Impact of COVID-19 pandemic in the care of people living with HIV and cancer at an oncologic center in Mexico

新冠疫情对墨西哥一家肿瘤中心艾滋病合并癌症患者护理的影响

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Abstract

BACKGROUND: People living with HIV(PLWH) and cancer are among the most vulnerable patients and require constant access to medical services. We compared the characteristics of PLWH and cancer in Mexico, before and during the COVID-19 pandemic. METHODS: Patients admitted 1 year before (pre-pandemic) and 1 year after the start of the pandemic (pandemic) were included. Clinical characteristics, HIV-related variables, and 90-day mortality were compared. Data are described a proportions (N,%) and central tendency measures. A multiple regression model for variables associated with 90-day mortality was performed. RESULTS: Seventy-nine patients were seen in the pre-pandemic period; 92 during the pandemic. Main diagnoses were Kaposi Sarcoma and lymphoma. CD4(+) cell count at diagnosis was lower during the pandemic: 81 cells/mm(3) vs. 128 cells/mm(3), p = .035. CD4+<100 cells/mm(3) at first consultation increased from 41% to 58% during the pandemic (p = .041). Only BMI <20 kg/m(2) was associated to death (aOR 8.27, 95%CI 1.74-39.25) (p = .008). The pandemic period was not associated with a higher 90-day mortality. CONCLUSIONS: PLWH and cancer presented to care with advanced disease overall. This was more pronounced during the pandemic period. Mortality was associated with AIDS-related variables regardless of study period. This underscores the need for strategies to maintain in-person access to health-care services for PLWH.

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