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Long-coronavirus disease among people living with HIV in western India: An observational study
Sanjay Pujari1, Sunil Gaikwad1, Abhishek Chitalikar1
1Institute of Infectious Diseases, Pune, India.
Insights
Long-COVID is prevalent in people living with HIV (PLHIV), especially after moderate-severe COVID-19. Integrating long-COVID care into HIV clinics is crucial for this population.
Area of Science:
- Infectious Diseases
- Public Health
- HIV Medicine
Background:
- Long-COVID presents a growing health challenge for individuals recovering from COVID-19.
- Limited data exists on the prevalence, characteristics, and risk factors of long-COVID among people living with HIV (PLHIV).
Purpose of the Study:
- To investigate the prevalence and identify risk factors for long-COVID in people living with HIV.
- To understand the clinical presentation and symptom duration of long-COVID in this specific cohort.
Main Methods:
- A prospective, observational study conducted at a tertiary HIV clinic in India.
- Screening of 94 PLHIV using a questionnaire for long-COVID symptoms (present >30 days post-illness onset).
- Logistic regression analysis to determine risk factors associated with long-COVID development.
Main Results:
- The prevalence of long-COVID among PLHIV was 43.6%.
- Moderate-to-severe acute COVID-19 illness was a significant risk factor (aOR 4.7, p=0.016).
- Common symptoms included cough and fatigue; persistent symptoms were noted in 10.6% of cases.
Conclusions:
- Long-COVID is common in PLHIV, particularly those with moderate-to-severe COVID-19.
- Integration of long-COVID diagnosis and care into antiretroviral therapy clinics is recommended for PLHIV.
Background:
Long-COVID is emerging as a significant problem among individuals who recovered from COVID-19. Scant information is available on the prevalence, characteristics, and risk factors for long-COVID among people living with HIV (PLHIV).
Setting:
A tertiary level, private, HIV clinic in western India.
Methods:
A prospective, observational study was conducted to assess the prevalence of long-COVID among PLHIV. Long-COVID was defined as the presence of at least one symptom after 30 days of illness onset. A questionnaire for assessing general, cardiorespiratory, neuro-psychiatric, and gastro-intestinal symptoms was used to screen individuals with history of confirmed COVID-19. Data on demographics, HIV-related variables, comorbidities, and severity of COVID-19 were abstracted from electronic medical records. Univariate and multivariate logistic regression were used to identify risk factors for long-COVID.
Results:
Ninety-four PLHIV were screened for long-COVID. Median (interquartile range [IQR]) age was 51 (47-56) years and 73.4% were males. The majority (76.6%) had a history of asymptomatic-mild COVID-19 illness. The prevalence of long-COVID was 43.6% (95% confidence interval [CI], 33.4-54.2). Moderate-severe COVID-19 illness was significantly associated with long-COVID (adjusted odds ratio, 4.7; 95% CI, 1.4-17.9; p = .016). Among individuals with long-COVID, cough (22.3%) and fatigue (19.1%) were the commonest symptoms. The median (IQR) duration for resolution of symptoms was 15 (7-30) days. Ten individuals (10.6%) had persistent symptoms at a median of 109 days since the onset of COVID-19.
Conclusion:
Long-COVID is common among PLHIV with moderate-severe acute COVID-19 illness. There is a need for integration of long-COVID diagnosis and care services within antiretroviral therapy clinics for PLHIV with COVID-19.
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