The characteristics of HIV-positive patients with mild/asymptomatic and moderate/severe course of COVID-19 disease—A report from Central and Eastern Europe

Kowalska, Justyna D.; Kase, Kerstin; Vassilenko, Anna; Harxhi, Arjan; Lakatos, Botond; Dragovic, Gordana; Verhaz, Antonija; Yancheva, Nina; Dumitrescu, Florentina; Jilich, David; Machala, Ladislav; Skrzat‐Klapaczyńska, Agata; Matulionytė, Raimonda

doi:10.1016/j.ijid.2020.12.026

Cited by 18 publications

(14 citation statements)

References 19 publications

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“…The patient living with HIV had great concerns about whether they are at high risk for the pandemic and the worse outcomes if they get infected with COVID-19. Research ndings on these concerns have been in agreement with previous studies conducted elsewhere [18,19,[33][34][35][36]. Studies indicated that though the pandemic affected the health care for all disease conditions, chronic patients such as people living with HIV are likely to be uniquely vulnerable [4,37,38].…”

Section: Discussionsupporting

confidence: 85%

COVID-19 Burden on HIV Patients Attending Antiretroviral Therapy in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study

Chilot

Woldeamanuel

Manyazewal

2021

Preprint

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Background There has been promising progress towards screening, testing, and retaining HIV patients in care in Ethiopia. Concern exists that possible disruptions in HIV programs due to COVID-19 could result in more HIV-related mortality and new HIV infections. This study aimed to investigate the real-time burden of COVID-19 on HIV patients attending antiretroviral therapy. Methods We conducted a facility-based, multicentre, cross-sectional study among HIV patients attending antiretroviral therapy in 10 healthcare facilities in Addis Ababa, Ethiopia, in the COVID-19 pandemic period. Data was collected using adapted, interviewer-based questionnaires, and entered into Epi Info version 7 and exported to SPSS version 26 for analysis. Result A total of 212 patients with HIV were included. Participants who missed visits for refill were 58 (27.4%). When the effects of other independent variables on appointments/visits for refill were controlled, the following characteristics were found to be the most important pridictors of missed appointments (P < 0.05): age ≥ 55 [AOR = 6.73, 95% CI (1.495–30.310)], fear of COVID-19 [AOR = 24.93, 95% CI (2.798-222.279)], transport disruption [AOR = 4.90, 95% CI (1.031–23.174)], reduced income for traveling to health facility [AOR = 5.64, 95% CI (1.234–25.812)], and limited access to mask [AOR = 7.67, 95% CI (1.303–45.174)], sanitizer [AOR = 0.07, 95% CI (0.007–0.729)] and non-medical support [AOR = 2.32, 95% CI (1.547–12.596)]. The participants were well aware of the COVID-19 preventive measures. The most costly COVID-19 preventive measures that cause financial burden to the patients were costs for buying facemasks (63.7%), disinfectants (55.2) and sops for handwashing (22.2). Participants who missed follow-up diagnostic tests were 56 (26.4%). Variables which were found to be statistically significant include the following: age ≥ 55 [AOR = 0.22, 95% CI (0.076–0.621)], partial lockdown [AOR = 0.10, 95% CI (0.011–0.833)], limited access to health services [AOR = 0.15, 95% CI (0.045–0.475)], reduced income for traveling to health facility [AOR = 0.18, 95% CI (0.039–0.784)], and unable to get mask [AOR = 0.12, 95% CI (0.026–0.543)]. Participants who missed counseling services were 55 (25.9%). In multivariate logistic regression the following were statisticaly significant: age ≥ 55 [AOR = 0.21, 95% CI (0.078–0.570)], fear of COVID-19 [AOR = 0.11, 95% CI (0.013–0.912)], reduced income [AOR = 0.17, 95% CI (0.041–0.699)], unable to get face mask [AOR = 0.19, 95%CI (0.039–0.959)], and partial lockdown [AOR = 0.08, 95% CI (0.008–0.790)]. Conclusions COVID-19 had a significant burden on HIV patients to attend their routine clinical care and treatment, which may lead to treatment failure and drug resistance. The impact was on their appointments for medication refills and clinical and laboratory follow-ups. Targeted initiatives are needed to sustain HIV clinical care and treatment services and improve the wellbeing of people living with HIV.

