Presentation and outcome of COVID-19 in HIV patients with high viral loads and opportunistic infections: a case series

  • Yasmine O. Hardy Department of Medicine, Komfo Anokye Teaching Hospital/School of Medical Sciences, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
  • Divine A. Amenuke Department of Medicine, Komfo Anokye Teaching Hospital/School of Medical Sciences, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
  • Kojo A. Hutton-Mensah Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
  • David R. Chadwick Department of Infectious Diseases, South Tees Hospitals NHS Foundation Trust, Centre for Clinical Infections, Middlesbrough, United Kingdom
  • Rita Larsen-Reindorf Ashanti Regional Health Directorate, Ghana Health Service, Kumasi, Ghana
Keywords: COVID-19, advanced HIV, clinical outcome, SARS-CoV-2, Ghana

Abstract

Coronavirus disease 2019 (COVID-19) is especially severe in patients with underlying chronic conditions, with increased risk of mortality. There is concern that people living with HIV (PLWH), especially those with severe immunosuppression, and COVID-19 may have severe disease and a negative clinical outcome. Most studies on COVID-19 in PLWH are from Asia, Europe and America where population dynamics, antiretroviral treatment coverage and coexisting opportunistic infections may differ from that in sub-Saharan Africa. We report on the clinical profile and outcome of three cases of PLWH co-infected with SARS-CoV-2. They all presented with fever, cough and breathlessness and also had advanced HIV infection as evidenced by opportunistic infections, high HIV viral loads and low CD4 counts. The patients responded favourably to the standard of care and were discharged home. Our findings suggest that PLWH with advanced immunosuppression may not necessarily have an unfavourable disease course and outcome. However, case-controlled studies with a larger population size are needed to better understand the impact of COVID-19 in this patient population.

Published
2020-12-31

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print ISSN: 0016-9560