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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

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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146246/
https://www.ncbi.nlm.nih.gov/pubmed/35632714
http://dx.doi.org/10.3390/v14050972
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author 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
author_facet 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
author_sort Kowalska, Justyna D.
collection PubMed
description 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.
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spelling pubmed-91462462022-05-29 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 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 Viruses Article 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. MDPI 2022-05-05 /pmc/articles/PMC9146246/ /pubmed/35632714 http://dx.doi.org/10.3390/v14050972 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
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
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146246/
https://www.ncbi.nlm.nih.gov/pubmed/35632714
http://dx.doi.org/10.3390/v14050972
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