Skip to main content
Top
Published in: BMC Infectious Diseases 1/2020

Open Access 01-12-2020 | Tocilizumab | Case report

New HIV diagnoses in patients with COVID-19: two case reports and a brief literature review

Authors: Jiu-Cong Zhang, Xiao-Hui Yu, Xiao-Han Ding, Hao-Yu Ma, Xiao-Qing Cai, Sheng-Chao Kang, Da-Wei Xiang

Published in: BMC Infectious Diseases | Issue 1/2020

Login to get access

Abstract

Background

COVID-19 is novel infectious disease with an evolving understanding of its epidemiology and clinical manifestations. Severe cases developed life-threatening complications, such as respiratory failure, shock, and multiple organs dysfunction. Immunocompromised patients often present atypical presentations of viral infected diseases.

Case presentation

We report newly diagnosed HIV infections in two patients with COVID-19 in China. In our two cases, both patients with elevated IL-6 received Tocilizumab treatment, but did not present obvious therapeutic effect.

Conclusions

These cases highlight possible co-detection of known immunocompromised diseases such as HIV. The two cases we reported stressed the risk of misdiagnosis, especially during the pandemic of an infectious disease and the importance of extended testing even if in immune-compromised condition the immune state may be ignored.
Appendix
Available only for authorised users
Literature
2.
go back to reference Mirzaei H, McFarland W, Karamouzian M, Sharifi H. COVID-19 among people living with HIV: a systematic review. AIDS Behav. 2020:1–8. Mirzaei H, McFarland W, Karamouzian M, Sharifi H. COVID-19 among people living with HIV: a systematic review. AIDS Behav. 2020:1–8.
3.
go back to reference Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, Xing F, Liu J, Yip CC, Poon RW, Tsoi HW, Lo SK, Chan KH, Poon VK, Chan WM, Ip JD, Cai JP, Cheng VC, Chen H, Hui CK, Yuen KY. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514–23.CrossRefPubMed Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, Xing F, Liu J, Yip CC, Poon RW, Tsoi HW, Lo SK, Chan KH, Poon VK, Chan WM, Ip JD, Cai JP, Cheng VC, Chen H, Hui CK, Yuen KY. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514–23.CrossRefPubMed
4.
go back to reference Zhang JC, Zhang HJ, Li Y, Jing D, Liu Q, Zhao K, Liu QQ, Zhuang Y, Kang WZ, Sun YT. Changes in levels of T cell subpopulations to monitor the response to antiretroviral therapy among HIV-1-infected patients during two years of HIV-1 replication suppression. Scand J Infect Dis. 2013;45(5):368–77.CrossRefPubMed Zhang JC, Zhang HJ, Li Y, Jing D, Liu Q, Zhao K, Liu QQ, Zhuang Y, Kang WZ, Sun YT. Changes in levels of T cell subpopulations to monitor the response to antiretroviral therapy among HIV-1-infected patients during two years of HIV-1 replication suppression. Scand J Infect Dis. 2013;45(5):368–77.CrossRefPubMed
5.
go back to reference Burchell AN, Allen VG, Gardner SL, Moravan V, Tan DH, Grewal R, Raboud J, Bayoumi AM, Kaul R, Mazzulli T, McGee F, Rourke SB. OHTN cohort study team. High incidence of diagnosis with syphilis co-infection among men who have sex with men in an HIV cohort in Ontario, Canada. BMC Infect Dis. 2015;15:356.CrossRefPubMed Burchell AN, Allen VG, Gardner SL, Moravan V, Tan DH, Grewal R, Raboud J, Bayoumi AM, Kaul R, Mazzulli T, McGee F, Rourke SB. OHTN cohort study team. High incidence of diagnosis with syphilis co-infection among men who have sex with men in an HIV cohort in Ontario, Canada. BMC Infect Dis. 2015;15:356.CrossRefPubMed
6.
go back to reference Bozicevic I, Lepej SZ, Rode OD, Grgic I, Jankovic P, Dominkovic Z, Lukas D, Johnston LG, Begovac J. Prevalence of HIV and sexually transmitted infections and patterns of recent HIV testing among men who have sex with men in Zagreb, Croatia. Sex Transm Infect. 2012;88(7):539–44.CrossRefPubMed Bozicevic I, Lepej SZ, Rode OD, Grgic I, Jankovic P, Dominkovic Z, Lukas D, Johnston LG, Begovac J. Prevalence of HIV and sexually transmitted infections and patterns of recent HIV testing among men who have sex with men in Zagreb, Croatia. Sex Transm Infect. 2012;88(7):539–44.CrossRefPubMed
