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

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

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 c...

Full description

Saved in:
Bibliographic Details
Published in:Viruses Vol. 14; no. 5; p. 972
Main Authors: Kowalska, Justyna D, Bieńkowski, Carlo, Fleischhans, Lukáš, Antoniak, Sergii, Skrzat-Klapaczyńska, Agata, Suchacz, Magdalena, Bogdanic, Nikolina, Gokengin, Deniz, Oprea, Cristiana, Karpov, Igor, Kase, Kerstin, Matulionyte, Raimonda, Papadopoulos, Antonios, Rukhadze, Nino, Harxhi, Arjan, Jilich, David, Lakatos, Botond, Sedlacek, Dalibor, Dragovic, Gordana, Vasylyev, Marta, Verhaz, Antonia, Yancheva, Nina, Begovac, Josip, Horban, Andrzej
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 05-05-2022
MDPI
Subjects:
Antiretroviral therapy
ARDS
CD4 antigen
CD4 Lymphocyte Count
Comorbidity
Computed tomography
Coronaviruses
COVID-19
COVID-19 - epidemiology
Diabetes
Disease
Drug therapy
ECEE
Europe, Eastern
HIV
HIV Infections - complications
HIV Infections - drug therapy
HIV Infections - epidemiology
Hospitalization
Human immunodeficiency virus
Humans
Infections
Intensive care
Lungs
Observational studies
Oxygen therapy
Patients
pneumonia
Regression analysis
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Tomography
Europe, Eastern
Eastern Europe
COVID-19
SARS-CoV-2
HIV
pneumonia
ARDS
ECEE
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:1999-4915
1999-4915
DOI:10.3390/v14050972