Recurrence hospitalization due to SARS-CoV-2 infection on human immunodeficiency virus patients

Authors

  • Ni Made Dwita Yaniswari Department of Pulmonology, Wangaya Hospital, Denpasar, Bali, Indonesia
  • Wayan Wahyu Semara Putra Department of Pulmonology, Wangaya Hospital, Denpasar, Bali, Indonesia
  • Sandy Laveda Department of Pulmonology, Wangaya Hospital, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.18203/2349-3933.ijam20230705

Keywords:

COVID, HIV, COVID on HIV, Persistent virus shedding, Seroconversion, Immunocompromised

Abstract

COVID-19 is a global health concern with varying severity. Moderate to severe cases require isolation for 10-20 days, and those with weakened immune systems (like HIV) should isolate for 20 days. Indonesia has a rising number of HIV cases. HIV-positive individuals have a higher risk of COVID-19 and may have lower antibody levels after vaccination. Two case studies of HIV-positive patients who contracted SARS-CoV-2 are presented. In case 1, a 29-year-old patient who received the COVID-19 vaccine and was on antiretroviral therapy was hospitalized three times with worsening symptoms, and unfortunately did not survive. In case 2, a 46-year-old patient with a history of tuberculosis and also on antiretroviral therapy was hospitalized twice, reporting mild symptoms, and did not experience any further symptoms related to COVID-19 after being discharged. Both patients tested positive for COVID-19 using rapid antigen tests and PCR tests and did not report any history of contact with COVID-positive individuals. These case studies highlight the challenges faced by HIV-positive individuals in managing COVID-19, and the need for continued research in this area. Immunocompromised COVID-19 patients need special isolation, even with mild symptoms. Longer isolation periods may be necessary, as studies show positive tests can still mean infectiousness. Viral culture tests can help identify contagious individuals who test positive on PCR tests. People with HIV may need a COVID-19 booster vaccine due to lower antibody levels after the initial vaccine. Further research is needed to develop antiviral treatments for COVID-19 infection in individuals with immunocompromised.

References

Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020;36:71-6.

Dzinamarira T, Murewanhema G, Chitungo I, Ngara B, Nkambule SJ, Madziva R, et al. Risk of mortality in HIV-infected COVID-19 patients: A systematic review and meta-analysis. J Infect Publ Heal. 2022;15:654-61.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395(10223):507-13.

Centers for Disease Control and Prevention. Ending Isolation and Precautions for People with COVID-19: Interim Guidance. CDC. 2022. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html. Accessed on 25 January, 2023.

Iradukunda PG, Pierre G, Muhozi V, Denhere K, Dzinamarira T. Knowledge, Attitude, and Practice Towards COVID-19 Among People Living with HIV/AIDS in Kigali, Rwanda. J Community Heal. 2021;46(2):245-50.

Dzinamarira T, Kamanzi C, Mashamba-Thompson TP. Key stakeholders’ perspectives on implementation and scale up of HIV self-testing in Rwanda. Diagnostics. MDPI AG. 2020;10.

UNAIDS. Fact Sheet 2022 Global HIV statistics. 2022 Available at: https://www.unaids.org/en/resources/fact-sheet. Accessed on 25 January, 2023.

KEMENKES RI. Infodatin HIV-AIDS 2020. Available at: https://www.kemkes.go.id/downloads/resources/download/pusdatin/infodatin/infodatin%202020%20HIV.pdf. Accessed on 25 January, 2023.

Marteens G, Boullee A. CD4 T-cell responses to combination antiretroviral therapy. Lancet. 2007;370:368.

Barbera LK, Kamis KF, Rowan SE, Davis AJ, Shehata S, Carlson JJ, et al. HIV and COVID-19: review of clinical course and outcomes. Vol. 22, HIV Research and Clinical Practice. Taylor and Francis Ltd. 2021:102-18.

Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q et al. Prevalence of comorbidities and its effects in coronavirus disease 2019 patients: A systematic review and meta-analysis. Int J Infectious Dis. 2020;94:91-5.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J et al. Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.

