Banca de DEFESA: THAIS LORENNA SOUZA SALLES

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : THAIS LORENNA SOUZA SALLES
DATE: 20/12/2023
TIME: 14:00
LOCAL: Videoconferência
TITLE:

Clinical characteristics and outcomes of covid-19 in people living with HIV


KEY WORDS:
COVID-19. HIV. Intensive Care Unit. Mechanical Ventilation. Mortality.

PAGES: 86
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:
Introduction: The COVID-19 pandemic has brought large challenges to people living with
the human immunodeficiency virus (PLHIV). Evidence demonstrates association between
HIV infection and clinical complications of COVID-19, however, the results on severity and
mortality remains inconsistent. Furthermore, there is a lack of studies investigating the
influence of HIV infection on the COVID-19 outcomes in Latin America in different waves
of the pandemic. Objective: To evaluate clinical characteristics and outcomes of patients
coinfected with HIV and SARS-CoV-2, and to compare this outcomes with a paired sample
without HIV infection in two consecutive years. Methods: This is a substudy of a
retrospective multicentric cohort, which included 27 Brazilian hospitals, comprising
hospitalized COVID-19 patients from March to September 2020 and March to December
2021. Data collection was performed by review of medical records to obtain the variables of
interest. The primary outcomes were intensive care unit admission (ICU), invasive
mechanical ventilation, and death. Patients with COVID-19 and HIV infection were matched
with the controls using score and propensity (up to 4:1), by age, sex, number of comorbidities
and hospital of origin. Groups were compared using the Chi-Square Test or Fisher Exact Test
for categorical variables and the Wilcoxon Test for continuous variables. Results were
considered statistically significant at a significance level of p<0.05. Results: From 17,101
COVID-19 patients hospitalized during the study period, 130 PLHIV were identified (86 in
2020 and 44 in 2021). The median age in 2020 and 2021 periods was 54 and 53 years,
respectively, with no significant differences between cases and controls. Both groups had a
similar frequency of comorbidities in two study periods, except for a lower frequency of
obesity (5.8% vs 16.8%; p = 0.016), and a higher frequency of chronic obstructive pulmonary
disease (9.3% vs 3.8%; p = 0.049), and cancer (15.1% vs 7.1%; p = 0.032) among PLHIV, in
2020. The most frequent COVID-19 symptoms between groups were dyspnea (2020: 60.5%
vs 67.0%; p= 0.314 / 2021: 68.2% vs 69.7%; p = 0.989) and fever (2020: 58.1% vs 61.1%; p=
0.710 / 2021: 45.5% vs 43.4%; p= 0.942). Regarding specific information related to HIV
infection, all PLHIV with available data were on antiretroviral therapy (2020 and 2021:
100.0%) and most had suppressed viral loads (2020: 78.1% and 2021: 71.4%). In 2020, only
54.7% of PLHIV with available data had CD4+ T lymphocyte counts above 500 cells/μL,
however, 70.0% had counts above 500 cells/μL in 2021. PLHIV and their controls showed
similar prevalence for admission to the ICU and invasive mechanical ventilation requirement
in the two periods, with no significant differences. In 2020, in-hospital mortality was higher
in the HIV group compared to the controls (27,9% vs. 17.7%; p = 0.049), however, this
finding was very similar between both groups in 2021 (25.0% vs. 25.1%; p > 0.999).
Conclusion: The results reiterate that PLHIV had higher mortality from covid-19 in the early
stages of the pandemic. However, this finding was not sustained in 2021, when mortality
among PLHIV was similar to the control group.

BANKING MEMBERS:
Externa à Instituição - CHRISTIANE CORREA RODRIGUES CIMINI - UFVJM
Externo à Instituição - UNAÍ TUPINAMBÁS - UFMG
Interna - 1715700 - CLARECI DA SILVA CARDOSO
Externa ao Programa - 1971548 - CRISTINA SANCHES
Presidente - 1544480 - EDUARDO SERGIO DA SILVA
Externa à Instituição - MILENA SORIANO MARCOLINO - UFMG
Notícia cadastrada em: 15/12/2023 10:01
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