Association Between CD4 Count and COVID-19 Severity in a Cohort of People Living with HIV in Marseille, France
Assane Diouf1,2, Ngo Ngai Christine1,3, Dudouet Pierre3, Ngom Ndèye Fatou4,5, Lagier Jean-Christophe3, Million Mathieu3 and Seydi Moussa1,2
ABSTARCT
COVID-19 can cause severe forms, especially in the presence of acknowledged risk factors. However, the few published results on COVID-19 in PLHIV appear conflicting, particularly regarding the evolution of the disease.
Objective: To describe the characteristics of COVID-19, and to assess the association between the CD4 cell count and COVID-19 severity in PLHIV.
Methods: We conducted a cross-sectional study including all PLHIV followed at the IHU Méditerranée Infections with a confirmed diagnosis of COVID-19 between March 2020 and March 2022. The association between COVID=19 severity and CD4 count was analysed using a logistic regression model.
Results: We included 71 patients with a median (IQR) age of 53 (42 - 58) years including 53.5% of men. Risk factors for severe disease were found in 32.4%. A proportion of 93% were on triple ARV therapy, including 12.5% on protease inhibitors (PIs); 39.2% had CD4 count ≥ 500/mm3, and for 36.8%, plasma HIV RNA was < 1 log copies/ml at the time of COVID-19 diagnosis. In our study population, 16.9% had a News 2 score ˃ 4, while 25.4% were ospitalized. Among these, three were admitted in intensive care unit, but no deaths occurred. The probability of being hospitalized was 5.8 times higher for a patient with a CD4 count < 500/mm3 than in a patient with a CD4 count < 500/mm3.
Conclusion: Among PLWH coinfected with SARS-CoV-2 in Marseille, we found that hospitalization was associated with a CD4 count ˂ 500/mm3.
