Does Long COVID in people living with HIV resemble the functional phenotype of non-HIV individuals who had moderate or severe acute COVID-19? A retrospective cross-sectional study

Anna Gabriela Santos¹Jefferson Valente²Cássia Goulart²Fernanda Facioli¹Bernardo Maia Da Silva²Victor Irungu Mwangi¹Hector Bonilla³Frits Franssen⁴Camila Amaral²Thaís Jordão Perez Sant'Anna Motta¹Marcia Alexandre¹Luiz Carlos De Lima Ferreira¹Gerson Cipriano Junior⁵Guilherme Peixoto Tinoco Arêas¹Fernando Almeida-Val^2*

• ¹Federal University of Amazonas, Manaus, Amazonas, Brazil
• ²Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
• ³Stanford University, Stanford, California, United States
• ⁴Maastricht University Medical Centre, Maastricht, Limburg, Netherlands
• ⁵University of Brasilia, Brasilia, Distrito Federal, Brazil

Introduction: It has been postulated that individuals with long COVID have reduced exercise capacity, just as people living with HIV (PLWH), although having even lower exercise capacity. The extent to which long COVID in PLWH resembles long COVID in individuals who presented different COVID-19 phenotypes is unknown, so we aimed to determine if the long COVID profile in PLWH resembled the symptoms experienced by individuals with long COVID following mild/moderate or severe acute COVID-19, two years after the initial disease. Material and methods: A pulmonary function test and a six-minute walk test (6MWT) were performed on adult individuals with PACS (Post-Acute COVID Syndrome) in 3 groups: COVID-19+PLWH (plwHCOV), mild/moderate COVID-19 (mmCOV); severe COVID-19 (seCOV).Results: 63 individuals were included: plwHCOV (n=12), mmCOV (n=33) and seCOV (n=18). Across all groups, males were predominant. BMI was 25±3, 28±4, and 32±7 kg/m 2 in plwHCOV, mmCOV, and seCOV, respectively (p=0.003). The plwHCOV walked 545m (±93) at the 6MWT, which was comparable to the mmCOV group (555m±63) but significantly higher than the seCOV group (435m±84) (p<0.0001). The plwHCOV group had worse forced expiratory volume in 1 st second (FEV1%, 80±12) (p<0.0001), forced vital capacity (FVC%, 83±11) (p=0.002) and FEV1/FVC (0.80±0.1, p=0.004) when compared to the seCOV group. Interestingly, PLWH had comparable 6MWT, FEV1, FVC, and FEV1/FVC results as mmCOV.Our results indicate that even two years post-COVID-19 infection, PLWH exhibits significantly decreased spirometry compared to the seCOV group. Despite this lung function impairment, their functional capacity was similar to individuals with PACS following mild/moderate COVID-19.