First Case of COVID-19 N501Y Variant of Concern Infection in a Patient with Chronic HIV Infection

Main Article Content

Wendy Ye
Joanne Britto
John Neary
Mark Crowther

COVID-19, Diagnostic Error, HIV, Immunocompromised

Abstract

COVID-19 pneumonia continues to have high global prevalence, mortality, and morbidity with the emergence of new variants of concerns due to vaccination inequality. There continues to be limited data on the outcomes of HIV-infected patients with COVID-19. In this report, we present the case of a 62-year old male with chronic HIV who presented with unexplained fever and initial negative COVID-19 PCR, and no radiographic evidence of COVID-19 on chest x-ray or CT Chest. Due to the increased prevalence of COVID-19 and the emergence of variants of concern, diagnostic testing for COVID-19 should be repeated in patients who are persistently febrile despite previous negative swabs and lack of exposure. Patients with immunocompromised states, such as HIV infection, may have atypical clinical presentations, time to PCR positivity, or imaging findings of COVID-19. A thorough investigation for other causes of unexplained fever should also be conducted despite the community prevalence of COVID-19.


Resume
La pneumonie COVID-19 continue d’avoir une prévalence, une mortalité et une morbidité élevées dans le monde, avec l’émergence de nouvelles variantes préoccupantes en raison de l’inégalité de la vaccination. Il existe toujours peu de données sur les résultats des patients infectés par le VIH atteints de COVID-19. Dans ce rapport, nous présentons le cas d’un homme de 62 ans atteint du VIH chronique qui s’est présenté avec une fièvre inexpliquée et une PCR initiale négative pour le COVID-19, et aucune preuve radiographique du COVID-19 sur la radiographie du thorax ou le CT Chest. En raison de l’augmentation de la prévalence du COVID-19 et de l’émergence de variantes préoccupantes, le test de diagnostic du COVID-19 doit être répété chez les patients qui sont constamment fébriles malgré des écouvillons négatifs antérieurs et l’absence d’exposition. Les patients immunodéprimés, tels que les personnes infectées par le VIH, peuvent avoir des présentations cliniques atypiques, un délai de positivité de la PCR ou des résultats d’imagerie du COVID-19. Une recherche approfondie d’autres causes de fièvre inexpliquée doit également être menée malgré la prévalence communautaire du COVID-19.

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