Prevalence of HIV in patients hospitalized for COVID-19 and associated outcomes: a systematic review and meta-analysis

Objective

To conduct a systematic review and meta-analysis of the prevalence of HIV in patients hospitalized for COVID-19 and delineating clinical outcomes including mortality.

Design/Methods

MEDLINE, SCOPUS, OVID, and Cochrane Library databases and medrxiv.org were searched from January 1st, 2020, to June 15th, 2020. Data were extracted from studies reporting the prevalence of HIV among hospitalized COVID-19 patients and their clinical outcomes.

Analyses were performed using random-effects models on log-transformed proportions and risk ratio estimates, and heterogeneity was quantified.

Results

A total of 144,795 hospitalized COVID-19 patients were identified from 14 studies in North America, Europe, and Asia. Median age was 55 years, and 66% were male. The pooled prevalence of HIV in COVID-19 patients was 1.22% [95% confidence interval (CI): 0.61%-2.43%)] translating to a 2-fold increase compared to the respective local-level pooled HIV prevalence in the general population of 0.65% (95% CI: 0.48%-0.89%). When stratified by country, the pooled HIV prevalence among COVID-19 patients in United States (1.43%, 95% CI: 0.98%–2.07%) was significantly higher compared to Spain (0.26%, 95% CI: 0.23%-0.29%) but was not different from China (0.99%, 95% CI: 0.25%-3.85%). The pooled mortality rate in HIV-positive patients hospitalized for COVID-19 was 14.1% (95% CI: 5.78%-30.50%) and was substantially higher in the United States compared to other countries.

Conclusions

The prevalence of HIV among COVID-19 patients appeared higher than the general population, suggesting a greater susceptibility to COVID-19 for PLWH. The pooled mortality rate is high, but the rates vary significantly across countries.

Suggested Reviewers

Nelson Sewankambo, MD, PhD

Makerere University College of Health Sciences

Opposed Reviewers