CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

non-specific COVID-19 related disorders (RR: 0.53, 95% CI: 0.51-0.56). In general, associations were slightly stronger at younger ages but persisted regardless of SARS-CoV-2 variant period, number of vaccine doses received, or time since vaccination. Conclusion: Pre-infection vaccination was associated with reduced risk of several PCC outcomes and hence may decrease the long-term consequences of COVID-19. Long COVID Between People With and Without HIV: A Statewide Cohort Analysis Xueying Yang , Ziang Liu, Jiajia Zhang, Bankole Olatosi, Sharon Weissman, Xiaoming Li University of South Carolina at Columbia, Columbia, SC, USA Background: Evidence on stratification of long COVID symptoms by immunocompromise status is lacking. People with HIV (PWH) have been documented to have an elevated risk of severe COVID-19 outcomes, yet the data on long COVID among PWH are limited. Using a large, statewide sampled dataset, this study aims to characterize and compare the risks of a panel of post acute sequelae of COVID-19 between PWH and non-PWH comparison group. Methods: Using an integrated statewide electronic health record data from HIV cohort and COVID-19 tester cohort, we were able to identify COVID-19 positive individuals by HIV status between March 02, 2020 and April 14, 2022 in South Carolina. Using the COVID-19 diagnosis date as the index date, a total of 132 individual long COVID sequelae were ascertained through ICD-10 codes until the end of the cohort. Risks of individual sequelae were compared between PWH and non-PWH groups. For each long COVID condition, we examined diagnnoses as outcomes separately and only excluded the specific diagnosis one year before the index date for models examining that same outcome in both PWH and non-PWH. We employed logistic regression models to estimate the odds ratio of the risks of individual sequelae between case and control groups, adjusting for socio-demographics and comorbidities. Results: Among a total of 1,351,489 COVID-19 positive individuals, 3,485 were PWH and 1,348,004 were PWoH. PWH were generally older than PWoH (47 vs 36 years old), had a higher proportion of male (64% vs 45%) and Black population (73% vs 26%). The prevalence of any long COVID condition was 58.68% and 33.80% for PWH and non-PWH, respectively. After adjusting covariates, PWH were associated with a higher risk of 118 individual long COVID sequelae in nearly every organ system, such as Circulatory Disease (Encephalis: adjusted odds ratio [aOR]:5.86, 95%CI: 2.37-14.48), Mental, Behavioral and Neurodevelopmental Disorders (Stimulant-related disorders: aOR:4.61, 95%CI: 3.31-6.43; Sedative-related disorders: aOR:3.20, 95%CI: 1.31-7.78; Miscellaneous Mental and Behavioral Disorders/conditions: aOR:3.03, 95%CI: 1.56-5.90), and Diseases of the Genitourinary System (Nephritis: aOR:3.98, 95%CI: 1.75-9.06). Conclusion: In this large observational study, PWH appears to have a higher risk of a variety of long COVID outcomes. These findings warrant further investigation in understanding how PWH leads to worse long COVID outcomes with more observational studies in persons with or without HIV. COVID-19 Vaccine Protection Against Long COVID: A Population-Based Cohort Study Xueying Yang , Ziang Liu, Jiajia Zhang, Bankole Olatosi, Sharon Weissman, Xiaoming Li University of South Carolina at Columbia, Columbia, SC, USA Background: Vaccination before SARS-CoV-2 infection might confer partial protection against the development of post-COVID conditions ("long COVID") compared to unvaccinated individuals. However, evidence is limited in this regard. This study aims to systematically investigate the association between different vaccination status on a series of long COVID conditions by organ system. Methods: We identified COVID-19 positive adults between March 17, 2021 and January 15, 2022 from the statewide COVID-19 tester cohort. Setting the date of first positive SARS-CoV-2 as the index time (T0), we selected the individuals who were alive at least 30 days after T0. A total of 132 individual long COVID conditions were ascertained through ICD-10 codes from day 30 after T0 until a maximum of 180 days of follow-up. Individuals were classified as: partially vaccinated if they receive one dose of Pfizer-BioNTech or Moderna vaccines; fully vaccinated if they received either two doses of Pfizer-BioNTech or Moderna vaccines or a single dose of Janssen; and boosted vaccination if they receive the booster dose before T0. We employed Cox regression models to estimate the

