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在有和没有 HIV 的医疗补助管理式医疗人群中,社会人口统计学特征和合并症与 SARS-CoV-2 急性后期后遗症的关联。

The association of sociodemographic characteristics and comorbidities with post-acute sequelae of SARS-CoV-2 in a Medicaid managed care population with and without HIV.

机构信息

Brookdale Center for Healthy Aging, at Hunter College, City University of New York, New York City, New York, United States of America.

Amida Care, New York City, New York, United States of America.

出版信息

PLoS One. 2024 Jul 25;19(7):e0306322. doi: 10.1371/journal.pone.0306322. eCollection 2024.

Abstract

Understanding how post-acute sequelae of SARS-CoV-2 infection (PASC) affects communities disproportionately affected by HIV is critically needed. This study aimed to identify the prevalence of PASC symptoms among Medicaid enrollees at risk for or living with HIV. Through a web survey, we received 138 valid responses from Medicaid-managed plan members who had received a COVID diagnosis. Participants' mean age was 45.4 years (SD = 11.9) and most were non-Hispanic Black (43.5%) or Hispanic (39.1%). Almost thirty-two percent reported inadequate incomes and 77.5% were HIV-positive. In the overall population, the frequently reported symptoms included neck/back/low back pain, brain fog/difficulty concentrating, bone/joint pain, muscle aches, and fatigue. Findings indicate that there is no statistically significant difference in the prevalence and intensity of PASC symptoms lasting 6 months or more between individuals living with and without HIV. Multiple regression analysis found that the number of PASC symptoms 6 months or longer was independently associated with inadequate incomes and comorbidities (cardiac problems, cancer, fibromyalgia) (R2 = .34). Those with inadequate incomes and comorbidities have more numerous PASC symptoms. Implications for health care delivery and long-term COVID services will be discussed.

摘要

了解 SARS-CoV-2 感染后后遗症 (PASC) 如何不成比例地影响受艾滋病毒影响较大的社区是至关重要的。本研究旨在确定在有感染艾滋病毒风险或患有艾滋病毒的医疗补助受保人中,PASC 症状的流行率。通过网络调查,我们从接受过 COVID 诊断的医疗补助管理计划成员中收到了 138 份有效回复。参与者的平均年龄为 45.4 岁(SD = 11.9),大多数是非西班牙裔黑人(43.5%)或西班牙裔(39.1%)。近 32%的人报告收入不足,77.5%的人 HIV 阳性。在总体人群中,经常报告的症状包括颈部/背部/下背部疼痛、脑雾/注意力不集中、骨/关节疼痛、肌肉疼痛和疲劳。研究结果表明,HIV 阳性和 HIV 阴性个体中,持续 6 个月或更长时间的 PASC 症状的流行率和强度没有统计学上的显著差异。多元回归分析发现,持续 6 个月或更长时间的 PASC 症状数量与收入不足和合并症(心脏问题、癌症、纤维肌痛)独立相关(R2 =.34)。收入不足和合并症的人有更多的 PASC 症状。将讨论医疗保健提供和长期 COVID 服务的影响。

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