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1.
MEDLINE;
Preprint in English | MEDLINE | ID: ppcovidwho-326640

ABSTRACT

Background: Whether HIV infection is associated with differences in clinical outcomes among people hospitalized with COVID-19 is uncertain. Objective: To evaluate the impact of HIV infection on COVID-19 outcomes among hospitalized patients. Methods: Using the American Heart Association's COVID-19 Cardiovascular Disease registry, we used hierarchical mixed effects models to assess the association of HIV with in-hospital mortality accounting for patient demographics and comorbidities and clustering by hospital. Secondary outcomes included major adverse cardiac events (MACE), severity of illness, and length of stay (LOS). Results: The registry included 21,528 hospitalization records of people with confirmed COVID-19 from 107 hospitals in 2020, including 220 people living with HIV (PLWH). PLWH were younger (56.0+/-13.0 versus 61.3+/-17.9 years old) and more likely to be male (72.3% vs 52.7%), Non-Hispanic Black (51.4% vs 25.4%), on Medicaid (44.5% vs 24.5), and active tobacco users (12.7% versus 6.5%). Of the study population, 36 PLWH (16.4%) had in-hospital mortality compared with 3,290 (15.4%) without HIV (Risk ratio 1.06, 95%CI 0.79-1.43;risk difference 0.9%, 95%CI -4.2 to 6.1%;p=0.71). After adjustment for age, sex, race, and insurance, HIV was not associated with in-hospital mortality (aOR 1.13;95%CI 0.77-1.6;p 0.54) even after adding body mass index and comorbidities (aOR 1.15;95%CI 0.78-1.70;p=0.48). HIV was not associated with MACE (aOR 0.99, 95%CI 0.69-1.44, p=0.91), severity of illness (aOR 0.96, 95%CI 0.62-1.50, p=0.86), or LOS (aOR 1.03;95% CI 0.76-1.66, p=0.21). Conclusion: HIV was not associated with adverse outcomes of COVID-19 including in-hospital mortality, MACE, or severity of illness. Condensed Abstract: We studied 21,528 patients hospitalized with COVID-19 at 107 hospitals in AHA's COVID-19 registry to examine the association between HIV and COVID-19 outcomes. More patients with HIV were younger, male, non-Hispanic Black, on Medicaid and current smokers. HIV was not associated with worse COVID-19 in-hospital mortality (Risk ratio 1.06, 95%CI 0.79-1.43;p=0.71) even after adjustment (aOR 1.15;95%CI 0.78-1.70;p=0.48). HIV was also not associated with MACE (aOR 0.99, 95%CI 0.69-1.44, p=0.91) or severity of illness (aOR 0.96, 95%CI 0.62-1.50, p=0.86. Our findings do not support that HIV is a major risk factor for adverse COVID-19 outcomes.

