RESUMEN
Background: People living with HIV (PLWH) are at increased risk of severe COVID-19. The UK recommends vaccination against COVID-19 for PLWH with two primary doses, a booster dose, then seasonal boosters (i.e. four doses by Autumn 2022). Vaccination uptake in the UK has been lower among non-white minority ethnic groups than in the white British population, despite these groups having a higher risk of severe COVID-19. Method(s): We evaluated vaccine uptake by PLWH attending treatment services at two NHS Trusts in North East England. To ensure representation of minorities, alternating PLWH from white and ethnic minorities (excluding white minorities) were purposively selected for review from the HIV and AIDS Reporting System;vaccination data were obtained from regional integrated care records. Result(s): 200 PLWH were included. 103 (51.5%) were from ethnic minority groups, of whom 78 (75.7%) were of black African ethnicity. Vaccination rates in the total population and among ethnic groups are shown in the table below. Similar proportions of white and minority ethnic background PLWH had received up to two vaccinations. These proportions among white PLWH were similar to those reported in the general English population, while fewer Black African PLWH were unvaccinated than in the general population (14.1% vs. 26%, data not shown). Vaccine uptake among PLWH diverged beyond 3 doses, with white people being almost three times as likely to have received four doses (OR 2.92;95% CI 1.63 to 5.19;pvalue for difference in distribution across all doses=0.005). Conclusion(s): Although ethnic minority PLWH were less likely to be fully vaccinated than white ethnicity PLWH, the proportion of unvaccinated black African PLWH was lower than that reported from the general population. This could infer that regular contact with healthcare professionals coupled with consistent promotion of vaccination by HIV clinicians can improve uptake. (Table Presented).
RESUMEN
Background: People living with HIV (PLWH) are at increased risk of severe or critical COVID-19. This is in addition to the increased risk associated with any coexisting conditions such as chronic pulmonary disease (CPD), chronic kidney disease and cardiovascular disease. Vaccination against COVID-19 is therefore strongly recommended for PLWH. Method(s): We conducted a descriptive study to evaluate comorbidities among PLWH attending for HIV care at two NHS Trusts in North East England and who were under- or unvaccinated against COVID-19, defined as having received either zero or 1 doses of any COVID-19 vaccine by 01/10/2022. PLWH under active care were identified using the HIV and AIDS Reporting System (HARS) dataset. Vaccination data were obtained from regional integrated care records (RICR) and cross-referenced with HARS. Information on comorbidities was collated for any patients who were under- or unvaccinated. To quantify risk and clinical vulnerability, we calculated the Charlson Comorbidity Index (CCI) for each of these patients. A CCI score >=1 is associated with mortality/poor outcomes in patients with COVID-19. Result(s): 141 under- or unvaccinated patients were identified out of a total cohort of 1492 patients who attended for HIV care (9.5%);of these, 96 (68.1%) and 45 (31.9%) had received zero and one vaccination respectively. The median age of this under-/unvaccinated cohort was 41 years and 91 (64.5%) were male. 62 patients (44.0%) had a CCI score of 1 or more;13 patients (9.2%) had a diagnosis of AIDS during the time period evaluated;11 (84.6%) of the patients with an AIDS diagnosis were completely unvaccinated. Non-HIV comorbidities included liver disease (10/141, 7.1%), solid organ cancer (5/141, 3.5%), CPD (4/141, 2.8%) and connective tissue disease (3/141, 2.1%). Six patients (4.3%) had >=2 comorbidities. Conclusion(s): Nearly half of the under-/unvaccinated PLWH attending our services were identified as being at an increased risk of having a poor outcome in the event of contracting COVID-19. Proactively identifying these individuals would allow services to offer tailored support in making informed decisions about vaccinations. Useful strategies may include the use of patient information leaflets and targeted discussion with patients explaining their individual risk from COVID-19.
RESUMEN
Introduction: The primary objective of this study was to assess whether proton pump inhibitor (PPI) use at pre-admission affected clinical outcomes among covid 19 hospitalised patients. Aims & Methods: Prospectively captured data was analysed to include patients (>18 year) at the hospital with covid 19 infection . PPI data was derived from hospital and primary care records and the study period is over between February 2020 and February 2021.Clinical outcomes of covid 19 patients who were on proton pump inhibitors preadmission were compared with that of covid 19 patients who were not on proton pump inhibitors at the same time. The primary endpoint of the study was 60-day mortality, intensive care unit admission, high dependency unit admission as well as the development of covid-19 complications. Additional endpoints included length of critical care admission. Result(s): A total of 305 patients were included in the study,158 were on proton pump inhibitors and 147 not on proton pump inhibitor at index admission. There were 101 males and 57 females with a mean age of 61.65 in the PPI group, and in the no-PPI group there were 92 males and 55 females with a mean age of 57.28. The mean length of stay was9.98 in the PPI group and 11.83 in the non-PPI group. There was a slightly increased mortality rate of 29.93% in the non-PPI group compared with 28.48 % in the PPI group. Intensive Care Unit (ITU) and High Dependency Unit (HDU) admissions were higher in the non-PPI group (64.62%,30.6% respectively) than in the PPI group (58.22%,27.21%). Complications were more common in the non-PPI group;84.3% had pulmonary complications,7.3% had thromboembolic complications. In the PPI group 72.15% had pulmonary complications which was over 10 % less than in the non-PPI group, 4.4% had thromboembolic complications which was 1.66 times less than the non-PPI group. Conclusion(s): In Our study PPI usage at index admission failed to show any worsening of outcomes in Covid 19 hospitalised patients, as opposed to recent published papers. This proposed causation needs further evaluation via well conducted prospective studies.