Risk of Severe COVID-19 Disease and the Pandemic's Impact on Service Utilization Among a Longitudinal Cohort of Persons with HIV-Washington, DC.
Risk of Severe COVID-19 Disease and the Pandemic's Impact on Service Utilization Among a Longitudinal Cohort of Persons with HIV-Washington, DC.
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DOI：
10.1007/s10461-022-03662-0
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发表时间：
2022-10
影响因子：
4.4
通讯作者：
Castel, Amanda D.
中科院分区：
文献类型：
--
作者：
Monroe, Anne K.;Xiao, Jiayang;Greenberg, Alan E.;Levy, Matt E.;Temprosa, Marinella;Resnik, Jenna B.;Castel, Amanda D.
HIV 感染者 (PWH) 的医疗合并症负担很重，可能会增加他们患严重 COVID-19 的风险。此外，在 COVID-19 大流行期间，艾滋病毒护理服务已经进行了重组，对艾滋病毒结果的影响尚不清楚。本研究的目的首先是，使用包含临床风险因素的定义来检查感染者中感染严重 COVID-19 的风险，其次是检查该流行病对 HIV 护理的影响。我们使用了来自华盛顿特区队列的数据，这是在华盛顿特区接受艾滋病毒护理的一大群人。我们发现，所有年龄段的参与者中，很大一部分都符合严重 COVID-19 的高风险（58%）或高风险（34%）。 2019 年至 2020 年间，接触次数增加（17.7%，活跃 DC 队列参与者进行了接触，增加至 23.5%），而实验室利用率下降（14.4%，活跃 DC 队列参与者进行了 HIV RNA 检测，减少至 11.4%）。我们工作的意义包括通过疫苗接种等策略保护艾滋病毒易感人群免于感染 COVID-19 以及可能出现严重并发症的重要性。此外，认识到艾滋病毒服务的提供可能会因大流行而长期改变，因此需要进行调整以确保在实现 90-90-90 目标方面持续取得进展。在线版本包含可在 10.1007/s10461-022-03662-0 获取的补充材料。
People with HIV (PWH) have a high burden of medical comorbidities, potentially putting them at increased risk for severe COVID-19. Additionally, during the COVID-19 pandemic, HIV care delivery has been restructured and the impact on HIV outcomes is unknown. The objectives of this study were first, to examine the risk of severe COVID-19 among PWH, using a definition incorporating clinical risk factors, and second, to examine the pandemic’s impact on HIV care. We used data from the DC Cohort, a large cohort of people receiving HIV care in Washington, DC. We found that a high proportion of participants across all age groups qualified as increased (58%) or high risk (34%) for severe COVID-19. Between 2019 and 2020, encounters increased (17.7%, increasing to 23.5% of active DC Cohort participants had an encounter) while laboratory utilization decreased (14.4%, decreasing to 11.4% of active DC Cohort participants had an HIV RNA test performed). Implications of our work include the importance of protecting vulnerable people with HIV from acquiring COVID-19 and potentially manifesting severe complications through strategies including vaccination. Additionally, acknowledging that HIV service delivery will likely be changed long-term by the pandemic, adaptation is required to ensure continued progress towards 90-90-90 goals. The online version contains supplementary material available at 10.1007/s10461-022-03662-0.
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