Outcomes among HIV-positive patients hospitalized with COVID-19

Background: SARS-CoV-2 infection continues to cause significant morbidity and mortality worldwide. Preliminary data on SARS-CoV-2 infection suggests that some immunocompromised hosts experience worse outcomes. We performed a retrospective matched cohort study to characterize outcomes in HIV-positive patients with SARS-CoV-2 infection. Methods: Leveraging data collected from electronic medical records for all patients hospitalized at NYU Langone Health with COVID-19 between March 2, 2020 and April 23, 2020, we matched 21 HIV-positive patients to 42 non-HIV patients using a greedy nearest neighbor algorithm. Admission characteristics, laboratory results, and hospital outcomes were recorded and compared between the two groups. Results: While there was a trend toward increased rates of ICU admission, mechanical ventilation, and mortality in HIV-positive patients, these differences were not statistically significant. Rates for these outcomes in our cohort are similar to those previously published for all patients hospitalized with COVID-19. HIV-positive patients had significantly higher admission and peak CRP values. Other inflammatory markers did not differ significantly between groups, though HIV-positive patients tended to have higher peak values during their clinical course. Three HIV-positive patients had superimposed bacterial pneumonia with positive sputum cultures, and all three patients expired during hospitalization. There was no difference in frequency of thrombotic events or myocardial infarction between these groups. Conclusion: This study provides evidence that HIV coinfection does not significantly impact presentation, hospital course, or outcomes of patients infected with SARS-CoV-2, when compared to matched non-HIV patients. A larger study is required to determine if the trends we observed apply to all HIV-positive patients.

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HIV patients at the crossroads of European cardiovascular recommendations. Which path they should follow?

European Heart Journal ◽

10.1093/ehjci/ehaa946.3311 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Sanetra ◽

P Gorzelak-Pabis ◽

E Wlazlowska ◽

E Jablonowska ◽

M Broncel

Keyword(s):

Medical Records ◽

Treatment Duration ◽

Lipid Lowering ◽

Hiv Positive ◽

Lipid Lowering Therapy ◽

Specific Group ◽

Hiv Patients ◽

Therapeutic Goals ◽

Lowering Therapy ◽

Therapeutic Recommendations

Abstract Background/Introduction Recently, HIV patients' life expectancy has been significantly improved due to HAART. It is estimated that HIV positive individuals experience twice the risk of cardiovascular diseases rather than a general population and suffer from cardiovascular incidents in mean age 46 years. However there is no consensus between cardiovascular recommendations for this group of patients. Purpose The aim of the study is the analysis of HIV patients in the light of different cardiovascular recommendations and thus highlighting the inaccuracies of guidelines for this specific group of patients. Methods We performed retrospective analysis of 388 HIV infected patients based on medical records. Then we confronted our patients with different cardiovascular recommendations (PTN AIDS and ESC/EAS 2019 Dyslipidemia Guidelines vs. EACS Guidelines 2019). Results HIV-positive patients included in the study were: 311 men (80.4%) and 77 women (19.6%) in average age 41.7±10 years. The average BMI was 25.3±5 kg. Average HIV infection time was 8.96±7 years. Mean antiretroviral (arv) treatment duration was 4.6±3 years. Eleven participants (2.8%) had ischemic heart disease, 23.5% had hypertension and 3.4% HIV patients were diabetics. Half of patients (50.3%) were active smokers. Fourteen HIV patients (3.6%) experienced cardiovascular incidents in mean age 41.8±6 years. The actual average LDL in those patients is 93.14±21 mg/dl and currently only one of them achieves therapeutic LDL. HIV patients in consideration of PTN AIDS and ESC/EAS 2019 Dyslipidemia Guidelines vs. EACS Guidelines 2019 were scheduled in the Table. Conclusion(s) HIV patients included in our study poorly reach therapeutic recommendations neither provided by ESC/EAS and PTN AIDS or EACS Guidelines. Therapeutic goals reachability is worse in patients on lipid lowering therapy which along with low mean doses of statins indicates that HIV patients hypolipemic treatment is insufficient. There is no consensus on European cardiovascular guidelines for HIV patients, and thus there is a huge gap between recommendations and clinical practice. Funding Acknowledgement Type of funding source: None

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Should Electronic Medical Records Be an Alternative to Reference Intervals for Interpretation of Laboratory Results in Geriatric Subjects?

