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Impact of COVID-19 on the Care of Patients with HIV Infection
Marta Rosas Cancio-Suárez1,2, Cecilia Alonso1, María Jesús Vivancos1,2
1Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Carretera de Colmenar Km 9.1, 28034 Madrid, Spain.
Insights
The COVID-19 pandemic did not significantly impact HIV care retention, treatment adherence, or viral suppression for people living with HIV (PLWH). Hospitalization and mortality rates remained stable, demonstrating resilience in HIV service delivery.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- COVID-19 pandemic lockdowns disrupted healthcare services, including HIV screening and management.
- People living with HIV (PLWH) require continuous care and treatment adherence for viral suppression.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on the care of PLWH.
- To compare HIV clinic outcomes during pre-pandemic, pandemic, and post-pandemic periods.
Main Methods:
- Retrospective cohort study of 3265 patients.
- Comparison of outpatient follow-up, new patient numbers, treatment adherence, hospitalizations, and deaths across three periods: pre-pandemic (2019), pandemic (March 2020-Feb 2021), and post-pandemic (March-Sept 2021).
Main Results:
- A significant decrease in new patients and viral load tests during the pandemic period (p < 0.01).
- Constant numbers of drug refills, patients with undetectable viral loads (85%-93%), and hospital admissions across all periods.
- No significant increase in all-cause mortality.
Conclusions:
- Despite disruptions, HIV care retention, treatment adherence, and viral suppression remained stable.
- The pandemic did not significantly affect hospitalization rates or mortality among PLWH.
- HIV services demonstrated resilience during the COVID-19 pandemic.
Abstract:
The COVID-19 pandemic and associated lockdown measures have been associated with substantial disruptions to health care services, including screening for human immunodeficiency virus (HIV) and management of people living with HIV (PLWH). Data from 3265 patients were examined in a retrospective cohort study. We compared outpatient follow-up for PLWH, the number of new patients, treatment adherence, hospitalizations, and deaths during the "pandemic period" (March 2020 to February 2021), the "pre-pandemic period" (the equivalent time frame in 2019), and the "post-pandemic period" (March to September 2021). During the pandemic period, the number of new patients seen at the HIV clinic (116) as well as the requested viral load tests (2414) decreased significantly compared to the pre-pandemic (204 and 2831, respectively) and post-pandemic periods (146 and 2640, respectively) (p < 0.01 for all the comparisons). However, across the three study periods, the number of drug refills (1385, 1330, and 1411, respectively), the number of patients with undetectable viral loads (85%, 90%, and 93%, respectively), and the number of hospital admissions among PLWH remained constant. Despite the COVID-19 pandemic's impact, our findings show stability in the retention of clinical care, adherence to treatment, and viral suppression of PLWH, with no significant impact on hospitalization rates or all-cause mortality.
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