Difficulties of diagnosis and management tactics of COVID-19 in HIV-infected patients in a non-infectious hospital

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Abstract

The spread of COVID-19 over the past three years has posed difficult tasks for doctors related to rapid diagnosis and provision of highly qualified medical care to patients, including with co-infection ― SARS-CoV-2/human immunodeficiency virus.

The analysis of the combined course of COVID-19 and human immunodeficiency virus demonstrated the synergistic effect of SARS-CoV-2 and human immunodeficiency virus on the human body. Numerous studies have shown that COVID-19 is more severe and is accompanied by high mortality in older people and in the presence of comorbid pathology. Including important role belongs to diseases accompanied by suppression of cellular immunity, which lead to frequent complications and longer viremia, which can be observed with human immunodeficiency virus infection. The similarity of clinical, laboratory and radiological data does not allow to differentiate COVID-19 and human immunodeficiency virus opportunistic diseases with lung damage (pneumocystic pneumonia, cytomegalovirus and candidiasis etiology), in an early period, especially in patients without an established human immunodeficiency virus status.

Identification of the features of the course of the disease, alertness towards human immunodeficiency virus infection in patients admitted to the hospital with COVID-19 at a young age, the peculiarities of the epidemiological history will allow early diagnosis and improve management tactics.

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About the authors

Margarita V. Nagibina

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Author for correspondence.
Email: infektor03@gmail.com
ORCID iD: 0000-0001-5327-9824
SPIN-code: 6779-9405

MD, Dr. Sci. (Med.), Professor

Russian Federation, 20/1, Delegatskaya street, Moscow, 127473

Aleksandra S. Sycheva

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: docsycheva@gmail.com
ORCID iD: 0000-0001-8804-9914
SPIN-code: 7563-0151

MD

Russian Federation, 20/1, Delegatskaya street, Moscow, 127473

Alexander A. Solodov

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: docsol@mail.ru
ORCID iD: 0000-0002-8263-1433
SPIN-code: 6946-8672

MD, Dr. Sci. (Med.), Professor

Russian Federation, 20/1, Delegatskaya street, Moscow, 127473

Anastasia L. Kebina

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: akebina@list.ru
ORCID iD: 0000-0002-7570-9650
SPIN-code: 1173-3423

Assistant

Russian Federation, 20/1, Delegatskaya street, Moscow, 127473

Maria A. Malyavina

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: mari_malyavina173@mail.ru
ORCID iD: 0000-0002-7500-110X

MD

Russian Federation, 20/1, Delegatskaya street, Moscow, 127473

Lyuaza V. Tebueva

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: Lyuaza.tebueva@mail.ru
ORCID iD: 0000-0002-0818-8330

Student

Russian Federation, 20/1, Delegatskaya street, Moscow, 127473

Bela M. Tuglanova

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: tuglanova13@rambler.ru
ORCID iD: 0000-0002-5654-7692

MD

Russian Federation, 20/1, Delegatskaya street, Moscow, 127473

References

  1. Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91–95. doi: 10.1016/j.ijid.2020.03.017
  2. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;17(323):1061–1069. doi: 10.1001/jama.2020.1585
  3. Lee KW, Yap SF, Ngeow YF, Lye MS. COVID-19 in people living with HIV: a systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18(7):3554. doi: 10.3390/ijerph18073554
  4. Dolgova NN, Ryndich AA, Suladze AG, et al. Some clinical and epidemiological aspects of COVID-19 in people living with HIV. Infectious diseases: news, opinions, training. 2022;11(1):41–46. (In Russ). doi: 10.33029/2305-3496-2022-11-1-41-46
  5. Mazus AI, Nagibina MV, Bessarab TP, et al. COVID-19/HIV co-infection: characteristics of patients of the Moscow megalopolis. Therapy. 2021;7(4):18–24. (In Russ). doi: 10.18565/therapy.2021.4.18-24
  6. Blanco JL, Reyes-Urueña JM, Sued O, et al. Overview of SARS-CoV-2 infection in adults living with HIV. Lancet HIV. 2021;8(5):e294–e305. doi: 10.1016/S2352-3018(21)00070-9
  7. Sergevnin VI, Sarmometov EV, Rozhkova MV. Prevalence and severity of the clinical course of a new coronavirus infection among HIV-infected people in comparison with the general population. Epidemiology and Vaccination Prevention. 2021;20(3):30–36. (In Russ). doi: 10.31631/2073-3046-2021-20-3-30-36
  8. Vizcarra P, Pérez-Elías M, Quereda C, et al. Description of COVID-19 in HIV-infected individuals: a single-centre, prospective cohort. Lancet HIV. 2020;7(8):554–564. doi: 10.1016/S2352-3018(20)30164
  9. Mirzaei H, McFarland W, Karamouzian M, Sharifi H. COVID-19 among people living with HIV: a systematic review. AIDS Behav. 2021;25(1):85–92. doi: 10.1007/s10461-020-02983-2

Supplementary files

Supplementary Files
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1. Fig. 1. Computed tomography of the chest organs of the patient G., born in 1978, from 06.02.2022. Signs of bilateral polysegmental inflammatory-interstitial changes (probability of viral pneumonia is high), CT-4 (80%), pulmonary edema cannot be ruled out.

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2. Fig. 2. The same patient. Computed tomography of the chest organs from 11.02.2022: picture of diffuse interstitial lung changes, CT-4 (83%), low probability of viral pneumonia (COVID-19). Enlargement of intrathoracic lymph nodes. Needs to be differentiated from HIV-associated pneumonia (according to volume of analyses).

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3. Fig. 3. The same patient. Computed tomography of the chest organs from 26.02.2022: negative dynamics, an increase in the volume and density of previously identified interstitial infiltration foci (96%) and cavities in the upper lobes on the left.

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Свидетельство о регистрации СМИ № 014448 от 08.02.1996 г. выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор). 
Свидетельство о регистрации СМИ ЭЛ № ФС 77 - 80652 от 15.03.2021 г. выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).


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