Advances in Intelligent Systems and Computing - Advances in Human Factors and Ergonomics in Healthcare and Medical Devices ◽

10.1007/978-3-030-50838-8_28 ◽

2020 ◽

pp. 203-206

Author(s):

Sudip Datta

Keyword(s):

Electronic Medical Records ◽

Medical Records ◽

Reference Intervals ◽

Laboratory Results

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The Comparative Experimental Study of Multilabel Classification for Diagnosis Assistant Based on Chinese Obstetric EMRs

Journal of Healthcare Engineering ◽

10.1155/2018/7273451 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 4

Author(s):

Kunli Zhang ◽

Hongchao Ma ◽

Yueshu Zhao ◽

Hongying Zan ◽

Lei Zhuang

Keyword(s):

Electronic Medical Records ◽

Medical Records ◽

Latent Dirichlet Allocation ◽

Nearest Neighbor ◽

Fertility Level ◽

K Nearest Neighbor ◽

Multilabel Classification ◽

Multilabel Learning ◽

Chief Complaints ◽

Physical Examinations

Obstetric electronic medical records (EMRs) contain massive amounts of medical data and health information. The information extraction and diagnosis assistants of obstetric EMRs are of great significance in improving the fertility level of the population. The admitting diagnosis in the first course record of the EMR is reasoned from various sources, such as chief complaints, auxiliary examinations, and physical examinations. This paper treats the diagnosis assistant as a multilabel classification task based on the analyses of obstetric EMRs. The latent Dirichlet allocation (LDA) topic and the word vector are used as features and the four multilabel classification methods, BP-MLL (backpropagation multilabel learning), RAkEL (RAndom k labELsets), MLkNN (multilabel k-nearest neighbor), and CC (chain classifier), are utilized to build the diagnosis assistant models. Experimental results conducted on real cases show that the BP-MLL achieves the best performance with an average precision up to 0.7413 ± 0.0100 when the number of label sets and the word dimensions are 71 and 100, respectively. The result of the diagnosis assistant can be introduced as a supplementary learning method for medical students. Additionally, the method can be used not only for obstetric EMRs but also for other medical records.

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Comparison of Clinical Features and Prognosis in Patients With Cryptogenic and Secondary Organizing Pneumonia

10.20944/preprints202108.0395.v1 ◽

2021 ◽

Author(s):

Keum-Ju Choi ◽

Eun-Hyung Yoo ◽

Kyung Chan Kim ◽

Eun Jin Kim

Keyword(s):

Symptom Onset ◽

Medical Records ◽

Bronchoalveolar Lavage Fluid ◽

Clinical Course ◽

Lavage Fluid ◽

Group Differences ◽

Organizing Pneumonia ◽

Steroid Use ◽

Radiologic Findings ◽

Laboratory Results

Organizing pneumonia (OP) can be diagnosed pathologically, and cryptogenic OP (COP) and secondary OP (SOP) have been classified by cause and underlying context. Because it is clinically difficult to differentiate between COP and SOP, this study investigated characteristics that could distinguish between COP and SOP. The medical records of patients who underwent lung biopsy from 2016 to 2018 were retrospectively reviewed. Eighty-five patients had pathologically proven OP, including 16 diagnosed with COP and 69 diagnosed with SOP. The most common cause of SOP was infectious pneumonia, observed in 57 (82.6%) of the 69 patients. Median time from symptom onset to hospital admission is shorter (P=0.006) and fever was more common (P=0.021) in the SOP. Some laboratory results differed significantly between the two groups. Lymphocyte in bronchoalveolar lavage fluid were higher in the COP (P=0.012). Radiologic findings showed that effusion was more common in the SOP (P=0.043). There were no between-group differences in steroid use, 30 day and in-hospital mortality rates, and rates of OP outcomes and recurrences. Infection is the main cause of SOP. Symptom onset is more rapid in patients with SOP. Pleural effusion was more common in the SOP but there were no differences in clinical course.

