HIV and COVID-19 Co-Infection: Epidemiology, Clinical Characteristics, and Treatment

Viruses, Journal Year: 2023, Volume and Issue: 15(2), P. 577 - 577

Published: Feb. 20, 2023

The COVID-19 pandemic has been a global medical emergency with significant socio-economic impact. People HIV (PWH), due to the underlying immunosuppression and particularities of stigma, are considered vulnerable population at high risk. In this review, we report what is currently known in available literature regards clinical implications overlap two epidemics. PWH share same risk factors for severe as general (age, comorbidities), but virological immunological status also plays an important role. Clinical presentation does not differ significantly, there some opportunistic infections that can mimic or co-exist COVID-19. should be prime candidates preventative treatments when they available, setting resistant strains, might easy. When considering small-molecule medications, physicians need always remember address potential interactions ART, immunosuppressants, aware risks infections. shares similarities how public perceives patients—with fear unknown prejudice. There opportunities treatment hidden research leaps gained both monoclonal antibody vaccine development.

Language: Английский

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The impact of immunosuppression on the mortality and hospitalization of Monkeypox: a systematic review and meta-analysis of the 2022 outbreak

Virology Journal, Journal Year: 2024, Volume and Issue: 21(1)

Published: June 5, 2024

Abstract Background Limited data is available regarding the severity and mortality of Mpox in individuals with immunocompromised conditions. Therefore, we performed this meta-analysis to understand impact HIV- or non-HIV-associated immunosuppression on requiring hospitalization mortality. Methods A thorough literature search was from 2022 up January 2024. The results were presented as odds ratios (ORs). We only included patients who required for rather than isolation. Results total 34 studies analysis. Our analysis did not find a significant difference risk between HIV-positive those HIV-negative (OR = 1.03; P 0.85; 7 studies; CD4 count fewer 200 cells/µL less 0.5% across all studies). Patients lower an unsuppressed RNA viral load (> copies/ml) had significantly higher 5.3, < 0.001) 3, 0.001), respectively. Most reported deaths HIV counts below cells/µL, some fatal cases occurring non-HIV immunosuppressed patients, particularly organ transplant recipients. Based autopsy findings, confirmed multiple organs, digestive tract, lung, testes. Furthermore, documented death that suspected be related hemophagocytic lymphohistiocytosis (HLH) immune reconstitution inflammatory syndrome (IRIS). reports showed concomitant non-Mpox infections at time Conclusions finding shows acts opportunistic pathogen individuals. These should prioritized early care closely monitored signs deteriorating clinical Clinical manifestations findings strongly suggest dissemination lungs. However, presence complicates assessment attribution death. Caution exercised when interpreting suggesting poorer outcomes immunosuppression, current evidence scarce further research needed.

Language: Английский

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Azvudine versus Paxlovid in COVID‐19: A systematic review and meta‐analysis

Reviews in Medical Virology, Journal Year: 2024, Volume and Issue: 34(4)

Published: June 7, 2024

Abstract This systematic review and meta‐analysis aimed to compare the effectiveness safety of azvudine versus nirmatrelvir/ritonavir (Paxlovid) in treating coronavirus disease 2019 (COVID‐19). The researchers conducted searches on PubMed, Cochrane Library, Web Science, medRxiv, Google Scholar until January 2024. risk bias tool was utilised evaluate quality included studies, data analysis performed using Comprehensive Meta‐Analysis software. Thirteen including 4949 patients, were analysed. results showed no significant difference between Paxlovid groups terms mortality rate (odds [OR] = 0.84, 95% confidence interval [CI]: 0.59–1.21), negative polymerase chain reaction (PCR) conversion time (standard mean [SMD] 1.52, CI: −1.07–4.11), hospital stay (SMD −0.39, −1.12–0.33). However, a observed two intensive care unit admission (OR 0.42, 0.23–0.75) need for mechanical ventilation 0.61, 0.44–0.86) favour azvudine. incidence adverse events group significantly lower 0.66, 0.43–0.99). certainty evidence rated as low moderate. Azvudine demonstrated similar reducing rates, PCR stay. better improving other outcomes. Regarding level evidence, further research is needed validate or challenge these results.

Language: Английский

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SARS-CoV-2 Variants and Clinical Outcomes of Special Populations: A Scoping Review of the Literature

Viruses, Journal Year: 2024, Volume and Issue: 16(8), P. 1222 - 1222

Published: July 30, 2024

The ongoing COVID-19 pandemic has significantly impacted special populations, including immunocompromised individuals, people living with HIV (PLWHIV), pediatric patients, and those chronic liver disease (CLD). This scoping review aims to map the clinical outcomes of these vulnerable groups when infected various SARS-CoV-2 variants. identifies trends patterns, noting that early variants, such as Alpha Delta, are associated more severe outcomes, higher hospitalization mortality rates. In contrast, Omicron variant, despite its increased transmissibility, tends cause milder manifestations. highlights necessity for surveillance tailored healthcare interventions due heterogeneity patient populations evolving nature virus. Continuous monitoring adaptive strategies essential mitigate impact on high-risk groups.