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Section: Discussionsupporting

confidence: 85%

COVID-19 Burden on HIV Patients Attending Antiretroviral Therapy in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study

Chilot

Woldeamanuel

Manyazewal

2021

Preprint

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“…Linked to risk of covid-19 severity and possibly the risk of long covid, the role of immune suppression is still being debated. Immune suppression may have protective effects against long term effects of covid-19 infection149150151; however, these findings are conflicted 152153…”

Section: Risk Factorsmentioning

confidence: 99%

Long covid—mechanisms, risk factors, and management

Crook

Raza

Nowell

et al. 2021

BMJ

1,194

1,213

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Since its emergence in Wuhan, China, covid-19 has spread and had a profound effect on the lives and health of people around the globe. As of 4 July 2021, more than 183 million confirmed cases of covid-19 had been recorded worldwide, and 3.97 million deaths. Recent evidence has shown that a range of persistent symptoms can remain long after the acute SARS-CoV-2 infection, and this condition is now coined long covid by recognized research institutes. Studies have shown that long covid can affect the whole spectrum of people with covid-19, from those with very mild acute disease to the most severe forms. Like acute covid-19, long covid can involve multiple organs and can affect many systems including, but not limited to, the respiratory, cardiovascular, neurological, gastrointestinal, and musculoskeletal systems. The symptoms of long covid include fatigue, dyspnea, cardiac abnormalities, cognitive impairment, sleep disturbances, symptoms of post-traumatic stress disorder, muscle pain, concentration problems, and headache. This review summarizes studies of the long term effects of covid-19 in hospitalized and non-hospitalized patients and describes the persistent symptoms they endure. Risk factors for acute covid-19 and long covid and possible therapeutic options are also discussed.

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“…The opinion of medical and social staff is highly important as they may influence their recommendations and, thus, the opinion of the general population, resulting in an increase in the success of the campaign. The vaccination of medical and social staff in hospitals or other public facilities with large numbers of patients, such as oncology or infectious diseases, helps prevent the spread of COVID-19 among immune-compromised patients [ 12 , 13 , 14 , 15 , 16 ]. However, health workers are not a homogeneous group, and most are not experts in vaccination [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Early COVID-19 Vaccination of Romanian Medical and Social Personnel

Manolescu

Zaharia²,

Dumitrescu

et al. 2021

Vaccines

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Background: In December 2020, the first doses of COVID-19 vaccines arrived in Romania and were made available to medical and social staff. Vaccine hesitancy appeared as a barrier to effectively ending the pandemic. The opinions of medical and social staff influence the opinion of the general population. This study assesess the attitudes, knowledge, and opinion of medical and social personnel toward COVID-19 vaccines and vaccination and the influencing factors. Methods: 1025 persons participated in an online cross-sectional study from March until July 2021. Results: Out of 1021 eligible responders, 719 (70.42%) had been vaccinated: 227 with one dose (22.23%) and 492 with two doses (48.18%). There were 302 responders who were not vaccinated at all. Out of them, 188 refused vaccinations. The participants showed a good understanding and knowledge of SARScoV-2 transmission and treatment. Geographic area, medical profession, and medical experience influenced COVID-19 vaccination (p < 0.001). There were no associations between willingness to vaccinate and vaccine/virus knowledge. Most of the responders who were vaccinated or wanted to be vaccinated indicated an mRNA vaccine as their first choice. The variables that were significantly associated with reporting COVID-19 vaccine acceptance after logistic regression were: living in an urban area (Ora = 1.58, 95% CI: 0.98–2.56), being female (Ora = 1.59; 95% CI:1.03–2.44), and being a medical doctor (Ora = 3.40; 95% CI: 1.84–6.26). Conclusions: These findings show that vaccine hesitancy persists in medical and social personnel in Romania, and, hence, it may be reflected in the hesitancy of the general population toward vaccination.

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The characteristics of HIV-positive patients with mild/asymptomatic and moderate/severe course of COVID-19 disease—A report from Central and Eastern Europe

Cited by 18 publications

References 19 publications

COVID-19 Burden on HIV Patients Attending Antiretroviral Therapy in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study

COVID-19 Burden on HIV Patients Attending Antiretroviral Therapy in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study

Long covid—mechanisms, risk factors, and management

Early COVID-19 Vaccination of Romanian Medical and Social Personnel

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