S.V. MOISEEVA¹, A.R. BILALOVA¹, A.R. AKBEROV¹, I.M. KHAERTYNOVA¹, B.SH. FATKULLIN², F.K. SIRAZIEVA³

 ¹Kazan State Medical Academy — Branch Campus of the FSBEI FPE RMACPE MOH Russia, Kazan

²Republic Clinical Infectious Hospital named after Prof. A.F. Agafonov, Kazan

³Republic Center for Prevention and Struggle against AIDS and Infectious Diseases, Kazan

 Contact details:

Moiseeva S.V. — PhD (medicine), Assistant Lecturer of the Department of Infectious Diseases

Address: 36 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-917-239-96-97, e-mail: sgerasimova.kgma@gmail.com

 The purpose — to investigate the clinical and laboratory manifestations of the concurrent course of HIV and SARS-CoV-2 infections.

Material and methods. We examined 76 patients with concurrent HIV and COVID-19 (with predominant circulation of Delta and Omicron variants of the SARS-CoV-2 virus), hospitalized between January and December 2022 at the Republic Clinical Infectious Hospital named after Professor A.F. Agafonov. The patients were divided into 2 groups, those who recovered (group I) and those with a fatal outcome (group II). All patients underwent laboratory and instrumental studies in accordance with Temporary Medical Advices version 17 (December 14, 2022); the HIV viral load and CD4+ T-lymphocyte level were additionally determined. Statistical analysis was performed using StatTech v. 2.8.8 and Statistica v.10.0 software.

Results. Of the 76 patients with concurrent HIV and COVID-19 infections, 23.6% were newly diagnosed with HIV upon admission. The mortality rate in this category was 44.4%, all at stages 4B–4C. Comparative analysis of complaints from patients with concurrent infections showed that group II patients had complaints of unsteady gait and speech disturbances. Comorbid pathology was detected in 100% of patients with a fatal outcome. A significant inverse correlation was found between the level of CD4+ T-lymphocytes and the duration of SARS-CoV-2 virus shedding. Analysis of laboratory parameters during hospitalization revealed a statistically significant decrease in monocyte levels in group II patients throughout the observation period.

Conclusions. A doctor should be cautious of unsteady gait and speech disturbances in patients with coronavirus infection and HIV, which may indicate possible involvement of the central nervous system. HIV patients with secondary diseases have similar complaints to those with COVID-19, complicating the timely diagnosis of coronavirus infection, especially when they have opportunistic diseases. The duration of SARS-CoV-2 shedding in patients with immunodeficiency due to HIV infection is related to the level of CD4+ T-lymphocytes. Decreased monocyte levels are a prognostically unfavorable factor for a severe course of the disease with an adverse outcome.

Key words: COVID-19, HIV infection, duration of SARS-CoV-2 shedding, concurrent disease course, monocytes, hospitalization outcome.

(For citation: Moiseeva S.V., Bilalova A.R., Akberov A.R., Khaertynova I.M., Fatkullin B.Sh., Sirazieva F.K. Clinical and laboratory characteristic of patients with COVID-19 and HIV. Practical medicine. 2023. Vol. , № , P.)

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