota diversity was observed in the classification according to the disease severity. Immediately after the disease onset, remarkable changes were observed in the gut microbiota of PLWH-CoV, and the changing with a decrease in some short-chain fatty acid-producing bacteria and an increase in colitis-related pathobiont. In the second week after disease onset, relative amounts of specific bacteria distinguished between disease severity. One month after the disease onset, dysbiosis of the gut microbiota persisted, and the number of Enterobacteriaceae, mainly Escherichia-Shigella, which is potentially pathogenic, increased and were enriched in patients who developed post-acute sequelae of COVID-19 (PASC). CONCLUSION The changes in the gut microbiota associated with SARS-CoV-2 infection observed in PLWH in this study indicated a persistent decrease in SCFA-producing bacteria and an intestinal environment with an increase in opportunistic pathogens associated with enteritis. This report demonstrates that the intestinal environment in PLWH tends to show delayed improvement even after COVID-19 recovery, and highlights the importance of the dysbiosis associated with SARS-CoV-2 infection as a potential factor in the COVID-19 severity and the PASC in PLWH.
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Affiliation(s)
- Aya Ishizaka
- Division of Infectious Diseases, Advanced Clinical Research Center, the Institute of Medical Science, the University of Tokyo, Tokyo, Japan
| | - Michiko Koga
- Division of Infectious Diseases, Advanced Clinical Research Center, the Institute of Medical Science, the University of Tokyo, Tokyo, Japan
| | - Taketoshi Mizutani
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, the University of Tokyo, Chiba, Japan.
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, the University of Tokyo, 6-2-3 Kashiwanoha, 277-0882, Kashiwa-shi, Chiba, Japan.
| | - Seiya Yamayoshi
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- The Research Center for Global Viral Diseases, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
| | - Kiyoko Iwatsuki-Horimoto
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Eisuke Adachi
- Department of Infectious Diseases and Applied Immunology, IMSUT Hospital of Institute of Medical Science, the University of Tokyo, Tokyo, Japan
| | - Yutaka Suzuki
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, the University of Tokyo, Chiba, Japan
| | - Yoshihiro Kawaoka
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- The Research Center for Global Viral Diseases, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Pandemic Preparedness, Infection and Advanced Research Center, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Yotsuyanagi
- Division of Infectious Diseases, Advanced Clinical Research Center, the Institute of Medical Science, the University of Tokyo, Tokyo, Japan.
- Department of Infectious Diseases and Applied Immunology, IMSUT Hospital of Institute of Medical Science, the University of Tokyo, Tokyo, Japan.
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, the University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, 108-8639, Tokyo, Japan.
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Cilloniz C, Motos A, Canseco J, Peñasco Y, Ricart P, Abril E, García JMG, Ortiz AB, Mateo NG, Sánchez-Miralles Á, Franco N, Riera J, Ferrer R, Bustamante-Munguira E, Caballero J, Gándara AMDL, Sancho S, Masclans JR, Urrelo-Cerrón L, Carbonell N, Socías L, Barberà C, Lorente JA, Rodríguez ÓP, Menéndez R, de Gonzalo-Calvo D, Ceccato A, Fernandez-Barat L, Garcia-Gasulla D, Gabarrus A, Garcia-Vidal C, Moreno A, Barbé F, Miro JM, Torres A. Clinical Outcomes of Critical COVID-19 in HIV-Infected Adults: A Propensity Score Matched Analysis. Arch Bronconeumol 2023; 59:772-778. [PMID: 37661559 DOI: 10.1016/j.arbres.2023.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Catia Cilloniz
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain; University of Barcelona, Spain; Faculty of Health Sciences, Continental University, Huancayo, Peru.
