Convalescent plasma as adjunctive therapy for hospitalized patients with COVID-19:The Co-CLARITY Trial

Background and Objective@#Convalescent plasma therapy (CPT) may reduce the risk of disease progression among patients with COVID-19. This study was undertaken to evaluate the efficacy and safety of CPT in preventing ICU admission among hospitalized COVID-19 patients.@*Methods@#In this open-label randomized controlled trial, we randomly assigned hospitalized adult patients with COVID-19 in a 1:1 ratio to receive convalescent plasma as an adjunct to standard of care or standard of care alone. The primary endpoint was ICU admission within first 28 days of enrolment. Primary safety endpoints include rapid deterioration of respiratory or clinical status within four hours of convalescent plasma transfusion and cumulative incidence of serious adverse events during the study period including transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), severe allergic reactions, and transfusion-related infections.@*Results@#A total of 22 patients were assigned to receive convalescent plasma as an adjunct to standard of care and 22 to receive standard of care alone. The median time from onset of COVID-19 symptoms to study enrolment was eight days (IQR, 4 to 10). Two patients (9.1%) in the CPT group and one patient (4.5%) in the control group were admitted to the ICU. The primary outcome measure, ICU admission, was not different between the two groups (q-value >0.9). No patient who received convalescent plasma had rapid deterioration of respiratory/clinical status within four hours of transfusion and none developed TRALI, TACO, anaphylaxis, severe allergic reactions, or transfusion-related infections. There was also no significant difference in the secondary outcomes of 28-day mortality (two patients in the CPT group and none in the control group, q-value >0.90), dialysis-free days, vasopressor-free days, and ICU-free days.@*Conclusions@#Among hospitalized COVID-19 patients, no significant differences were observed in the need for ICU admission between patients given CPT as adjunct to standard of care and those who received standard of care alone. Interpretation is limited by early termination of the trial which may have been underpowered to detect a clinically important difference.

Quality of life and its determinants among Filipino people living with HIV/AIDS enrolled in the treatment hub of a tertiary government hospital

@#<p style="text-align: justify;"><strong>Objective.</strong> To assess the quality of life (QoL) and its determinants among Filipino People Living with HIV (PLHIV).</p><p style="text-align: justify;"><strong>Methods.</strong> This is a cross-sectional analytical study. Adult Filipino PLHIV linked to the treatment hub of a tertiary government hospital in the Philippines were surveyed utilizing the WHOQOL-HIV BREF assessment tool. Other variables of interest were obtained from medical records. Linear regression analysis was applied.</p><p style="text-align: justify;"><strong>Results.</strong> A total of 341 HIV-seropositive patients were included. The median age was 32 years, and respondents were mostly male (93.55%). Majority had good general QoL (58.6%). Regression analysis showed that among the factors associated with good general QoL were: CD4 ? 200 cells/?L (p = 0.043), and ARV duration > 3 months (p = 0.022). Conversely, low education (p ? 0.001), poor treatment adherence (p ? 0.001), and presence of opportunistic infections (p ? 0.05) were associated with poor general QoL. Female sex (p = 0.025) and unemployment (p = 0.006) were associated with poor QoL in the environment and independence domains, respectively.</p><p style="text-align: justify;"><strong>Conclusion.</strong> Most Filipino PLHIV have good QoL across all domains. While several factors were associated with good QoL including higher CD4 count and being on ARV for more than 3 months, presence of opportunistic infections, poor treatment adherence and low education were associated with poor QoL among patients with HIV infection.</p>

Measurement of anxiety and depression among HIV patients seen in the Philippine General Hospital using the Hospital Anxiety and Depression Scale - Pilipino Version (HADS-P)

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> HIV patients suffer from anxiety and depression but a formal assessment infrequently happens.</p><p style="text-align: justify;"><strong>ObJECTIVES:</strong> The study aimed to measure the prevalence of anxiety and depression among HIV patients in UPPhilippine General Hospital.</p><p style="text-align: justify;"><strong>METHODS:</strong> This study involving 417 HIV-positive patients used the Hospital Anxiety and Depression Scale - Pilipino version to identify cases, with stepwise regression analysis for correlation.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The prevalence of anxiety, depression, and mixed diagnosis was 10.1% (0.072-0.130), 3.1% (0.014-0.048), and 10.8% (0.078-0.138), respectively. Anxiety was correlated with female sex (OR = 7.82, CI 1.03-59.49), unemployment (OR = 1.76, CI 0.90-3.42), smoking (OR = 1.84, CI 0.89-3.79), homosexuality (OR = 7.64, CI 1.36-42.74), and non-use of protective methods during intercourse (OR = 1.81, CI 0.84-3.93). Depression was correlated with unemployment (OR = 2.79, CI 0.91-8.54) and non-disclosure of status (OR = 3.04, CI 0.79-11.67). Mixed diagnosis was correlated to unemployment (OR = 2.09, CI 1.10-3.96), smoking (OR = 2.14, CI 1.08-4.25), homosexuality (OR = 3.14, CI 0.92- 10.65), and non-use of protective methods during intercourse (OR = 1.65, CI 0.77-3.53).</p><p style="text-align: justify;"><b>CONCLUSIONS:</b> Lower prevalence of anxiety and depression among HIV patients was found in this study compared with other countries. There is, however, a need to allocate resources for screening mental health problems in HIV patients.</p>