CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

functional domains: vision, hearing, mobility, communication, cognition, and self-care. Long COVID was defined as having symptoms lasting ≥3 months that individuals did not have before COVID-19. We also assessed symptom severity and receipt of ≥1 vaccine dose. Weighted proportions (95% CI) were compared using Rao-Scott Chi-squared tests. We performed weighted logistic regression, controlling for sociodemographics and vaccination status, and calculated adjusted odds ratios (aOR; 95% CI). All analyses accounted for complex survey design. Results: In this unweighted sample of 8946 adults (weighted n=89437918), the mean age was 44 years and 63.4% were White, followed by 19.2% Hispanic, 9.6% Black, and 7.8% Asian or Other. Overall, 7.6% (95% CI, 7.0-8.3%) had a disability and 19.7% (95% CI, 18.7-20.7%) experienced long COVID. The percentage of long COVID was higher among adults with a disability than those without (33.7% [95% CI, 29.7-37.8%] vs 18.5% [95% CI, 17.5-19.6%]; P <.001). We observed a similar pattern across specific functional domains (Figure). When adjusting for covariates, adults with a disability had significantly greater odds of long COVID than those without (aOR, 2.01; 95% CI, 1.62-2.49; P <.001). Furthermore, adults with a disability were more likely than those without to have experienced severe COVID-19 symptoms (26.3% [95% CI, 22.8-29.8%] vs 13.6% [95% CI, 12.8-14.5%]; P <.001). The proportion of having received ≥1 COVID vaccine dose was similar between adults with a disability (21.0%; 95% CI, 19.1-23.0%) and those without (20.4%; 95% CI, 19.5-21.2%) ( P =.518). Conclusions: Long COVID was more prevalent in US adults with a functional disability, and disability was associated with long COVID. Adults with a disability also experienced more severe COVID-19 symptoms. Findings suggest that screening for symptoms and improving care access may help address long COVID disparities in populations with disabilities.

of COVID-19 diagnosis and 0.25-year intervals thereafter; each time point after diagnosis was compared with the value at diagnosis. Results: Between April 2021 and September 2022, 269 participants on ≥ 48 weeks of stable ART (97% males, median age 32 [interquartile range 29-37]) were diagnosed with COVID-19. Of these, 221 (82%) were diagnosed with COVID-19 during the Omicron wave; 229 (85%) received ≥2 doses of COVID-19 vaccines prior to diagnosis; 4 (1.5%) required supplemental oxygen, 1 required intensive care, and there were no fatalities. Compared with values at the time of COVID-19 diagnosis, there were significant declines in the TMA z-score at 3 months (0.90 vs 0.55, p=0.02) and the NPZ-4 score at 6 months (1.02 vs. 0.89, p=0.03) after diagnosis ( Figure 1 ). CT1, CT2, and GPB z-scores remained stable over this period. Conclusions: In this cohort of young, mostly male PWH with HIV suppression after early ART, we observed modest but significant changes in processing speed and overall neurocognitive performance up to 6 months after acute COVID-19. Longer follow-up and monitoring of post-acute cognitive sequelae of SARS-CoV 2 infection together with longitudinal assessments of soluble immune markers in cerebrospinal fluid and brain MRI are ongoing to determine the long-term impact of COVID-19 on cognitive outcomes in PWH.

