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The Presence of Either Typical or Atypical Radiological Changes Predicts Poor COVID-19 Outcomes in HIV-Positive Patients from a Multinational Observational Study: Data from Euroguidelines in Central and Eastern Europe Network Group
JD. Kowalska, C. Bieńkowski, L. Fleischhans, S. Antoniak, A. Skrzat-Klapaczyńska, M. Suchacz, N. Bogdanic, D. Gokengin, C. Oprea, I. Karpov, K. Kase, R. Matulionyte, A. Papadopoulos, N. Rukhadze, A. Harxhi, D. Jilich, B. Lakatos, D. Sedlacek, G....
Language English Country Switzerland
Document type Journal Article, Observational Study
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PubMed
35632714
DOI
10.3390/v14050972
Knihovny.cz E-resources
- MeSH
- COVID-19 * epidemiology MeSH
- HIV Infections * complications drug therapy epidemiology MeSH
- Humans MeSH
- CD4 Lymphocyte Count MeSH
- SARS-CoV-2 MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Geographicals
- Europe, Eastern MeSH
HIV-positive patients may present lungs with multiple infections, which may hinder differential diagnoses and the choice of treatment in the course of COVID-19, especially in countries with limited access to high-standard healthcare. Here, we aim to investigate the association between radiological changes and poor COVID-19 outcomes among HIV-positive patients from Central and Eastern Europe. Between November 2020 and May 2021, the Euroguidelines in Central and Eastern Europe Network Group started collecting observational data on HIV and COVID-19 co-infections. In total, 16 countries from Central and Eastern European submitted data (eCRF) on 557 HIV-positive patients. The current analyses included patients who had a radiological examination performed. Logistic regression models were used to identify the factors associated with death, ICU admission, and partial recovery (poor COVID-19 outcomes). Factors that were significant in the univariate models (p < 0.1) were included in the multivariate model. Radiological data were available for 224 (40.2%) patients, 108 (48.2%) had computed tomography, and 116 (51.8%) had a chest X-ray. Of these, 211 (94.2%) were diagnosed using RT-PCR tests, 212 (94.6%) were symptomatic, 123 (55.6%) were hospitalized, 37 (16.6%) required oxygen therapy, and 28 (13.1%) either died, were admitted to ICU, or only partially recovered. From the radiologist's description, 138 (61.6%) patients had typical radiological changes, 18 (8.0%) atypical changes, and 68 (30.4%) no changes. In the univariate models, CD4 count (OR = 0.86 [95% CI: 0.76-0.98]), having a comorbidity (2.33 [1.43-3.80]), HCV and/or HBV co-infection (3.17 [1.32-7.60]), being currently employed (0.31 [0.13-0.70]), being on antiretroviral therapy (0.22 [0.08-0.63]), and having typical (3.90 [1.12-13.65]) or atypical (10.8 [2.23-52.5]) radiological changes were all significantly associated with poor COVID-19 outcomes. In the multivariate model, being on antiretroviral therapy (OR = 0.20 [95% CI:0.05-0.80]) decreased the odds of poor COVID-19 outcomes, while having a comorbidity (2.12 [1.20-3.72]) or either typical (4.23 [1.05-17.0]) or atypical (6.39 [1.03-39.7]) radiological changes (vs. no changes) increased the odds of poor COVID-19 outcomes. Among HIV patients diagnosed with symptomatic SARS-CoV-2 infection, the presence of either typical or atypical radiological COVID-19 changes independently predicted poorer outcomes.
Astar Medical Center 79041 Lviv Ukraine
Department of Pharmacology Clinical Pharmacology and Toxicology School of Medicine
Faculty of Medicine in Plzeň University Hospital Plzeň Charles University 30599 Plzen Czech Republic
Infectious Diseases AIDS and Clinical Immunology Center 16 Al Kazbegi Ave 0102 Tblisi Georgia
University of Belgrade Dr Subotica 1 3 24101 Belgrade Serbia
West Tallinn Central Hospital Paldiski Road 62 10149 Tallin Estonia
References provided by Crossref.org
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