Consequences of the COVID-19 pandemic on the continuum of care in a cohort of people living with HIV followed in a single center of Northern Italy.
Consequences of the COVID-19 pandemic on the continuum of care in a cohort of people living with HIV followed in a single center of Northern Italy.
复制标题
DOI：
10.1186/s12981-020-00314-y
复制
发表时间：
2020-10-04
影响因子：
2.2
通讯作者：
Castelli F
中科院分区：
文献类型：
--
作者：
Quiros-Roldan E;Magro P;Carriero C;Chiesa A;El Hamad I;Tratta E;Fazio R;Formenti B;Castelli F
在 COVID-19 大流行期间，医院面临着越来越大的压力，艾滋病毒感染者面临着感染 SARS-CoV-2 并中断艾滋病毒连续护理的风险。这是一项回顾性、观察性研究。我们比较了布雷西亚 Spedali Civili 的一组 HIV 感染者 (PLWH) 在 COVID-19 大流行高峰期和 2019 年 10 月至 11 月期间就诊的次数、发放的抗逆转录病毒药物以及新诊断的 HIV 和住院的人数。数据从管理文件以及纸质和电子临床图表中检索。分类变量使用频率和百分比来描述，而连续变量使用平均值、中位数和四分位距 (IQR) 值来描述。使用学生 t 检验和曼-惠特尼检验比较连续变量的平均值。使用 χ2 检验比较分类变量的比例。截至2019年12月31日，我们诊所共追踪了3875名感染者。平均年龄为 51.4±13 岁，其中 28% 为女性，18.8% 为非意大利人。总体而言，98.9% 的人接受了 ART (n = 3834)，93% 的人接受了病毒抑制。 2019 年和 2020 年两个季度，分别有 1217 名和 1162 名患者到我们的 HIV 门诊就诊。比较这两个时期，我们观察到漏诊率从 5% 上升至 8% (p < 0.01)，新诊断 HIV 的人数从 2019 年的每月 6.4 例减少到 2020 年的每月 2.5 例 (p = 0.01)，ART 配药量下降，以及因 COVID-19 住院的 HIV 患者增加。包含蛋白酶抑制剂 (PI) 的 ART 方案的平均下降幅度小于不包含 PI 的 ART (16.6% vs 21.6%，p<0.05)。目前尚不清楚这是否可能是由于人们认为 PI 可能对新冠病毒有效。我们的经验强调了具有弹性的医疗保健系统的重要性以及实施新策略的必要性，以保证即使在紧急情况下也能持续提供艾滋病毒护理。
During the COVID-19 pandemic, hospitals faced increasing pressure, where people living with HIV risked to either acquire SARS-CoV-2 and to interrupt the HIV continuum of care. This is a retrospective, observational study. We compared the numbers of medical visits performed, antiretroviral drugs dispensed and the number of new HIV diagnosis and of hospitalizations in a cohort of people living with HIV (PLWH) followed by the Spedali Civili of Brescia between the bimester of the COVID-19 pandemic peak and the bimester of October–November 2019. Data were retrieved from administrative files and from paper and electronic clinical charts. Categorical variables were described using frequencies and percentages, while continuous variables were described using mean, median, and interquartile range (IQR) values. Means for continuous variables were compared using Student’s t-tests and the Mann–Whitney test. Proportions for categorical variables were compared using the χ2 test. As of December 31st, 2019, a total of 3875 PLWH were followed in our clinic. Mean age was 51.4 ± 13 years old, where 28% were females and 18.8% non-Italian. Overall, 98.9% were on ART (n = 3834), 93% were viro-suppressed. A total of 1217 and 1162 patients had their visit scheduled at our out-patient HIV clinic during the two bimesters of 2019 and 2020, respectively. Comparing the two periods, we observed a raise of missed visits from 5 to 8% (p < 0.01), a reduction in the number of new HIV diagnosis from 6.4 in 2019 to 2.5 per month in 2020 (p = 0.01), a drop in ART dispensation and an increase of hospitalized HIV patients due to COVID-19. ART regimens including protease inhibitors (PIs) had a smaller average drop than ART not including PIs (16.6 vs 21.6%, p < 0.05). Whether this may be due to the perception of a possible efficacy of PIs on COVID19 is not known. Our experience highlights the importance of a resilient healthcare system and the need to implement new strategies in order to guarantee the continuum of HIV care even in the context of emergency.
登录
查看更多内容
影响因子：
158.5
作者：
Cao, B.;Wang, Y.;Wang, C.
通讯作者：
Wang, C.
影响因子：
11.8
作者：
Gervasoni, Cristina;Meraviglia, Paola;Cattaneo, Dario
通讯作者：
Cattaneo, Dario
影响因子：
1.6
作者：
Comelli, Agnese;Izzo, Ilaria;Quiros-Roldan, Eugenia
通讯作者：
Quiros-Roldan, Eugenia
影响因子：
5.5
作者：
Lu, Hongzhou
通讯作者：
Lu, Hongzhou
通过计算方法分析 SARS-CoV-2 的治疗靶点并发现潜在药物
影响因子：
14.5
作者：
Wu, Canrong;Liu, Yang;Li, Hua
通讯作者：
Li, Hua