Language: Английский

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Exploring the Dynamics of SARS-CoV-2 and HIV Co-infection: Mutation Risks, Therapeutic Efficacy, and Future Variant Prevention

Diagnostic Microbiology and Infectious Disease, Journal Year: 2025, Volume and Issue: 111(3), P. 116707 - 116707

Published: Jan. 21, 2025

Language: Английский

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Navigating Coronavirus Disease 2019 in Immunocompromised Populations

Infectious Disease Clinics of North America, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

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Design, and synthesis of 2,4-thiazolidinedione substituted 1–3-5-triazine derivatives as anti-HIV agent via inhibition of reverse transcriptase along with anti-SARS CoV-2, antibacterial and antibiofilm activity

Bioorganic Chemistry, Journal Year: 2025, Volume and Issue: 160, P. 108427 - 108427

Published: April 2, 2025

Language: Английский

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High and Rapid Uptake of COVID-19 Vaccine Among Chicago Women with and Without HIV

Women s Health Reports, Journal Year: 2025, Volume and Issue: 6(1), P. 442 - 452

Published: Jan. 1, 2025

Language: Английский

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HIV and SARS-CoV-2 infection in postpartum Kenyan women and their infants

PLoS ONE, Journal Year: 2023, Volume and Issue: 18(1), P. e0278675 - e0278675

Published: Jan. 17, 2023

Background HIV may increase SARS-CoV-2 infection risk and COVID-19 severity generally, but data are limited about its impact on postpartum women their infants. As such, we characterized among mother-infant pairs in Nairobi, Kenya. Methods We conducted a nested study of 62 HIV-uninfected 64 healthy living with HIV, as well HIV-exposed uninfected (N = 61) HIV-unexposed 64) infants, participating prospective cohort. serology was performed plasma collected between May 1, 2020-February 2022 to determine the incidence, factors, symptoms infection. RNA PCR sequencing also available stool samples from seropositive participants. Results seropositivity found 66% 126 mothers 44% 125 There no significant association maternal (Hazard Ratio [HR] 0.810, 95% CI: 0.517–1.27) or infant exposure (HR 1.47, 0.859–2.53). Maternal associated two-fold increased 2.31, 1.08–4.94). Few participants (13% mothers, 33% infants) had symptoms; participant experienced severe death. Seroreversion occurred half sequences obtained were related contemporaneously circulating variants. Conclusions These indicate that Kenyan infants at high for antibody responses waned over an average 8–10 months. However, most cases asymptomatic did not have substantially COVID-19.

Language: Английский

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ICU Mortality Across Prepandemic and Pandemic Cohorts in a Resource-Limited Setting

CHEST Critical Care, Journal Year: 2023, Volume and Issue: 1(1), P. 100005 - 100005

