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Resilience and Frailty in People Living With HIV During the COVID Era: Two Complementary Constructs Associated With Health-Related Quality of Life.
Guaraldi, Giovanni; Milic, Jovana; Barbieri, Sara; Marchiò, Tommaso; Caselgrandi, Agnese; Volpi, Sara; Aprile, Emanuele; Belli, Michela; Venuta, Maria; Mussini, Cristina.
  • Guaraldi G; Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy.
  • Milic J; Modena HIV Metabolic Clinic (MHMC), University of Modena and Reggio Emilia, Modena, Italy.
  • Barbieri S; Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy; and.
  • Marchiò T; Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy.
  • Caselgrandi A; Modena HIV Metabolic Clinic (MHMC), University of Modena and Reggio Emilia, Modena, Italy.
  • Volpi S; Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy.
  • Aprile E; University of Modena and Reggio Emilia, Modena, Italy.
  • Belli M; University of Modena and Reggio Emilia, Modena, Italy.
  • Venuta M; Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy; and.
  • Mussini C; Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy; and.
J Acquir Immune Defic Syndr ; 89(Suppl 1): S65-S72, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1722746
ABSTRACT

BACKGROUND:

Resilience is defined as an individual's positive adaptation to stressors. The COVID-19 pandemic represents a generalized stressor which may affect differently people living with HIV (PLWH). The objective of this study was to characterize resilience in PLWH with particular regarding the identification of frailty-resilience phenotypes, which may differently affect health-related quality of life (HR-QoL).

METHODS:

This was an observational study of PLWH attending Modena HIV Metabolic Clinic. Frailty was assessed in 2019, before the onset of the COVID-19 pandemic by using 37-Item frailty index ranging from 0 to 1. The frailty index score was categorized as fit (<0.25) or frail (>0.25). In January 2021, PLWH were offered to complete a set of electronic questionnaires including the CD-RISC-25 for resilience and EQ-5D5L and SF-36 for HR-QoL. Resilience was defined as CD-RISC-25 score >75.7 (ranging from 0 to 100).

RESULTS:

Of 800 PLWH reached by mail, 575 (72%) completed the questionnaires. The median age and HIV duration were 54.5 and 24.3 years, respectively. Impaired resilience was associated with loneliness [odds ratio (OR = 2.39; 1.20 to 4.76, P < 0.001)]. Predictors for EQ-5D5L <89.7% were the phenotypes "frail/nonresilient" [OR = 5.21, 95% confidence interval (CI) 2.62 to 10.33] and "fit/nonresilient" (OR = 5.48, 95% CI 2.8 to 10.74). Predictors for SF-36 <64.40 were the phenotypes "frail/nonresilient" (OR = 7.43, 95% CI 2.57 to 21.22) and "fit/nonresilient" (OR = 6.27, 95% CI 2.17 to 18.16). Both models were corrected for age, sex, HIV duration, and nadir CD4.

CONCLUSIONS:

Resilience characterizes the well-being of PLWH during the COVID-19 crisis. This construct is complementary to frailty in the identification of clinical phenotypes with different impacts on HR-QoL.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Quality of Life / Aging / HIV Infections / Frail Elderly / Resilience, Psychological / Frailty / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Male Language: English Journal: J Acquir Immune Defic Syndr Journal subject: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Year: 2022 Document Type: Article Affiliation country: QAI.0000000000002865

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Quality of Life / Aging / HIV Infections / Frail Elderly / Resilience, Psychological / Frailty / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Male Language: English Journal: J Acquir Immune Defic Syndr Journal subject: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Year: 2022 Document Type: Article Affiliation country: QAI.0000000000002865