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Comorbidity indices in people with HIV and considerations for coronavirus disease 2019 outcomes.

ABSTRACT: OBJECTIVE:To determine comorbidity indices in people with HIV (PWH) and lifestyle-similar HIV-negative controls. DESIGN:Cross-sectional analysis of the Pharmacokinetic and clinical Observations in PeoPle over fiftY cohort study in the United Kingdom and Ireland. METHODS:The Elixhauser Comorbidity Index (ECI), Charlson Comorbidity Index and the Comorbidity Burden Index were compared between older PWH and HIV-negative controls using the Mann-Whitney U test; the magnitude of the difference between groups was quantified using the r effect size. RESULTS:The 699 PWH and 304 HIV-negative controls were predominantly male (87.5% vs. 64.0%), white (86.3% vs. 90.0%) and had median ages of 57 and 58 years, respectively. Among PWH, the median (interquartile range) CD4 T-cell count was 624 (475, 811) cells/?l; 98.7% were on antiretroviral therapy. The median (interquartile range) ECI was 0 (0, 8) and 0 (-3, 1), Charlson Comorbidity Index was 2 (1, 5) and 1 (0, 1) and Comorbidity Burden Index 8.6 (2.2, 16.8) and 5.9 (0.6, 10.8), respectively. While all three indices were significantly higher in PWH than in controls (P?

SUBMITTER: Winston A

PROVIDER: S-EPMC7493769 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Comorbidity indices in people with HIV and considerations for coronavirus disease 2019 outcomes.

Winston Alan A De Francesco Davide D Post Frank F Boffito Marta M Vera Jaime J Williams Ian I Anderson Jane J Mallon Patrick W G PWG Sabin Caroline A CA

AIDS (London, England) 20201001 12

<h4>Objective</h4>To determine comorbidity indices in people with HIV (PWH) and lifestyle-similar HIV-negative controls.<h4>Design</h4>Cross-sectional analysis of the Pharmacokinetic and clinical Observations in PeoPle over fiftY cohort study in the United Kingdom and Ireland.<h4>Methods</h4>The Elixhauser Comorbidity Index (ECI), Charlson Comorbidity Index and the Comorbidity Burden Index were compared between older PWH and HIV-negative controls using the Mann-Whitney U test; the magnitude of t ...[more]

PMID: 32732634

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Project description:ObjectivesThere are over 4,000 trials conducted in people with coronavirus disease 2019. However, the variability of outcomes and the omission of patient-centered outcomes may diminish the impact of these trials on decision-making. The aim of this study was to generate a consensus-based, prioritized list of outcomes for coronavirus disease 2019 trials.DesignIn an online survey conducted in English, Chinese, Italian, Portuguese, and Spanish languages, adults with coronavirus disease 2019, their family members, health professionals, and the general public rated the importance of outcomes using a 9-point Likert scale (7-9, critical importance) and completed a Best-Worst Scale to estimate relative importance. Participant comments were analyzed thematically.SettingInternational.SubjectsAdults 18 years old and over with confirmed or suspected coronavirus disease 2019, their family members, members of the general public, and health professionals (including clinicians, policy makers, regulators, funders, and researchers).InterventionsNone.MeasurementsNone.Main resultsIn total, 9,289 participants from 111 countries (776 people with coronavirus disease 2019 or family members, 4,882 health professionals, and 3,631 members of the public) completed the survey. The four outcomes of highest priority for all three groups were: mortality, respiratory failure, pneumonia, and organ failure. Lung function, lung scarring, sepsis, shortness of breath, and oxygen level in the blood were common to the top 10 outcomes across all three groups (mean > 7.5, median ≥ 8, and > 70% of respondents rated the outcome as critically important). Patients/family members rated fatigue, anxiety, chest pain, muscle pain, gastrointestinal problems, and cardiovascular disease higher than health professionals. Four themes underpinned prioritization: fear of life-threatening, debilitating, and permanent consequences; addressing knowledge gaps; enabling preparedness and planning; and tolerable or infrequent outcomes.ConclusionsLife-threatening respiratory and other organ outcomes were consistently highly prioritized by all stakeholder groups. Patients/family members gave higher priority to many patient-reported outcomes compared with health professionals.

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Comorbidity indices in people with HIV and considerations for coronavirus disease 2019 outcomes.

Publications

Comorbidity indices in people with HIV and considerations for coronavirus disease 2019 outcomes.

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