Presence of HIV Can Affect Treatment of Long COVID

Annie Antar, MD, PhD, Johns Hopkins Medicine, discussed how those diagnosed with HIV can have different presentations of long COVID and how that needs to be considered when treating the long-term condition.

Transcript

What additional factors influence treatment decisions in patients with HIV and how does long COVID impact these considerations?

If we step back from the word "long COVID" and just look at the rates of death or rates of new heart attack or rates of new comorbidities in the year after having COVID-19, that's higher in people living with HIV than not, and that was in that Grace McComsey paper.

It's clear that if you're living with HIV in that year after the COVID-19 [pandemic], you're more likely to have something go wrong with you than if you didn't have HIV. Some of those people might have a heart attack, but they don't say, "I have long COVID," even though maybe the risk of that heart attack was increased because of HIV and long COVID, or like HIV and having had COVID. I think even when people don't recognize that they have long COVID, I fear that just having had COVID-19 will translate to a higher rate of problems in people living with HIV. And then for the people who know they have long COVID, it absolutely affects everything about their life. When they're going to their doctor, hopefully, their doctor is a little bit versed in long COVID and trying to come up with symptom treatment plans for them, and that might impact when they take their medications and all sorts of things about how they carry out their day. I guess we'll have to see over time how this plays out.

I personally had a patient with long COVID, but he actually died. He died of a heart attack within a year of having had COVID-19. Then I had another patient whose main long COVID symptom is anosmia, and she doesn't think it affects the rest of her life, but a lot of people have anosmia and then don't have the rest of the long COVID symptoms. I'm not sure she's like a good example of a person with long COVID. But the person that I described before was very short of breath. He used to go out and walk on the track a bunch. He couldn't do that after having COVID-19. Sadly, he had a heart attack and died, which is really, really sad, within, I think, 6 or 8 months. I think we'll just have to see over time.