We read with interest the report by Blanco and colleagues of five people living with HIV who were admitted to a Barcelona hospital with COVID-19. We believe that caution is required before drawing conclusions on the outcome of COVID-19 in this population. 

Evidence is evolving that protease inhibitors developed for the treatment of HIV, both lopinavir and darunavir boosted by ritonavir or cobicistat, are not efficacious against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vivo. Therefore, antiretroviral combinations should not be changed in an attempt to treat SARS-CoV-2 infection, because neither drug combination is a firstline choice in most guidelines for HIV and changing treatment could lead to increased rates of adverse events.

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