Background Prior research has established some risk factors for an increased risk of severe disease and mortality from coronavirus disease 2019 (COVID-19). However, the impact of HIV infection on SARS-CoV-2 susceptibility and severity is a significant gap in the literature. In the same way, not many studies across the globe have analyzed the degree of vaccination willingness among people living with HIV/AIDS (PLWHA) and considerations regarding prioritizing this population during vaccination plans, particularly in developing countries. Methods A descriptive-analytical cross-sectional study was conducted. Self-completed electronic surveys directed to PLWHA were performed via Twitter in February 2021, using accounts of HIV activists. Results 460 (87.1%) participants were willing to be vaccinated with any COVID-19 vaccine. The reasons for that were listed as 1) the belief that vaccination prevents both the COVID-19 infection (81.3%) as well as being a spreader (52.2%); 2) having a high occupational risk of becoming infected with COVID-19 (22%); and 3) the belief that they would be at high risk of death because of COVID-19 (21.3%). Only 56 (10.6%) participants expressed hesitancy toward vaccination, and 12 (2.2%) stated they did not want to get vaccinated. Conclusions Our results may support the prioritization of people living with HIV during the implementation of vaccination plans in developing countries. New strategies should be adopted to overcome the hesitancy and unwillingness toward the COVID-19 vaccination, especially in populations with risk factors for severe disease.
This is an open access article distributed in accordance with the CC-BY-NC-ND (Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International) license. The article can be used by giving appropriate credit and mentioning the license, but only for non-commercial purposes and only in the original version. For further information: https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en CliniCal geriatriCs -Original investigatiOn
Background Due to the poor outcomes reported in older patients with hematological malignancies (HM) and pulmonary infections, there is a need to identify patients at high risk of mortality. Objective: This study aims to find the association between frailty and mortality in patients above 65 years of age with HM hospitalized with pulmonary infections. Methods A cross-sectional, retrospective study was conducted on the clinical data of 64 HM older patients with pulmonary infection hospitalized in a tertiary university hospital in Bucaramanga, Colombia, between January 2015 and December 2020. Patients were assessed using Clinical Frailty Scale (CFS) and were divided into three groups: CFS 1–4 fit; CFS 5–6 frail and CSF 7–9 severely frail. The association between frailty and in-hospital mortality was the primary outcome. All statistical analyses were performed using Stata/IC 14.0. Results The number of participants classified as fit, frail, and severely frail was 21 (32.8%), 22 (34.3%), and 21 (32.8%), respectively. 48.4% were women, and the mean age was 75.4 ± 6.85 years. A total of 45 patients (70.3%) died during hospitalization. We found a significantly higher in-hospital mortality rate among frail (23.8% vs. 90.9%; p < .001) and severely frail patients (23.8% vs. 95.2%; p < .001), when compared to fit patients. After multivariate analysis, high CFS score was an independent risk factor for mortality, OR was 6.8 (1.40–32.97, p = .001) for frail and 14.4 (1.76–117.32 p = .013) for severely frail compared to fit patients, after adjustment for sex, type of HM and the presence of comorbidities. Table 1Baseline characteristics of study participants.Image 1Kaplan-Meier survival estimate for mortality for patients ≥65 years with hematological malignancies and pulmonary infection. Conclusion Clinical Frailty Scale (CFS) could be used as a potentially useful tool in predicting mortality of pulmonary infections in elderly patients with HM. These results could suggest that the use of this score extends beyond evaluating the degree of frailty and could predict adverse outcomes and help decision making in complex clinical scenarios. Disclosures All Authors: No reported disclosures.
Background Invasive fungal infection (IFI) is a potentially lethal complication in patients with hematological malignancies (HM). However, studies are scarce in this population, especially in developing countries. The aim of this study was to investigate the prevalence, epidemiology, predictive factors, and outcomes of IFI in patients with HM hospitalized in non-HEPA-filtered rooms (resource-limited settings) in a reference center in Colombia. Methods A cross-sectional, retrospective study was conducted on the clinical data of HM patients and pulmonary infection hospitalized in a tertiary university hospital in Bucaramanga, Colombia, between 2015 and 2020. The primary outcome was proven/probable IFI according to the EORTC/MSGERC criteria. A descriptive and group comparison analysis were performed between patients with IFI and patients with non-fungal infections. The main risk factors for the development of IFI were identified by multivariate stepwise logistic regression analysis. Table 1Statistically significant variables in the univariate analysis of patient characteristics compared between patients with invasive fungal infection and patients with non-fungal infection.Image 1Associated factors to develop invasive fungal infections (IFIs) in patients with HM. The graph shows the variables showed statistically significant difference in the multivariate analysis. Results In 201 patients, the prevalence of proven/probable IFI was 21.39% (43 cases). The most common IFI was caused by Aspergillus spp. (41.8%), followed by Candida spp. (34.8%), Mucor spp. (6.9%), Penicillium spp. (4.6%) and Cryptococcus neoformans (4.6%). The lung was the most commonly affected site (n=34; 81.3%); four patients (9.3%) developed fungal sinusitis and disseminated IFI, respectively. In-hospital mortality was 86% (37/43). Multivariate logistic regression analysis (area under the ROC curve=0.90) showed that antibiotic use ≥3 weeks (OR, 4.11; 95% CI, 1.26-13.31; p< .001), history of pulmonary infection (OR, 5.75; 95% CI, 1.41-23.39; p< .001) and neutropenia duration ≥21 days (OR, 5.88; 95% CI, 1.26-19.86; p < .001) were independent risk factors for the development of IFI and mould-active prophylaxis (OR: 0.20; 95% CI: 0.060–0.705; p=0.012) was significantly associated with a lower occurrence of IFI. Conclusion HM patients in resource-limited settings have a high prevalence of IFI with an elevated mortality. The use of mould-active prophylaxis is associated with a significantly lower occurrence of IFI. Cost-effective strategies for prevention and early diagnosis of IFI are required to improve survival in patients with HM. Disclosures All Authors: No reported disclosures.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.