Since emerging into the human population in late 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reached across the globe to infect >80 million people. The coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 can range in severity from mild and asymptomatic to severe and fatal. Identifying risk factors for adverse outcomes in COVID-19 is a major challenge. In the context of the existing HIV-1 pandemic, whether COVID-19 disproportionately burdens people living with HIV-1 infection (PLWH) is unclear. The following discussion highlights pressing questions and challenges in the HIV-1 and SARS-CoV-2 syndemic, including (i) age, sex, and race as drivers of COVID-19 severity; (ii) whether chronic inflammation common in PLWH influences immune response; (iii) whether disease severity and trajectory models for COVID-19 ought to be calibrated for PLWH; (iv) vaccine considerations, and finally, (v) long-term health outcomes in PLWH that are further burdened by coinfection with SARS-CoV-2.

中文翻译：

---

HIV-1 和 SARS-CoV-2 流行病中的紧迫问题和挑战

自 2019 年底在人类中出现以来，严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 已在全球范围内感染超过 8000 万人。由 SARS-CoV-2 引起的 2019 年冠状病毒病 (COVID-19) 的严重程度可以从轻微、无症状到严重、致命。识别 COVID-19 不良后果的风险因素是一项重大挑战。在当前 HIV-1 大流行的背景下，尚不清楚 COVID-19 是否给 HIV-1 感染者 (PLWH) 带来了不成比例的负担。以下讨论重点介绍了 HIV-1 和 SARS-CoV-2 综合征中的紧迫问题和挑战，包括 (i) 年龄、性别和种族是 COVID-19 严重程度的驱动因素；(ii) 感染者常见的慢性炎症是否影响免疫反应；(iii) 是否应该针对 PLWH 校准 COVID-19 的疾病严重程度和轨迹模型；(iv) 疫苗考虑因素，最后，(v) 感染者的长期健康结果因 SARS-CoV-2 合并感染而进一步加重。