Data-to-Care (D2C) is a strategy that uses HIV surveillance data or other data sources to identify out-of-care (OOC) persons with HIV (PWH) and link or re-engage them in care to improve viral suppression (VS). While some evidence suggests D2C is effective, no comprehensive systematic review has been published. This review aims to determine the effectiveness of D2C. A systematic search in five databases (i.e., MEDLINE, EMBASE, PsycINFO, CINAHL, sociological abstracts) identified 3868 U.S. studies published between January 2009 and January 2021 that described D2C interventions and measured HIV care outcomes. Two reviewers screened titles/abstracts, reviewed full reports for eligibility, and abstracted data. Risk of bias was assessed using the Mixed Methods Appraisal Tool, and included studies were synthesized quantitatively and qualitatively (Protocol registered on PROSPERO ID = CRD42020173095). Thirty-four studies with 30 unique interventions were identified. Two different meta-analyses, each with six interventions, found that D2C approached significance in improving engagement in care (Relative Risk (RR) 95% CI 1.18 [0.99 to 1.41]) and VS (RR 95% CI 1.44 [0.99 to 2.09]). Studies that could not be incorporated into the meta-analyses, also showed improvements in engagement in care (median percent [IQI]: 63% [45% to 81%], 18 interventions) and VS (median percent [IQI]: 39% [25% to 57%], 14 interventions). Overall, this systematic review suggests that D2C may enhance HIV care outcomes, emphasizing the need for effective strategies to identify and engage OOC persons in care.

BACKGROUND: Little is known about how symptoms or symptom clusters of Post-COVID Conditions (PCC) impact an individual's return to pre-COVID health. METHODS: We used four state-level COVID-19 case reporting systems and patient-reported survey data to identify patients with PCC and associations with an individual's return to pre-COVID health after laboratory-confirmed SARS-CoV-2 infection. Participants had a positive SARS-CoV-2 test between March-December 2020. Weighted regression models were used to 1) estimate prevalence of PCC; 2) identify risk factors associated with developing PCC; and 3) examine associations between PCC symptom clusters and return to pre-COVID health. Factor analysis was used to statistically identify post-COVID symptom clusters. FINDINGS: Prevalence of PCC in this population-based sample was 29·9% for persons with SARS-CoV-2 infection, during the pre-delta variant period (March-December 2020); 77·2% of persons experiencing PCC had not returned to pre-COVID health within 8-60 weeks after infection. Female sex, acute COVID-19 illness severity, and number of pre-existing comorbidities were significant risk factors associated with PCC. Myalgic encephalomyelitis/chronic fatigue syndrome-like symptoms, upper-respiratory symptoms, and gastrointestinal symptoms were significantly associated with not returning to pre-COVID health. INTERPRETATION: Understanding PCC symptom clustering may provide insight into pathophysiology, severity of PCC, and management for patients who have not returned to their usual state of health after SARS-CoV-2 infection. Tracking PCC can help measure the impact of COVID-19 vaccination and acute COVID-19-specific treatments on reducing PCC in the US.

Long-term symptoms often associated with COVID-19 (post-COVID conditions or long COVID) are an emerging public health concern that is not well understood. Prevalence of post-COVID conditions has been reported among persons who have had COVID-19 (range = 5%-80%), with differences possibly related to different study populations, case definitions, and data sources (1). Few studies of post-COVID conditions have comparisons with the general population of adults with negative test results for SARS-CoV-2, the virus that causes COVID-19, limiting ability to assess background symptom prevalence (1). CDC used a nonprobability-based Internet panel established by Porter Novelli Public Services* to administer a survey to a nationwide sample of U.S. adults aged ≥18 years to compare the prevalence of long-term symptoms (those lasting >4 weeks since onset) among persons who self-reported ever receiving a positive SARS-CoV-2 test result with the prevalence of similar symptoms among persons who reported always receiving a negative test result. The weighted prevalence of ever testing positive for SARS-CoV-2 was 22.2% (95% confidence interval [CI] = 20.6%-23.8%). Approximately two thirds of respondents who had received a positive test result experienced long-term symptoms often associated with SARS-CoV-2 infection. Compared with respondents who received a negative test result, those who received a positive test result reported a significantly higher prevalence of any long-term symptom (65.9% versus 42.9%), fatigue (22.5% versus 12.0%), change in sense of smell or taste (17.3% versus 1.7%), shortness of breath (15.5% versus 5.2%), cough (14.5% versus 4.9%), headache (13.8% versus 9.9%), and persistence (>4 weeks) of at least one initially occurring symptom (76.2% versus 69.6%). Compared with respondents who received a negative test result, a larger proportion of those who received a positive test result reported believing that receiving a COVID-19 vaccine made their long-term symptoms better (28.7% versus 15.7%). Efforts to address post-COVID conditions should include helping health care professionals recognize the most common post-COVID conditions and optimize care for patients with persisting symptoms, including messaging on potential benefits of COVID-19 vaccination.