Epidemiological, Clinical, Paraclinical and Evolutionary Aspects of SARS-CoV-2 Infection in 22 HIV-Infected Patients Followed at the Fann Outpatient Treatment Center

Abstract

Introduction: Appearig at the end of 2019, an acute respiratory disease caused by a new coronavirus (SARS-CoV-2) quickly spread from China to all parts of the world. Cardiovascular disease, hypertension, diabetes, respiratory tract diseases, and cancer, among others, are poor predictive factors for SARS-CoV-2 infection. However, it is not yet well established to date that the human immunodeficiency virus type 1 (HIV-1) increases mortality from COVID-19. We decided to describe aspectsof COVID-19 in HIV infected patients, followed up at the Outpatient Treatment Centre (CTA) in Dakar-Fann. Methodology: This was a retrospective descriptive and analytical study of PLHIV over 15 years of age followed at the Outpatient Treatment Centre in Fann in whom the diagnosis of COVID-19 was made between July 2020 and September March 2021 by the polymerase chain reaction method in time real (RT-PCR). Results: A total of 22 PLWHA had COVID-19 with a predominance of women (15/22 or 68%). The median age was 47 years (33-85). The majority (91%) were infected with HIV-1. The mean last LTCD4 count in patients before COVID-19 diagnosis was 582 cells/mm³ [51-1415]. The last viral load before SARS-CoV2 infection was undetectable in 19 patients or 86%. One patient was in virological rebound with 353.158copies/ml. Two had no available viral load, one was profile 2 (HIV-2) and one double profile (HIV1+2). One among the patients was an active smoker. Comorbidities were found in 14 patients (64%) dominated by hypertension (7/14) and obesity/overweight (6/14). One case of hepatic cytolysis due to auto-immune disease was noted. The most frequent symptoms were headache, severe asthenia, fever, anosmia, breath shortness and cough. Anti-COVID-19 therapy was initiated following to the national protocol in addition to ART (8 on ATRIPLA, 4 TLD and 2 on ATZ/r and LPV/r). Half of the patients were treated in hospital (11/22, i.e., 50%), including one in intensive care, namely the one with a virological rebound. The case lethality rate was 9% (02/22). The two deaths involved patients over 65 years of age who did not receive any vaccine, one of whom suffered from an auto-immune disease with poor treatment observance. Conclusion: Most patients were virologically controlled with a good LTCD4 level > 582 cells/mm³. The comorbidities found were identical to those already described, proving once again that HIV is probably not a separate factor. However, good monitoring of co-morbidities, support for therapeutic compliance and vaccination should enable effective control of this pandemic in HIV patients.