who initiated antiretroviral therapy (ART) during acute HIV (AHI) is unknown. We assessed pre-COVID-19 characteristics and compared immunologic and neuropsychiatric outcomes of participants with and without PASC in the RV254 AHI study in Thailand. Methods: Participants enrolled and initiated ART during AHI, with standardized longitudinal assessment of blood T cell counts and viral load (VL), cognition (Color Trails 1 & 2, Grooved Pegboard, Trail Making A), and mood (Hospital Anxiety & Depression Scale, Patient Health Questionnaire-9). By 7/2023, those ≥1 year after confirmed COVID were stratified as no PASC or PASC by persistence or occurrence of >1 PASC symptom (on a PASC symptom questionnaire) ≥3 months after acute COVID, lasting for >2 months. Demographic characteristics, COVID-19 course (time period/variant, number of infections, and hospitalization), and immunologic, cognitive, and mood parameters pre- and post-COVID-19 were compared in PASC vs no PASC using nonparametric methods. Results: 216 RV254 participants were assessed a median 15[IQR 13-17] months after acute COVID; 55(25%) had experienced PASC and 15(7%) had ongoing symptoms. Common symptoms were fatigue (55%), exercise intolerance (25%), sleep disturbance (15%), cough (13%), and memory impairment (13%). PASC vs no PASC had similar pre-COVID parameters including median age 30 vs 31 years; 95% vs 98% male; CD4+ count 706 vs 701 cells/ul; pre-COVID VL >50 cps/ml 0% vs 1%; duration from AHI to acute COVID 6.0 vs 5.4 years (all p>.05). Those with PASC had a higher pre-COVID frequency of moderate-to-severe anxiety (HADS A>11), fewer COVID vaccinations, and higher hospitalization rates with longer median hospital stay (Table 1). No differences were detected in variant type, number of infections, or immunologic and neuropsychiatric measures pre- to post-COVID between PASC and no PASC participants. Conclusion: In this cohort of young mostly male PWH on suppressive ART initiated during AHI, 25% experienced PASC and 7% had ongoing symptoms >1year after documented COVID-19. Immunologic and neuropsychiatric changes pre- and post-COVID did not differ in participants with and without PASC. Higher pre-COVID anxiety severity, frequency of COVID hospitalization, and fewer COVID vaccinations associated with PASC, suggesting opportunities to prevent PASC in PWH including mental health interventions and vaccination Post-COVID Conditions Following COVID-19 Vaccination: A Matched Analysis of Patients With SARS-CoV-2 Deborah E Malden 1 , In-Lu Amy Liu 1 , Lei Qian 1 , Lina S. Sy 1 , Bruno J. Lewin 1 , Dawn T. Asamura 1 , Denison S. Ryan 1 , Cassandra Bezi 1 , Sharon Saydah 2 , Sara Y. Tartof 1 , for the Vaccine Safety Datalink Team 1 Kaiser Permanente Southern California, Pasadena, CA, USA, 2 Centers for Disease Control and Prevention, Atlanta, GA, USA Background: COVID-19 vaccinations protect against severe illness and death, but associations with post-COVID conditions (PCC) are less clear. We aimed to evaluate the association between prior vaccination and new-onset PCC among individuals with SARS-CoV-2 infection across eight large healthcare systems in the United States. Methods: This study was a retrospective matched cohort study using electronic health records (EHR) from patients of all ages with SARS-CoV-2 positive tests (PCR or antigen) during March 2021-February 2022. Vaccinated and unvaccinated COVID-19 cases were matched on location, test date, severity of acute infection, age, and sex. Vaccination status was ascertained using EHR and integrated data on externally administered vaccines. Adjusted relative risks (RRs) were obtained from Poisson regression. PCC was defined as a new diagnosis in one of 13 PCC categories from 30 days to 6 months following a SARS-CoV-2 positive test. Results: The primary analysis included 161,531 COVID-19 cases among vaccinated patients and 161,531 matched unvaccinated cases. Compared to unvaccinated cases, vaccinated cases had a similar or lower risk of all PCC categories except mental health disorders (RR: 1.06, 95% CI:1.02-1.10). Vaccination was associated with ≥10% lower risk of sensory (RR 0.90,95% CI 0.86-0.95), circulatory (RR 0.88, 95% CI 0.83-0.94), blood and hematologic (RR 0.79, 95% CI 0.71-0.89), skin and subcutaneous (RR 0.69, 95% CI 0.66-0.72), and

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CROI 2024 260