Risk Factors for COVID‐19 Mortality Among People Living with HIV

Abstract

Research ObjectiveAmidst 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 DesignThis 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 StudiedStudies 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 FindingsSearches 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.ConclusionsAmong 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 PracticeOur 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.