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1.
Open Forum Infectious Diseases ; 7(SUPPL 1):S303-S304, 2020.
Article in English | EMBASE | ID: covidwho-1185836

ABSTRACT

Background: The effects of the COVID-19 pandemic on people living with HIV (PWH) are unknown. Beyond SARS-CoV-2 co-infection, the pandemic may have devastating consequences for HIV care delivery. Understanding these is crucial as reduced antiretroviral therapy (ART) availability alone could lead to ≥500,000 AIDS-related deaths in 2020-2021. With Latin America now a focal point in the pandemic, we sought to describe the impact of COVID-19 on HIV care at Latin American clinical sites. Methods: Caribbean, Central and South America network for HIV epidemiology (CCASAnet) and additional Brazilian HIV care sites in Argentina, Brazil, Chile, Haiti, Honduras, Mexico, and Peru were included. An electronic survey of COVID-19 effects on HIV clinic operations was administered in Spanish or English via phone and email, April 28-June 2, 2020. We also compared national COVID-19 case, mortality, and policy data from public sources. Results: Brazil's and Mexico's epidemics appear most pronounced, with >10,000 confirmed COVID-19-related deaths (Figure 1);countries implemented “social distancing” policies at different times after initial cases, with Haiti earliest and Mexico latest (Figure 2). Nearly all 13 sites reported decreased hours and providers for HIV care. Twelve of 13 reported increased use of telehealth, suspension/postponements of routine HIV appointments, and/or suspension of HIV research. Eleven of 13 reported initiation of new COVID-19 research but suspension of community HIV testing, and nearly half provided additional ART supplies. Nearly 70% reported impacts on HIV viral load testing and nearly 40% reported personal protective equipment stock-outs (Table). All 13 sites experienced changes in resources/services in tandem with national policies;there was wide variation, however, in the number of economic and health supports implemented thus far (e.g., quarantines, tax deferrals, interest rate reductions, etc.), from 172 COVID-19-related policies in Brazil to only 30 in Mexico Conclusion: The COVID-19 pandemic has already had a substantial effect on daily operations of HIV clinics in Latin America. The downstream effects of these impacts on HIV outcomes in Latin America will need to be further studied. (Table Presented).

2.
Open Forum Infectious Diseases ; 7(SUPPL 1):S260, 2020.
Article in English | EMBASE | ID: covidwho-1185747

ABSTRACT

Background: The main risk factors for severe COVID-19 described are diabetes, hypertension, cardiovascular disease, obesity, chronic lung and renal disease. HIV infection has not been found to be an independent factor for severe COVID-19, however, only small case series of HIV and COVID-19 have been reported. The aim of this study is to describe clinical characteristics and outcomes of HIV positive patients with COVID-19 hospitalized in a tertiary care hospital in Mexico City. Methods: A single-center review of HIV-infected patients diagnosed with COVID-19 was performed using medical records from March 1st, 2020 to May 20th, 2020. We describe the clinical characteristics and outcomes Results: A total of 11 PLWH were diagnosed with COVID-19, only 9 were hospitalized and are described here. One died, 6 were discharged and 2 remain hospitalized (table 1). Overall, the median age was 46 years, all males and most (7/9) were on INSTI based ART regimen and undetectable HIV viral load (9/9), with a median of CD4 counts of 581 cell/mm3. The median days since onset of COVID19 symptoms was 7 days. 6/9 had at least one comorbidity: hypertension (3/9) and chronic kidney disease (3/9). 7/9 had body max index >25. 7/9 had moderate to severe lung disease, evidenced by computed tomography. 4/9 required invasive mechanical ventilation, and all were successfully extubated. Conclusion: Most of the HIV patients who required hospitalization due to COVID19 had comorbidities. In spite of severe and critical presentations, most patients have recovered. Outcomes appear no different from those seen for non-HIV infected patients, however larger studies to determine the risk that HIV infection confers to COVID19 outcomes are needed.

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