ABSTRACT
In this prospective, multicentric, observational study, we describe the clinical characteristics and outcomes of people living with HIV (PLHIV) requiring hospitalization due to COVID-19 in Chile and compare them with Chilean general population admitted with SARS-CoV-2. Consecutive PLHIV admitted with COVID-19 in 23 hospitals, between 16 April and 23 June 2020, were included. Data of a temporally matched-hospitalized general population were used to compare demography, comorbidities, COVID-19 symptoms, and major outcomes. In total, 36 PLHIV subjects were enrolled; 92% were male and mean age was 44 years. Most patients (83%) were on antiretroviral therapy; mean CD4 count was 557 cells/mm3. Suppressed HIV viremia was found in 68% and 56% had, at least, one comorbidity. Severe COVID-19 occurred in 44.4%, intensive care was required in 22.2%, and five patients died (13.9%). No differences were seen between recovered and deceased patients in CD4 count, HIV viral load, or time since HIV diagnosis. Hypertension and cardiovascular disease were associated with a higher risk of death (p = 0.02 and 0.006, respectively). Compared with general population, the HIV cohort had significantly more men (OR 0.15; IC 95% 0.07-0.31) and younger age (OR 8.68; IC 95% 2.66-28.31). In PLHIV, we found more intensive care unit admission (OR 2.31; IC 95% 1.05-5.07) but no differences in the need for mechanical ventilation or death. In this cohort of PLHIV hospitalized with COVID-19, hypertension and cardiovascular comorbidities, but not current HIV viro-immunologic status, were the most important risk factors for mortality. No differences were found between PLHIV and general population in the need for mechanical ventilation and death.
Subject(s)
COVID-19/diagnosis , Coinfection/immunology , Coinfection/virology , HIV Infections/complications , Hospitalization/statistics & numerical data , SARS-CoV-2 , Adult , Black or African American , Aged , Anti-HIV Agents/therapeutic use , CD4 Lymphocyte Count , COVID-19/therapy , COVID-19 Serological Testing , Chile/epidemiology , Critical Care , Female , HIV Infections/drug therapy , HIV Infections/epidemiology , Humans , Intensive Care Units , Male , Middle Aged , Pandemics , Prospective StudiesABSTRACT
Kidney biopsies were performed in two women during their 21st and 24th week of pregnancy. The first patient developed an abrupt nephrotic syndrome without hypertension or kidney failure. The pathological study disclosed diffuse podocyte alterations such as those observed in focal and segmental glomerulosclerosis, which had a good response to steroidal treatment. The second patient had a progressive renal failure associated with non-nephrotic proteinuria. The biopsy disclosed a fibrillary glomerulopathy.
Subject(s)
Kidney/pathology , Nephrotic Syndrome/pathology , Pregnancy Trimester, Second , Renal Insufficiency/pathology , Adult , Biopsy, Needle , Female , Glomerulonephritis/pathology , Glomerulosclerosis, Focal Segmental/pathology , Humans , Nephrotic Syndrome/diagnosis , Pregnancy , Proteinuria/blood , Renal Insufficiency/diagnosis , Young AdultABSTRACT
El glosario semiológico en Dermatología es la recopilación parcelada de una gran cantidad de lesiones, signos, epónimos, analogías y comparaciones con las que se describen los diversos procesos de nuestra especialidad
