CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

than heterosexual adults. Sexual minority adults also had greater odds of having received the vaccine (aOR: 2.19, 95%CI: 1.77-2.71). Conclusion: In this national U.S. sample, sexual minority populations experienced more severe and prolonged COVID-19 symptoms than their heterosexual counterparts, despite being more likely to be vaccinated. Future research is needed to explore factors contributed to severe COVID-19 symptoms or long COVID in sexual minority populations.

hazard ratio of the risks of individual sequelae by vaccination status, adjusting for relevant covariates. The incident symptoms or conditions that were significantly associated with vaccination status were grouped by organ systems. Results: Among a total of 246,508 subjects, the prevalence of any long COVID conditions was 26.03%, with no major differences across the pandemic waves (e.g., Omicron). With a reference group of unvaccinated individuals, individuals with any dose of vaccination were associated with lower odds of 68 individual sequalae conditions, which involves 11 organ systems. Such protective effect was even higher among individuals who received booster dose. For example, a decreased risk of the disease of the Respiratory System was observed for individuals with fully (adjusted hazard ratio [aHR]: 0.75, 95%CI: 0.68, 0.84) and booster vaccination (aHR: 0.60, 95%CI: 0.53-0.68). Likewise, a reduced risk was also observed for the diseases of the Circulatory System (fully: aHR: 0.88, 95%CI: 0.83-0.93; booster: aHR:0.72, 95%CI: 0.64-0.81), Skin and Subcutaneous Tissue (fully: aHR:0.75, 95%CI: 0.68, 0.84; booster: aHR: 0.52, 95%CI: 0.40-0.69). Conclusion: In this statewide longitudinal observational study, we observed that fully or boosted vaccination appears to have some extent of protection against the development of multiple long COVID outcomes.

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Persistence of Anxiety and Depression in US Adults by COVID-19 Vaccination Status, 2020-2023 Yanhan Shen 1 , Kate Penrose 1 , McKaylee Robertson 1 , Rachael Piltch Loeb 1 , Sasha Fleary 1 , Sarah Kulkarni 1 , Chloe Teasdale 1 , William You 1 , Subha Balasubramanian 1 , Surabhi Yadav 1 , Bai Xi Jasmine Chan 1 , Milton L. Wainberg 2 , Scott Ratzan 1 , Denis Nash 1 , Angela Parcesepe 3 1 City University of New York, New York, NY, USA, 2 Columbia University, New York, NY, USA, 3 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Background: The COVID-19 pandemic has impacted mental health among adults in the US. However, little is known about the persistence of symptoms of anxiety and depression, over the three years since the emergence of SARS-CoV-2 or the relationship between such symptoms and COVID-19 vaccination. We described the persistence of anxiety and depression among a large cohort of US adults. Methods: Participants from the CHASING COVID Cohort completed the Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-8) at least one of 14 assessments, approximately every 3 months between July 2020 and June 2023. Persistent symptoms of anxiety or depression was defined as reported moderate/severe symptoms of anxiety (GAD-7>9) or depression (PHQ-8 >9) for >=7 assessments. Participants were classified as vaccinated (or unvaccinated) if they reported any (or never) COVID-19 vaccine between December 2020 and June 2023. We conducted multiple imputations for 18.3% missing GAD-7 or PHQ-8 scores. We used latent class growth analysis (LCGA) to identify groups of participants with shared GAD-7 or PHQ-8 trajectories over 36 months of follow-up. Chi-square tests were used to compare sociodemographic factors among those with and without persistent symptoms of anxiety/ depression and by LCGA groups. At each time point, log-binomial models were used to estimate the age- and gender-adjusted prevalence of moderate/severe anxiety or depression stratified by vaccination status. Results: Among 5652 participants, prevalence of persistent symptoms of anxiety or depression was 19.0% (N=1074) and 22.8% (N=1288) over 36 months, respectively. Using LCGA model, 26.7% (N=1509) and 26.8% (N=1516) of participants had persistently high trajectory of GAD-7 or PHQ-8 over 36 months. Participants who were young, female, non-White, socioeconomically disadvantaged, and unvaccinated were more likely to have persistent symptoms of anxiety/depression or persistent high trajectory of GAD-7/PHQ-8. After COVID-19 vaccines became universally available, the adjusted prevalence of moderate/severe anxiety or depression symptoms decreased among vaccinated individuals compared with unvaccinated (Figure). These differences were sustained over the duration of follow-up. Conclusion: Further investigations are warranted to elucidate bidirectional relationships between COVID-19 vaccination and mental health symptoms, including the extent to which moderate/severe mental health symptoms may be a barrier to staying up to date on COVID-19 vaccination.

Poster Abstracts

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Sexual Minority Adults Experienced More Severe and Longer COVID-19 Symptoms Than Heterosexual Adults Xinyi Li 1 , Jincong Q. Freeman 2 , Yijin Xiang 3 , Yong G. Lee 4 , Victoria Umutoni 2 1 George Washington University, Washington, DC, USA, 2 University of Chicago, Chicago, IL, USA, 3 University of Southern California, Los Angeles, CA, USA, 4 Rutgers University, Newark, NJ, USA Background: Lacking access to COVID-19-related care could prolong symptoms and accentuate adverse health outcomes among vulnerable populations, including sexual minority populations. We investigated the relationships between sexual orientation and COVID-19 diagnosis, symptoms, and vaccination status. Methods: Data for this analysis were from the 2022 National Health Interview Survey. Sexual orientation was self-reported, categorized as sexual minority (self-identified as gay, lesbian, bisexual, or other) and heterosexual. Weighted percentages of self-reported COVID-19 diagnosis, symptoms, and vaccination status were tabulated by sexual orientation, with p-values computed using Rao Scott Chi-squared tests. Separate weighted logistic regression models were fit to compare these outcomes by sexual orientation and to calculate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI), controlling for age, race/ ethnicity, education level, health insurance coverage, and general health status. All analyses accounted for complex sample design. Results: The unweighted sample was 26,057 (weighted n=239,527,538); of whom 94.5% identified as heterosexual and 5.5% as sexual minority. Compared with heterosexual adults, higher proportions of sexual minority adults reported ever been told they had COVID-19 by healthcare providers (33.8% vs. 30.7%, p=0.05), tested positive for COVID-19 by an antibody or blood test (42.0% vs. 38.2%, p=0.02), experienced severe symptoms (17.3%vs. 14.3%, p=0.10), had symptoms for ≥3 months (26.5% vs. 19.2%, p<0.001), received at least one COVID vaccine (85.3% vs. 79.2%, p<0.001), and are currently experiencing symptoms (17.8% vs. 13.0%, p<0.001). After covariate adjustment, sexual minority adults had greater odds of having had severe COVID-19 symptoms (aOR: 1.36, 95% CI: 1.01-1.83), symptoms for ≥3 months (aOR: 1.56, 95% CI: 1.21-2.02), and currently experiencing symptoms (aOR: 1.63, 95% CI: 1.23-2.15)

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