CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

920

WITHDRAWN

conflicting due to inconsistent definitions of LC. We used the RECOVER Scoring System (RSS) to define and assess the burden and pattern of LC presentation in PWH vs PWoH who had prior COVID-19 in the MACS/WIHS Combined Cohort Study (MWCCS). Methods: We included MWCCS participants who self-reported a positive COVID-19 test between 04/2020 and 11/2023. Participants who completed the prospectively administered COVID-19 survey including symptom type and duration between 30 and 365 days after COVID-19 infection date were evaluated for LC. LC was defined using the RSS, which weights 12 common LC symptoms according to strongest association with LC in and sums the weights for a total score. Participants with total scores ≥12 met criteria for LC. Among those with LC, we characterized LC symptom type by HIV serostatus, sex, and COVID-19 vaccination status using chi-square tests. Results: Of 4,970 participants, 1,616 (33%) reported a positive COVID test during the study period, of whom 153 (10%) met RSS criteria for LC. Among PWH who reported having COVID, 97/1010 (9.6%) had LC, compared to 56/606 (9.2%) of PWoH (p=0.89). Among persons with LC, half were female, 63% were PWH (median CD4 758 cells/mm 3 ; 91% had HIV RNA <200 cp/ml), and most (93%) had received 1 dose of COVID vaccine at time of survey. Overall, the most common LC symptoms were chronic cough (94%), post-exertional malaise (93%), and loss of smell/taste (88%), while the least common were brain fog (28%), dizziness (19%), and palpitations (13%). There was no significant difference in LC symptom type by HIV serostatus (Figure). Neither sex nor vaccination status had measurable impact on LC prevalence or symptom type in the study population. Conclusions: Using the highly specific yet conservative RSS to define LC, PWH and PWoH were similarly likely to develop LC after an acute COVID-19 infection. LC symptoms were similar in both PWH and PWoH. Our study is limited by the relatively small number of individuals with LC. These findings will inform work on assessing the trajectory of LC symptoms over time and by comorbidity status to better understand their progression and implications. The figure, table, or graphic for this abstract has been removed. Long COVID Is a Multisystem Disorder: Assessment of the National Academies Definition Lawrence Huang 1 , Amitabh Gunjan 2 , Anudeep S. Appe 2 , Paul A. Mckelvey 3 , Heather A. Algren 4 , Mark Berry 5 , Essy Mozaffari 5 , Bill J. Wright 3 , Jennifer J. Hadlock 1 , Jason D. Goldman 4 1 Institute for Systems Biology, Seattle, WA, USA, 2 Providence Global Healthcare Innovation Center, Hyderabad, India, 3 Providence Health and Services, Portland, OR, USA, 4 Swedish Medical Center, Seattle, WA, USA, 5 Gilead Sciences, Inc, Foster City, CA, USA Background: Long COVID is an infection-associated chronic condition occurring after SARS-CoV-2 infection that can manifest as one or multiple symptoms or diagnosable conditions, as newly defined by the National Academies. We evaluated this new Long COVID definition. Methods: We reviewed hospital admissions from 5/1/20 – 9/30/22 in electronic health records (EHR) from a multistate healthcare system. The COVID+ group had first SARS-CoV-2 lab test or encounter diagnosis between 30 days before to 5 days after admission, and the non-COVID group was admitted with no prior or current SARS-CoV-2 test or diagnosis. The populations were balanced with overlap weights based on a high-dimensional propensity score of pre-specified variables and the top 100 comorbidities differing between the groups. Hazard ratios (HR) were calculated for the combined primary outcome including any of the individual secondary outcomes or U09.9 (Post-Covid Conditions). Secondary outcomes included 29 individual incident diagnoses 90 to 360 days after admission. To account for multiplicity on the secondary outcomes, a Bonferroni corrected p-value < 0.0017 was considered significant. Results: Admissions included 45,065 persons with and 417,268 persons without COVID-19 during the study period. Mean age was 58 years, 62% were female, 25.4% were non-white, and 13% were Hispanic. After weighting, standardized difference was < 0.01 for age, sex, race, ethnicity, insurance, vaccination, variant era, WHO ordinal scale, steroid use, immunocompromised status and 100 clinical features. In the COVID+ and non-COVID groups 16,945 (37.6%) and 122,201 (29.3%) met the combined primary outcome, respectively. The HR for the primary outcome after weighting was 1.29 (95%CI 1.27, 1.32), p < 0.00001. Of the individual secondary outcomes, all but one outcome (post-exertional malaise) had significantly elevated HR in the COVID+ vs. non-COVID groups, after adjustment for multiplicity (Figure). Incident diagnoses with strong associations (HR > 2) included thromboembolism, hair loss, diabetes mellitus,

Poster Abstracts

922

921

Assessing the Burden of Long COVID in Persons With HIV Using the RECOVER Scoring System Kamaria Dansby 1 , Cyra C. Mehta 1 , Tsungirirai Maramba 1 , Lauren F. Collins 1 , Caitlin A. Moran 2 , Brad Aouizerat 3 , Joseph Margolick 4 , Michelle Floris-Moore 5 , Kara Chew 6 , Valentina Stosor 7 , Gypsyamber DSouza 8 , Kathryn Anastos 9 , Ighovwerha Ofotokun 1 , Phyllis Tien 10 1 Emory University, Atlanta, GA, USA, 2 Emory University Hospital, Atlanta, GA, USA, 3 New York University, New York City, NY, USA, 4 The Johns Hopkins University School of Medicine, Baltimore, MD, USA, 5 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 6 University of California Los Angeles, Los Angeles, CA, USA, 7 Northwestern University, Chicago, IL, USA, 8 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 9 Albert Einstein College of Medicine, Bronx, NY, USA, 10 University of California San Francisco, San Francisco, CA, USA Background: Some individuals recovering from COVID-19 experience persistent symptoms after initial infection, a condition known as Long Covid (LC). Persons with vs without HIV (PWH; PWoH) are hypothesized to be at greater risk of LC due to chronic immune dysregulation. However, existing data are sparse and

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