Raya, Reynie Purnama;
Kamila, Ami;
Alqahtani, Jaber S;
Hjazi, Ahmed M;
Li, Amy;
Oyelade, Tope;
(2021)
Global and regional prevalence and outcomes of COVID-19 in people living with HIV: A cutting-edge systematic review and meta-analysis.
medRxiv
10.1101/2021.07.12.21260361.
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Abstract
BACKGROUND: The relationship between HIV infection and COVID-19 clinical outcome is uncertain, with conflicting data and hypotheses. We aimed to assess the prevalence and risk of severe COVID-19 and death in people living with HIV (PLWH) on the global and continental level. METHODS: Electronic databases were systematically searched in July 2021. Studies were screened and then extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Narratives were synthesised and data pooled for global and continental prevalence and relative risk of severity and mortality in HIV-infected COVID-19 patients using random-effect model. Risk of bias was assessed using the Newcastle-Ottawa score, Egger’s test and presented as funnel plots. RESULTS: A total of 46 studies were included involving 18,034,947 COVID-19 cases of which 31,269 were PLWH. The global prevalence of PLWH with SARS-CoV-2 infection was 1% (95% CI = 0.9% -1.1%) with the highest prevalence observed in sub-Saharan Africa. The relative risk (RR) of COVID-19 severity was significant only in Africa (RR, 95% CI = 1.14, 1.08 – 1.24) while risk of COVID-19 mortality was 1.53% (95% CI = 1.45 – 2.03) globally. The prevalence of PLWH in COVID-19 cases was significantly low, and the calculated global risk ratio show that HIV infection may be linked with increased COVID-19 death. The between-studies heterogeneity was significantly high while risk of publication bias was not significant. CONCLUSION: There is low prevalence of HIV-SARS-CoV-2 co-infection. HIV infection was linked with severe COVID-19 in Africa and increased risk of death globally.
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