Fatal case of HIV and COVID-19

Elhadi, Muhammed; Momen, Ahmed Abdulhakim; Ali Senussi Abdulhadi, Osama Mohamed; Msherghi, Ahmed

Abstract Background We describe the first death in Libya from coronavirus disease 2019 (COVID-19) presenting as acute kidney failure. Case presentation We report an 86-year-old woman in Tripoli, Libya, with no recent travel history. She had a history of type 2 diabetes mellitus and human immunodeficiency virus (HIV) infection for which she reported noncompliance with treatment. On March 15, 2020, she was diagnosed with lobar pneumonia and her condition did not improve. On March 30, the patient presented to Tripoli University Hospital Emergency Department with a cough, temperature of 39°C, respiratory rate of 24 breaths/min, a pulse of 110 beats/min, and blood pressure of 130/80 mmHg. A nasopharyngeal swab and sputum were negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on real-time reverse transcription-polymerase chain reaction (RT-PCR). On April 1, 2020, the patient’s status deteriorated and she was diagnosed with acute kidney injury as a complication of sepsis, with a urea level of 240 mg/dL (reference range, 5–50 mg/dL) and creatinine level of 7.69 mg/dL (reference range, 0.4–1.3 mg/dL). The patient was referred for dialysis at Tripoli University Hospital on April 2. However, the patient died despite attempting resuscitation due to multiple organ dysfunction syndrome following acute kidney injury. A nasopharyngeal swab and sputum were collected, which were positive for SARS-CoV-2 on real-time RT-PCR. Conclusions This case provides an insight into the importance of testing for SARS-CoV-2, in the context of an epidemic, all patient with atypical presentation particularly those with associated HIV infection.