ABSTRACT
Background: At the start of the UK national lockdown in March 2020, many of the most vulnerable patients with HIV were encouraged to shield, and HIV outpatient services were forced to remodel. We aimed to look at: first, how emergency admissions for patients with HIV had changed in 2020 in comparison with previous years and during/after lockdown;second, to examine whether any fall in admissions related to vulnerability factors (new diagnoses, CD4<350, other HIV-related presentations). Finally, to see if the spectrum of presentations had changed. Method: Retrospective analysis of databases covering HIV admissions for two hospital sites in our urban trust was performed for matched time period (March -August) for 2017-2020. Elective and maternity admissions were excluded, as well as patients who did not have a recorded CD4 count either during the relevant admission or in the 18 months prior. Results: Admissions fell for the period of March to August 2020 compared with previous years (see table). There were 7 covid admissions. A spike in admissions was seen in June, but admissions fell again in July and August. Patients with low CD4 counts (<350) accounted for a similar proportion of total admissions in 2020 (47.8%) compared with previous years (47.0%). Although admissions directly related to HIV fell slightly in 2020 (11, compared with an average of 16), they came to represent a slightly higher proportion of admissions (16.4%) compared with previous years (average 13.8%). This was one of only two admission categories which proportionately increased in 2020. Conclusion: The fall in admissions during lockdown was to be expected. However, although numbers rebounded in June, this did not continue in July and August. There are numerous potential explanations for this. The reduction in emergency admissions for patients with a low CD4 count is of particular concern;the impact of this on morbidity or mortality remains to be seen. (Table Presented).