| | - Anna Motos
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain; University of Barcelona, Spain
| | - Joan Canseco
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain
| | - Yhivian Peñasco
- Intensive Medicine Department, Hospital Universitario Marqués of Valdecilla, Santander, Spain
| | - Pilar Ricart
- Intensive Medicine Department, Hospital Universitari Germans Trias, Badalona, Spain
| | - Elena Abril
- Hospital Universitario Torrejón, Madrid, Spain
| | | | - Aaron Blandino Ortiz
- Intensive Care Department, Hospital Universitario Ramón y Cajal, Madrid, Spain; Universidad de Alcalá, Madrid, Spain
| | - Nadia García Mateo
- Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, Salamanca, Spain
| | | | | | - Jordi Riera
- Intensive Care Department, Vall d'Hebron Hospital Universitari, SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Ricard Ferrer
- Intensive Care Department, Vall d'Hebron Hospital Universitari, SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | | | - Jesús Caballero
- Critical Care Department, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain
| | | | - Susana Sancho
- Critical Care Department, Hospital Universitario y Politecnico de La Fe, Valencia, Spain
| | - Joan-Ramon Masclans
- Critical Care Department, Hospital del Mar, Critical Illness Research Group (GREPAC), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - Nieves Carbonell
- Intensive Care Unit, Hospital Clinico Universitario de Valencia, Spain
| | - Lorenzo Socías
- Intensive Care Unit, Hospital Son Llàtzer, Palma de Mallorca, Illes Balears, Spain
| | | | - José A Lorente
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Hospital Universitario de Getafe, Madrid, Spain
| | - Óscar Peñuelas Rodríguez
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Hospital Universitario de Getafe, Madrid, Spain
| | - Rosario Menéndez
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Pulmonology Service, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - David de Gonzalo-Calvo
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Hospital Santa Maria, IRBLleida, Lleida, Spain
| | - Adrian Ceccato
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Critical Care Center, ParcTaulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain; Intensive Care Unit, Hospital Universitari Sagrat Cor, Grupo Quironsalud, Barcelona, Spain
| | - Laia Fernandez-Barat
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain; University of Barcelona, Spain
| | | | - Albert Gabarrus
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain
| | - Carolina Garcia-Vidal
- Department of Infectious Diseases, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Asunción Moreno
- Department of Infectious Diseases, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Ferran Barbé
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Pulmonary Department, Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Spain
| | - José M Miro
- Department of Infectious Diseases, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain; University of Barcelona, Spain; Pulmonology Department, Hospital Clinic of Barcelona, Spain
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Möller IK, Gisslén M, Wagner P, Sparén P, Carlander C. COVID-19 hospitalization outcomes in adults by HIV status; a nation-wide register-based study. HIV Med 2023; 24:1045-1055. [PMID: 37286199 DOI: 10.1111/hiv.13515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 05/11/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To assess the outcome of patients hospitalized with COVID-19 by HIV status and risk factors for severe COVID-19 in people living with HIV (PWH), we performed a nationwide cohort study using register data. METHODS All people aged ≥18 years hospitalized with a primary COVID-19 diagnosis (U07.1 or U07.2) in Sweden between February 2020 and October 2021 were included. The primary outcome was severe COVID-19 [intensive care unit (ICU) admission or 90-day mortality]. Secondary outcomes were days in hospital and ICU, complications in hospital, and risk factors for severe COVID-19 in PWH. Regression analyses were performed to assess severe COVID-19 by HIV status and risk factors. RESULTS Data from 64 815 hospitalized patients were collected, of whom 121 were PWH (0.18%). PWH were younger (p < 0.001), and larger proportions were men (p = 0.014) and migrants (p < 0.001). Almost all PWH had undetectable HIV-RNA (93%) and high CD4 T-cell counts (median = 560 cells/μL, interquartile range: 376-780). In an unadjusted model, PWH had statistically significant lower odds of severe COVID-19 compared with patients without HIV [odds ratio (OR) = 0.6, 95% confidence interval (CI): 0.34-0.94], but there was no significant difference after adjusting for age and comorbidity (adjusted OR = 0.7, 95% CI: 0.43-1.26). A statistically significant lower proportion of PWH (8%, 95% CI: 5-15%) died within 90 days compared with those without HIV (16%, 95% CI: 15-16%, p = 0.024). There was no statistically significant difference in days in hospital and complications during the hospital stay between PWH and patients without HIV. CONCLUSIONS In this nationwide study including well-treated PWH, HIV was not a risk factor in hospitalized patients for developing severe COVID-19.
