People with HIV don’t have a high chance of dying because of COVID-19 once underlying health conditions are considered, investigators from America report in the online edition of AIDS. However, the study did find that, even after considering comorbidities like obesity, kidney and lung disease, individuals with HIV were more apparent than closely matched HIV-negative people to be hospitalized due to COVID-19.
Dr. Yousaf Hadi and his team at the University of West Virginia conducted the study with over 400 individuals with HIV and COVID-19 co-infection. It’s among the largest research on the subject so far and had a strong methodology, directly comparing hospitality and mortality rates between people with HIV and carefully matched HIV-negative controls.
Their analysis found that results of COVID in HIV populations are not any different than HIV-negative inhabitants, even in patients with a history of treatment with antiretrovirals.
But he found that individuals with HIV becoming ill with COVID-19 had a higher rate of serious underlying illnesses than HIV-negative people. Indeed, due to this, their initial analysis showed higher mortality rates among individuals with HIV compared to HIV-negative individuals with COVID-19.
The implications of COVID-19 disease for those who have HIV are unclear. On the one hand, some studies indicate that individuals living with HIV have a slightly high risk of COVID-19-related death. This excess mortality risk could possibly be explained by the existence of underlying health conditions or social factors. However, it has also been argued that standard anti-HIV drugs might provide some protection against COVID-19 and its effects.
In the current research, Dr. Hadi and his colleagues analyzed the features and outcomes of over 50,000 people with confirmed COVID-19 who received care at health care institutions in cities across the USA. A total of 404 of those people were HIV positive.
The two study results were death within 30 days of COVID-19 diagnosis and hospitalization due to the infection.
Data were also gathered on potential risk factors for poorer COVID-19 results, such as age, sex, chronic kidney or lung disease, and cigarette smoking. These were all taken into consideration once the investigators conducted their comparisons.
The HIV-positive people had an average age of 48 years, 71% were male, and 50 percent were African American. Just under three-quarters (70 percent ) had taken antiretrovirals, but only 46 percent had been prescribed HIV treatment within six months of the COVID-19 diagnosis.
More information from the United States
Comparison With HIV-negative Coronavirus patients showed that people with HIV were more expected to be male (71 percent vs. 51 percent , p < 0.001), African American (50% vs 25%, p < 0.001) and to have existing health conditions such as hypertension (46% vs. 28%, p < 0.001), diabetes (22% vs. 15%, p < 0.001), obesity (26 percent vs. 21%, p = 0.03), chronic kidney disease (17% vs 7%, p < 0.001), heart disease (14% vs 8%, p < 0.001) chronic lung disease (25% vs 16%, p < 0.001), and be cigarette smokers (14% vs 7%, p < 0.001).
The researchers’ first study found that mortality rates within 30 days of COVID-19 analysis were higher among individuals with HIV compared to HIV-negative people (5.0% vs. 3.2%), a statistically significant 55% gap (risk ratio (RR) = 1.55; 95 percent CI, 1.01-2.39).
People with HIV were also more inclined to be hospitalized due to COVID-19 (19 percent vs. 11 percent; RR = 1.83; 95 percent CI, 1.50-2.24).
The investigators then undertook another analysis, matching all the HIV-positive people with an HIV-negative person with similar characteristics, including existing health conditions.
In this analysis, the HIV-positive and HIV-negative groups’ mortality risk difference ceased to be statistically significant (5.0percent vs. 3.7 percent; RR = 1.33; 95 percent CI, 0.69-2.57).
This finding was unchanged when the risk was analyzed based on the use of antiretrovirals. Analogous people taking HIV therapy with HIV-negative people revealed that the death rate was 3.9 percent compared to 3.2 percent for their matched controls, a non-major difference.
However, it was nevertheless the case that individuals with HIV were more likely to be hospitalized following a COVID-19 diagnosis (19 percent vs. 11%, RR = 1.70; 95 percent CI, 1.21-2.38).
“COVID crude mortality is greater in HIV-positive patients compared to non-HIV patients. However, propensity-matched reports revealed no difference in results, demonstrating that high mortality is driven by a greater load of risk factors for acute COVID from the HIV patients,” state Dr. Hadi and his coworkers. “Patients with HIV represent a cohort of patients with many risk factors for severe disease that requires special consideration in public health efforts. Early diagnosis and intensive surveillance may be required to avoid a syndemic’ of ailments in this vulnerable cohort.”
Stay Physically Active During COVID-19: Info for Individuals with HIV
Physical activity is one of the best things you can do to better your wellbeing. It can help you feel better, work better, and sleep better. Additionally, it lowers stress and anxiety. All these gains are still–and perhaps more–important during the COVID-19 pandemic.
Physical activity may also help you lower your risk of developing cardiovascular disease, type 2 diabetes, and many kinds of cancer. All of these are health conditions that may affect people with HIV.
Staying active can be challenging when many of us stay at home and sit longer than normal. However, it is essential to continue to keep a physically active lifestyle. CDC gives ideas for how to become physically active while social distancing:
- Catch up on household jobs such as cleaning out the cupboard. Vacuuming is also physical concrete activity.
