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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| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/14/5/972 |
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| author | Justyna D. Kowalska Carlo Bieńkowski Lukáš Fleischhans Sergii Antoniak Agata Skrzat-Klapaczyńska Magdalena Suchacz Nikolina Bogdanic Deniz Gokengin Cristiana Oprea Igor Karpov Kerstin Kase Raimonda Matulionyte Antonios Papadopoulos Nino Rukhadze Arjan Harxhi David Jilich Botond Lakatos Dalibor Sedlacek Gordana Dragovic Marta Vasylyev Antonia Verhaz Nina Yancheva Josip Begovac Andrzej Horban |
| author_facet | Justyna D. Kowalska Carlo Bieńkowski Lukáš Fleischhans Sergii Antoniak Agata Skrzat-Klapaczyńska Magdalena Suchacz Nikolina Bogdanic Deniz Gokengin Cristiana Oprea Igor Karpov Kerstin Kase Raimonda Matulionyte Antonios Papadopoulos Nino Rukhadze Arjan Harxhi David Jilich Botond Lakatos Dalibor Sedlacek Gordana Dragovic Marta Vasylyev Antonia Verhaz Nina Yancheva Josip Begovac Andrzej Horban |
| author_sort | Justyna D. Kowalska |
| collection | DOAJ |
| 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 (<i>p</i> < 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. |
| first_indexed | 2024-03-10T01:37:58Z |
| format | Article |
| id | doaj.art-f1e926dccb0d43e7a87ced2c0a0c3dfd |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-10T01:37:58Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-f1e926dccb0d43e7a87ced2c0a0c3dfd2023-11-23T13:31:09ZengMDPI AGViruses1999-49152022-05-0114597210.3390/v14050972The 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 GroupJustyna D. Kowalska0Carlo Bieńkowski1Lukáš Fleischhans2Sergii Antoniak3Agata Skrzat-Klapaczyńska4Magdalena Suchacz5Nikolina Bogdanic6Deniz Gokengin7Cristiana Oprea8Igor Karpov9Kerstin Kase10Raimonda Matulionyte11Antonios Papadopoulos12Nino Rukhadze13Arjan Harxhi14David Jilich15Botond Lakatos16Dalibor Sedlacek17Gordana Dragovic18Marta Vasylyev19Antonia Verhaz20Nina Yancheva21Josip Begovac22Andrzej Horban23Department of Adults’ Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, PolandDepartment of Adults’ Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, PolandDepartment of Infectious Diseases, 1st Faculty of Medicine, Faculty Hospital Bulovka Hospital, Charles University in Prague, 18081 Prague, Czech RepublicViral Hepatitis and AIDS Department, Gromashevsky Institute of Epidemiology and Infectious Diseases, Amosova str. 5-a, 03038 Kyiv, UkraineDepartment of Adults’ Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, PolandDepartment of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, 01-201 Warsaw, PolandSchool of Medicine, University Hospital for Infectious Diseases, University of Zagreb, Miorogojska 8, 10000 Zagreb, CroatiaDepartment of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, 35100 Izmir, TurkeyVictor Babes Clinical Hospital for Infectious and Tropical Diseases, Carol Davila University of Medicine and Pharmacy, 030303 Bucharest, RomaniaDepartment of Infectious Diseases, Belarusian State Medical University, Dzerginskogo 83, 220116 Minsk, BelarusWest Tallinn Central Hospital, Paldiski Road 62, 10149 Tallin, EstoniaFaculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, 08410 Vilnius, LithuaniaMedical School, University General Hospital Attikon, National and Kapodistrian University of Athens, 12462 Athens, GreeceInfectious Diseases, AIDS and Clinical Immunology Center, 16. Al Kazbegi Ave, 0102 Tblisi, GeorgiaInfectious Disease Service, University Hospital Center of Tirana, Rr. Didres, Nr 372, 33979 Tirana, AlbaniaDepartment of Infectious Diseases, 1st Faculty of Medicine, Faculty Hospital Bulovka Hospital, Charles University in Prague, 18081 Prague, Czech RepublicNational Institute of Hematology and Infectious Diseases, South-Pest Central Hospital, National Center of HIV, 1097 Budapest, HungaryFaculty of Medicine in Plzeň, University Hospital Plzeň, Charles University, 30599 Plzen, Czech RepublicDepartment of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine; University of Belgrade, Dr Subotica 1/III, 24101 Belgrade, SerbiaAstar Medical Center, 79041 Lviv, UkraineDepartment for Infectious Diseases, Faculty of Medicine, University of Banja Luka, Republika Srpska, 78000 Banja Luka, Bosnia and HerzegovinaDepartment for AIDS, Specialized Hospital for Active Treatment of Infectious and Parasitic Disease Sofia, Medical University of Sofia, 1233 Sofia, BulgariaSchool of Medicine, University Hospital for Infectious Diseases, University of Zagreb, Miorogojska 8, 10000 Zagreb, CroatiaDepartment of Adults’ Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, PolandHIV-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 (<i>p</i> < 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.https://www.mdpi.com/1999-4915/14/5/972HIVCOVID-19ECEEpneumoniaARDSSARS-CoV-2 |
| spellingShingle | Justyna D. Kowalska Carlo Bieńkowski Lukáš Fleischhans Sergii Antoniak Agata Skrzat-Klapaczyńska Magdalena Suchacz Nikolina Bogdanic Deniz Gokengin Cristiana Oprea Igor Karpov Kerstin Kase Raimonda Matulionyte Antonios Papadopoulos Nino Rukhadze Arjan Harxhi David Jilich Botond Lakatos Dalibor Sedlacek Gordana Dragovic Marta Vasylyev Antonia Verhaz Nina Yancheva Josip Begovac Andrzej Horban 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 Viruses HIV COVID-19 ECEE pneumonia ARDS SARS-CoV-2 |
| 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 | HIV COVID-19 ECEE pneumonia ARDS SARS-CoV-2 |
| url | https://www.mdpi.com/1999-4915/14/5/972 |
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