Consensus statement on the assessment of comorbidities in people living with HIV in Romania

Streinu‐Cercel, Anca; Săndulescu, Oana; Poiană, Cătălina; Dorobanţu, Maria; Mircescu, Gabriel; Lăzureanu, Voichiţa Elena; Dumitru, Irina-Magdalena; Chirilă, Odette; Streinu‐Cercel, Adrian

doi:10.18683/germs.2019.1178

Cited by 13 publications

(10 citation statements)

References 29 publications

(38 reference statements)

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“…In the present study, the patient exhibited the risk factors of advanced age, pre-existing cardiac comorbidities, type 2 diabetes mellitus, obesity, immunosuppressive therapy and central venous catheterization upon admission. Similar to patients with HIV, patients infected with COVID-19 can have multiple comorbidities, which cause higher mortality rates compared with that in the general population, in spite of therapeutic care advances (10). The number and severity of respiratory infections is continuously increasing due to environmental changes and the lack of vaccination (11).…”

Section: Discussionmentioning

confidence: 99%

Bacterial endocarditis masked by COVID‑19: A case report

Bajdechi

Vlad

Dumitrașcu³

et al. 2021

Exp Ther Med

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Infective endocarditis represents a rare complication among patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2); it is often a nosocomial infection and the symptomatology can be masked by respiratory failure symptoms from SARS-CoV-2 bronchopneumonia. Management of patients with severe forms of SARS-COV-2 infection who also have associated infective endocarditis is very difficult, especially in mono-specialty hospitals (such as infectious diseases hospitals) where access to cardiological investigations is limited. The current study presents the case of a 73-year-old woman with increased cardiovascular risk (high blood pressure, diabetes mellitus and obesity), with uninvestigated ischaemic heart disease, who was admitted to the Department of Infectious Diseases in the Clinical Infectious Diseases Hospital (Constanta, Romania) due to SARS-CoV-2. Although the evolution was initially favorable, the condition of the patient significantly deteriorated on the 14th day of hospitalization due to the development of Enterococcus faecium infective endocarditis. Despite the therapy, the evolution was fulminant. Infection with coronavirus disease 2019 can result in numerous comorbidities, which cause higher mortality rates than in the general population.

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Section: Discussionmentioning

confidence: 99%

Bacterial endocarditis masked by COVID‑19: A case report

Bajdechi

Vlad

Dumitrașcu³

et al. 2021

Exp Ther Med

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“…A declining trend in the percentage of patients undergoing ART before admission was because of a decreasing rate of admission due to ART adverse events. It was noted that there was a declining trend in inhospital mortality in the past decade, which was partly due to an intensified medical care strategy (21)(22)(23)(24). We performed regular screening for TB infection, CMV infection, cryptococcal infection, Toxoplasma gondii infection, and Penicillium marneffei infection in HIV inpatients as well as regular brain, lung, and abdominal computed tomography scans.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately, 17.7% (11/62) and 51.6% (32/62) of all deaths occurred within the first week and first 2 weeks of hospitalization, respectively. The causes of death included PJP (21), TB ( 16), sepsis syndrome (6), malignant tumor ( 5), cryptococcal meningitis (5), HIV encephalopathy (5), invasive pulmonary aspergillosis infection (3), and hepatic failure (1). Cancer-related deaths accounted for 8.1% of the deaths.…”

Section: Risk Factors For Mortalitymentioning

confidence: 99%

In-hospital Mortality and Causes of Death in People Diagnosed With HIV in a General Hospital in Shenyang, China: A Cross-Sectional Study

Zhou

Wang

et al. 2021

Front. Public Health

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Background: Acquired immune deficiency syndrome (AIDS), caused by human immunodeficiency virus (HIV) infection, is a serious public health issue. This study investigated the correlated factors and possible changing trend of in-hospital death in patients diagnosed with HIV in the past decade in our hospital.Methods: We retrospectively collected data of firstly hospitalized patients with HIV in the Department of Infectious Disease in the First Affiliated Hospital of China Medical University from January 1, 2010 to December 31, 2019, and compared various factors that correlated with in-hospital death, including age, sex, opportunistic infections, and antiretroviral therapy (ART) status. Cox regression analysis was used to identify the risk factors for death.Results: In total, 711 patients were recruited for this study, and 62 patients died in the hospital. The in-hospital mortality rate was 8.72%. Tuberculosis (TB), malignancies, and thrombocytopenia were associated with mortality. Antiviral treatment before admission was found to be a protective factor. There was a declining trend in in-hospital mortality from 19.2% in 2010 to 6.3% in 2019 (linear-by-linear association test, p < 0.001), partly due to intensified medical care strategy.Conclusions: Till date, AIDS-defining illnesses remain the major cause of hospital admission and in-hospital mortality. TB and malignancies were correlated risk factors for in-hospital mortality. ART before admission was found to be beneficial, and considering the decreasing rate of in-hospital mortality, the implementation of intensified medical care strategy requires further effort.

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“…CM was defined and diagnosed when C. neoformans was isolated in culture from cerebrospinal fluid, with positive CSF India ink staining in direct microscopy, or with the detection of a positive Ag titer. Patients who previously completed treatment for CM and again grew a CSF culture of C. neoformans were considered a relapse [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Clinical Profile of 24 AIDS Patients with Cryptococcal Meningitis in the HAART Era: A Report from an Infectious Diseases Tertiary Hospital in Western Romania

et al. 2021

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Management of cryptococcal infections among patients suffering from acquired immunodeficiency syndrome (AIDS) represents a medical challenge. This retrospective study aims to describe the disease management and outcomes among 24 AIDS patients who suffered from Cryptococcus neoformans meningitis. The parameters evaluated from our patients’ database records include epidemiological data, clinical manifestations, biochemical and microbiological analysis of patients’ cerebrospinal fluid (CSF), treatment profiles, and disease outcomes. All patients included in the study had a lymphocyte count of less than 200 CD4/mm3. Of the 24 patients included in this study, five had been diagnosed with HIV infection since childhood, after receiving HIV-infected blood transfusions. The most prominent symptom was fatigue in 62.5% of patients, followed by nausea/vomiting and headache. Seven patients had liver cirrhosis due to hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, while Kaposi sarcoma and cerebral toxoplasmosis were found in two patients. Six out of 24 patients died due to bacterial sepsis and acute respiratory distress syndrome (ARDS). High intracranial pressure was the strongest predictive factor for mortality (OR = 2.9), followed by ARDS (OR = 1.8), seizures at disease onset (OR = 1.4), and diabetes mellitus (OR = 1.2). Interestingly, patients younger than 40 years old had a significantly lower survival rate than that of the older patients. Before developing Cryptococcal meningitis, all patients had low adherence to the early ART treatment scheme and skipped the follow-up visits. All patients received a combination of amphotericin B and flucytosine as induction therapy, adding fluconazole for maintenance. Simultaneously, AIDS HAART was initiated at diagnosis of the cryptococcal infection. A combined regimen of antifungals and highly active antiretroviral therapy showed improved patient recovery with minor side effects.

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Consensus statement on the assessment of comorbidities in people living with HIV in Romania

Cited by 13 publications

References 29 publications

Bacterial endocarditis masked by COVID‑19: A case report

Bacterial endocarditis masked by COVID‑19: A case report

In-hospital Mortality and Causes of Death in People Diagnosed With HIV in a General Hospital in Shenyang, China: A Cross-Sectional Study

Clinical Profile of 24 AIDS Patients with Cryptococcal Meningitis in the HAART Era: A Report from an Infectious Diseases Tertiary Hospital in Western Romania

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