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Abstract Background: Since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, patients with chronic kidney disease vulnerable to suffering more severe COVID-19 disease and worse outcomes have been identified Objectives: Our study's aim was to determine the incidence, characteristics, and outcomes of SARS-CoV-2 infection in patients of hemodialysis (HD) units in Mexico and to describe the availability of confirmatory testing Methods: This study was multicentric study of 19 HD units, conducted between March 2020 and March 2021 Results: From a total of 5779 patients, 955 (16.5%) cases of suspicious COVID-19 were detected; a SARS-CoV-2 reverse transcription polymerase chain reaction test was done in only 50.6% of patients. Forty-five percentages were hospitalized and 6% required invasive mechanical ventilation (IMV). There was no significant difference in mortality between confirmed (131/483) and suspicious (124/472) cases (p = 0.74). The percentage of patients in need of hospitalization, IMV, and deceased was greater than in the rest of the study population Conclusions: The study revealed that 49.4% of the cases were not confirmed, a worrisome observation given that this is a highly vulnerable population (higher probability of contagion and worse outcomes), in which 100% of patients should have a confirmatory test
ABSTRACT
Objetivo. Establecer las características y causas de muerte de pacientes VIH positivos que fallecen al estar hospitalizados. Material y métodos. Se incluyeron pacientes VIH positivos que fallecieron durante la hospitalización entre 2010 y 2013. Se recabaron datos sociodemográficos y clínicos, causas de muerte y muertes prevenibles. Se consideraron prevenibles aquellas muertes en pacientes con menos de seis meses de terapia antirretroviral altamente activa (TARAA) o sin tratamiento y con menos de 350 CD4+ al momento del diagnóstico o del internamiento, con o sin enfermedades oportunistas. Resultados. Se identificaron 128 muertes. La mediana de CD4+ fue 47 cels/mm³; 18% llegó al internamiento sin diagnóstico de VIH, 51% tenía menos de seis meses de haber sido diagnosticado y 40.5% no había recibido TARAA. Las principales causas de muerte fueron eventos definitorios de sida (65.6%). Se identificaron 70 muertes prevenibles (57%). Conclusión. A pesar del acceso universal a TARAA, en México los pacientes VIH positivos siguen falleciendo por eventos relacionados con sida, que es un indicador de diagnóstico tardío del VIH. Es urgente implementar programas de detección temprana para hacer accesible el beneficio de la TARAA.
Objective. To establish the characteristics and causes of death of HIV patients who die while hospitalized. Materials and methods. We included HIV+ patients who died during hospitalization, in three hospitals in Mexico City between 2010 and 2013. Sociodemographic and clinical data were collected as well as causes of death. We identified preventable deaths (defined as deaths that occurred in patients with less than six months of HAART, or without HAART, with less than 350 CD4 at diagnosis and/or opportunistic events as the cause of hospitalization). Results. 128 deaths were analyzed. The median of CD4 count was 47 cells/mm³; 18% of the patients ignored their HIV status at the time of hospitalization, 51% had less than six months of HAART, 40.5% had never received HAART before. The main causes of death were AIDS defining events, with 65.6%. We identified 70 preventable deaths (57%). Conclusions. Despite universal access to HAART, HIV patients in Mexico are still dying of AIDS defining illnesses, an indicator of late diagnosis. It is urgent to implement HIV testing programs to allow earlier diagnosis and make HAART benefit accessible to all.