Resumen

Background : COVID-19 pandemic decreased accessibility to health services in chronic diseases as HIV, with disruption of the continuum of HIV care. In addition, COVID-19 added more death during first waves before immunization, but in PLWH in ART knowledge about impact in the mortality was poor in studies in follow-up. Methods : Retrospective study from clinical records of PLWH reported dead from a cohort of national hospital enrolled in ART between 2017-2022 years. Causes of death were classified from death certificate as related with: COVID-19, any severe acute respiratory infection (SARI), advanced HIV, infectious disease no related with HIV (ID no-HIV), CNS infection, neoplastic, cardiovascular, and other chronic diseases. Logistic regression model was made including covariates: MSM, sex-working, gender, death in health center, age at HIV diagnosis, time to start ART, abandonment episodes, current abandonment, baseline cd4, CD4 nadir, last ART scheme, viral suppression, tuberculosis background during HIV, and death year. Results : Were recovered 211/240 completed records from PLWH reported as death. Since 2020 deaths were increased in comparison to previous years, but deaths related with advance HIV, SARI, and other no opportunistic ID were increased since 2019 (Figure). In each adjusted regression model by deaths related with COVID-19, advanced HIV and SARI, risk were associated with death in health center (PR: 5.32 CI95%: 2.21-12.82; PR: 2.53 CI95%: 1.01-6.37; PR: 35.17 CI95%: 3.87-319.88 respectively). Additionally, there was less risk of death related SARI with MSM. (PR: 0.39 CI95%: 0.16-0.95); viral suppression or abandonment were not related. Conclusions : COVID-19 pandemic reinforced the trend in deaths due the advanced HIV status, SARI and the same COVID-19 during the first 2 years, period with poor COVID-19 immunization coverage. The health centers probably identified better the death causes and it is the reason of the high risk in the model, but is unexplained the less risk of death due SARI in MSM people, it needs to assess other factors involved.