COVID-19 epidemiology and performance of the WHO clinical algorithm to diagnose COVID-19 in people with HIV from Ukraine.

IF 1.4 4区 医学 Q4 IMMUNOLOGY International Journal of STD & AIDS Pub Date : 2024-06-01 Epub Date: 2024-02-06 DOI:10.1177/09564624241231016
Marta Vasylyev, Vira Buhiichyk, Nadiia Buhiichyck, Albert Groenendijk, Iryna Ben, Lesya Ostapiuk, Maryana Sluzhynska, Wouter F W Bierman, Jeroen J A van Kampen, Ferdinand W N M Wit, Peter Reiss, Bart J A Rijnders, Oleksandra Sluzhynska, Casper Rokx
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Abstract

Background: The two main objectives were to evaluate the COVID-19 point prevalence and the test performance of the WHO case definition to diagnose COVID-19 clinically in people with HIV in West Ukraine.

Methods: Multicenter cross-sectional study in Lviv, Ukraine, from October 2020-November 2021. COVID-19 unvaccinated people with HIV were included regardless of COVID-19 symptoms at routine clinical visits and had standardized medical, quality of life (EQ(5D)) and SARS-CoV-2 serology assessments. Reported symptoms indicating potential COVID-19 events at inclusion or between March 2020 and inclusion were classified by the WHO case definition as suspected, probable or confirmed. A clinical COVID-19 case was defined as being SARS-CoV-2 seropositive with at least a suspected COVID-19 according to the WHO case definition. The primary endpoints were the clinical COVID-19 prevalence and the test characteristics of the WHO case definition with SARS-CoV-2 serology as reference. (Clinicaltrials.gov:NCT04711954).

Results: The 971 included people with HIV were median 40 years, 38.8% women, 44.8% had prior AIDS, and 55.6% had comorbidities. SARS-CoV-2 seroprevalence was 40.1% (95%CI:37.0-43.1) and 20.5% (95%CI:18.0-23.1) had clinical COVID-19 median 4 months (IQR:2-7) before inclusion. Clinical COVID-19 occurred less frequently in people with HIV with tuberculosis history, injecting drug use, CD4+ T-cells <200/mL and unemployment. The quality of life was not impacted after COVID-19. An at least probable COVID-19 classification by the WHO case definition had 44.1% sensitivity (95%CI:38.7-49.7), 85.2% specificity (95%CI:81.5-88.4), 66.6% positive predictive value (95%CI:59.8-73.0) and 69.5% negative predictive value (95%CI:65.5-73.3) to diagnose COVID-19.

Conclusions: COVID-19 unvaccinated people with HIV from Ukraine had a significant COVID-19 rate and using the WHO case definition had insufficient diagnostic accuracy to diagnose these cases. The lower burden in vulnerable people with HIV was unexpected but might reflect a shielding effect.

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COVID-19 流行病学和世界卫生组织诊断乌克兰艾滋病毒感染者 COVID-19 的临床算法的性能。
背景:研究的两个主要目的是评估 COVID-19 的点流行率和世界卫生组织病例定义在乌克兰西部艾滋病毒感染者中的临床诊断能力:两个主要目标是评估 COVID-19 的点流行率和世界卫生组织病例定义的测试性能,以便在西乌克兰的艾滋病毒感染者中临床诊断 COVID-19:2020年10月至2021年11月在乌克兰利沃夫进行多中心横断面研究。未接种 COVID-19 疫苗的艾滋病病毒感染者无论在常规临床就诊时是否出现 COVID-19 症状,均被纳入研究范围,并接受标准化医疗、生活质量(EQ(5D))和 SARS-CoV-2 血清学评估。根据世界卫生组织的病例定义,在纳入时或 2020 年 3 月至纳入期间报告的表明可能发生 COVID-19 事件的症状被分为疑似、可能或确诊病例。根据世界卫生组织的病例定义,COVID-19临床病例是指SARS-CoV-2血清学阳性且至少有疑似COVID-19病例。主要终点是临床 COVID-19 感染率和以 SARS-CoV-2 血清学为参照的世界卫生组织病例定义的检测特征。(Clinicaltrials.gov:NCT04711954):971名艾滋病病毒感染者的年龄中位数为40岁,38.8%为女性,44.8%曾患艾滋病,55.6%有合并症。SARS-CoV-2血清阳性率为40.1%(95%CI:37.0-43.1),20.5%(95%CI:18.0-23.1)在纳入前4个月(IQR:2-7)出现临床COVID-19。临床 COVID-19 在有结核病史、使用注射毒品、CD4+ T 细胞的 HIV 感染者中发生率较低:来自乌克兰的未接种 COVID-19 疫苗的艾滋病病毒感染者的 COVID-19 感染率很高,而使用世界卫生组织的病例定义诊断这些病例的准确性不足。感染艾滋病毒的易感人群的感染率较低是意料之外的,但可能反映了一种屏蔽效应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.60
自引率
7.10%
发文量
144
审稿时长
3-6 weeks
期刊介绍: The International Journal of STD & AIDS provides a clinically oriented forum for investigating and treating sexually transmissible infections, HIV and AIDS. Publishing original research and practical papers, the journal contains in-depth review articles, short papers, case reports, audit reports, CPD papers and a lively correspondence column. This journal is a member of the Committee on Publication Ethics (COPE).
期刊最新文献
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