Risk of mortality in HIV-infected COVID-19 patients: A systematic review and meta-analysis

Tafadzwa Dzinamarira; Grant Murewanhema; Itai Chitungo; Bernard Ngara; Sphamandla Josias Nkambule; Roda Madziva; Helena Herrera; Solomon Mukwenha; Diego F Cuadros; Patrick Gad Iradukunda; Moreblessing Mashora; Nigel Tungwarara; Gallican Nshogoza Rwibasira; Godfrey Musuka

doi:10.1016/j.jiph.2022.05.006

Risk of mortality in HIV-infected COVID-19 patients: A systematic review and meta-analysis

J Infect Public Health. 2022 Jun;15(6):654-661. doi: 10.1016/j.jiph.2022.05.006. Epub 2022 May 16.

Authors

Affiliations

¹ School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa; ICAP at Columbia University, Harare, Zimbabwe. Electronic address: u19395419@up.ac.za.
² Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe.
³ Faculty of Medicine, College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
⁴ Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa.
⁵ University of Nottingham, UK.
⁶ University of Portsmouth, UK.
⁷ ICAP at Columbia University, Harare, Zimbabwe.
⁸ University of Cincinnati, USA.
⁹ London School of Hygiene and Tropical Medicine, University of London, London, UK.
¹⁰ Department of Public Health, Mount Kenya University, Kigali, Rwanda.
¹¹ Department of Health Studies, University of South Africa, South Africa.
¹² Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda.

Abstract

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.

Keywords: AIDS; COVID-19; HIV; Meta-analysis; Mortality; Systematic review.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

COVID-19*
Comorbidity
Databases, Factual
HIV Infections* / complications
HIV Infections* / epidemiology
Humans
World Health Organization