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Affiliation(s)
- Isabela Killander Möller
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Gisslén
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Philippe Wagner
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Centre for Clinical Research Västmanland, Västmanland County Hospital, Uppsala University, Västerås, Sweden
| | - Pär Sparén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christina Carlander
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Centre for Clinical Research Västmanland, Västmanland County Hospital, Uppsala University, Västerås, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Rombini MF, Cecchini D, Diana Menendez S, Calanni L, Cuini R, Obieta E, Greco MM, Morales F, Morganti L, Migazzi C, El Kozah Y, Parenti P, Cassetti I. Tenofovir-Containing Antiretroviral Therapy and Clinical Outcomes of SARS-CoV-2 Infection in People Living with HIV. Viruses 2023; 15:v15051127. [PMID: 37243213 DOI: 10.3390/v15051127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Tenofovir has been hypothesized to be effective against COVID-19 and is available as two prodrugs, tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF), both part of antiretroviral therapy (ART) regimens. People living with human immunodeficiency virus (PLWH) might be at higher risk for COVID-19 progression; however, information about the impact of tenofovir on COVID-19 clinical outcomes remains controversial. The COVIDARE is a prospective observational multicentric study in Argentina. PLWH with COVID-19 were enrolled from September 2020 to mid-June 2022. Patients were stratified according to baseline ART into those with tenofovir (TDF or TAF) and those without. Univariate and multivariate analyses were performed to evaluate the impact of tenofovir vs. non-tenofovir-containing regimens on major clinical outcomes. Of the 1155 subjects evaluated, 927 (80%) received tenofovir-based ART (79% TDF, 21% TAF) whilst the remaining population was under non-tenofovir regimens. The non-tenofovir group had older age and a higher prevalence of heart and kidney disease. Regarding the prevalence of symptomatic COVID-19, tomographic findings, hospitalization, and mortality, no differences were observed. The oxygen therapy requirement was higher in the non-tenofovir group. In the multivariate analyses, a first model with adjustment for viral load, CD4 T-cell count, and overall comorbidities showed that oxygen requirement was associated with non-tenofovir ART. In a second model with adjustment by chronic kidney disease, tenofovir exposure was not statistically significant.
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Affiliation(s)
| | - Diego Cecchini
- Helios Salud, Buenos Aires 1141, Argentina
- Hospital Cosme Argerich, Buenos Aires 1155, Argentina
| | | | | | - Rosana Cuini
- Hospital Teodoro Álvarez, Buenos Aires 1406, Argentina
| | - Elena Obieta
- Hospital Municipal Ciudad de Boulogne, Boulogne 1609, Argentina
| | - María M Greco
- Hospital Español de La Plata, La Plata 1902, Argentina
| | | | | | - Claudia Migazzi
- Hospital Presidente Perón de Avellaneda, Avellaneda 1872, Argentina
| | - Yasmin El Kozah
- Helios Salud, Buenos Aires 1141, Argentina
- Hospital Municipal Ciudad de Boulogne, Boulogne 1609, Argentina
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5
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Abstract
PURPOSE OF REVIEW HIV/AIDS and COVID-19 have been the major pandemics overwhelming our times. Given the enduring immune disfunction featuring people living with HIV (PLWH) despite combination antiretroviral therapy (cART), concerns for higher incidence and severity of SARS-CoV-2 infection as well as for suboptimal responses to the newly developed vaccines in this population arose early during the pandemics. Herein, we discuss the complex interplay between HIV and SARS-CoV-2, with a special focus on the immune responses to SARS-CoV-2 natural infection and vaccination in PLWH. RECENT FINDINGS Overall, current literature shows that COVID-19 severity and outcomes may be worse and immune responses to infection or vaccination lower in PLWH with poor CD4 + T-cell counts and/or uncontrolled HIV viremia. Data regarding the risk of post-acute sequelae of SARS-CoV-2 infection (PASC) among PLWH are extremely scarce, yet they seem to suggest a higher incidence of such condition. Scarce immunovirological control appears to be the major driver of weak immune responses to SARS-CoV-2 infection/vaccination and worse COVID-19 outcomes in PLWH. Therefore, such individuals should be prioritized for vaccination and should receive additional vaccine doses. Furthermore, given the potentially higher risk of developing long-term sequelae, PLWH who experienced COVID-19 should be ensured a more careful and prolonged follow-up.
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Affiliation(s)
- Matteo Augello
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan, Via A. Di Rudinì, 8, 20142, Milan, Italy
| | - Valeria Bono
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan, Via A. Di Rudinì, 8, 20142, Milan, Italy
| | - Roberta Rovito
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan, Via A. Di Rudinì, 8, 20142, Milan, Italy
| | - Camilla Tincati
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan, Via A. Di Rudinì, 8, 20142, Milan, Italy
| | - Giulia Marchetti
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan, Via A. Di Rudinì, 8, 20142, Milan, Italy.
