Risk Factors for COVID-19 Mortality Among People Living with HIV
Abstract
Research Objective
Amidst the COVID-19 pandemic, certain groups are highly susceptible to life-threatening infection. In particular, people living with HIV (PLWH) are vulnerable to worsened outcomes of COVID-19. Hence, to better understand factors that increase the likelihood of death, the purpose of this work was to systematically review the literature in order to assess the risk factors for COVID-19 mortality among PLWH.
Study Design
This systematic review was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted in PubMed, Scopus, Global Health, and WHO Coronavirus Database. During the screening process, duplicate articles were removed; thereafter, articles were screened based on title/abstract, and then based on a full-text review.
Population Studied
Studies that included PLWH who died after infection of COVID-19, and had some description of the risk factors for mortality, were eligible for this review.
Principal Findings
Searches generated a total of 530 articles, and, after screening, 15 articles were eligible for inclusion. It was consistently found that males living with HIV have a higher risk for mortality than females. Individuals in the age range of approximately 50-65 years had amongst the highest rates of death compared to other age groups. Individuals with additional comorbidities, especially diabetes and hypertension, had an elevated risk of death. Those with a decreased CD4 count were more likely to die; rates were particularly high for those with a CD4 count of less than 200.
Conclusions
Among PLWH, males aged 50-65 with comorbidities appear to be at the highest risk of mortality from COVID-19. In addition, those who have had interruptions in their HIV treatment regimens are at an elevated risk.
Implications for Policy or Practice
Our findings highlight the need to ensure that, amidst COVID-19 prevention efforts, focus be placed particularly on males aged 50-65 living with HIV and other comorbidities. Furthermore, it is important to recognize that COVID-19 has likely led to major interruptions of HIV treatment regimens for many patients; considering that those with a lower CD4 count are at a higher risk of death, it is critical that more efforts be made to ensure that PLWH receive their HIV treatment during the COVID-19 pandemic.
