Estado funcional, qualidade de vida e função pulmonar de pessoas vivendo com HIV com sequelas de COVID-19 após 2 anos de doença aguda

Abstract

Introduction: Individuals affected by COVID-19 may experience sequelae that limit their activities of daily living and general functional capacity. Co-infections involving COVID 19 may involve peculiar characteristics and deserve attention. One of the most relevant conditions, which has been impacting the world for decades with high rates of infection and morbidity and mortality, is HIV/AIDS infection, whose association between the degree of immunosuppression, virological and medication status and functional, respiratory and quality of life aspects still require in-depth investigations. Objectives: To evaluate the functional changes presented by individuals living or not with HIV, affected by COVID-19. Methods: Comparative cross-sectional study where adult individuals of both sexes were evaluated for functional and respiratory capacity. Individuals living or not with HIV and affected by Covid-19 were included. Results: Pulmonary function tests and the six-minute walk test (6MWT) were performed on 63 adult individuals: Covid HIV n=12; mild/moderate COVID-19 n=33; Severe COVID-19, n=18. The time between acute COVID-19 and functional assessments occurred on average 24±5 months from the first diagnosis of COVID-19. The Covid-HIV group included patients with at least 6 months of adherence to ART, with average CD4 levels of 768±240 cells/mm3, undetectable viral load (<40 cells/mL), no history or previous lung diseases and average time of HIV infection of 8±5 years. Male gender was predominant among the groups. The BMI was 25±3, 28±4 and 32±7 kg/m2 in Covid-HIV, Covid-Mild and Covid-Severe, respectively (p=0.003). The Covid-HIV group walked 545m (±93) in the 6MWT, which was similar to the Covid-Mild group (555m±63), but significantly greater than the Covid Severe group (435m±84) (p<0.0001) . The Covid-HIV group had worse forced expiratory volume in the first second (FEV1, 2.6±0.7 L/s) (p=0.038), forced vital capacity (FVC%, 83±11) (p=0.002) and FEV1/FVC (0.80). ±0.1, p=0.004) when compared to the Covid Severe group. Conclusion: People living with HIV/AIDS had worse lung function compared to individuals without HIV who had severe Covid and showed a similar response to the 6MWT of individuals who had moderate/mild Covid.