P5‐150: COVID‐19 patients with a late diagnosis of HIV

Desdiani Desdiani ¹, Nita Yulianti², Anindita Basuki³

¹Faculty of Medicine, Universitas Sultan Ageng Tirtayasa, Indonesia, ²Department of Clinical Pathology, Bhayangkara Brimob Hospital, Indonesia, ³Department of Radiology, Bhayangkara Brimob Hospital, Indonesia

Coronavirus disease 2019 (COVID‐19) is a novel infectious disease that can cause respiratory symptoms and extrapulmonary manifestations. A severe case of COVID‐19 is reported to have a remarkable mortality rate. A comprehensive understanding of this novel infectious disease is still being developed, including the clinical manifestations of patients with comorbidities. COVID‐19 in patients with immunocompromised showing non‐specific clinical manifestation and often do not respond to treatment. We present a case of a 58‐year old Indonesian male diagnosed with TB initially with clinical symptoms, laboratory and radiological thorax CT scans suggesting COVID‐19. The patient was positive for COVID‐19 from the molecular rapid test for COVID‐19 and anal swab but did not respond to standard first‐line therapy for COVID‐19. It was discovered later that the patient's test for anti‐HIV was reactive with absolute CD4 13,7 cell/μL, lactate dehydrogenase 385 U/L, and procalcitonin 0.24 ng/mL. The patient was then subjected to additional drugs, including remdesivir, azithromycin, dexamethasone, low molecular weight heparin (LMWH), ritonavir‐lopinavir, and other supporting drugs. Ten days later, the polymerase chain reaction (PCR) test result was negative, the laboratory and radiology had also improved. This case discusses the possibility of co‐detection of COVID‐19 with immune system diseases such as HIV and emphasizes the importance of extended testing for suspicious cases to provide precise treatment.