Characterisation of PLWH with COVID-19 in a tertiary care reference centre for emerging infectious diseases in Portugal

Background: In the current COVID-19 pandemic, some risk factors for severe disease and death have been identified, including age, male gender, diabetes mellitus, cardiovascular and lung diseases, chronic kidney disease and cancer Although still scarce, current data does not support an increased risk for severe COVID-19 on PLWH [1,2] Our aim was to describe clinical characteristics and outcomes of PLWH with COVID-19 followed in our hospital, a reference centre for emerging infectious diseases in Portugal Materials and methods: Retrospective analysis on cases of PLWH with a confirmed COVID-19 diagnosis between 2 March and 14 July 2020 The data showcased in Table 1 was collected from patient records Proven COVID-19 required a positive SARS-CoV-2 nucleic acid amplification test on respiratory samples Results: We followed 2092 patients with COVID-19, eight of whom were PLWH (six males, mean age 48 ± 15 years) on ART at the time of diagnosis, which included protease inhibitors (PI) in two and tenofovir alafenamide in two Median CD4 + T cell count was 626 (range 14 to 1337) cells/mm3 Seven were virally suppressed and had a CD4 + T cell count =350 cells/mm3, and six had at least one comorbidity other than HIV Two patients received treatment with hydroxychloroquine, both of whom were hospitalised: one with concomitant ankylosing spondylitis on methotrexate and the other diagnosed with SARS-CoV-2 pneumonia while hospitalised for candidaemia The latter was a 67-year-old HIV-2 infected patient on a failing ART regimen without immune recovery and with detectable HIV viraemia, and the only casualty in our cohort He had multiple comorbid conditions and required treatment with supplemental oxygen therapy Seven patients were classified as having mild disease, six of whom currently considered fully recovered with a median 40 5 days (range 21 to 74 days) until two consecutive negative SARS-CoV-2 PCR tests Conclusions: PLWH accounted for < 0 4% of patients with COVID-19 in our centre PLWH may still get infected during PI-and/or tenofovir-based ART A severe clinical picture among those with viral suppression on ART was not seen thereby adding to the growing body of evidence supporting the notion that adequately controlled HIV does not by itself place one at increased risk for severe disease or excess mortality