COVID-19 Infection Outcomes and Testing Outreach Efforts Among People Living With HIV in Milwaukee, Wisconsin.

INTRODUCTION: Since the beginning of the COVID-19 pandemic, the incidence and severity of COVID-19 co-infection in people living with HIV (PLWH) has been an area of investigative research. Clinic databases of PLWH provide opportunities to investigate outcomes of COVID-19 co-infection and efficacy of outreach efforts, which are integral to patient care during health crises. METHODS: All PLWH over 18 years of age who receive care at the Froedtert & Medical College of Wisconsin Adult Infectious Disease Clinic and who had a COVID-19 test performed during May 2020 through March 2021 were included for analysis. All patients received an individualized phone call with COVID-19 testing education and information. Automated data collection and manual chart review were used to acquire information on demographics, outreach efforts, COVID-19 testing results, and COVID-19 clinical course. RESULTS: Four hundred sixty-two COVID-19 tests completed on 793 PLWH were included, with 40 (8.7%) positive tests and 422 (91.3%) negative tests on a predominantly young, male, and virally suppressed cohort. Most patients had mild to moderate COVID-19 infection (20/27, 74.07%), with 1 patient requiring hospitalization and zero deaths. Three hundred fourteen (39.59%) patients accepted outreach for COVID-19 testing; 171 were tested in our health system, with 72 of those tests occurring within 2 weeks. Outreach efforts demonstrated a statistically significant increase in COVID-19 testing (P < 0.001). CONCLUSIONS: In this largely young, male, virally suppressed cohort of PLWH, most COVID-19 co-infections were associated with mild to moderate disease severity, with 1 hospitalization and zero deaths. Individualized patient outreach efforts were associated with a significant increase in COVID-19 testing, most of which occurred after a single phone call. This outreach process could have utility in other public health arenas, though may be limited by larger patient populations.

Cardiopulmonary Exercise Testing for Surgical Risk Stratification in Adults with Congenital Heart Disease.

Adult congenital heart disease (ACHD) patients often require repeat cardiothoracic surgery, which may result in significant morbidity and mortality. Currently, there are few pre-operative risk assessment tools available. In the general adult population, pre-operative cardiopulmonary exercise testing (CPET) has a predictive value for post-operative morbidity and mortality following major non-cardiac surgery. The utility of CPET for risk assessment in ACHD patients requiring cardiothoracic surgery has not been evaluated. Retrospective chart review was conducted on 75 ACHD patients who underwent CPET less than 12 months prior to major cardiothoracic surgery at Children's Hospital of Wisconsin. Minimally invasive procedures, cardiomyopathy, acquired heart disease, single ventricle physiology, and heart transplant patients were excluded. Demographic information, CPET results, and peri-operative surgical data were collected. The study population was 56% male with a median age of 25 years (17-58). Prolonged post-operative length of stay correlated with increased ventilatory efficiency slope (VE/[Formula: see text] slope) (P = 0.007). Prolonged intubation time correlated with decreased peak HR (P = 0.008), decreased exercise time (P = 0.002), decreased heart rate response (P = 0.008) and decreased relative peak oxygen consumption (P = 0.034). Post-operative complications were documented in 59% of patients. While trends were noted between post-operative complications and some measurements of exercise capacity, none met statistical significance. Future studies may further define the relationship between exercise capacity and post-operative morbidity in ACHD patients.