HIV and COVID-19

Patient 1

Patient 2

Patient 3

Patient 4

Patient 5

Patient 6

Patient 7

Demographics and Baseline HIV status

Age (years)

38

49

47

50

53

54

56

Race

Hispanic

African American

Hispanic

Caucasian

Caucasian

Caucasian

Caucasian

Gender

Male

Feale

Male

Male

Male

Male

Male

HIV risk factor, COVID-19 Exposure

MSM, Uknown

Heterosexual, Uknown

MSM, Partner COVID + Exposure

Unknown, Hospital Employee

MSM, Partner COVID + Exposure

MSM, Unknown

MSM, Uknown

Comorbidities (HTN,DM,cancer, smoking, immunosuppression, chronic inflammatory diseases, cardiac conditions)

Kaposi Sarcoma on chemotherapy

GERD, Obesity

Tobacco Smoker

T2DM, Moderate persistant asthma

Melanoma, HTN

Former Smoker, T2DM, HTN

Kaposi Sarcoma, Syphilis, Hepatitis C

HIV status (values at or before COVID-19 dx)

Positive

Positive

Positive

Positive

Positive

Positive

Positive

Year of HIV diagnosis

2018

2002

2015

2000

1999

2001

2007

CD4 Cell count (cells per μL)

30

173

1,178

29.8

628

328

874

CD4:CD8 ratio

0.1

0.2

1.5

0.8

0.7

0.4

0.8

HIV viral load at or beore admission (copeis per mL)

517

Not Detected, <40

Not Detected, <40

Not Detected, <40

Not Detected, <40

Not Detected, <40

Not Detected, <40

ART- regimen before admission

(Biktarvy)BIC/FTC/TAF, Atovaquone

(Biktarvy)BIC/FTC/TAF

(Descovy) FTC/TAF, (Tivicay) DTG

(Triumeq) ABC / DTG / 3TC

(Biktarvy)BIC/FTC/TAF

(Genvoya) EVG/COBI/FTC/TAF

(Genvoya) EVG/COBI/FTC/TAF

BMI

23.57

35.1

30.1

27.5

35

41.3

26.1

Duration of Symptoms (Days)

6

6

Uknown

25

49

29

25

COVID-19 Diagnosis

4/29/20

5/19/20

6/30/20

4/13/20

5/15/20

5/13/20

6/26/20

Symptoms and Vital signs

Temperature

103 °F

100.3 °F

n/a

100.2 °F

98 °F

96.2 °F

98.2 °F

Symptoms

Nausea, chills, and night sweats

Fever, chills, myalgia, headache, cough, chest pressure, loss of appetite, vomiting after eating or drinking

 Fever, fatigue, sore throat, intermittent cough, and generalized body aches

Fever, chills, cough (productive), and Shortnes of breath

Pleuritic chest pain

Fatigue, congestion, rhinorrhea, cough, wheezing, weakness, headache, decreased concentration, and increased sleep

Fever, chills, congestion, cough (non-productive), diaphoresis, fatigue, and lack of smell (chronic)

Blood pressure (mm Hg)

136/72

150/82

n/a

116/78

n/a

112/64

132/88

Respiratory Rate (breaths per min)

20

n/a

n/a

22

16

16

n/a

Heart Rate (beats per min)

118

95

n/a

108

71

96

68

Chest X-Ray (CXR) findings or CT chest w/out contrast

CXR:No radiographic evidence of cardiopulmonary findings

n/a

CXR: No active chest disease

CT chest w/out contrast: Patchy foci of ground glass opacities scattered throughout lungs most pronounced in bilateral lower lobes, representing infectious process. Multifocal Pneumonia

n/a

CXR: No acute cardiopulmonary abnormality

CXR: Cardiac silhouette and pulmonary vasculature are normal. No edema or infiltrate. There is a granuloma in the right lung base and left upper lobe. Minor nodularity in the right apex is also unchanged from 2018.

