Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Modena HIV Metabolic Clinic (MHMC), University of Modena and Reggio Emilia, Modena, Italy.
J Acquir Immune Defic Syndr. 2022 Feb 1;89(Suppl 1):S65-S72. doi: 10.1097/QAI.0000000000002865.
Resilience is defined as an individual's positive adaptation to stressors. The COVID-19 pandemic represents a generalized stressor which may affect differently people living with HIV (PLWH). The objective of this study was to characterize resilience in PLWH with particular regarding the identification of frailty-resilience phenotypes, which may differently affect health-related quality of life (HR-QoL).
This was an observational study of PLWH attending Modena HIV Metabolic Clinic. Frailty was assessed in 2019, before the onset of the COVID-19 pandemic by using 37-Item frailty index ranging from 0 to 1. The frailty index score was categorized as fit (<0.25) or frail (>0.25). In January 2021, PLWH were offered to complete a set of electronic questionnaires including the CD-RISC-25 for resilience and EQ-5D5L and SF-36 for HR-QoL. Resilience was defined as CD-RISC-25 score >75.7 (ranging from 0 to 100).
Of 800 PLWH reached by mail, 575 (72%) completed the questionnaires. The median age and HIV duration were 54.5 and 24.3 years, respectively. Impaired resilience was associated with loneliness [odds ratio (OR = 2.39; 1.20 to 4.76, P < 0.001)]. Predictors for EQ-5D5L <89.7% were the phenotypes "frail/nonresilient" [OR = 5.21, 95% confidence interval (CI): 2.62 to 10.33] and "fit/nonresilient" (OR = 5.48, 95% CI: 2.8 to 10.74). Predictors for SF-36 <64.40 were the phenotypes "frail/nonresilient" (OR = 7.43, 95% CI: 2.57 to 21.22) and "fit/nonresilient" (OR = 6.27, 95% CI: 2.17 to 18.16). Both models were corrected for age, sex, HIV duration, and nadir CD4.
Resilience characterizes the well-being of PLWH during the COVID-19 crisis. This construct is complementary to frailty in the identification of clinical phenotypes with different impacts on HR-QoL.
韧性被定义为个体对压力源的积极适应。COVID-19 大流行是一种普遍的压力源，可能会对不同的 HIV 感染者（PLWH）产生影响。本研究的目的是描述 PLWH 的韧性，特别是确定可能对健康相关生活质量（HR-QoL）产生不同影响的脆弱-韧性表型。
这是一项对参加摩德纳 HIV 代谢诊所的 PLWH 进行的观察性研究。在 COVID-19 大流行之前，于 2019 年使用 37 项衰弱指数（范围为 0 至 1）评估衰弱情况。衰弱指数评分被归类为健康（<0.25）或脆弱（>0.25）。2021 年 1 月，PLWH 被提供机会完成一套电子问卷，包括 CD-RISC-25 用于评估韧性，EQ-5D5L 和 SF-36 用于评估 HR-QoL。韧性定义为 CD-RISC-25 评分>75.7（范围为 0 至 100）。
通过邮件联系了 800 名 PLWH，其中 575 名（72%）完成了问卷。中位年龄和 HIV 持续时间分别为 54.5 岁和 24.3 年。韧性受损与孤独感相关[比值比（OR）=2.39；1.20 至 4.76，P<0.001)]。EQ-5D5L<89.7%的预测因素为“脆弱/无韧性”表型[OR=5.21，95%置信区间（CI）：2.62 至 10.33]和“健康/无韧性”表型（OR=5.48，95%CI：2.8 至 10.74）。SF-36<64.40 的预测因素为“脆弱/无韧性”表型（OR=7.43，95%CI：2.57 至 21.22）和“健康/无韧性”表型（OR=6.27，95%CI：2.17 至 18.16）。这两个模型都经过年龄、性别、HIV 持续时间和 CD4 最低点的校正。
韧性描述了 COVID-19 危机期间 PLWH 的幸福感。与脆弱性一起，该构念可用于确定对 HR-QoL 产生不同影响的临床表型。
