REVIEW PAPER
The incidence and outcome of COVID-19 in patients living with HIV: an umbrella review of systematic reviews and meta-analyses
1
Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
2
School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
3
Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
4
Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
5
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
6
Shahid Beheshti University of Medical Sciences, Tehran, Iran
7
Clinical Research Development Center, Qom University of Medical Sciences, Qom, Iran
8
Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
9
Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
10
Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
11
Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
Submission date: 2023-05-03
Final revision date: 2023-08-18
Acceptance date: 2023-08-25
Publication date: 2026-09-25
Corresponding author
Esmaeil Mehraeen
Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran, postal code: 5681761351
Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran, postal code: 5681761351
HIV & AIDS Review 2026;25(3):169-184
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The COVID-19 pandemic has surrogated the world and enforced a massive burden. Several risk factors, such as immunosuppression state, were recognized for severe COVID-19. Human immunodeficiency virus (HIV) is an immunosuppressing virus that deteriorates people living with HIV (PLWH) and makes them vulnerable to pathogens. It is expected that PLWH are more susceptible to severe COVID-19; however, research demonstrates conflicting results. This study aimed to provide conclusive evidence for the incidence and outcome of COVID-19 in PLWH.
Material and methods:
A comprehensive search of databases, including Cochrane, PubMed/MEDLINE, Scopus, and Web of Science was conducted from inception to April 13, 2022. Systematic reviews and meta-analysis representing data on the incidence and outcome of COVID-19 in PLWH were included in an umbrella review.
Results:
Fever and cough were the most prevalent symptoms. Most research indicated that the mortality rate in PLWH was higher. Commonly prescribed medications included tenofovir disoproxil fumarate, emtricitabine, lamivudine, hydroxychloroquine, oseltamivir, arbidol, and remdesivir. PLWH had higher C-reactive protein, ferritin, interleukin 6, and D-dimer levels. Most hospitalized PLWH suffered from severe symptoms.
Conclusions:
Clinical features of underlying AIDS, antiviral treatments received, other underlying comorbidities, and laboratory findings, may affect the mortality risk among COVID-19 patients with HIV. However, more studies are needed to evaluate the risk and long-term effects of the COVID-19 vaccine on the mortality rate of patients with HIV and SARS-CoV-2 co-infection.
The COVID-19 pandemic has surrogated the world and enforced a massive burden. Several risk factors, such as immunosuppression state, were recognized for severe COVID-19. Human immunodeficiency virus (HIV) is an immunosuppressing virus that deteriorates people living with HIV (PLWH) and makes them vulnerable to pathogens. It is expected that PLWH are more susceptible to severe COVID-19; however, research demonstrates conflicting results. This study aimed to provide conclusive evidence for the incidence and outcome of COVID-19 in PLWH.
Material and methods:
A comprehensive search of databases, including Cochrane, PubMed/MEDLINE, Scopus, and Web of Science was conducted from inception to April 13, 2022. Systematic reviews and meta-analysis representing data on the incidence and outcome of COVID-19 in PLWH were included in an umbrella review.
Results:
Fever and cough were the most prevalent symptoms. Most research indicated that the mortality rate in PLWH was higher. Commonly prescribed medications included tenofovir disoproxil fumarate, emtricitabine, lamivudine, hydroxychloroquine, oseltamivir, arbidol, and remdesivir. PLWH had higher C-reactive protein, ferritin, interleukin 6, and D-dimer levels. Most hospitalized PLWH suffered from severe symptoms.
Conclusions:
Clinical features of underlying AIDS, antiviral treatments received, other underlying comorbidities, and laboratory findings, may affect the mortality risk among COVID-19 patients with HIV. However, more studies are needed to evaluate the risk and long-term effects of the COVID-19 vaccine on the mortality rate of patients with HIV and SARS-CoV-2 co-infection.
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