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COVID‐19 in people living with HIV: Clinical implications of dynamics of the immune response to SARS‐CoV‐2
Author(s) -
Mondi Annalisa,
Cimini Eleonora,
Colavita Francesca,
Cicalini Stefania,
Pinnetti Carmela,
Matusali Giulia,
Casetti Rita,
Maeurer Markus,
Vergori Alessandra,
Mazzotta Valentina,
Gagliardini Roberta,
De Zottis Federico,
Schininà Vincenzo,
Girardi Enrico,
Puro Vincenzo,
Ippolito Giuseppe,
Vaia Francesco,
Capobianchi Maria Rosaria,
Castilletti Concetta,
Agrati Chiara,
Antinori Andrea
Publication year - 2021
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.26556
Subject(s) - medicine , immune system , immunology , pneumonia , immunosuppression , proinflammatory cytokine , antibody , respiratory failure , viral load , coronavirus , disease , covid-19 , virus , inflammation , infectious disease (medical specialty)
Little evidence on coronavirus disease 2019 (COVID‐19) in people living with HIV (PLWH) is currently available. We reported clinical and viroimmunological data of all HIV‐positive patients admitted to our center with COVID‐19 from March 1 to May 12, 2020. Overall, five patients were included: all were virologically‐suppressed on antiretroviral therapy and CD4+ count was greater than 350 cell/mm 3 in all but two patients. Although all patients had evidence of pneumonia on admission, only one developed respiratory failure. Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) RNA was never detected from nasopharyngeal swabs in two patients, whereas in the others, viral clearance occurred within a maximum of 43 days. Immunoglobulin G production was elicited in all patients and neutralizing antibodies in all but one patient. Specific‐T‐cell response developed in all patients but was stronger in those with the more severe presentations. Similarly, the highest level of proinflammatory cytokines was found in the only patient experiencing respiratory failure. Despite a mild presentation, patients with more pronounced immunosuppression showed high degrees of both cytokines production and immune activation. Our study did not find an increased risk and severity of COVID‐19 in PLWH. Adaptative cellular immune response to SARS‐CoV‐2 appeared to correlate to disease severity. The mild clinical picture showed in advanced HIV patients, despite a significant T‐cell activation and inflammatory profile, suggests a potential role of HIV‐driven immunological dysregulation in avoiding immune‐pathogenetic processes. However, other possible explanations, as a protective role of certain antiretroviral drugs, should be considered. Further larger studies are needed to better clarify the impact of HIV infection on COVID‐19.