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6
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Venturas JP. HIV and COVID-19 Disease. Semin Respir Crit Care Med 2023; 44:35-49. [PMID: 36646084 DOI: 10.1055/s-0042-1758852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Despite effective antiretroviral therapy (ART), HIV infected individuals throughout the world remain at significant risk of respiratory infections and non-communicable disease. Severe disease from SARS-CoV-2 is associated with a hyperinflammatory phenotype which manifests in the lungs as pneumonia and in some cases can lead to acute respiratory failure. Progression to severe COVID-19 is associated with comorbid disease such as obesity, diabetes mellitus and cardiovascular disease, however data concerning the associated risks of HIV coinfection are still conflicting, with large population studies demonstrating poorer outcomes, whilst smaller, case-controlled studies showing better outcomes. Furthermore, underlying immunopathological processes within the lungs and elsewhere, including interactions with other opportunistic infections (OI), remain largely undefined. Nonetheless, new and repurposed anti-viral therapies and vaccines which have been developed are safe to use in this population, and anti-inflammatory agents are recommended with the caveat that the coexistence of opportunistic infections is considered and excluded. Finally, HIV infected patients remain reliant on good ART adherence practices to maintain HIV viral suppression, and some of these practices were disrupted during the COVID-19 pandemic, putting these patients at further risk for acute and long-term adverse outcomes.
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Affiliation(s)
- Jacqui P Venturas
- Department of Internal Medicine and Pulmonology, Charlotte Maxeke Johannesburg Academic Hospital and Universtity of the Witwatersrand, Johannesburg, South Africa
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7
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Muthuka JK, Oluoch K, Wambura FM, Nzioki JM, Nabaweesi R. HIV and Associated Indicators of COVID-19 Cytokine Release Syndrome: A Meta-Analysis and Meta-Regression. Cureus 2023; 15:e34688. [PMID: 36909058 PMCID: PMC9994766 DOI: 10.7759/cureus.34688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 02/09/2023] Open
Abstract
The aim of this review was to evaluate the risk of COVID-19 cytokine release syndrome (CRS) with HIV infection and meta-regress for indicator covariates. Electronic databases, including Google Scholar, Cochrane Library, Web of Sciences (WOS), EMBASE, Medline/PubMed, COVID-19 Research Database, and Scopus, were systematically searched till February 30, 2022. All human studies were included, irrespective of publication date or region. Eleven studies, with a total of 2,005,274 detailing cytokine release syndrome defined by specific parameters, were included. To pool the estimate, a random-effects model with risk ratio (RR) as the effect measure was used. Moreover, publication bias and sensitivity analysis were evaluated followed by meta-regression analysis to account for any possible covariates. This systematic review, meta-analysis, and meta-regression trial was registered (CRD42021264761) on the PROSPERO register. HIV infection showed an increased risk for COVID-19 cytokine release syndrome (RR= 1.48, 95% CI (1.16, 1.88) (P=0.002)) with substantial heterogeneity (I2 > 80%) and a 4.6% cumulative incidence. The true effects size in 95% of all the comparable populations (prediction interval) fell between 0.67 to 3.29. HIV infection further showed an increased risk for intensive care unit (ICU) admission ((P<0.0001) (I² = 0%)] and mechanical ventilation (MV) ((P=0.04) (I² = 0%)) as the key indicators of cytokine release syndrome. Meta-regression analysis demonstrated that COVID-19 cytokine release syndrome was influenced by the year a study was published (R² = 0.55) and the region from where the study was conducted (R² = 0.11). On meta-regression analysis, the combined impact of all covariates in the model explained at least some of the variance in effect size (Q = 16.21, df = 6, P= 0.0127), and the proportion of variance explained by covariates on comparing the model with and without the covariates was 73 % and highly significant (Tau² = 0.1100, Tau = 0.3317, I² = 86.5%, Q = .99, df = 10, P<0.0001) (R² = 0.73). Our updated meta-analysis indicated that HIV infection was significantly associated with an increased risk for COVID-19 cytokine release syndrome, which, in addition, might be moderated by the year a study was published and the region in which the study was conducted. Further, the risk for intensive care unit (ICU) admission and mechanical ventilation (MV) were identified as the key indicators of cytokine release syndrome. We believe the updated data anchoring cytokine release syndrome will contribute to more substantiation of the findings reported by similar earlier studies.
