Xia Wanyuan, Zheng Daikun, Wu Linbing, Tang Zhi, Ye Qiong, Zhang Yuqiang, Leng Chongli, Bao Ping, Fan Mingyue, Liu Min, Kang Jiming
School of Public Health and Management, Chongqing Three Gorges Medical College, 366 Tianxing Road, Baianba Street, Wanzhou District, Chongqing, 404120, People's Republic of China.
School of Foreign Languages, Panzhihua University, Panzhihua City, Sichuan Province, People's Republic of China.
Sci Rep. 2025 May 20;15(1):17464. doi: 10.1038/s41598-025-99528-1.
SARS-CoV-2 and its subvariants continue to spread globally. People living with HIV (PLWH), who have weakened immune systems, have heightened concerns about the virus. Thus, the relationship between COVID-19 and HIV remains unclear, and the risks of COVID-19 for PLWH have yet to be fully understood. The study conducted a retrospective cross-sectional survey on the Wenjuanxing platform to identify lifestyle risk factors and epidemic phenotypes associated with the severity of COVID-19 in PLWH. All respondents were over 18 years old and were receiving antiretroviral therapy. The survey included questions about their health status during the COVID-19 illness, and questions about basic sociodemographic information, lifestyle factors, and HIV treatment history. This study included 984 HIV patients with a mean age of 54.44 ± 14.4 years. Among the participants, 635 (64.53%) were male. A total of 33 (3.35%) respondents were unvaccinated, while 951 (96.65%) had received at least one vaccine dose, with 868 (88.21%) participants having received three or more vaccine doses. The association between the severity of COVID-19 symptoms and CD4 count (p = 0.652) and HIV viral load (p = 0.916) was found to be statistically insignificant. In reduced multivariate logistic model, passive smoking increased the risk of severe COVID-19 symptoms compared with non-smokers (odds ratios [OR] 1.66; 95% confidence interval [CI] 1.11-2.48). Mild (OR 2.23; 95% CI 1.55-3.24) and moderate/severe anxiety (OR 5.22; 95% CI 2.36-13.28) were also positively associated with severe COVID-19 symptoms compared to individuals with no anxiety. Comorbidity (OR 1.5; 95% CI 1.04-2.17) demonstrated a significant association with severe COVID-19 symptoms. Moderate/severe anxiety was significantly associated with a higher hospital admission rate (OR 2.62; 95% CI 1.27-5.37) compared to those without anxiety. Patients who consumed whole grains more than three times per week had a lower risk of hospital admission (OR 0.61; 95% CI 0.41-0.89). However, both anxiety and wholegrain intake were nonsignificant for hospitalization rates in individuals who tested positive for COVID-19 through real-time PCR or antigen test. In full multivariate logistic model for SARS-CoV-2 infection of hospitality, CD4 count (> 500 cells/mm) (OR 0.64; 95% CI 0.41-0.99) and the CD4 count (200-500 cells/mm) (OR 0.68; 95% CI 0.45-1.04) were significantly associated with hospital admission rates compared to CD4 count (< 200 cells/mm), but the results were inconsistent in the reduced logistic models and analysis of Group B. This study indicates that anxiety is positively associated with worsened COVID-19 symptoms and higher hospitalization rates, suggesting a significant link between anxiety and the severity of COVID-19. However, the study did not find evidence of a correlation between CD4 count, HIV viral load, and the severity of COVID-19 or hospitalization rates.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）及其变异株继续在全球传播。免疫系统较弱的艾滋病毒感染者（PLWH）对该病毒愈发担忧。因此，新冠病毒病（COVID-19）与艾滋病毒之间的关系仍不明确，COVID-19对PLWH的风险尚未完全了解。该研究在问卷星平台上进行了一项回顾性横断面调查，以确定与PLWH中COVID-19严重程度相关的生活方式风险因素和流行表型。所有受访者均年满18岁且正在接受抗逆转录病毒治疗。调查包括关于他们在感染COVID-19期间的健康状况的问题，以及关于基本社会人口统计学信息、生活方式因素和艾滋病毒治疗史的问题。本研究纳入了984例艾滋病毒患者，平均年龄为54.44±14.4岁。参与者中，635例（64.53%）为男性。共有33例（3.35%）受访者未接种疫苗，而951例（96.65%）至少接种了一剂疫苗，其中868例（88.21%）参与者接种了三剂或更多剂疫苗。发现COVID-19症状的严重程度与CD4细胞计数（p=0.652）和艾滋病毒病毒载量（p=0.916）之间的关联无统计学意义。在简化多变量逻辑模型中，与非吸烟者相比，被动吸烟增加了出现严重COVID-19症状的风险（优势比[OR]为1.66；95%置信区间[CI]为1.11-2.48）。与无焦虑的个体相比，轻度（OR为2.23；95%CI为1.55-3.24）和中度/重度焦虑（OR为5.22；95%CI为2.36-13.28）也与严重COVID-19症状呈正相关。合并症（OR为1.5；95%CI为1.04-2.17）与严重COVID-19症状存在显著关联。与无焦虑的人相比，中度/重度焦虑与更高的住院率显著相关（OR为2.62；95%CI为1.27-5.37）。每周食用全谷物超过三次的患者住院风险较低（OR为0.61；95%CI为0.41-0.89）。然而，对于通过实时聚合酶链反应或抗原检测COVID-19呈阳性的个体，焦虑和全谷物摄入量对住院率均无显著影响。在针对酒店业SARS-CoV-2感染的完整多变量逻辑模型中，与CD4细胞计数（<200个细胞/mm³）相比，CD4细胞计数（>500个细胞/mm³）（OR为0.64；95%CI为0.41-0.99）和CD4细胞计数（200-500个细胞/mm³）（OR为0.68；95%CI为0.45-1.04）与住院率显著相关，但在简化逻辑模型和B组分析中结果不一致。本研究表明，焦虑与COVID-19症状加重和更高的住院率呈正相关，提示焦虑与COVID-19的严重程度之间存在显著联系。然而，该研究未发现CD4细胞计数、艾滋病毒病毒载量与COVID-19严重程度或住院率之间存在相关性的证据。