O2 Saturation on room air

99%

95%

ND

98%

88%

96%

97%

PaO2/FiO2 ratio

n/a

452

n/a

n/a

n/a

n/a

n/a

Laboratory Results

White blood cell count (k/ul)

15.1

ND

ND

3.6

ND

ND

ND

Abs Lymptocyte (k/ul)

1.1

ND

ND

1.3

ND

ND

ND

Platelets (k/ul)

88

ND

ND

113

ND

ND

ND

LDH (U/L)

278

ND

ND

176

ND

ND

ND

C-reactive protein (mg/dL)

41.9

ND

ND

27.3

ND

ND

ND

D-dimer (ng/mL)

0.9

ND

ND

0.34

ND

ND

ND

Ferritin (ng/mL)

452

ND

ND

314

ND

ND

ND

Procalcitonin (ng/mL)

0.55

ND

ND

<0.05

ND

ND

ND

Severity of the infection at admission (mild/mod/severe)

Mild

Mild

Mild

Moderate/Severe

Mild

Mild

Moderate

ART ( mention the full regimen)

ART at admission maintained

Not admitted inpatient but continued on ART therapy

Not admitted inpatient but continued on ART therapy

ART at admission maintained

Not admitted inpatient but continued on ART therapy

Not admitted inpatient but continued on ART therapy

Not admitted inpatient but continued on ART therapy

Other antiviral treatments

None

None

None

None

None

None

None

Other antibiotics

Vancomycin, Cefepime, Flagyl, Fluconazole/Miconazole (14 days), Cefdinir (7 days), Doxycycline (7 days)

None

None

Vancomycin, Zosyn,  Azithromycin (5 days), Hydroxychloroquine (5 days)

None

Azithromycin

Ceftriaxone, Doxycycline, Azithromycin

Admitted to intesive care unit

No

No

No

No

No

No

No

Invasive or non-invasive ventilation

No

No

No

No

No

No

No

Corticosteroids or Tocilizumab

No

No

No

Methylprednisolone 40mg IV once then Prednisone 40mg (5days)

No

Triamcinolone Acetonide 40mg IM once

No

Length of hospital stay (days)

4

0

0

6

0

0

0

Length of home quarantine (days)

14

14

14

10

14

14

14

Outcomes

Discharged home

Discharged home

Unknown

Discharged home

Discharged home

Discharged home

Discharged home

Repeat COVID19 Testing done

No

No

No

Yes, after 5 months negative

No

No

No

Seen in hospital for admission within 30,60,90 days

2 ED visits after 60 days for rash and skin abcesses

Seen in ED after a month for constipation. No respiratory symtoms

Seen by PCP after 2 weeks having air hunger and productive cough, improved by the end of 1 month

Required 2 rounds of antibiotics for Bronchitis with doxycyline and Levaquin, continue to have shortnes of breath till about 58 days out from diagnosis

Required albuterol inhaler for 2 months to help breath better

No

No

COVID-19

Patient 1

Patient 2

Patient 3

Patient 4

Patient 5

Patient 6

Patient 7

Demographics and Baseline HIV status

Age (years)

38

39

45

50

53

53

59

Race

African American

Hispanic

Asian

Caucasian

Caucasian

Caucasian

African American

Gender

Male

Male

Male

Male

Male

Female

Male

HIV risk factor, COVID-19 Exposure

n/a, Work

n/a, unknown (Costco employ)

n/a, unknown (work?)

n/a, unknown

n/a, waterfall tourist destination in Eastern Iowa

n/a, unknown

n/a, Works at Nebraska beef

Comorbidities (HTN,DM,cancer, smoking, immunosuppression, chronic inflammatory diseases, cardiac conditions)

HTN, DM, ESRD, Anemia, tobacco use, hx of alcohol abuse

GERD, Hypertension, Severe sleep apnea

None

T2DM, HTN, HLD, Sleep apnea

T2DM

None

None

HIV status (values at or before COVID-19 dx)

Presumed Negative

Presumed Negative

Presumed Negative

Presumed Negative

Presumed Negative

Presumed Negative

Presumed Negative

Year of HIV diagnosis

n/a

n/a

n/a

n/a

n/a

n/a

n/a

CD4 Cell count (cells per μL)

n/a

n/a

n/a

n/a

n/a

n/a

n/a

CD4:CD8 ratio

n/a

n/a

n/a

n/a

n/a

n/a

n/a

HIV viral load at or beore admission (copeis per mL)

n/a

n/a

n/a

n/a

n/a

n/a

n/a

ART- regimen before admission

n/a

n/a

n/a

n/a

n/a

n/a

n/a

BMI

23.61

47

23.9

36.6

39.7

30.1

23

Duration of Symptoms (Days)

