ABSTRACT
BACKGROUND: Underlying immunodeficiency is associated with severe COVID-19, but the prognosis of persons with human immunodeficiency virus (HIV) (PWH) with COVID-19 is under debate. Aim: assessment of the mortality rate and major determinants of death in HIV-infected patients hospitalized with COVID-19 in Spain before vaccine availability. Design: Retrospective nationwide public database analysis. METHODS: Nationwide, retrospective, observational analysis of all hospitalizations with COVID-19 during year 2020 in Spain. Stratification was made according to HIV status. The National Registry of Hospital Discharges was used with the ICD-10 coding list. RESULTS: A total of 117 694 adults were hospitalized with COVID-19 during 2020. Only 234 (0.2%) were HIV-positives. More than 95% were on antiretroviral therapy. Compared to HIV-negatives, PWH were younger (mean age 53.2 vs. 66.5 years old; P<0.001) and more frequently male (74.8% vs. 56.6%; P<0.001). Most co-morbidities predisposing to severe COVID-19 (diabetes, hypertension, dementia and cardiovascular disease) were more frequent in HIV-negatives. In contrast, the rate of baseline liver disease was over 6-fold higher in PWH (27.4% vs. 4.4%; P<0.001). In-hospital mortality was lower in PWH (9.4% vs. 16%; P=0.004). In multivariate analysis, older age, dementia and especially advanced liver disease (relative risk (RR): 7.6) were the major determinants of death in PWH hospitalized with COVID-19. CONCLUSION: HIV-infected patients hospitalized in Spain with COVID-19 during 2020 had better survival than HIV-negatives, most likely explained by younger age and lower rate of co-morbidities. However, advanced liver disease was a major predictor of death in PWH hospitalized with COVID-19.
Subject(s)
COVID-19 , Dementia , HIV Infections , Aged , Humans , Male , Middle Aged , COVID-19/complications , HIV , HIV Infections/complications , HIV Infections/epidemiology , Hospital Mortality , Retrospective Studies , FemaleABSTRACT
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Subject(s)
Humans , Patient Satisfaction , Sanitary Management , Health Care SurveysSubject(s)
Acromegaly/blood , Lipids/blood , Octreotide/pharmacology , Growth Hormone/blood , Growth Hormone/drug effects , Humans , Time FactorsABSTRACT
The aim of the present study was to ascertain whether sex differences exist in GH response to GHRH, and the influence that menstrual cycle have on this response. A GHRH test was performed on nine healthy men and ten women on days one and twelve of the menstrual cycle. Basal GH levels, (mean +/- SE) (7.98 +/- 3.09 ng/ml in women and 0.13 +/- 0.07 ng/ml in men, p less than 0.05) as well as maximal GH response (40.17 +/- 11.96 ng/ml in women and 9.63 +/- 2.32 ng/ml in males, p less than 0.01) were significantly higher in women than in men. In spite of a significant increase in estradiol levels during the menstrual cycle (75.88 +/- 2.48 pg/ml on day one and 198.40 +/- 28.65 pg/ml on day twelve, p less than 0.01) neither basal plasma GH levels, nor GH response to GHRH were significantly different. In conclusion, these results confirm that GH response to GHRH is higher in women than in men, and that this difference is not modified during the first phase of the menstrual cycle.
