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Case Report

DOI: 10.36959/695/571

# Covid-19 Infection in an HIV-Positive Patient

Hulya Caskurlu*

Department of Infectious Diseases, Medeniyet University School of Medicine, İstanbul, Turkey

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## Abstract

The COVID-19 pandemic affects all age groups but follows a more mortal trajectory in patients with preexisting conditions such as immune deficiency, chronic lung disease, diabetes, and cardiovascular problems. Hence, HIV-positive patients with immune deficiency are at risk therefore, it is especially important for these patients to have continuous access to treatment during the pandemic.

The number of defined COVID-19 positive HIV patients is very limited despite the fact that there are approximately 37.9 million HIV-positive patients globally. Therefore, we decided to publish this study reporting an HIV patient treated for COVID-19 in our clinic.

## Keywords

COVID 19, HIV, Pandemics

## Introduction

New type coronavirus SARS-COV-2 first surfaced in the Chinese city of Wuhan on December 1st, 2019, to turn into a global concern in quick succession. The World Health Organization declared this a pandemic on March 11, 2020. The patients infected with COVID-19 have 80% mild symptoms, while 14% become serious and 6% attain critical conditions. Patients with pneumonia due to COVID-19 require hospital admission 10% of the time, while 10% within this group develop an acute respiratory distress syndrome (ARDS) subject to intensive care unit admission [1,2].

While COVID-19 mortality rates are higher among elderly patients with chronic lung disease, diabetes, and cardiovascular diseases, it is also known to cause multi organ deficiencies and death among younger patients [3]. COVID-19 also poses a significant burden for patients living with HIV [4].

There are currently no specific treatments for COVID-19 with proven results and efficacy. Over 100 randomized studies involving various medications are currently ongoing to find a cure for this disease. These medications include antiretrovirals used in HIV treatment as well [1,5].

The number of defined COVID-19 positive HIV patients is very limited despite the fact that there are approximately 37.9 million HIV-positive patients globally. Therefore, we deemed important to publish this study reporting an HIV patient that has been treated for COVID-19 in our clinic.

## Case

Informed consent given from patient. A 44-year-old man was admitted to our hospital emergency room (ER) with fe-

ver and cough symptoms. It was discovered that even though the patient took lopinavir/ritonavir and emtricitabine-ten of ovirdisoproxil antiretroviral treatment due to acquired immune deficiency syndrome (AIDS) for the past 5-years, he had stopped taking medications in the past month. The patient had been suffering symptoms for the past 10 days and had been prescribed oseltamivir by the previous medical center, without any improvement to his general condition. On physical examination, he has fever 37.9, turgor, normal tonus, bilaterally equal breath, and noral-ronkus were detected. No anomalies were found in the cardiovascular, gastrointestinal, and genitourinary systems. Blood pressure was recorded at 120/80 mmHg, pulse rate was 80/min, and breath rate was 18/min. The patient was moved to the infectious diseases ward following discovery of bilateral peripheral infusion in the thorax CT performed at the ER. Nasopharyngeal swab test was found positive for SARS-CoV-2 by reverse transcription PCR assay. Initial treatment was lopinavir/ritonavir 400/100 mg, Doxycycline 2 x 100 mg, Ceftriaxone 2 x 1 g iv, Emtricitabine/ Ten of ovirdisoproxil 200/245 mg 1 x 1. HIV RNA results taken during admission returned to 90 IU/ml, with a CD4 count of 623/mm [3]. The patient was discharged with directions

*Corresponding author: Hulya Caskurlu, Department of Infectious Diseases, Medeniyet University School of Medicine, İstanbul, Turkey

Accepted: March 16, 2021

Published online: March 18, 2021

Citation: Caskurlu H (2021) Covid-19 Infection in an HIV-Positive Patient. Clin J HIV AIDS 5(1):55-56
of self-isolation after 5 days of hospitalization following his improvement in general condition and stable vital functions.

Discussion

While COVID-19 impacts everyone, it is evident that mor-
tality rates are higher among patients with comorbidities and
immune deficiencies. Hence, it is especially important to eval-
uate patients with acquired immune deficiencies [3]. During
the pandemic in April, 5 patients were reported in Spain and
1 in Wuhan, China, with co-infections of HIV and COVID-19
[6,7]. Most recently by May 18, the amount of case reports
has reached a dozen, covering approximately 100 COVID-19
infected HIV patients [8]. Our case is different from these oth-
ers since the patient was discharged without intensive care
unit intervention. Age younger than 50-years, no preexisting
conditions such as hypertension and/or diabetes, having no
respiratory issues during admission, and having a CD4 num-
ber of 623/mm [3] are all important factors leading to pa-
tient's improvement and discharge.

It is necessary to inform HIV-positive patients on infection
control measures, such as taking medications consistently,
exercising social-distancing and social-isolation, and using
masks/gloves. In addition, it is recommended to keep HIV-re-
lated infections in mind during diagnosis, as these symptoms
might be confused with viral-related pneumonia symptoms.

References

1. Bhimraj A, Morgan RL, Shumaker A, et al. (2020) Infectious diseases society of america guidelines on the treatment and management of patients with COVID-19. Clin Infect Dis.

2. Turkish Ministry of Health (2020) Guide COVID-19. New Coronavirus.

3. Islam S, Sobur A, Akter M, et al. (2020) Coronavirus Disease 2019 (COVID-19) pandemic, lessons to be learned. J AdvVet Anim Res 7: 260-280.

4. Shiau S, Krause KD, Valera P, et al. (2020) The Burden of COVID-19 in People Living with HIV: A Syndemic Perspective. AIDS and Behav 24: 2244-2249.

5. Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB (2020) Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A review. JAMA 323: 1824-1836.

6. Zhu F, Cao Y, Xu S, et al. (2020) Co-infection of SARS-CoV-2 and HIV in a patient in Wuhan city, China. J MedVirol 92: 529-530.

7. Blanco JL, Ambrosioni J, Garcia F, et al. (2020) COVID-19 in patients with HIV: Clinical case series.

8. (2020) COVID-19 in People Living with Human Immunodeficiency Virus: A Case Series of 33 Patient. Infection.

DOI: 10.36959/695/571

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