{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T03:26:20Z","timestamp":1776396380191,"version":"3.51.2"},"reference-count":15,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T00:00:00Z","timestamp":1651708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>HIV-positive patients may present lungs with multiple infections, which may hinder differential diagnoses and the choice of treatment in the course of COVID-19, especially in countries with limited access to high-standard healthcare. Here, we aim to investigate the association between radiological changes and poor COVID-19 outcomes among HIV-positive patients from Central and Eastern Europe. Between November 2020 and May 2021, the Euroguidelines in Central and Eastern Europe Network Group started collecting observational data on HIV and COVID-19 co-infections. In total, 16 countries from Central and Eastern European submitted data (eCRF) on 557 HIV-positive patients. The current analyses included patients who had a radiological examination performed. Logistic regression models were used to identify the factors associated with death, ICU admission, and partial recovery (poor COVID-19 outcomes). Factors that were significant in the univariate models (p &lt; 0.1) were included in the multivariate model. Radiological data were available for 224 (40.2%) patients, 108 (48.2%) had computed tomography, and 116 (51.8%) had a chest X-ray. Of these, 211 (94.2%) were diagnosed using RT-PCR tests, 212 (94.6%) were symptomatic, 123 (55.6%) were hospitalized, 37 (16.6%) required oxygen therapy, and 28 (13.1%) either died, were admitted to ICU, or only partially recovered. From the radiologist\u2019s description, 138 (61.6%) patients had typical radiological changes, 18 (8.0%) atypical changes, and 68 (30.4%) no changes. In the univariate models, CD4 count (OR = 0.86 [95% CI: 0.76\u20130.98]), having a comorbidity (2.33 [1.43\u20133.80]), HCV and\/or HBV co-infection (3.17 [1.32\u20137.60]), being currently employed (0.31 [0.13\u20130.70]), being on antiretroviral therapy (0.22 [0.08\u20130.63]), and having typical (3.90 [1.12\u201313.65]) or atypical (10.8 [2.23\u201352.5]) radiological changes were all significantly associated with poor COVID-19 outcomes. In the multivariate model, being on antiretroviral therapy (OR = 0.20 [95% CI:0.05\u20130.80]) decreased the odds of poor COVID-19 outcomes, while having a comorbidity (2.12 [1.20\u20133.72]) or either typical (4.23 [1.05\u201317.0]) or atypical (6.39 [1.03\u201339.7]) radiological changes (vs. no changes) increased the odds of poor COVID-19 outcomes. Among HIV patients diagnosed with symptomatic SARS-CoV-2 infection, the presence of either typical or atypical radiological COVID-19 changes independently predicted poorer outcomes.<\/jats:p>","DOI":"10.3390\/v14050972","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T02:46:39Z","timestamp":1651805199000},"page":"972","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Presence of Either Typical or Atypical Radiological Changes Predicts Poor COVID-19 Outcomes in HIV-Positive Patients from a Multinational Observational Study: Data from Euroguidelines in Central and Eastern Europe Network Group"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1166-4462","authenticated-orcid":false,"given":"Justyna D.","family":"Kowalska","sequence":"first","affiliation":[{"name":"Department of Adults\u2019 Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6488-4576","authenticated-orcid":false,"given":"Carlo","family":"Bie\u0144kowski","sequence":"additional","affiliation":[{"name":"Department of Adults\u2019 Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0776-7066","authenticated-orcid":false,"given":"Luk\u00e1\u0161","family":"Fleischhans","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, 1st Faculty of Medicine, Faculty Hospital Bulovka Hospital, Charles University in Prague, 18081 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3332-2762","authenticated-orcid":false,"given":"Sergii","family":"Antoniak","sequence":"additional","affiliation":[{"name":"Viral Hepatitis and AIDS Department, Gromashevsky Institute of Epidemiology and Infectious Diseases, Amosova str. 5-a, 03038 Kyiv, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agata","family":"Skrzat-Klapaczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Adults\u2019 Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2190-8494","authenticated-orcid":false,"given":"Magdalena","family":"Suchacz","sequence":"additional","affiliation":[{"name":"Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, 01-201 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolina","family":"Bogdanic","sequence":"additional","affiliation":[{"name":"School of Medicine, University Hospital for Infectious Diseases, University of Zagreb, Miorogojska 8, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deniz","family":"Gokengin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, 35100 Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiana","family":"Oprea","sequence":"additional","affiliation":[{"name":"Victor Babes Clinical Hospital for Infectious and Tropical Diseases, Carol Davila University of Medicine and Pharmacy, 030303 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"Karpov","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Belarusian State Medical University, Dzerginskogo 83, 220116 Minsk, Belarus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerstin","family":"Kase","sequence":"additional","affiliation":[{"name":"West Tallinn Central Hospital, Paldiski Road 62, 10149 Tallin, Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raimonda","family":"Matulionyte","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, 08410 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4735-2620","authenticated-orcid":false,"given":"Antonios","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Medical School, University General Hospital Attikon, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nino","family":"Rukhadze","sequence":"additional","affiliation":[{"name":"Infectious Diseases, AIDS and Clinical Immunology Center, 16. Al Kazbegi Ave, 0102 Tblisi, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjan","family":"Harxhi","sequence":"additional","affiliation":[{"name":"Infectious Disease Service, University Hospital Center of Tirana, Rr. Didres, Nr 372, 33979 Tirana, Albania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Jilich","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, 1st Faculty of Medicine, Faculty Hospital Bulovka Hospital, Charles University in Prague, 18081 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Botond","family":"Lakatos","sequence":"additional","affiliation":[{"name":"National Institute of Hematology and Infectious Diseases, South-Pest Central Hospital, National Center of HIV, 1097 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-6679","authenticated-orcid":false,"given":"Dalibor","family":"Sedlacek","sequence":"additional","affiliation":[{"name":"Faculty of Medicine in Plze\u0148, University Hospital Plze\u0148, Charles University, 30599 Plzen, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0438-0309","authenticated-orcid":false,"given":"Gordana","family":"Dragovic","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine; University of Belgrade, Dr Subotica 1\/III, 24101 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Vasylyev","sequence":"additional","affiliation":[{"name":"Astar Medical Center, 79041 Lviv, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonia","family":"Verhaz","sequence":"additional","affiliation":[{"name":"Department for Infectious Diseases, Faculty of Medicine, University of Banja Luka, Republika Srpska, 78000 Banja Luka, Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Yancheva","sequence":"additional","affiliation":[{"name":"Department for AIDS, Specialized Hospital for Active Treatment of Infectious and Parasitic Disease Sofia, Medical University of Sofia, 1233 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2641-4327","authenticated-orcid":false,"given":"Josip","family":"Begovac","sequence":"additional","affiliation":[{"name":"School of Medicine, University Hospital for Infectious Diseases, University of Zagreb, Miorogojska 8, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrzej","family":"Horban","sequence":"additional","affiliation":[{"name":"Department of Adults\u2019 Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"555301","DOI":"10.3389\/fmed.2020.555301","article-title":"Current Understanding of COVID-19 Clinical Course and Investigational Treatments","volume":"7","author":"Aguilar","year":"2020","journal-title":"Front. 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