Published: May 4, 2023

BackgroundHospital adaptation and resiliency, required during public health emergencies to optimize outcomes, are understudied especially in resource-limited settings.Research QuestionWhat the prepandemic pandemic critical illness outcomes a setting context of capacity strain?Study Design MethodsWe performed retrospective cohort study among patients admitted ICUs at two hospitals KwaZulu-Natal Department Health South Africa preceding COVID-19 (2017-2022). We used multivariate logistic regression analyze association between three patient cohorts (prepandemic non-COVID-19, COVID-19) ICU strain primary outcome mortality.ResultsThree thousand hundred twenty-one were period 2,539 (n = 375 [14.8%] with n 2,164 [85.2%] without COVID-19). The non-COVID-19 similar. Compared cohorts, showed older age, higher rates chronic cardiovascular disease diabetes, less extrapulmonary organ dysfunction, longer length stay. cohort, similar odds mortality (OR, 1.06; 95% CI, 0.90-1.25; P .50) whereas significantly increased 3.91; 3.03-5.05 < .0005). occupancy was not associated either 1.05 per 10% change occupancy; 0.96-1.14; .27) or pooled 1.01 0.98-1.03; .52).InterpretationPatients before broadly clinical characteristics suggesting care important differences mortality. Hospital settings. What strain? Three .52). Patients Take-home PointsStudy Question: How did compare across peripandemic degrees setting?Results: comparable occupancy, although pandemic, for COVID-19.Interpretation: These results suggest degree resiliency that may exceed being reported better-resourced settings, perhaps owing more longitudinal experience scarce resource allocation delivery under adverse circumstances. Study setting? Results: COVID-19. Interpretation: In face acute surge events such as tested on their adaptation, ability improve primarily affected (ie, infected) by implementing new processes based accumulated experience, is, continue deliver high-quality bystander patients, those uninfected but who still require this time), despite presence event.1Anderson J.E. Aase K. Bal R. et al.Multilevel influences resilient healthcare six countries: an international comparative protocol.BMJ Open. 2020; 10e039158Crossref Scopus (11) Google Scholar, 2Anesi G.L. Jablonski J. Harhay M.O. al.Characteristics, trends COVID-19-related learning system United States.Ann Intern Med. 2021; 174: 613-621Crossref PubMed (72) 3Anesi Lynch Y. Evans L. A Conceptual adaptable approach hospital preparedness due emerging infectious diseases.Crit Care Explor. 2e0110Crossref (32) 4Meyer D. Bishai Ravi S.J. al.A checklist resilience outbreaks natural hazards.BMJ Glob Health. 5: e002429Crossref (24) 5Prescott H.C. Levy M.M. Survival from severe coronavirus 2019: is it changing?.Crit 49: 351-353Crossref (4) Scholar Although much attention respiratory viral event initially naturally focused infected optimal often overlooked. However, has potential large impacts population health. Prepandemic research demonstrated relationship poorer within individual wards.6Churpek Gupta S. Spicer A.B. al.Hospital-level variation death critically ill COVID-19.Am J Respir Crit 204: 403-411Crossref (29) During been all-comer ICUs, hospitals, general population.7French G. Hulse M. Nguyen al.Impact excess deaths pandemic—United States, July 2020-July 2021.MMWR Morb Mortal Wkly Rep. 70: 1613-1616Crossref 8Wilcox M.E. Rowan K.M. Harrison D.A. Doidge J.C. Does unprecedented strain, experienced impact outcome?.Crit 2022; 50: e548-e556Crossref (14) 9Zampieri F.G. Bastos L.S.L. Soares Salluh J.I. Bozza F.A. short-term patients: observational Brazilian ICUs.Intensive 47: 1440-1449Crossref (17) 10Duclos A. Cordier Q. Polazzi al.Excess surgical attributable exposure French intensive intermediate units pandemic.Intensive 2023; 313-323Crossref (0) caused devastating globally. Despite heavy burden disease, settings African continent particular remain underrepresented research,11Naidoo A.V. Hodkinson P. Lai King Wallis L.A. authorship papers pandemic.BMJ 6: e004612Crossref (13) vaccination 30% portend prolonged regional pandemic.12Covid-19 vaccine tracker: global race vaccinate. Financial Times Updated December 23, 2022. Accessed February 9, 2023. https://ig.ft.com/coronavirus-vaccine-tracker/?areas=gbr&areas=usa&areas=eue&areas=xaf&cumulative=1&doses=full&populationAdjusted=1Google Scholar,13Bakamutumaho B. Lutwama J.J. Owor N. al.Epidemiology, characteristics, hospitalized Uganda, 2020-2021.Ann Am Thorac Soc. 19: 2100-2103Crossref (1) studies have absence high-fidelity local restricted analyses within-pandemic comparisons.14African Critical Outcomes (ACCCOS) Investigators. Patient infection high-care (ACCCOS): multicentre, prospective, study.Lancet. 397: 1885-1894Abstract Full Text PDF (85) Scholar,15Maslo C. Friedland Toubkin Laubscher Akaloo T. Kama Characteristics Omicron wave compared previous waves.JAMA. 327: 583-584Crossref (252) It remains unclear whether same relationships persist where referral admission practices resources exist, strain. particular, our prior shown metric highly decisions well-resourced settings.16Anesi Chowdhury Small D.S. al.Association novel index units.Ann 17: 1440-1447Crossref (19) Scholar,17Anesi Liu V.X. Gabler N.B. al.Associations unit disposition sepsis presenting emergency department.Ann 2018; 15: 1328-1335Crossref (40) rigorous gatekeeping exist scarcity preserve beds most likely benefit.18Anesi Allorto N.L. al.Intensive setting: 2-hospital Africa.J Intensive 35: 1104-1111Crossref (15) Chronically be overwhelmed easily pandemic-related alternatively As part Capacity Strain Group, we data source Integrated Electronic Database,19Allorto Wise R.D. Development evaluation integrated electronic management metropolitan service.South Afr Anaesth Analg. 