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Clinical signs of tuberculosis relapses in HIV patients

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2020-98-6-32-35 ◽

2020 ◽

Vol 98 (6) ◽

pp. 32-35

Author(s):

E. Yu. Zorkаltsevа ◽

Yu. O. Egorovа

Keyword(s):

Central Nervous System ◽

Hiv Infection ◽

Treatment Efficacy ◽

Medical Records ◽

Clinical Signs ◽

Clinical Manifestations ◽

Hiv Positive ◽

Hiv Patients ◽

The Central Nervous System ◽

Hiv Negative

The objective: to study clinical manifestations of tuberculosis relapses and their treatment outcomes in patients with HIV infection.Subjects and Methods. 132 medical records of patients with tuberculosis relapses were analyzed; 69 of them were HIV-positive and 63 were HIV-negative. All of them were admitted to Irkutsk Regional Clinical Tuberculosis Hospital from 2016 to 2019, and then continued treatment of tuberculosis on the out-patient basis. Treatment efficacy was assessed in February 2020.Results. More severe clinical forms of tuberculosis relapses were typical of HIV patients including generalized forms affecting the central nervous system. Therefore, among these patients, the mortality rate is significantly higher (24.6%) than in tuberculosis relapses with no concurrent HIV infection (6.3%), p ≤ 0.05.

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Systematically collected information at encounters with HIV-positive students: A review of 10 years of electronic medical records

Journal of American College Health ◽

10.1080/07448481.2018.1557196 ◽

2019 ◽

Vol 68 (4) ◽

pp. 327-331

Author(s):

Jacob D. Ball ◽

Denny Fe Agana ◽

Sheldon Waugh ◽

Kai Wang ◽

Tyler G. James ◽

...

Keyword(s):

Electronic Medical Records ◽

Medical Records ◽

Hiv Positive

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Measurement and application of patient similarity in personalized predictive modeling based on electronic medical records

BioMedical Engineering OnLine ◽

10.1186/s12938-019-0718-2 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Ni Wang ◽

Yanqun Huang ◽

Honglei Liu ◽

Xiaolu Fei ◽

Lan Wei ◽

...

Keyword(s):

Electronic Medical Records ◽

Predictive Modeling ◽

Predictive Models ◽

Medical Records ◽

Nearest Neighbor ◽

Training Sample ◽

Logistic Regression Models ◽

Diabetes Status ◽

Individualized Prediction ◽

Prediction Techniques

Abstract Background Conventional risk prediction techniques may not be the most suitable approach for personalized prediction for individual patients. Therefore, individualized predictive modeling based on similar patients has emerged. This study aimed to propose a comprehensive measurement of patient similarity using real-world electronic medical records data, and evaluate the effectiveness of the individualized prediction of a patient’s diabetes status based on the patient similarity. Results When using no more than 30% of the whole training sample, the personalized predictive models outperformed corresponding traditional models built on randomly selected training samples of the same size as the personalized models (P < 0.001 for all). With only the top 1000 (10%), 700 (7%) and 1400 (14%) similar samples, personalized random forest, k-nearest neighbor and logistic regression models reached the globally optimal performance with the area under the receiver-operating characteristic (ROC) curve of 0.90, 0.82 and 0.89, respectively. Conclusions The proposed patient similarity measurement was effective when developing personalized predictive models. The successful application of patient similarity in predicting a patient’s diabetes status provided useful references for diagnostic decision-making support by investigating the evidence on similar patients.

