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Changes in Care and Outcome for Children and Adolescents Living With HIV/AIDS During the COVID19 Pandemic in
Tobias Hante1, Emilia Salzmann-Manrique1, Marla Braun1
1Goethe University Frankfurt, University Hospital Frankfurt, Department of Pediatrics and Adolescent Medicine Frankfurt Germany.
Insights
The COVID-19 pandemic negatively impacted medical visits and virological control in German children and adolescents with HIV/AIDS. This highlights the need for adaptive healthcare strategies during health crises.
Area of Science:
- Pediatric Infectious Diseases
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic significantly disrupted global healthcare systems and daily life.
- Children and adolescents living with HIV/AIDS require consistent medical monitoring and care.
- Understanding the pandemic's specific impact on this vulnerable population is crucial for maintaining health outcomes.
Purpose of the Study:
- To investigate the effect of the COVID-19 pandemic on medical visits and health outcomes in pediatric and adolescent HIV/AIDS patients in Germany.
- To compare healthcare utilization and clinical parameters before and during the pandemic.
- To identify factors influencing changes in medical care and outcomes.
Main Methods:
- Analysis of medical visit data and clinical outcomes (viral load, immunological parameters) over 30 months.
- Comparison of data from a period before the pandemic with a period during the pandemic.
- Inclusion of 52 participants from the German Pediatric and Adolescent HIV cohort on antiretroviral therapy.
Main Results:
- Fifty percent of participants experienced fewer medical visits during the pandemic, with a significant decline observed in male patients.
- Viral load control remained stable for half the participants, but borderline viral load measurements increased significantly during the pandemic.
- Age was negatively associated with the number of medical visits, indicating older adolescents had fewer visits.
Conclusions:
- The COVID-19 pandemic had a negative impact on the outcomes of children and adolescents with HIV/AIDS in Germany.
- The findings suggest a fragile nature of virological control in this population during health crises.
- Implementation of adaptive measures, such as virtual consultations, is recommended to mitigate future impacts.
Background And Aims:
The COVID-19 pandemic impacted daily life and healthcare. This study investigated how this affected the outcome in children and adolescents living with HIV/AIDS.
Methods:
This study investigated medical visits and outcomes (viral load, immunological parameters) in participants in the German Pediatric and Adolescent HIV cohort for 30 months, covering a period before and during the COVID-19 pandemic.
Results:
Fifty-two participants receiving antiretroviral therapy (27 females, 25 males; median age: 18 years, IQR: 15.0, 22.0) were analysed. Fifty percent of patients had fewer medical visits, 21% had an unchanged number of visits, and 29% had more medical visits when comparing the pandemic period with the prior period. (p = 0.016). This decline is primarily attributed to the first phase of the pandemic, where the incidence ratio of medical controls was 0.66 (95% CI 0.42-0.97) compared to the previous period (p = 0.05).In male patients, there was a significant reduction in medical visits which was not seen in females. Among male patients, 60% experienced a decrease in control visits, while 20% remained unchanged (p = 0.015). Age of the patients was significantly negatively associated with number of visits (rho = -0.39; 95% CI [-0.63 to -0.15]; p = 0.004) before and during the pandemic (rho = -0.37; 95% CI [-0.58 to -0.12]; p = 0.007).Half of the participants did not present with positive viral loads (≥ 20 cps/mL) in any of the two periods. Borderline cases of viral load measurements increased during the pandemic from 38% to 62% cases (p = 0.03), with the largest difference during the first wave.
Conclusion:
Overall, the study shows a negative impact during the COVID-19 pandemic on the outcome in children and adolescents living with HIV in Germany and indicates the fragile nature of virological control in this population. Appropriate measures including virtual consultations should be implemented to improve outcome in future pandemic situations.
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