7.
go back to reference Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, Wang T, Zhang X, Chen H, Yu H, Zhang X, Zhang M, Wu S, Song J, Chen T, Han M, Li S, Luo X, Zhao J, Ning Q. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620–9.CrossRefPubMed Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, Wang T, Zhang X, Chen H, Yu H, Zhang X, Zhang M, Wu S, Song J, Chen T, Han M, Li S, Luo X, Zhao J, Ning Q. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620–9.CrossRefPubMed
9.
go back to reference Blanco JL, Ambrosioni J, Garcia F, Martínez E, Soriano A, Mallolas J, Miro JM. COVID-19 in HIV investigators. COVID-19 in patients with HIV: clinical case series. Lancet HIV. 2020;7:e314–6.CrossRefPubMed Blanco JL, Ambrosioni J, Garcia F, Martínez E, Soriano A, Mallolas J, Miro JM. COVID-19 in HIV investigators. COVID-19 in patients with HIV: clinical case series. Lancet HIV. 2020;7:e314–6.CrossRefPubMed
11.
go back to reference Gervasoni C, Meraviglia P, Riva A, Giacomelli A, Oreni L, Minisci D, Atzori C, Ridolfo A, Cattaneo D. Clinical features and outcomes of HIV patients with coronavirus disease 2019. Clin Infect Dis. 2020. https://doi.org/10.1093/cid/ciaa579. Online ahead of print. Gervasoni C, Meraviglia P, Riva A, Giacomelli A, Oreni L, Minisci D, Atzori C, Ridolfo A, Cattaneo D. Clinical features and outcomes of HIV patients with coronavirus disease 2019. Clin Infect Dis. 2020. https://​doi.​org/​10.​1093/​cid/​ciaa579. Online ahead of print.
15.
16.
go back to reference Ruan L, Zhang Y, Luo Y, Yu X, Zeng Y, Peng H, Han L, Chen L, Roy S, Cheng Q, Li H, Guo X, Xiong D, Gan H, Liu M. Clinical features and outcomes of four HIV patients with COVID-19 in Wuhan, China. J Med Virol. 2020. https://doi.org/10.1002/jmv.26223. Ruan L, Zhang Y, Luo Y, Yu X, Zeng Y, Peng H, Han L, Chen L, Roy S, Cheng Q, Li H, Guo X, Xiong D, Gan H, Liu M. Clinical features and outcomes of four HIV patients with COVID-19 in Wuhan, China. J Med Virol. 2020. https://​doi.​org/​10.​1002/​jmv.​26223.
19.
go back to reference Mang S, Kaddu-Mulindwa D, Metz C, Becker A, Seiler F, Smola S, Maßmann A, Becker SL, Papan C, Bals R, Lepper PM, Danziger G. Pneumocystis Jirovecii Pneumonia and SARS-CoV-2 Co-Infection in newly diagnosed HIV-1 infection. Clin Infect Dis. 2020. p. ciaa906. https://doi.org/10.1093/cid/ciaa906. Online ahead of print. Mang S, Kaddu-Mulindwa D, Metz C, Becker A, Seiler F, Smola S, Maßmann A, Becker SL, Papan C, Bals R, Lepper PM, Danziger G. Pneumocystis Jirovecii Pneumonia and SARS-CoV-2 Co-Infection in newly diagnosed HIV-1 infection. Clin Infect Dis. 2020. p. ciaa906. https://​doi.​org/​10.​1093/​cid/​ciaa906. Online ahead of print.
20.
go back to reference Cillóniz C, García-Vidal C, Moreno A, Miro J, Torres A. Community-acquired bacterial pneumonia in adult HIV infected patients. Expert Rev Anti-Infect Ther. 2018;16(7):579–88.CrossRef Cillóniz C, García-Vidal C, Moreno A, Miro J, Torres A. Community-acquired bacterial pneumonia in adult HIV infected patients. Expert Rev Anti-Infect Ther. 2018;16(7):579–88.CrossRef
22.
go back to reference Zhang C, Wu Z, Li JW, Zhao H, Wang GQ. The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality. Int J Antimicrob Agents. 2020;55(5):105954 Epub 2020 Mar 29.CrossRefPubMed Zhang C, Wu Z, Li JW, Zhao H, Wang GQ. The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality. Int J Antimicrob Agents. 2020;55(5):105954 Epub 2020 Mar 29.CrossRefPubMed
23.
go back to reference Fu B, Xu X, Wei H. Why tocilizumab could be an effective treatment for severe COVID-19? J Transl Med. 2020;18(1):164.CrossRefPubMed Fu B, Xu X, Wei H. Why tocilizumab could be an effective treatment for severe COVID-19? J Transl Med. 2020;18(1):164.CrossRefPubMed