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Affiliation(s)
- John K Muthuka
- Epidemiology, Public Health & Biostatistics, Jomo Kenyatta University of Agriculture & Technology, Nairobi, KEN.,Public Health Sciences, Kenya Medical Training College, Nairobi, KEN
| | - Kelly Oluoch
- Pharmacy, Kenya Medical Training College, Nairobi, KEN
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Lee MJ, Nori A, Fidler S, Kulasegaram R, Fox J, Smith C. Response to 'The use of tenofovir in patients with COVID-19'. HIV Med 2022; 23:929-930. [PMID: 35194929 PMCID: PMC9111571 DOI: 10.1111/hiv.13278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Ming Jie Lee
- Imperial College LondonDepartment of Infectious Disease, and Imperial College NHS TrustLondonUK
- Harrison WingGuys’ and St Thomas’ NHS Foundation TrustLondonUK
| | - Achyuta Nori
- Harrison WingGuys’ and St Thomas’ NHS Foundation TrustLondonUK
| | - Sarah Fidler
- Imperial College LondonDepartment of Infectious Disease, and Imperial College NHS TrustLondonUK
| | | | - Julie Fox
- Harrison WingGuys’ and St Thomas’ NHS Foundation TrustLondonUK
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9
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Favara G, Barchitta M, Maugeri A, Faro G, Agodi A. HIV infection does not affect the risk of death of COVID-19 patients: A systematic review and meta-analysis of epidemiological studies. J Glob Health 2022; 12:05036. [PMID: 35972980 PMCID: PMC9380965 DOI: 10.7189/jogh.12.05036] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background Even during the current Coronavirus Disease 2019 (COVID-19) pandemic, the infection with the Human Immunodeficiency Virus (HIV) continues to pose a major threat, worldwide. In fact, the World Health Organization (WHO) defined the HIV infection as a risk factor for both severe COVID-19, at hospital admission, and in-hospital mortality. Despite this evidence, however, there remains the need for investigating whether SARS-CoV-2 infection could increase the risk of death among people living with HIV (PLHIV). Thus, we conducted a systematic review and meta-analysis to assess the impact of the SARS-CoV-2 infection on the risk of death among PLHIV and HIV- seronegative people. Methods The literature search was carried out on PubMed, Embase and Web of Science databases, from the inception to February 2022. Epidemiological studies on patients tested positive for SARS-CoV-2 infection, which compared the proportion of deaths between PLHIV and HIV-seronegative people, were considered eligible for the inclusion. The pooled odds ratio (OR) was obtained through meta-analysis of the comparison between PLHIV and HIV-seronegative people. Study quality was assessed by using the Newcastle-Ottawa Quality Assessment. Results On a total of 1001 records obtained from the literature search, the present systematic review and meta-analysis included 28 studies on 168 531 PLHIV and 66 712 091 HIV-seronegative patients with SARS-CoV-2 infection. The meta-analysis showed no difference in the risk of death between PLHIV and HIV-seronegative patients (OR = 1.09; 95% confidence interval (CI) = 0.93-1.26; P > 0.001). However, a significant heterogeneity was found for this comparison (I2 = 88.8%, P < 0.001). Conclusions Although our meta-analysis suggests no difference in the risk of death of PLHIV with SARS-CoV-2 infection, if compared with HIV-seronegative patients, further research should be encouraged to improve the current knowledge about the impact of SARS-CoV-2 and HIV co-infection.
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10
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Rosenthal EM, Rosenberg ES, Patterson W, Ferguson WP, Gonzalez C, DeHovitz J, Udo T, Rajulu DT, Hart-Malloy R, Tesoriero J. Factors associated with SARS-CoV-2-related hospital outcomes among and between persons living with and without diagnosed HIV infection in New York State. PLoS One 2022; 17:e0268978. [PMID: 35613145 DOI: 10.1371/journal.pone.0268978] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background Persons living with diagnosed HIV (PLWDH) are at increased risk for severe illness due to COVID-19. The degree to which this due to HIV infection, comorbidities, or other factors remains unclear. Methods We conducted a retrospective matched cohort study of individuals hospitalized with COVID-19 in New York State between March and June 2020, during the first wave of the pandemic, to compare outcomes among 853 PLWDH and 1,621 persons without diagnosed HIV (controls). We reviewed medical records to compare sociodemographic and clinical characteristics at admission, comorbidities, and clinical outcomes between PLWDH and controls. HIV-related characteristics were evaluated among PLWDH. Results PLWDH were significantly more likely to have cardiovascular (matched prevalence-ratio [mPR], 1.22 [95% CI, 1.07–1.40]), chronic liver (mPR, 6.71 [95% CI, 4.75–9.48]), chronic lung (mPR, 1.76 [95% CI, 1.40–2.21]), and renal diseases (mPR, 1.77 [95% CI, 1.50–2.09]). PLWDH were less likely to have elevated inflammatory markers upon hospitalization. Relative to controls, PLWDH were 15% less likely to require mechanical ventilation or extracorporeal membrane oxygenation (ECMO) and 15% less likely to require admission to the intensive care unit. No significant differences were found in in-hospital mortality. PLWDH on tenofovir-containing regimens were significantly less likely to require mechanical ventilation or ECMO (risk-ratio [RR], 0.73 [95% CI, 0.55–0.96]) and to die (RR, 0.74 [95% CI, 0.57–0.96]) than PLWDH on non-tenofovir-containing regimens. Conclusions While hospitalized PLWDH and controls had similar likelihood of in-hospital death, chronic disease profiles and degree of inflammation upon hospitalization differed. This may signal different mechanisms leading to severe COVID-19.
