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The Effect of COVID-19 Restrictions on General and HIV Positive Inpatient Admissions and Treatment Outcomes: An

Andrew Kazibwe1,2, Bonniface Oryokot3,4, Andrew Peter Kyazze5

  • 1College of Health Sciences, School of Medicine, Department of Medicine, Makerere University, P. O. Box 7072, Kampala, Uganda. kazibweandy@gmail.com.

AIDS and Behavior
|May 25, 2023
PubMed

Insights

COVID-19 pandemic measures reduced hospital admissions and worsened patient outcomes, particularly for those with HIV. Healthcare systems must ensure continuity of care during epidemics to protect vulnerable populations.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • The COVID-19 pandemic led to measures that disrupted healthcare services.
  • Access to essential services for endemic infectious diseases, such as HIV, was curtailed.
  • Tertiary hospitals in low-resource settings faced significant challenges in maintaining routine care.

Purpose of the Study:

  • To compare inpatient outcomes before and during the COVID-19 pandemic.
  • To assess the impact of COVID-19 containment measures on general and HIV-positive (HIV+) inpatients.
  • To identify disparities in healthcare outcomes during the pandemic.

Main Methods:

  • Uncontrolled before-and-after study design.
  • Analysis of electronic medical records from a tertiary hospital in Uganda.
  • Comparison of patient admissions, length of stay, survival rates, and mortality incidence between pre- and peri-COVID-19 periods using statistical tests (Mann-Whitney U, Kaplan-Meier).

Main Results:

  • Total inpatient admissions decreased significantly in the peri-COVID-19 period compared to the pre-COVID-19 period (2192 vs. 5314).
  • Overall mortality rate increased from 17.6% to 41.8% (p < 0.01) during the pandemic.
  • Median length of hospital stay increased (6 vs. 4 days), and median survival decreased (11 vs. 20 days) in the peri-COVID-19 period.
  • The adjusted hazard ratio for death was 2.08 (p < 0.01) in the peri-COVID-19 period, with more pronounced negative effects observed in HIV+ patients.

Conclusions:

  • The COVID-19 pandemic period was associated with reduced inpatient admissions and poorer treatment outcomes for both general and HIV+ patients.
  • Disruptions to healthcare services disproportionately affected vulnerable populations, including those with HIV.
  • Future epidemic response strategies must prioritize minimizing disruptions to essential inpatient care, especially for individuals with chronic infectious diseases.

Keywords:
AfricaCOVID19HIV Care continuumHIV epidemiologyHealth systemsTreatment

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