Severe COVID-19 in HIV/Leishmania infantum coinfected patient: a successfully managed case report

• Published in: BMC infectious diseases Vol. 24; no. 1; pp. 854 - 7
• Main Authors: Farias, Pablo Cantalice Santos, Bezerra, Gilberto Silva Nunes, Neves, Patrícia Areias Feitosa, Cabral, Leandro Pimentel, Júnior, Walter Lins Barbosa, Guedes, Diego Lins, Xavier, Amanda Tavares, Medeiros, Zulma Maria, Lorena, Virgínia Maria Barros, Araújo, Paulo Sérgio Ramos, de Queiroz Balbino, Valdir, de Lima Neto, Reginaldo Gonçalves
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 23-08-2024; BioMed Central; BMC
• Subjects: Acquired immune deficiency syndrome; Acute respiratory distress syndrome; AIDS; Blood; Blood levels; Blood pressure; Body temperature; Brazil; C-reactive protein; Case report; Case reports; Clinical outcomes; Coinfection; Coinfection - parasitology; Coinfection - virology; Comorbidity; Computed tomography; Coronaviruses; Cough; COVID-19; COVID-19 - complications; Cytomegalovirus; Dehydrogenases; Development and progression; Disease transmission; Dyspnea; Female; Ferritin; Fever; Health aspects; Heart beat; Heart rate; HIV; HIV (Viruses); HIV Infections - complications; Human immunodeficiency virus; Humans; Immunology; Infection; Infections; L-Lactate dehydrogenase; Lactate dehydrogenase; Leishmania infantum; Leishmania infantum - isolation & purification; Leishmaniasis; Leishmaniasis, Visceral - complications; Leishmaniasis, Visceral - diagnosis; Leishmaniasis, Visceral - drug therapy; Leukopenia; Lymphocytes; Lymphopenia; Medical examination; Medical laboratories; Middle Aged; Neutropenia; Oxygen content; Oxygen saturation; Parasitic diseases; Parenchyma; Patients; Public health; Respiration; Respiratory distress syndrome; Respiratory failure; Respiratory rate; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Tuberculosis; Viral diseases; Brazil; Case report; SARS-CoV-2; Coinfection; Leishmaniasis; HIV
• DOI: 10.1186/s12879-024-09691-5
• EISSN: 1471-2334

Coronavirus disease 2019 originated in China and swiftly spread worldwide, posing a significant threat to public health. Caused by SARS-CoV-2, it manifests as a flu-like illness that can escalate to Acute Respiratory Distress Syndrome, potentially resulting in fatalities. In countries where HIV/Leishmania infantum is endemic, the occurrence of concurrent SARS-CoV-2/HIV/Leishmania infantum infections is a reality, prompting inquiries into appropriate clinical management.
We present the case of a 48-year-old woman who was hospitalized for 36 days across three different hospitals in the state of Pernambuco, Brazil. She was diagnosed with SARS-CoV-2/HIV/L. infantum coinfection. The patient exhibited severe COVID-19 symptoms, including fever, productive cough, and dyspnea. Throughout her hospitalization, she experienced oxygen saturation levels of ≤ 93%, along with fluctuations in blood pressure, respiratory rate, and heart rate. Her blood tests revealed lymphopenia, leukopenia, and neutropenia, while laboratory results indicated abnormal levels of d-dimer, AST, ALT, lactate dehydrogenase, ferritin, and C-reactive protein. A computed tomography scan revealed 75% involvement of the lung parenchyma with patchy ground-glass opacities.
Against all odds, the patient was discharged. The leukopenia associated with HIV/L. infantum may have played a decisive role. Further studies are necessary to better understand diagnostic strategies and clinical management measures for HIV/L. infantum coinfected patients who are susceptible to SARS-CoV-2 infection.