New HIV diagnoses in patients with COVID-19: two case reports and a brief literature review
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CASE REPORT
Open Access
New HIV diagnoses in patients with COVID-19: two case reports and a brief literature review Jiu-Cong Zhang1,2†, Xiao-Hui Yu1,2†, Xiao-Han Ding1,2†, Hao-Yu Ma1,2, Xiao-Qing Cai1,2, Sheng-Chao Kang1,2* and Da-Wei Xiang1,2*
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. Keywords: SARS-CoV-2, COVID-19, Co-infection, HIV, Case report, Literature review
Background An outbreak of pneumonia of unknown origin was first reported in Wuhan, China in December 2019. The cause had been identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was officially named as COVID-19 (coronavirus disease 2019) by World Health Organization (WHO), could induce symptoms including fever, dry cough, dyspnea, fatigue, and lymphopenia and ground-glass lung changes in radiology in infected patients. The pandemic of COVID-19 has posed great threat to public health across the globe. Until April 21, 2020, 2, 397,217 cases were confirmed globally, including 84,250 cases in China [1]. A total of 162,956 patients have died from this viral infection [2]. Severe cases developed life* Correspondence: [email protected]; [email protected] † Jiu-Cong Zhang, Xiao-Hui Yu and Xiao-Han Ding contributed equally to this work. 1 The 940 Hospital of Joint Logistic Support Force of PLA, Lanzhou 730050, China Full list of author information is available at the end of the article
threatening complications, such as respiratory failure, shock, and multiple organs dysfunction [3]. We report coinfection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and HIV in two patients in China.
Case presentation Case one
A 24-year-old man was seen in the clinic of a local Hospital on February 8, 2020, for fever with a maximum body temperature of 40 °C, accompanied by fatigue, poor appetite, dizziness. In the past half month, the body weight decreased by 2.5 kg. The patient lived in Wuhan and began having symptoms on February 8. A COVID-19 was diagnosed by SARS-CoV-2 RT-PCR came back positive on February 8 and a chest CT examination, which suggested interstitial lung disease on February 9 (Fig. 1). He was then hospitalized, but his symptoms of fever,
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