24.
go back to reference Luo P, Liu Y, Qiu L, Liu X, Liu D, Li J. Tocilizumab treatment in COVID-19: a single center experience. J Med Virol. 2020;92(7):814–8 Epub 2020 Apr 15.CrossRef Luo P, Liu Y, Qiu L, Liu X, Liu D, Li J. Tocilizumab treatment in COVID-19: a single center experience. J Med Virol. 2020;92(7):814–8 Epub 2020 Apr 15.CrossRef
25.
go back to reference Zhang C, Wu Z, Li JW, Zhao H, Wang GQ. Cytokine release syndrome in severe COVID-19: interleukin-6 receptor antagonist tocilizumab may be the key to reduce mortality. Int J Antimicrob Agents. 2020;55(5):105954 Epub 2020 Mar 29.CrossRefPubMed Zhang C, Wu Z, Li JW, Zhao H, Wang GQ. Cytokine release syndrome in severe COVID-19: interleukin-6 receptor antagonist tocilizumab may be the key to reduce mortality. Int J Antimicrob Agents. 2020;55(5):105954 Epub 2020 Mar 29.CrossRefPubMed
26.
go back to reference Xu X, Han M, Li T, Sun W, Wang D, Fu B, Zhou Y, Zheng X, Yang Y, Li X, Zhang X, Pan A, Wei H. Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl Acad Sci U S A. 2020;117(20):10970–5 Epub 2020 Apr 29.CrossRefPubMed Xu X, Han M, Li T, Sun W, Wang D, Fu B, Zhou Y, Zheng X, Yang Y, Li X, Zhang X, Pan A, Wei H. Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl Acad Sci U S A. 2020;117(20):10970–5 Epub 2020 Apr 29.CrossRefPubMed
27.
go back to reference Toniati P, Piva S, Cattalini M, Garrafa E, Regola F, Castelli F, Franceschini F, Airò P, Bazzani C, Beindorf EA, Berlendis M, Bezzi M, Bossini N, Castellano M, Cattaneo S, Cavazzana I, Contessi GB, Crippa M, Delbarba A, De Peri E, Faletti A, Filippini M, Filippini M, Frassi M, Gaggiotti M, Gorla R, Lanspa M, Lorenzotti S, Marino R, Maroldi R, Metra M, Matteelli A, Modina D, Moioli G, Montani G, Muiesan ML, Odolini S, Peli E, Pesenti S, Pezzoli MC, Pirola I, Pozzi A, Proto A, Rasulo FA, Renisi G, Ricci C, Rizzoni D, Romanelli G, Rossi M, Salvetti M, Scolari F, Signorini L, Taglietti M, Tomasoni G, Tomasoni LR, Turla F, Valsecchi A, Zani D, Zuccalà F, Zunica F, Focà E, Andreoli L, Latronico N. Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: a single center study of 100 patients in Brescia, Italy. Autoimmun Rev. 2020;19(7):102568 Epub 2020 May 3.CrossRefPubMed Toniati P, Piva S, Cattalini M, Garrafa E, Regola F, Castelli F, Franceschini F, Airò P, Bazzani C, Beindorf EA, Berlendis M, Bezzi M, Bossini N, Castellano M, Cattaneo S, Cavazzana I, Contessi GB, Crippa M, Delbarba A, De Peri E, Faletti A, Filippini M, Filippini M, Frassi M, Gaggiotti M, Gorla R, Lanspa M, Lorenzotti S, Marino R, Maroldi R, Metra M, Matteelli A, Modina D, Moioli G, Montani G, Muiesan ML, Odolini S, Peli E, Pesenti S, Pezzoli MC, Pirola I, Pozzi A, Proto A, Rasulo FA, Renisi G, Ricci C, Rizzoni D, Romanelli G, Rossi M, Salvetti M, Scolari F, Signorini L, Taglietti M, Tomasoni G, Tomasoni LR, Turla F, Valsecchi A, Zani D, Zuccalà F, Zunica F, Focà E, Andreoli L, Latronico N. Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: a single center study of 100 patients in Brescia, Italy. Autoimmun Rev. 2020;19(7):102568 Epub 2020 May 3.CrossRefPubMed
28.
go back to reference Bersanelli M. Controversies about COVID-19 and anticancer treatment with immune checkpoint inhibitors. Immunotherapy. 2020;12(5):269–73. Epub 2020 Mar 26.CrossRefPubMed Bersanelli M. Controversies about COVID-19 and anticancer treatment with immune checkpoint inhibitors. Immunotherapy. 2020;12(5):269–73. Epub 2020 Mar 26.CrossRefPubMed
Metadata
Title
New HIV diagnoses in patients with COVID-19: two case reports and a brief literature review
Authors
Jiu-Cong Zhang
Xiao-Hui Yu
Xiao-Han Ding
Hao-Yu Ma
Xiao-Qing Cai
Sheng-Chao Kang
Da-Wei Xiang
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2020
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-020-05480-y

Other articles of this Issue 1/2020

BMC Infectious Diseases 1/2020 Go to the issue