Ao L, Lu T, Cao Y, Chen Z, Wang Y, Li Z et al. Safety and immunogenicity of inactivated SARS-CoV-2 vaccines in people living with HIV. Emerg Microbes Infect. 2022;11(1):1126-34.

Huang X, Yan Y, Su B, Xiao D, Yu M, Jin X et al. Comparing Immune Responses to Inactivated Vaccines against SARS-CoV-2 between People Living with HIV and HIV-Negative Individuals: A Cross-Sectional Study in China. Viruses. 2022;14(2).

Jones TC, Biele G, Mühlemann B, Veith T, Schneider J, Beheim-Schwarzbach J et al. Estimating infectiousness throughout SARS-CoV-2 infection course. Science (1979). 2021;373(6551).

Lefferts B, Blake I, Bruden D, Hagen MB, Hodges E, Kirking HL et al. Morbidity and Mortality Weekly Report Antigen Test Positivity After COVID-19 Isolation-Yukon-Kuskokwim Delta Region, Alaska. 2022.

Vena A, Taramasso L, di Biagio A, Mikulska M, Dentone C, de Maria A et al. Prevalence and Clinical Significance of Persistent Viral Shedding in Hospitalized Adult Patients with SARS-CoV-2 Infection: A Prospective Observational Study. Infect Dis Ther. 2021;10(1):387-98.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020;395(10229):1054-62.

Liu W da, Chang SY, Wang JT, Tsai MJ, Hung CC, Hsu CL, et al. Prolonged virus shedding even after seroconversion in a patient with COVID-19. J Infect. 2020;81:318-56.

Yang JR, Deng DT, Wu N, Yang B, Li HJ, Pan X ben. Persistent viral RNA positivity during the recovery period of a patient with SARS-CoV-2 infection. J Med Virol. 2020;92(9):1681-3.

Velazquez-Salinas L, Verdugo-Rodriguez A, Rodriguez LL, Borca M v. The role of interleukin 6 during viral infections. Frontiers in Microbiology. Frontiers Media S.A. 2019;10.

Kermali M, Khalsa RK, Pillai K, Ismail Z, Harky A. The role of biomarkers in diagnosis of COVID-19-A systematic review. Life Sciences. 2020;254.

Wölfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Müller MA et al. Virological assessment of hospitalized patients with COVID-2019. Nature. 2020;581(7809):465-9.

Funk DJ, Bullard J, Lother S, Grande GV, Garnett L, Doan K et al. Persistence of live virus in critically ill patients infected with SARS-COV-2: a prospective observational study. Crit Care. 2022;26(1).

Taramasso L, Sepulcri C, Mikulska M, Magnasco L, Lai A, Bruzzone B et al. Duration of isolation and precautions in immunocompromised patients with COVID-19. J Hospital Infect. 2021;211:202-4.

Pekosz A, Parvu V, Li M, Andrews JC, Manabe YC, Kodsi S et al. Antigen-Based Testing but Not Real-Time Polymerase Chain Reaction Correlates with Severe Acute Respiratory Syndrome Coronavirus 2 Viral Culture. Clin Infect Dis. 2021;73(9):E2861-6.

Almendares O, Prince-Guerra JL, Nolen LD, Gunn JKL, Dale AP, Buono SA et al. Performance Characteristics of the Abbott BinaxNOW SARSCoV-2 Antigen Test in Comparison to Real-Time Reverse Transcriptase PCR and Viral Culture in Community Testing Sites during November 2020. J Clin Microbiol. 2022;60(1).

Cevik M, Tate M, Lloyd O, Maraolo AE, Schafers J, Ho A. SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis. Lancet Microbe. 2021;2(1):e13-22.

Sasikumar A, Muhammed Niyas V, Arjun R, Viswanathan G. Prolonged rapid antigen test positivity among COVID-19 patients. J Family Med Prim Care. 2022;11(4):1590.

World Health Organization (WHO). Antigen-detection in the diagnosis of SARS-CoV-2 infection Interim guidance. 2021. Available at: https://www.who.int/publications/i/item/antigen-detection-in-the-diagnosis-of-sars-cov-2infection-using-rapid-immunoassays. Accessed on 24 January, 2023.

Downloads

Published

2023-03-24

Issue

Section

Case Reports