1

2

10

5

Several days

n/a

4

COVID-19 Diagnosis

6/9/20

7/9/20

6/14/20

6/26/20

7/17/20

7/20/20

6/2/20

Symptoms and Vital signs

Temperature

98.9 °F

99.4 °F

98.4 °F

100.2 °F

97.9 °F

n/a

99 °F

Symptoms

Dizzy and weak

Fever and shotness of breath

Fevers at night, cough, loss of taste, and loss of appetite

Fever, sore throat, cough,  and shortness of breath

 Fever, cough, clear rhinorrhea, mild posterior nasal drainage, mild fatigue, and subjective chills

n/a

Fevers, mild cough, fatigue, and myalgias

Blood pressure (mm Hg)

153/89

157/91

120/67

172/103

150/99

n/a

168/124

Respiratory Rate (breaths per min)

20

20

20

18

20

n/a

20

Heart Rate (beats per min)

84

98

67

94

102

n/a

77

Chest X-Ray (CXR) findings or CT chest w/out contrast

CXR:No acute cardiopulmonary process. No evidence of pulmonary tuberculosis

CT angio Chest:Minimal diffuse interstitial prominence, suggests mild pulmonary congestion. Patchy opacities in the right perihilar region and possibly in the right lower lobe, may reflect multifocal pneumonia. Covid pneumonia should be excluded.

CXR:Bilateral multifocal groundglass opacifications consistent with atypical pneumonia versus pleuritis.

CXR:No acute cardiopulmonary process.

n/a

n/a

n/a

O2 Saturation on room air

96%

98%

97%

97%

96%

n/a

95%

PaO2/FiO2 ratio

428

>500

>500

>500

>500

n/a

>500

Laboratory Results

White blood cell count (k/ul)

6.3

4.1

3.5

3.7

n/a

n/a

n/a

Abs Lymptocyte (k/ul)

1.1

0.8

0.7

1.3

n/a

n/a

n/a

Platelets (k/ul)

146

204

134

184

n/a

n/a

n/a

LDH (U/L)

n/a

229

n/a

n/a

n/a

n/a

n/a

C-reactive protein (mg/dL)

n/a

61

n/a

n/a

n/a

n/a

n/a

D-dimer (ng/mL)

n/a

0.57

n/a

n/a

n/a

n/a

n/a

Ferritin (ng/mL)

n/a

290

n/a

n/a

n/a

n/a

n/a

Procalcitonin (ng/mL)

n/a

<0.05

n/a

n/a

n/a

n/a

n/a

Severity of the infection at admission (mild/mod/severe)

Mild

Moderate

Mild

Mild

Mild

Mild

Mild

ART ( mention the full regimen)

None

None

None

None

None

None

None

Other antiviral treatments

None

None

None

None

None

None

None

Other antibiotics

None

Ceftrixone and Azithromycin

None

None

None

None

None

Admitted to intesive care unit

No

No

No

No

No

No

No

Invasive or non-invasive ventilation

No

No

No

No

No

No

No

Corticosteroids or Tocilizumab

No

Dexamethasone

No

1 dose of dexamethasone

No

No

No

Length of hospital stay (days)

6

6

0

0

0

0

0

Length of home quarantine (days)

n/a

n/a

n/a

14

n/a

n/a

n/a

Outcomes

Discharged home

Discharged home

Discharged home from ED

Discharged home from ED

Discharged home from ED

Only lab test

Discharged home

Repeat COVID19 Testing done

Yes, outside facility noted to be postive for 1 month

7/16/2020 & 11/9/2020 +ve

No

No

No

No

Yes, 6/16/2020 negative

Seen in hospital for admission within 30,60,90 days

No

No

No

No

After 10 days admitted for 5 day and received Remdesivir and dexamethasone.

No

No