2.
PUBMED; 2021.
Preprint in English | PUBMED | ID: ppcovidwho-292909

ABSTRACT

Background: Whether HIV infection is associated with differences in clinical outcomes among people hospitalized with COVID-19 is uncertain. Objective: To evaluate the impact of HIV infection on COVID-19 outcomes among hospitalized patients. Methods: Using the American Heart Association's COVID-19 Cardiovascular Disease registry, we used hierarchical mixed effects models to assess the association of HIV with in-hospital mortality accounting for patient demographics and comorbidities and clustering by hospital. Secondary outcomes included major adverse cardiac events (MACE), severity of illness, and length of stay (LOS). Results: The registry included 21,528 hospitalization records of people with confirmed COVID-19 from 107 hospitals in 2020, including 220 people living with HIV (PLWH). PLWH were younger (56.0+/-13.0 versus 61.3+/-17.9 years old) and more likely to be male (72.3% vs 52.7%), Non-Hispanic Black (51.4% vs 25.4%), on Medicaid (44.5% vs 24.5), and active tobacco users (12.7% versus 6.5%). Of the study population, 36 PLWH (16.4%) had in-hospital mortality compared with 3,290 (15.4%) without HIV (Risk ratio 1.06, 95%CI 0.79-1.43;risk difference 0.9%, 95%CI -4.2 to 6.1%;p=0.71). After adjustment for age, sex, race, and insurance, HIV was not associated with in-hospital mortality (aOR 1.13;95%CI 0.77-1.6;p 0.54) even after adding body mass index and comorbidities (aOR 1.15;95%CI 0.78-1.70;p=0.48). HIV was not associated with MACE (aOR 0.99, 95%CI 0.69-1.44, p=0.91), severity of illness (aOR 0.96, 95%CI 0.62-1.50, p=0.86), or LOS (aOR 1.03;95% CI 0.76-1.66, p=0.21). Conclusion: HIV was not associated with adverse outcomes of COVID-19 including in-hospital mortality, MACE, or severity of illness. Condensed Abstract: We studied 21,528 patients hospitalized with COVID-19 at 107 hospitals in AHA's COVID-19 registry to examine the association between HIV and COVID-19 outcomes. More patients with HIV were younger, male, non-Hispanic Black, on Medicaid and current smokers. HIV was not associated with worse COVID-19 in-hospital mortality (Risk ratio 1.06, 95%CI 0.79-1.43;p=0.71) even after adjustment (aOR 1.15;95%CI 0.78-1.70;p=0.48). HIV was also not associated with MACE (aOR 0.99, 95%CI 0.69-1.44, p=0.91) or severity of illness (aOR 0.96, 95%CI 0.62-1.50, p=0.86. Our findings do not support that HIV is a major risk factor for adverse COVID-19 outcomes.

3.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-9231

ABSTRACT

Background: While pre-existing cardiovascular disease (CVD) appears to be associated with poor outcomes in patients with Coronavirus Disease 2019 (COVID-19), data on patients with CVD and concomitant cancer is limited. Evaluate the effect of underlying CVD and CVD risk factors with cancer history on in-hospital mortality in those with COVID-19.

4.
Journal of Cardiac Failure ; 26(10):S72-S73, 2020.
Article in English | EMBASE | ID: covidwho-871792

ABSTRACT

Background: The COVID-19 pandemic has introduced numerous changes to clinical and administrative practices in heart transplantation. One change is the transition of transplant selection committee meetings from in-person to remote video conference in order to maintain social distancing requirements. The impact of this transition on committee members and patient care is unknown. Methods: A 35-item anonymous survey, adapted from the validated Telehealth Usability Questionnaire, was developed and distributed electronically to the UCLA heart transplant selection committee. Quantitative and qualitative descriptive analyses were performed. Results: Of 83 committee members queried, 46 (55%) responded. 50% were non-physician members and 50% were physician members, including 48% cardiologists, 13% anesthesiologists, and 9% surgeons. Over a 6 week period, there was a 5% increase in the average number of attendees from in-person to video meetings. Respondents were satisfied with the ease of use, interface quality, and interaction quality of the video conference system, except for the ability to see meeting attendees. Overall, respondents were satisfied with video meetings, agreeing that they could contribute effectively and achieve their goals over video. However, if given the choice, 54% still preferred the in-person format. Respondents did not feel that video meetings impacted patient care, such as ability to clarify clinical questions, create management plans, and determine and/or update transplant listing status. Multitasking, technology integration, and location convenience were the predominant positive aspects of video meetings, while communication was the main negative, including inability to see attendees, audio interruptions and barriers to communication flow. Communication and clinical decision-making were the predominant positive aspects of in-person meetings (Figure). Conclusions: The transition from in-person to remote video conference heart transplantation selection committee meetings during the COVID-19 era has been well-received and does not appear to affect committee members’ perception of their ability to deliver patient care. Future, longer-term studies are needed to evaluate the impact of video meetings on transplant-related outcomes.

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