IMPACTO DA INFECÇÃO PELO CORONAVÍRUS NA CAPACIDADE FUNCIONAL E NA QUALIDADE DE VIDA EM PESSOAS QUE VIVEM COM O HIV

Abstract

INTRODUCTION: Covid-19 primarily affects the respiratory system, inducing a hyperinflammatory response that often progresses to pulmonary fibrosis in most cases. It is estimated that the complications of Covid-19 are more severe in people living with the human immunodeficiency virus (HIV) due to its immunosuppressive nature, resulting in compromised functional capacity (FC) and quality of life. OBJECTIVES: To assess the impact of coronavirus infection on FC and quality of life in people living with HIV (PLHIV). METHOD: Participants were divided into two groups: HIV/Covid-19 (n=10) and HIV/Non-Covid-19 (n=10). Sociodemographic variables, body mass index (BMI), HIV-related variables (antiretroviral therapy, HIV viral load, years since diagnosis, CD4 levels, comorbidities, and medications), functional capacity (Barthel Index, Handgrip Strength, and ADL-Glittre), and hospital records from the acute phase of Covid-19 (hospitalization, use of ventilatory support, and vaccination) were analyzed. Descriptive analysis was used for sample characterization, Student's t-test for quantitative and parametric data, the Mann-Whitney test for non-parametric data, and Fisher's Exact test for categorical variables. A significance level of 5% was considered. RESULTS: The study included 20 PLHIV, divided into the HIV/Covid-19 group (8 men and 2 women) and the HIV/Non-Covid-19 group (10 male participants). In the comparison of BMI, the HIV/Covid-19 group (42.71 ± 14.06 Kg/m2) had higher values than the HIV/Non-Covid-19 group (24.91 ± 2.32) (p< 0.001). There was no difference in the time since HIV diagnosis between the two studied groups (p= 0.16), nor in CD4 levels (p= 0.53). All participants had undetectable HIV viral loads and were receiving antiretroviral therapy. The severity of coronavirus infection in the HIV/Covid-19 group was estimated using the hospital severity scale, with 70% of patients classified with a score of 1. Both groups showed a reduction in Handgrip Strength, but there was no difference between them (p= 1). According to the Barthel Index, all participants achieved independence in ADLs. In the ADL-Glittre test, all participants in the HIV/Covid-19 group and 70% in the HIV/Non-Covid-19 group showed impairment, but there was no statistical difference (p= 0.21). Regarding the time to complete the ADL-Glittre, there was no difference between the groups (p= 0.92). In terms of quality of life, differences were observed in the physical (p= 0.03), psychological (p= 0.04), spirituality/religion/personal belief (p= 0.01), and overall quality of life and general health perception (p= 0.02) domains. CONCLUSION: In the studied sample, PLHIV predominantly experienced mild coronavirus infection and exhibited compromised FC and reduced Handgrip Strength similar to PLHIV who were not infected by the coronavirus during the chronic phase of Covid-19. However, they had a greater impact on quality of life in terms of physical, psychological, spirituality, overall quality of life, and general health perception.