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EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-311782


Background: Mental health symptoms in Emergency Department healthcare workers were measured in Brooklyn, New York, a COVID-19 epicenter.Methods: An email-distributed survey of Emergency Department healthcare workers was conducted September–December, 2020. Primary outcomes included symptoms of depression, psychological distress, perceived stress, and post-traumatic stress disorder (PTSD). Primary predictors included gender, age, race, healthcare worker status, SARS-CoV-2 testing, number of people to talk to, COVID-19-related home problems, mental health care interruption during COVID-19, loneliness, and survey date. Multivariable-adjusted linear regression analyses predicted continuous scores (b-coefficient, p-value). Multivariable-adjusted logistic regression analyses modelled likelihoods of clinically-relevant symptom burdens (Odds Ratio (OR) 95%Confidence Interval (95%CI)).Findings: Of 774 healthcare workers, 247 (31.9%) responded (mean age, 38.2±10.8 years;59.4% White;52.5% men;80.1% clinical;61.6% SARS-CoV-2 tested). Clinically-relevant symptom burdens were observed for psychological distress (35.8% clinical vs 13.8% non-clinical healthcare workers (p=0.019);and suggested for depression (53.9% clinical vs 35.7% non-clinical, p=0.072);perceived stress (63.6% clinical vs 44.8% non-clinical, p=0.053);and PTSD (18.2% clinical vs 3.6% non-clinical, p=0.064). Higher odds of clinically-relevant depression, perceived stress, and PTSD symptoms were observed for clinical vs non-clinical healthcare workers (ORs>1.0, 95%CI>1.00 lower limit). Increasing age, number of COVID-19-related home problems and people to talk to, loneliness and mental health care interruption were adversely associated with mental health (p<0.05);being male and SARS-CoV-2 testing were beneficial.Interpretation: COVID-19-related mental health burden was amplified among Emergency Department healthcare workers in Brooklyn.Funding: Maimonides Research Foundation;the NIH/National Heart, Lung and Blood Institute/National Institute on Aging, 3U01 HL146202 02S2.Declaration of Interest: None to declare. Ethical Approval: This protocol was approved by the Maimonides Medical Center institutional review board, and deemed exempt because the survey was anonymous and did not contain personal identifiers.

J Acquir Immune Defic Syndr ; 89(1): 1-8, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1561815


BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) symptoms among people living with HIV (PLWH) are not well described. SETTING: Longitudinal survey within the MACS/WIHS Combined Cohort Study (MWCCS) of PLWH compared with similar HIV-seronegative (SN) individuals. METHODS: Telephone-administered survey of MWCCS participants at 13 clinical research sites across the United States addressing COVID-19 symptoms, SARS-CoV-2 testing, and pandemic impact on social distancing and antiretroviral therapy (ART) use. Primary data collection occurred during May (wave 1), June-July (wave 2), and August-September, 2020 (wave 3). RESULTS: One-third of MWCCS participants were tested for SARS-CoV-2 infection; 10% was tested ≥2 times. Similar proportions of PLWH and SN participants were tested, but SARS-CoV-2 positivity was higher among PLWH than among SN individuals (9.4% vs 4.8%, P = 0.003). Odds of SARS-CoV-2 positivity remained higher among PLWH after adjusting for age, sex, race/ethnicity, and study site (adjusted odds ratio = 2.0, 95% confidence interval = 1.2 to 3.2). SARS-CoV-2 positivity was not associated with CD4 cell counts among PLWH. Among SARS-CoV-2 positive participants, 9% had no symptoms, 7% had 1-2 mild symptoms, and 84% had ≥3 symptoms. Most of the (98%) participants reported physical distancing during all survey waves; self-reported ART adherence among PLWH was not adversely affected during the pandemic compared with the previous year (similar adherence in 89% of participants, improved in 9% of participants, and decreased in 2% of participants). CONCLUSIONS: Despite similar SARS-CoV-2 testing and physical distancing profiles by HIV serostatus among MWCCS participants, PLWH who reported SARS-CoV-2 testing were more likely to have a positive test result. Additional studies are needed to determine whether and why PLWH are at increased risk of SARS-CoV-2 infection.

COVID-19/diagnosis , Fever/etiology , HIV Infections/complications , Pharyngitis/etiology , SARS-CoV-2/isolation & purification , Aged , CD4 Lymphocyte Count , COVID-19/epidemiology , COVID-19 Testing , Cohort Studies , Cough , Female , HIV Infections/drug therapy , HIV Infections/epidemiology , Humans , Longitudinal Studies , Male , Middle Aged , Prevalence
HIV Res Clin Pract ; 21(5): 130-139, 2020 10.
Article in English | MEDLINE | ID: covidwho-933809


BACKGROUND: SARS-CoV-2 infection among People Living With HIV (PLWH) is not well-described. OBJECTIVE: To study COVID-19 symptoms and SARS-CoV-2 PCR-based swab testing among participants of the Multicenter AIDS Cohort Study (MACS) and Women's Interagency HIV Study (WIHS). METHODS: A telephone survey was collected April-June 30, 2020. Symptom and testing prevalence were explored. Multivariable logistic regression was used to examine the factors associated with SARS-CoV-2 positivity. RESULTS: The survey was completed by 3411 participants, including 2078 (61%) PLWH and 1333 HIV-seronegative (SN) participants from across the US. Thirteen percent (n = 441) were tested for SARS-CoV-2 infection (13.4% of PLWH vs 12.2% of SN). Among those tested, positivity was higher in PLWH than SN (11.2% vs 6.1%, p = 0.08). Reasons for not being tested included testing not being available (30% of participants) and not knowing where to get tested (16% of participants). Most symptoms reported since January 2020 were similar in PLWH and SN, including headache (23% vs. 24%), myalgias (19% vs 18%), shortness of breath (14% vs 13%), chills (12% vs 10%), fever (6% vs 6%) and loss of taste or smell (6% vs 7%). Among PLWH who tested positive for SARS-CoV-2 DNA, the most common symptoms were headache (71%), myalgia (68%), cough (68%) and chills (65%). In multivariable analysis among those tested, the odds of SARS-CoV-2 positivity were higher among PLWH than SN (aOR = 2.22 95%CI = 01.01-4.85, p = 0.046) and among those living with others versus living alone (aOR = 2.95 95%CI = 1.18-7.40). CONCLUSION: Prevalence and type of COVID-19 symptoms were similar in PLWH and SN. SARS-CoV-2 infection may be elevated among PLWH.

COVID-19/physiopathology , COVID-19/virology , HIV Infections/physiopathology , HIV Infections/virology , Acquired Immunodeficiency Syndrome/epidemiology , Adult , Aged , Aged, 80 and over , Ageusia/epidemiology , Ageusia/virology , Anosmia/epidemiology , Anosmia/virology , COVID-19/epidemiology , Chills/epidemiology , Chills/virology , Coinfection , Cough/epidemiology , Cough/virology , Dyspnea/epidemiology , Dyspnea/virology , Female , Fever/epidemiology , Fever/virology , HIV Infections/epidemiology , Headache/epidemiology , Humans , Middle Aged , Prevalence , SARS-CoV-2/isolation & purification , United States/epidemiology