Poster Abstracts

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Hormonal Dysregulation in Long COVID: Exploring the Salivary Cortisol Profile Marta Camici 1 , Marta Franco 1 , Lorenzo Talamanca 2 , Manuela Petino 3 , Jessica Paulicelli 1 , Liliana Scarnecchia 4 , Alessandra Vergori 1 , Stefano Curcio 4 , Roberto Baldelli 4 , Paolo Zuppi 4 , Andrea Antinori 5 1 IRCCS Lazzaro Spallanzani, Rome, Italy, 2 ETH Zurich, Zurich, Switzerland, 3 Azienda Sanitaria Locale Roma 1 , Rome, Italy, 4 San Camillo Forlanini Hospital, Rome, Italy, 5 National Institute for Infectious Diseases L Spallanzani, Rome, Italy Background: While reduced morning serum cortisol (SC) is common in long COVID (LC) patients, measuring salivary cortisol throughout the day better reflects dynamic secretion and may offer greater sensitivity than SC. This study investigates this relationship, alongside hormonal dysregulation and LC predictors. Methods: This prospective, single-center, case-control study at a LC-clinic in Rome included 96 participants assessed at least 28 days post-positive SARS CoV-2 PCR test. LC was defined as at least one new or persisting symptom, with severe LC defined as four or more of fatigue, concentration/memory deficits, poor exercise tolerance, dyspnea, arthralgia, or dysautonomia. Fatigue, assessed using the Fatigue Assessment Scale (FAS) at baseline and 12 weeks, was defined as FAS ≥ 22 (severe: FAS ≥ 35). Two weeks post-BL, blood samples for hormonal assessment and salivary cortisol samples (8:00 AM, 3:00 PM, 11:00 PM) were collected. Patients with SC <15 µg/dL underwent a 1 µg ACTH stimulation test to assess for adrenal insufficiency. Salivary cortisol data from a control group (healthy, COVID-19-free for 4+ months) were also analyzed. Results: Of 96 patients, 60% were female, all white, mean age 58 ± 15 yrs, 61% had >3 comorbidities, 42% had prior COVID-19, and the mean SARS-CoV-2 vaccine doses received was 2.9 ± 1. 62.5% exhibited FAS scores ≥ 22. LC was present in 86% of participants, with 80% experiencing moderate and 20% severe symptoms. 13.5% were asymptomatic post-COVID (APC). Altered FAS was strongly associated with both LC presence and severity (p<0.0001), and negatively impacted daily life (p<0.001). Vaccination was found to be protective (p=0.03), while psychiatric comorbidities increased LC risk (p=0.04). One LC patient (1.2%) had adrenal insufficiency requiring replacement therapy. Morning salivary cortisol was higher in controls than in both APC and LC groups (p=0.005), while afternoon/evening cortisol was lower (Figure 1). Although morning SC did not differ between groups, median ACTH was higher in LC than APC (26 pg/ml vs 13 pg/ml; p<0.001). No differences were observed between

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Cognitive Trajectories 1 Year Before and After COVID-19 in an Early Treated HIV Cohort Ferron F. Ocampo 1 , Tyler Hamby 2 , Luxe-Naree Poonpitak 3 , Carlo Sacdalan 3 , Suwanna Puttamaswin 3 , Somchai Sriplienchan 3 , Nittaya Phanuphak 4 , Phillip Chan 5 , Trevor Crowell 2 , Lydie Trautmann 6 , Sandhya Vasan 6 , Robert Paul 7 , Serena Spudich 5 , for the RV254/SEARCH 010 Study Team 1 University of Toronto, Toronto, Canada, 2 US Military HIV Research Program, Bethesda, MD, USA, 3 SEARCH, Bangkok, Thailand, 4 Institute of HIV Research and Innovation, Bangkok, Thailand, 5 Yale University, New Haven, CT, USA, 6 Henry M Jackson Foundation, Bethesda, MD, USA, 7 University of Missouri St Louis, St Louis, MO, USA Background: There is accumulating evidence that SARS-CoV-2 infection may have lasting effects on cognition in a subset of individuals. However, there is scarce data on the impact of COVID-19 on cognitive performance in people with HIV (PWH), who may experience cognitive impairment despite viral suppression by antiretroviral therapy (ART). We examined the trajectory of cognitive parameters 1 year pre- and post-COVID-19 in PWH on stable ART initiated during acute HIV infection (AHI). Methods: RV254 participants are enrolled during AHI (Fiebig I-V), initiated ART within days, and longitudinally followed with a 4-test cognitive battery that evaluated executive function (Color Trails 1 & 2, CT1 & CT2), processing speed (Trail Making A, TMA), and fine motor speed/dexterity (non-dominant hand Grooved Pegboard, GPB). Raw scores were standardized and averaged to determine an overall performance (NPZ-4) score. In participants on ≥ 48 weeks of stable ART with documented COVID-19, cognitive test z-scores 1 year pre- and post-COVID-19 were regressed on time using linear mixed models. Time in years since COVID-19 diagnosis was entered as a linear spline with knots at the time

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