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Wang Y, Xie Y, Hu S, Ai W, Tao Y, Tang H, Jing F, Tang W. Systematic Review and Meta-Analyses of The Interaction Between HIV Infection And COVID-19: Two Years' Evidence Summary. Front Immunol 2022; 13:864838. [PMID: 35619709 PMCID: PMC9128408 DOI: 10.3389/fimmu.2022.864838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/13/2022] [Indexed: 12/20/2022] Open
Abstract
Introduction During the COVID-19 pandemic, people living with HIV (PLWH) were considered to be at risk of worse COVID-19 outcomes once infected. However, the existing evidence is inconsistent. This systematic review and meta-analysis aimed to compare the risk of SARS-CoV-2 infection, severe COVID-19 symptoms, and mortality among PLWH and patients without HIV. Method The articles included studies published in PubMed, Medline, Embase, and Cochrane between December 1, 2019, and December 1, 2021. We included the original studies published in English focusing on observational studies assessing the risk of SARS-CoV-2 infection, severe COVID-19 symptoms, and mortality among PLWH. Four independent reviewers extracted data. STrengthening the Reporting of OBservational studies in Epidemiology-Modified (STROBE-M) checklist was used for quality assessment. For the results with heterogeneity I2 >75%, a random-effects model was employed. Otherwise, a fixed-effects model was used. The risk of SARS-CoV-2 infection, severe COVID-19 symptoms, and mortality were compared with and without HIV. Results We included a total of 32 studies and 71,779,737 study samples, of whom 797,564 (1.11%) were PLWH. Compared with COVID-19 patients without HIV infection, PLWH had comparable risk of SARS-CoV-2 infection (adjusted Risk Ratio=1.07, 95% CI: 0.53-2.16, I2 = 96%, study n=6, n=20,199,805) and risk of developing severe COVID-19 symptoms (aRR=1.06, 95% CI: 0.97-1.16, I2 = 75%, n=10, n=2,243,370). PLWH, if infected with SARS-CoV-2, were found to have an increased risk of mortality compared with people without HIV (aRR=1.30, 95% CI: 1.09-1.56, I2 = 76%, study n=16, n=71,032,659). This finding was consistent across different subgroup analyses. Conclusion PLWH are at increased risk of COVID-19 related mortality once infected. The local health system should, on the one hand, strengthen COVID-19 prevention and clinical management among PLWH to avoid infection and, on the other hand, sustain the HIV care continuum for PLWH for HIV management.
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Affiliation(s)
- Yehua Wang
- College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Yewei Xie
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Institute for Healthcare Artificial Intelligence, Guangdong Second Provincial General Hospital, Guangzhou, China
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
| | - Siyue Hu
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
| | - Wei Ai
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yusha Tao
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
| | - Huilin Tang
- College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Fengshi Jing
- Institute for Healthcare Artificial Intelligence, Guangdong Second Provincial General Hospital, Guangzhou, China
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
| | - Weiming Tang
- Institute for Healthcare Artificial Intelligence, Guangdong Second Provincial General Hospital, Guangzhou, China
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
- Institute for Global Health and Infectious Diseases, School of Medicine, The University of North Carolina at Chapel Hill, NC, United States
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Kow CS, Ramachandram DS, Hasan SS. The use of tenofovir in patients with COVID-19. HIV Med 2022; 23:807-808. [PMID: 35023263 DOI: 10.1111/hiv.13228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/27/2021] [Accepted: 12/21/2021] [Indexed: 01/07/2023]
Affiliation(s)
- Chia Siang Kow
- School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia.,School of Pharmacy, Monash University Malaysia, Bandar Sunway, Subang Jaya, Malaysia
| | | | - Syed Shahzad Hasan
- School of Applied Sciences, University of Huddersfield, Huddersfield, UK.,School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
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