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      Coronavirus disease 2019 (COVID‐19) outcomes in HIV/AIDS patients: a systematic review


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          The aim of the study was to systematically review current studies reporting on clinical outcomes in people living with HIV (PLHIV) infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2).


          We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines. A comprehensive literature search was conducted in Global Health, SCOPUS, Medline and EMBASE using pertinent key words and Medical Subject Headings (MeSH) terms relating to coronavirus disease 2019 (COVID‐19) and HIV. A narrative synthesis was undertaken. Articles are summarized in relevant sections.


          Two hundred and eighty‐five articles were identified after duplicates had been removed. After screening, eight studies were analysed, totalling 70 HIV‐infected patients (57 without AIDS and 13 with AIDS). Three themes were identified: (1) controlled HIV infection does not appear to result in poorer COVID‐19 outcomes, (2) more data are needed to determine COVID‐19 outcomes in patients with AIDS and (3) HIV‐infected patients presenting with COVID‐19 symptoms should be investigated for superinfections.


          Our findings suggest that PLHIV with well‐controlled disease are not at risk of poorer COVID‐19 disease outcomes than the general population. It is not clear whether those with poorly controlled HIV disease and AIDS have poorer outcomes. Superimposed bacterial pneumonia may be a risk factor for more severe COVID‐19 but further research is urgently needed to elucidate whether PLHIV are more at risk than the general population.

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          Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis

          Background An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 and triggered a Public Health Emergency of International Concern (PHEIC). We aimed to find risk factors for the progression of COVID-19 to help reducing the risk of critical illness and death for clinical help. Methods The data of COVID-19 patients until March 20, 2020 were retrieved from four databases. We statistically analyzed the risk factors of critical/mortal and non-critical COVID-19 patients with meta-analysis. Results Thirteen studies were included in Meta-analysis, including a total number of 3027 patients with SARS-CoV-2 infection. Male, older than 65, and smoking were risk factors for disease progression in patients with COVID-19 (male: OR = 1.76, 95% CI (1.41, 2.18), P 40U/L, creatinine(Cr) ≥ 133mol/L, hypersensitive cardiac troponin I(hs-cTnI) > 28pg/mL, procalcitonin(PCT) > 0.5ng/mL, lactatede hydrogenase(LDH) > 245U/L, and D-dimer > 0.5mg/L predicted the deterioration of disease while white blood cells(WBC) 40U/L:OR=4.00, 95% CI (2.46, 6.52), P 28 pg/mL: OR = 43.24, 95% CI (9.92, 188.49), P 0.5 ng/mL: OR = 43.24, 95% CI (9.92, 188.49), P 245U/L: OR = 43.24, 95% CI (9.92, 188.49), P 0.5mg/L: OR = 43.24, 95% CI (9.92, 188.49), P < 0.00001; WBC < 4 × 109/L: OR = 0.30, 95% CI (0.17, 0.51), P < 0.00001]. Conclusion Male, aged over 65, smoking patients might face a greater risk of developing into the critical or mortal condition and the comorbidities such as hypertension, diabetes, cardiovascular disease, and respiratory diseases could also greatly affect the prognosis of the COVID-19. Clinical manifestation such as fever, shortness of breath or dyspnea and laboratory examination such as WBC, AST, Cr, PCT, LDH, hs-cTnI and D-dimer could imply the progression of COVID-19.
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            Covid-19: risk factors for severe disease and death

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              COVID-19 and Multi-Organ Response

              Since the outbreak and rapid spread of COVID-19 starting late December 2019, it has been apparent that disease prognosis has largely been influenced by multi-organ involvement. Comorbidities such as cardiovascular diseases have been the most common risk factors for severity and mortality. The hyperinflammatory response of the body, coupled with the plausible direct effects of SARS-CoV-2 on body-wide organs via ACE2, has been associated with complications of the disease. Acute respiratory distress syndrome, heart failure, renal failure, liver damage, shock and multi-organ failure have precipitated death. Acknowledging the comorbidities and potential organ injuries throughout the course of COVID-19 is therefore crucial in the clinical management of patients. This paper aims to add onto the ever-emerging landscape of medical knowledge on COVID-19, encapsulating its multi-organ impact.

                Author and article information

                HIV Med
                HIV Med
                HIV Medicine
                John Wiley and Sons Inc. (Hoboken )
                15 July 2020
                : 10.1111/hiv.12911
                [ 1 ] College of Medical and Dental Sciences University of Birmingham Birmingham UK
                [ 2 ] School of Public Health Imperial College London London UK
                [ 3 ] Department of Cardiothoracic Surgery Liverpool Heart and Chest Hospital Liverpool UK
                [ 4 ] Department of Integrative Biology, Faculty of Life Sciences University of Liverpool Liverpool UK
                Author notes
                [*] [* ] Correspondence: Dr Amer Harky, Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, Thomas Drive, L14 3PE, UK. Tel: +44 151 600 1616; e-mail: aaharky@ 123456gmail.com


                T. J. Cooper and B. L. Woodward contributed equally to this study.

                Author information
                © 2020 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                : 09 June 2020
                Page count
                Figures: 1, Tables: 3, Pages: 11, Words: 13974
                Original Research
                Original Research
                Custom metadata
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.6 mode:remove_FC converted:05.08.2020

                Infectious disease & Microbiology
                aids,coronavirus disease 2019,hiv,severe acute respiratory syndrome coronavirus


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