- Get outdoors. Go for a bike ride, walk, or wheelchair roll in your area or at another secure place where you can keep at least 6 feet of space between yourself and other pedestrians and cyclists. If you choose to see a nearby park, road, or recreational facility, check for closures or restrictions. If available, think about how many other people may be there and select a location where it’s going to be possible to maintain at least 6 feet of distance between yourself and other folks that aren’t from your household.
- Make binge-watching more active by doing push-ups or jumping jacks between episodes.
- Engage in active fun time. Any game or activity that gets everybody in your household moving and up counts!
- If you’re working at home during COVID-19, consider taking activity breaks during the day or walking around your home during conference calls. You can even find free tips on the internet for physical activity breaks during the workday like seat exercises, stretches, tai chi, or yoga.
What to Know Around HIV and COVID-19
People with HIV may have questions and concerns associated with their risk of severe illness from COVID-19.
This is an evolving, rapidly evolving situation, and CDC will give updated information as it becomes available.
Are People With HIV at greater risk for COVID-19 than other men and women?
We’re still learning about COVID-19 and how it affects people with HIV. Based on limited data, we consider that people with HIV on successful HIV treatment have the same risk for COVID-19 as individuals who don’t have HIV.
Older adults and individuals of any age who have severe existing medical conditions may be at increased risk for acute illness. This includes individuals who have weakened immune systems. The risk for those who have HIV becoming very sick is best in
- Individuals with a low CD4 cell count, and
- Individuals not on successful HIV treatment (antiretroviral treatment or ART).
What Can Individuals With HIV Do Protect Themselves From COVID-19?
There is presently no vaccine to prevent COVID-19. The best way to avoid getting sick is to avoid exposure to the virus.
People with HIV should take regular preventative actions to help stop the transmission of COVID-19.
If you have HIV and are taking your HIV medication, it’s necessary to continue your treatment and follow your medical care provider’s advice. This is the perfect way to keep your immune system healthy.
People with HIV should also continue to keep a healthy lifestyle by
- Getting a minimum of 8 hours of sleep, and
- Eating right,
- Reducing stress as far as possible.
Staying healthy aid your immune system fight off disease should it occur.
What Should I Do If I Think I Might Have COVID-19?
Consult your health care provider if you develop symptoms that may be consistent with COVID-19.
Most people have mild illnesses and can recuperate at home. If you think you’ve got COVID-19 and have symptoms of the disease, you ought to get analyzed.
It’s important to keep on taking your HIV medication as prescribed. This can help keep your immune system healthy.
If you experience acute symptoms, get emergency health care immediately. Call ahead of time and inform the operator that you might have COVID-19.
What Else Can Individuals With HIV Who Are At Greater Risk Of Getting Really Sick From COVID-19 Do To Protect Themselves?
Nearly half of the people in America with diagnosed HIV are aged 50 years and older. People with HIV have higher rates of certain existing health conditions. Older age and these conditions can raise their risk for more severe illness if people with HIV get COVID-19, particularly people with advanced HIV.
Steps that Individuals with HIV can take to prepare in addition to what’s advised for everyone:
- Be sure you have at least a 30- to a 90-day supply of your HIV medication and some other medicines or medical supplies you need to handle HIV. Ask your healthcare provider about receiving the medicine by mail.
- Speak to your medical care provider and be sure all your vaccinations are up-to-date, such as vaccinations against periodical influenza (flu) and bacterial infections. These vaccine-preventable ailments disproportionately affect people with HIV.
- Establish and maintain a strategy for distant clinical care. Try to set up a telemedicine link via your HIV care provider’s internet portal. If telemedicine isn’t available to you, be sure that you can communicate with your supplier by text or phone. You may upgrade your distant clinical care plan each year or any time you have a change in your health or HIV therapy.
- If your HIV is undetectable (or virally suppressed), speak with your medical care provider about delaying your regular medical and laboratory visits.
- If your medical care provider changed your HIV therapy, ask if it is safe to delay the change until follow-up monitoring and testing are possible.
- Ensure you can keep a social network remotely, such as online, by telephone, or from video chat. This may help you remain socially connected and emotionally healthy, particularly for those who have HIV.
- People with HIV can sometimes be more prone than others to need additional assistance from friends, family, neighbors, community health workers, and others. If you get sick, be sure you remain in touch by telephone or email with those who can assist you.
Can HIV Medication (ART) Be Used To Treat COVID-19?
Currently, treatment for COVID-19 is quite limited. There’s absolutely not any evidence that any medications used to treat HIV are successful against COVID-19. People with HIV shouldn’t change their HIV medication to prevent or cure COVID-19.
Some clinical trials are looking at if HIV medications can treat COVID-19. Other trials are taking a look at the efficacy of different drugs to treat COVID-19 in people with HIV and better understand how people with HIV handle COVID-19.
What Can Everyone Do To Reduce Stigma About COVID-19?
Reducing stigma and misinformation regarding COVID-19 are very significant. People with HIV have experience in dealing with stigma and maybe allies in preventing COVID-19 stigma. Learn how you can reduce stigma and help stop the spread of rumors about COVID-19.