Panutat Pattarapoom, Khawcharoenporn Thana
Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
Int J STD AIDS. 2025 Mar;36(3):231-240. doi: 10.1177/09564624241304849. Epub 2024 Dec 4.
Data on the impact of coronavirus disease 2019 (COVID-19) on hospitalization and outcomes among people living with HIV (PLHIV) are limited.
A retrospective cohort study was conducted among PLHIV hospitalized during the pre-COVID-19, COVID-19, and post-COVID-19 periods.
Of the 310 PLHIV included, 117, 125 and 68 were admitted during the three periods, respectively and 115 (37%) were newly diagnosed with HIV. Median CD4 cell counts and proportions of those with antiretroviral therapy (ART) adherence rates ≥95% at admission were different between the three periods [(206, 97 and 138 cells/mm ( = .02) and 97%, 89% and 100% ( = .06), respectively]. Of the 310 PLHIV, admission diagnoses were non-AIDS-related (62%) and AIDS-related (38%). Most of the non-AIDS-related diagnoses were infections other than opportunistic infections (OIs) (40%) while OIs were the most common for AIDS-related diagnoses (88%). The types of admission diagnoses were comparable between the three periods. Hospital mortality rates were 10%, 13% and 16% during pre-COVID-19, COVID-19 and post-COVID-19 periods, respectively ( = .80). By multivariable analysis, intensive care unit admission, underlying malignancy, monthly income less than $USD 400, and admission CD4 less than 50 cells/mm were independently associated with hospital mortality.
Although admission during COVID-19 pandemic period was not associated with increased mortality, we observed the impact of the pandemic on the lower CD4 cell count and ART adherence at admission among hospitalized PLHIV. Interventions to improve early care engagement, ART adherence, and close monitoring for those with identified mortality risks are needed for better HIV care, especially during pandemics.
关于2019冠状病毒病（COVID-19）对艾滋病毒感染者（PLHIV）住院情况及预后影响的数据有限。
对在COVID-19之前、期间和之后住院的PLHIV进行了一项回顾性队列研究。
纳入的310例PLHIV中，三个时期分别有117例、125例和68例入院，115例（37%）为新诊断的艾滋病毒感染者。三个时期入院时的CD4细胞计数中位数以及抗逆转录病毒治疗（ART）依从率≥95%的患者比例有所不同[分别为（206、97和138个细胞/mm³，P = 0.02）以及97%、89%和100%（P = 0.06）]。在310例PLHIV中，入院诊断为非艾滋病相关（62%）和艾滋病相关（38%）。大多数非艾滋病相关诊断为非机会性感染（OI）以外的感染（40%），而OI是艾滋病相关诊断中最常见的（88%）。三个时期的入院诊断类型具有可比性。COVID-19之前、期间和之后时期的医院死亡率分别为10%、13%和16%（P = 0.80）。通过多变量分析，入住重症监护病房、潜在恶性肿瘤、月收入低于400美元以及入院时CD4低于50个细胞/mm³与医院死亡率独立相关。
尽管在COVID-19大流行期间入院与死亡率增加无关，但我们观察到该大流行对住院PLHIV入院时较低的CD4细胞计数和ART依从性产生了影响。为了提供更好的艾滋病毒护理，尤其是在大流行期间，需要采取干预措施来改善早期护理参与、ART依从性，并对确定有死亡风险的患者进行密切监测。