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Clinical, haematological, and biochemical profile of HIV patient co-infected with hepatitis B and /or C

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20204885 ◽

2020 ◽

Vol 8 (11) ◽

pp. 3955

Author(s):

Sonu Suman

Keyword(s):

Hepatitis B ◽

Liver Enzymes ◽

Clinical Course ◽

Hiv Positive ◽

Biochemical Profile ◽

Hiv Patients ◽

B Virus ◽

Immunodeficiency Virus ◽

Prompt Diagnosis ◽

Positive Population

Background: Human immunodeficiency virus (HIV) positive population is at higher risk of getting infected with hepatitis B virus (HBV) or hepatitis C virus (HCV) or both. Co-infection with HBV/HCV may possibly complicate the clinical course of HIV in infected patients. Aim and objectives of the study were intended to determine clinical, haematological and biochemical profile of HIV patients co infected with hepatitis B and/or C.Methods: All consecutive patients presented with HIV infection who were coinfected with either Hepatitis B, C or both presenting to immunodeficiency or Gastroenterology OPD Base Hospital Delhi, were included in the study. It was a prospective, observational study.Results: HIV impacts the progression of HCV and increases the likelihood of subsequent liver damage as it is apparent in study by significant raised liver enzymes and hypoalbuminemia in HIV-HCV co infection compare to HIV–HBV. Conclusions: These coinfections are more common in younger and lesser educated people. Biochemical parameters could serve as pointers for early detection of liver disease as result of hepatitis co infections in HIV patients. Prompt diagnosis of HCV and HBV co-infection in HIV patients has both individual and public health benefits.

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COVID-19-Induced Anosmia and Ageusia Are Associated With Younger Age and Lower Blood Eosinophil Counts

American Journal of Rhinology and Allergy ◽

10.1177/19458924211004800 ◽

2021 ◽

pp. 194589242110048

Author(s):

Esha Sehanobish ◽

Mali Barbi ◽

Valerie Fong ◽

Meryl Kravitz ◽

Denise Sanchez Tejera ◽

...

Keyword(s):

Electronic Medical Records ◽

Medical Records ◽

Clinical Course ◽

Ethnically Diverse ◽

Lower Probability ◽

Blood Eosinophil ◽

Younger Age ◽

Lower Blood ◽

The Relationship ◽

Eosinophil Counts

Background Anosmia and ageusia are symptoms commonly associated with COVID-19, but the relationship with disease severity, onset and recovery are unclear. Objective To examine factors associated with anosmia and ageusia and the recovery from these symptoms in an ethnically diverse cohort. Methods Individuals tested for SARS-CoV-2 between March and April 2020 were eligible for the study. Randomly selected participants answered a telephone questionnaire on COVID-19 symptoms with a focus on anosmia and ageusia. Additionally, relevant past medical history and data on the COVID-19 clinical course were obtained from electronic medical records. 486 patients were in the COVID-19 group and 103 were COVID-19-negative. Results Patients who were younger were more likely to report anosmia and/or ageusia (odds ratio (OR) for anosmia per 1-year increase in age: 0·98, 95%CI:0–97-0·99, p = 0·003; for ageusia: 0·98, 95%CI:0·97-0·99, p = 0·005) as were patients with lower eosinophil counts (OR for anosmia per 0.1-K/μL increase in eosinophils: 0·02, 95%CI:0·001-0·46, p = 0·01, for ageusia 0·10, 95%CI:0·01-0·97, p = 0·047). Male gender was independently associated with a lower probability of ageusia (OR:0·56, 95%CI:0·38-0·82, p = 0·003) and earlier sense of taste recovery (HR:1·44, 95%CI:1·05-1·98, p = 0·02). Latinos showed earlier sense of taste recovery than white patients (HR:1·82, 95%CI:1·05-3·18, p = 0·03). Conclusion Anosmia and ageusia were more common among younger patients and those with lower blood eosinophil counts. Ageusia was less commonly reported among men, and time to taste recovery was earlier among both men and Latinos.

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