Are COVID-19 Outcomes Worse For Individuals Dwelling With HIV?
South Africa has the largest HIV epidemic in the world, with nearly 8 million people living with the disease. With South Africa recorded over 373,628 cases of COVID-19 positive cases to date, it is no surprise that questions have been asked about how the virus is developing in people with HIV.
New research – believed to be the largest study of a group of people both living with HIV and hospitalized with COVID-19 – sought to answer that question. According to the study, being HIV positive doesn’t pose a greater risk of worse COVID-19 outcomes.
Why you shouldn’t worry
In fact, the worst had been assumed when this was not researched at all, and while the scientists do not necessarily know why, they found that patients living with well-controlled HIV in their study population did not have worse outcome compared to any other to a similar comparison group. However, the scientists mentioned that more research would need to be done to confirm this.
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“In summary, we did not find any differences in adverse outcomes associated with HIV infection in hospitalized COVID-19 patients compared to a similar comparison group,” the study concluded.
“It is warranted to review this result in other large cohorts to improve our understanding of the effects of COVID-19 on people living with HIV. If this is confirmed, investigation of specific factors that contribute to similar results in this large group of patients with immune disorders may provide better insight into the pathogenesis of SARS-CoV-2. ”
What you need to know
If people living with HIV have worried about what contracting COVID-19 would mean for them, this study should alleviate their fears.
“I tell [my patients] “Look, take standard precautions, but there is no reason to live in fear that you will die more often from COVID with HIV,” said Dr. Keith Sigel, lead researcher on the study, in a statement.
“While this is the largest peer group study published to date, many of the no peer group studies have shown similar findings – that’s reassuring.”
The HIV awareness and education organization Avert has a few other important points that people with HIV should be aware of:
- Current evidence suggests that HIV is a lower risk factor for severe COVID-19 than other health conditions.
- People living with HIV that is untreated or virally suppressed may be at higher risk.
- Like the general population, older people living with HIV and those with other underlying diseases should take extra precautions to prevent illness.
- Try to have ART in your home for at least 30 days. If possible, ask after three months.
The new list of underlying conditions that increase your risk
The Centers for Disease Control and Prevention recently released a newly expanded list of underlying diseases that put people at increased risk of developing severe COVID-19. It did so after the organization reviewed published reports, pre-print studies, and several other data sources. Here is the updated list:
- Chronic kidney disease
- Type 2 diabetes
- COPD (chronic obstructive pulmonary disease)
- Obesity (BMI of 30 or higher)
- Immunocompromised state (weakened immune system) due to solid organ transplantation
- Severe heart conditions such as heart failure, coronary artery disease, or cardiomyopathies
- Sickle cell anemia
The CDC also included a list of other conditions that could increase a person’s risk for serious COVID-19 illness:
- Cystic fibrosis
- Neurological diseases such as dementia
- Liver disease
- Pulmonary fibrosis
- Type 1 diabetes
- Cerebrovascular disease
They made it clear that these lists are living documents that can be updated at any time as science develops.
New isolation guidelines for South Africans
The Minister of Health Dr. Zweli Mkhize announced that the recommended length of isolation for someone who tested positive for COVID-19 is now 10 days, instead of 14 days.
“The presence of a detectable virus when tested does not imply infectivity – it has been shown that in mild cases, virus cultures are generally positive only eight to nine days after the onset of symptoms,” said Dr. Mkhize in his statement.
“The duration of infectivity in patients with severe illness is less well documented. In general, patients with severe illness can excrete higher concentrations of the virus over a longer period of time than patients with mild illness.
The new guidelines are as follows:
- An asymptomatic patient can end isolation 10 days after the test.
- A patient with mild illness can end isolation 10 days after symptoms appear.
- A patient with severe illness can end isolation 10 days after clinical stability has been achieved.
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