ArticleCurrent HIV research2026
Understanding the Burden of Coinfection: COVID-19 in Hospitalized Patients with Diagnosed and Undiagnosed Advanced HIV.
Article in Current HIV research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn their struggle with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, physicians are intensively focused on high-risk patient groups. One such group includes immunosuppressed people living with HIV (PLWH). This study considers the most vulnerable cohort of advanced HIV patients in order to identify potential risk factors for unfavorable SARS-CoV-2 disease (COVID-19) outcomes.
methodThis study analyzed data from a census-based sample of 500 patients. The sample encompassed all consecutive patients during the study period (2020-2022) who met the inclusion and exclusion criteria. All selected patients, aged over 18 years, were hospitalized with confirmed advanced HIV and moderate to severe COVID-19 coinfection at the Infectious Disease Hospital (IDH) in Moscow from 2020 to 2022.
resultsThe overall mortality rate reached 27.0% (135 deaths; 95% CI 23.3-30.9%). Primary analysis identified three key independent predictors of mortality: mechanical ventilation demonstrated the strongest association (aOR 4.29, 95% CI 3.15-5.84, p < 0.001), followed by profound immunosuppression (CD4+ counts below 50 cells/mm³; aOR 3.28, 95% CI 2.41-4.47, p < 0.001) and high HIV viral load exceeding 20,000 copies/mL (aOR 3.37, 95% CI 2.52-4.51, p = 0.003). Secondary outcomes revealed important clinical patterns: oxygen support requirements showed a graded mortality risk from low-flow systems (aOR 3.40, p < 0.001) to mechanical ventilation (aOR 4.29, p < 0.001), while newly diagnosed HIV patients faced significantly higher mortality (46.2%) compared to known HIV cases (24.6%). Opportunistic infections substantially worsened prognosis, particularly Kaposi's sarcoma (aOR 3.17, 95% CI 2.28-4.41, p < 0.001), pneumocystis pneumonia (aOR 2.74, 95% CI 1.98-3.79, p < 0.001), and CMV pneumonitis (aOR 2.56, 95% CI 1.85-3.54, p < 0.001). Protective factors included preserved immunity (CD4+ >500 cells/mm³; aOR 2.77, 95% CI 2.08-3.69, p = 0.03) and virological suppression (aOR 2.22, 95% CI 1.67- 2.95, p = 0.001). Ferritin levels above 600 ng/mL emerged as an additional risk marker (aOR 1.73, 95% CI 1.32-2.27, p = 0.0006), though with less robust association than primary predictors.
conclusionThese findings can provide physicians with a risk-based prioritization algorithm for patients with COVID-19 and advanced HIV coinfection. Identifying patients at highest risk for unfavorable outcomes ensures timely ICU admission, faster patient examination, and initiation of dedicated treatment.
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