COVID-19 among people living with HIV in Lebanon

Background:There are conflicting reports of the interaction between COVID-19 and HIV infection among coinfected individuals, and there is a particular dearth of evidence among populations in the Middle East.Aim:To determine if living with HIV and use of antiretroviral therapy increases susceptibility to, and severity of, COVID-19. Methods:This cross-sectional study was based on telephone survey of COVID-19 symptoms duration and clinical course among 200 people living with HIV (PLWHs) and a review of medical records in Beirut, Lebanon, during Spring 2021. Data were collected from consenting patients using standardized forms. The laboratory and medical characteristics of PLWHs with and without COVID-19 were compared and the outcomes of COVID-19 were described. A binary logistic regression model for contracting COVID-19 was constructed based on clinically relevant covariates consistently associated with COVID-19. Significance level was set at 0.05 and statistical analysis was performed using SPSS version 27.0. The Lebanese American University Institutional Review Board approved the study protocol. Results:Fifty-two of 200 PLWHs contracted COVID-19 but only 4 progressed to severe COVID-19. No significant differences were found with respect to gender, time since HIV diagnosis, most recent CD4 count, viral load, substance use, comorbidities, or use of antiretroviral therapy. Older PLWHs were at lower risk of contracting COVID-19; COVID-19 infection was significantly associated with younger age. Conclusions:COVID-19 infection was associated with younger age among PLWHs in Lebanon, possibly due to behavioural and socioeconomic factors.

Role of Combining Anticoagulant and Antiplatelet Agents in COVID-19 Treatment: A Rapid Review

Although primarily affecting the respiratory system, COVID-19 causes multiple organ damage. One of its grave consequences is a prothrombotic state that manifests as thrombotic, microthrombotic, and thromboembolic events.Therefore, understanding the effect of antiplatelet and anticoagulation therapy in the context of COVID-19 treatment is important. The aim of this rapid review is to highlight the role of thrombosis in COVID-19 and provide new insights on the use of antithrombotic therapy in its management. A rapid systematic review was performed using preferred reporting items for systematic reviews. Papers published in English on antithrombotic agent use and COVID-19 complications were eligible. Results showed that the use of anticoagulants increased survival and reduced thromboembolic events in patients. However, despite the use of anticoagulants, patients still suffered thrombotic events likely due to heparin resistance. Data on antiplatelet use in combination with anticoagulants in the setting of COVID-19 is quite scarce. Current side effects of anticoagulation therapy emphasize the need to update treatment guidelines. In this rapid review, we address a possible modulatory role of antiplatelet and anticoagulant combination against COVID{square}19 pathogenesis. This combination may be an effective form of adjuvant therapy against COVID{square}19 infection. However, further studies are needed to elucidate potential risks and benefits associated with this combination. It was not appropriate or possible to involve patients or the public in the design, or conduct, or reporting, or dissemination plans of our research