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Risk of mortality in HIV-infected COVID-19 patients: A systematic review and meta-analysis
Tafadzwa Dzinamarira1, Grant Murewanhema2, Itai Chitungo3
1School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa; ICAP at Columbia University, Harare, Zimbabwe.
Insights
This study found no increased COVID-19 mortality risk for individuals with HIV. Current findings contribute to the ongoing debate regarding the connection between HIV infection and COVID-19 outcomes.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- The interplay between Human Immunodeficiency Virus (HIV) infection and Coronavirus Disease 2019 (COVID-19) clinical outcomes is a critical public health concern.
- This systematic review and meta-analysis aimed to elucidate the association between HIV comorbidity and COVID-19 mortality rates.
Approach:
- A comprehensive literature search was conducted across PubMed, Google Scholar, and WHO databases from December 1-7, 2021.
- Data extraction and screening followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Relative risk of mortality was calculated using a random-effects model, with study quality assessed by GRADE and bias by Egger's test.
Key Points:
- Analysis of 16 studies revealed a COVID-19 mortality rate of 7.97% in patients with HIV (4,287/53,801) versus 0.69% in those without HIV (127,961/18,513,747).
- The random-effects model indicated no statistically significant increase in mortality risk for COVID-19 patients with HIV (Relative Risk: 1.07, 95% Confidence Interval: 0.86-1.32).
- Substantial heterogeneity (I² = 91%) was observed across studies, but publication bias was not significant.
Conclusions:
- The findings do not establish a link between HIV infection and an elevated risk of COVID-19 mortality.
- This research contributes to the existing body of conflicting evidence on the relationship between HIV and COVID-19 outcomes.
Background:
The relationship between HIV infection and COVID-19 clinical outcomes remains a significant public health research problem. We aimed to determine the association of HIV comorbidity with COVID-19 mortality.
Methods:
We searched PubMed, Google Scholar and World Health Organization library databases for relevant studies. All searches were conducted from 1st to 7th December 2021. Title, abstract and full text screening was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relative risk of mortality in HIV-infected COVID-19 patients was computed using a random-effects model. All analyses were performed using Meta and Metasens statistical packages available in R version 4.2.1 software package. The quality of included studies was assessed using the GRADE approach, Egger's test was employed to determine the risk of bias.
Results:
A total of 16 studies were included in this review. Among the COVID-19 patients with HIV infection, the mortality rate due to COVID-19 was 7.97% (4 287/53,801), and among the COVID-19 patients without HIV infection, the mortality rate due to COVID-19 was 0.69% (127, 961/18, 513, 747). In the random effects model, we found no statistically significant relative risk of mortality in HIV-infected COVID-19 patients (RR 1.07, 95% CI 0.86-1.32). The between-studies heterogeneity was substantial (I2 = 91%, P < 0.01), while the risk of publication bias was not significant.
Conclusion:
Findings did not link HIV infection with an increased risk of COVID-19 mortality. Our results add to the conflicting data on the relationship between COVID-19 and HIV infection.
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