2015; 21: 31-35Crossref (7) which multiple publications Group.18Anesi Scholar,20Bishop Wilson D.P.K. Savarimuthu S.M. Anesi Prognostic value Quick Sepsis-Related Organ Failure Assessment (qSOFA) score medical suspected setting.Afr 27: 145-150Crossref (2) 21Kahn Association pre-ICU stay setting.SAJCC. 37: 98-103Crossref 22Savarimuthu Cairns al.qSOFA predictor Province, Africa.SAJCC. 36: 92-95Crossref database includes all referrals admissions (Pietermaritzburg, Africa): Greys Hospital, tertiary approximately 530 inpatient beds, Harry Gwala Regional (formerly Edendale Hospital), secondary 900 beds. serve urban suburban population, well referred surrounding district community hospitals. Each one multidisciplinary mixed surgical) admits adult pediatric (either overflow) closed, high-intensity staffing models typically led anesthesia consultant (equivalent attending physician surgeon States). oversees daytime rounds team officers (generalist doctors) registrars (trainees equivalent resident physicians States) staff overnight remote contact consultant. system, provided citizens out-of-pocket costs, treats 84% accounts 43% country's case mix notable for: comprising predominantly Black race, skewing male sex, including 20% HIV infection, having needs commonly resulting issues (trauma other postoperative monitoring) infection. allocated Society Medicine triage priority limited needing ICU-specific therapy (priority I) monitoring II), rare III), too IVA), sick IVB) benefit admission.18Anesi Scholar,23Task Force American College Medicine, MedicineGuidelines admission, discharge, triage.Crit 1999; 633-638Crossref into real-time workflow captures discrete set variables time end-ICU disposition.18Anesi Patient-level status noted teams real audited team. National SARS-CoV-2 extracted separately publicly available Our World Data dataset,24COVID-19 datasetOur Data; June 2, 2023.https://ourworldindata.org/covid-casesDate accessed: 2023Google raw Johns Hopkins University Center Systems Science Engineering repository.25Dong E. Du H. Gardner An interactive web-based dashboard track time.Lancet Infect Dis. 20: 533-534Abstract (5853) included (aged ≥ 18 years) January 1, 2017, through 30, 2022, cohorts: March 4, 2020, 5, 2020 (when recorded its first case24COVID-19 Scholar,25Dong Scholar) subgroup previously described studied.20Bishop periods surges dominated five variants Africa: Ancestral Wuhan (peak 2020), Beta variant 2021), Delta BA.1/BA.2 subvariants BA.4/BA.5 May 2022).26Hodcroft E.B. CoVariants.org. CoVariants.org website.https://covariants.orgDate coprimary measure defined palliative discharge ICU. adjustment (recorded admission) included: status, vs hospital.14African additionally adjusted national cumulative count fully vaccinated individuals, completion any series calendar day (patient-level available).24COVID-19 adjust because believed would colinear COVID-19-based (an variable), accounted herein. comorbidities, elected physiologic features exists causal pathway indication non-COVID-19) outcomes. analysis, assessing mortality, patient-level covariates individuals (first analysis). To account outcomes6Churpek Scholar,8Wilcox Scholar,27Kadri S.S. Sun Lawandi caseload survival 558 U.S. August 2020.Ann 1240-1251Crossref (82) Scholar,28Bravata D.M. Perkins A.J. Myers L.J. load demand US Veterans Affairs pandemic.JAMA Network 4e2034266Crossref (153) work sets,16Anesi Scholar,18Anesi Scholar,29Anesi failure.Am 205: 520-528Crossref (8) sensitivity analysis further metrics: burden, turnover, acuity (see e-Appendix 1 definitions), 7-day rolling mean incident cases million residents.24COVID-19 high trauma proportion (35.5% 37.0% 5.5% cohort) nontrauma another admission. second continuous variable, now stratified strategy (second also report predicted probabilities deciles. different risk variants, again strategy. Pandemic (e-Table 1) dominant variant26Hodcroft 50 cases/1 residents admission.24COVID-19 Periods considered between-surge periods. calculated descriptive statistics metrics ORs models. Sample size estimations assuming two-sided test type I error rate (α) 5% 80% power (type II [β], 20%). For sample size, estimated detectable OR 1.21 1.37 cohort.30Faul F. Erdfelder Lang A.G. Buchner G∗Power 3: flexible statistical program social, behavioral, biomedical sciences.Behav Res Methods. 2007; 39: 175-191Crossref allowing strong correlation (R2 0.6), effect difference 2.6% 9.2% cohort.31Ender PB. Stata package: California, Los Angeles Advanced Research Computing Statistical Methods Analytics website. 25, https://stats.oarc.ucla.edu/stata/ado/analysis/powerlog-hlp-htmGoogle Missing values model exposures, low (< 1%), complete analysis. .05 statistically significant CIs presented throughout. All conducted using version 14.2 (StataCorp LP). protocol approved Biomedical Ethics Committee ("Characteristics Admitted With ICU," 16, Pietermaritzburg, Africa) Tertiary ICUs," no. 00002156, November Africa), institutional review board Pennsylvania ("Association Mortality Resource-Limited Setting," 824688, 29, Philadelphia, PA). licensed use Creative Commons Attribution 4.0 International license.24COVID-19 Table e-Table 2 cohort.

Language: Английский

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