The COVID-19 pandemic has required many clinical and translational scientists and staff to work remotely to prevent the spread of the virus. To understand the impact on research programs, we assessed barriers to remote work and strategies implemented to support virtual engagement and productivity. A mixed-methods RedCap survey querying the remote work experience was emailed to Colorado Clinical and Translational Sciences Institute (CCTSI) scientists and staff in April 2020. Descriptive analyses, Fisher’s Exact tests, and content analysis were conducted. Respondents (n = 322) were primarily female (n = 240; 75%), 21–73 years old (mean = 42 years) with a PhD (n = 139; 44%) or MD (n = 56; 55%). Prior to COVID-19, 77% (n = 246) never or rarely (0–1 day a week) worked remotely. Remote work somewhat or greatly interfered with 76% (n = 244) of researchers’ programs and 71% (n = 231) reported slowing or stopping their research. Common barriers included missing interactions with colleagues (n = 198; 62%) and the absence of routines (n = 137; 43%). Strategies included videoconferencing (n = 283; 88%), altering timelines and expectations (n = 180; 56%). Scientists and staff experienced interference with their research when they shifted to remote work, causing many to slow or stop research programs. Methods to enhance communication and relationships, support productivity, and collectively cope during remote work are available.
Background
Clinical characteristics and outcomes in people living with HIV (PLWH) undergoing percutaneous coronary intervention (PCI) remain poorly described. We sought to compare real‐world treatment of coronary artery disease, as well as patient and procedural factors and outcomes after PCI between PLWH and uninfected controls.
Methods and Results
We utilized procedural registry data from the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program between January 1, 2009 and December 31, 2019 to analyze patients with obstructive coronary artery disease on angiography. In the PCI subgroup, we used inverse probability of treatment weighting and applied Cox proportional hazards to evaluate the association of HIV serostatus with outcomes, including all‐cause mortality at 5 years. Among 184 310 patients with obstructive coronary artery disease, treatment strategy was similar between PLWH and controls—35.7% versus 34.2% PCI, 13.6% versus 15% coronary artery bypass grafting, and 50.7% versus 50.8% medical therapy. The PCI cohort consisted of 546 (0.9%) PLWH and 56 811 (99.1%) controls. PLWH undergoing PCI had well‐controlled HIV disease, and compared with controls, were younger, more likely to be Black, had fewer traditional risk factors, more acute coronary syndrome, less extensive coronary artery disease, and similar types of stents and P2Y12 therapy. However, PLWH experienced worse survival as early as 6 months post‐PCI, which persisted over time and amounted to a 21% increased mortality risk by 5 years (hazard ratio, 1.21 [95% CI, 1.03–1.42;
P
=0.02]).
Conclusions
Despite well‐controlled HIV disease, a more favorable overall cardiovascular risk profile, and similar PCI procedural metrics, PLWH still have significantly worse long‐term survival following PCI than controls.
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