International team sheds light on severe cases of COVID-19 infection in patients with HIV
An international team of researchers, including scientists from the Institute of Fundamental Medicine and Biology of Kazan Federal University, has identified inflammatory markers associated with an increased risk of developing severe COVID-19 in people living with human immunodeficiency virus (HIV).
The results of a pilot study published in the journal International Journal of Molecular Sciences answer the question of why people with HIV may experience more severe consequences of coronavirus infection.
Scientists from Russia, South Africa, and Uzbekistan found a strong pro-inflammatory immune response to be a likely key factor in the development of severe disease in patients with coinfection.
From KFU, researchers from the Laboratory of Gene and Cell Technologies took part in the work. Among them were chief research associates Albert Rizvanov and Svetlana Khaibullina, senior researcher Emmanuel Kabwe, and others.
The study analyzed clinical and laboratory data from 18 patients from the Republic of Tatarstan: 9 had both HIV and COVID-19, and the other 9 had COVID-19 only.
The results were unexpected: all 4 fatal cases occurred in the group of HIV-positive patients infected with COVID-19. These patients also showed clear signs of a more severe course of disease, including a greater need for intensive care, significant lung damage, as well as markers of liver injury and coagulopathy (blood-clotting disorders).
The central finding was a unique immune profile in patients with coinfection. Although elevated levels of inflammatory markers were detected in both groups, the HIV/COVID-19 group showed significantly higher levels of specific pro-inflammatory cytokines, in particular IL-5, IL-6, IL-9, and IL-15.
"Our data indicate that the combination of HIV and SARS-CoV-2 infections creates a distinct immunological environment," explains Emmanuel Kabwe. "This specific 'cytokine signature' points to an excessive inflammatory response. It likely contributes to the severe clinical outcomes we observed, including organ damage and blood-clotting abnormalities."
This global public health challenge is being addressed through international efforts. The study's results highlight the importance of a specialized clinical approach for people living with HIV during ongoing respiratory pandemics.
"Understanding the molecular mechanisms that lead to severe disease in vulnerable population groups is one of the most important scientific priorities," notes Dr. Rizvanov. "The pilot study results lay a solid foundation for large-scale and long-term investigation of the problem and will make it possible to develop more specialized and personalized treatment approaches."
The authors conclude that careful monitoring for signs of hyperinflammation and coagulopathy is necessary in people living with HIV who are infected with SARS-CoV-2.
It should be noted that the project also involved lead researchers Sergey Morzunov, Ekaterina Martynova, Ilnur Salafutdinov, senior researcher Yuriy Davidyuk, as well as junior researcher Natalya Andreeva.
The study also included participants from the University of Pretoria (South Africa), the Center for Advanced Technologies (Republic of Uzbekistan), Kazan State Medical University, and Kazan State Medical Academy.
More information:
A Pilot Study of COVID-19 Outcomes in People Living with HIV in Tatarstan
www.mdpi.com/1422-0067/27/1/288
Provided by Kazan Federal University
