Etiology, clinical, and epidemiological characteristics of severe respiratory infection in people living with HIV

People living with HIV (PLWH) are more prone to severe respiratory infections. We used the severe acute respiratory infection (SARI) definition to describe the etiology, clinical, and epidemiological characteristics in this population. This was a prospective observational study including PLWH hospitalized with fever and cough. Those with symptom onset up to 10 days were classified as severe acute respiratory infection and 11–30 days as non-severe acute respiratory infection. Blood, urine samples and nasopharyngeal swabs were collected. Data were extracted from patient charts during their hospital stay. Forty-nine patients were included, median CD4 cell count: 80 cells/mm3, median time since HIV diagnosis and hospital admission: 84 months and 80% were antiretroviral therapy exposed. Twenty-seven patients were classified as SARI. Etiology was identified in 69%, 47% were polymicrobial. Respiratory virus (9 SARI vs. 13 non-SARI), bacteria (5 SARI vs. 4 non-SARI), Mycobacterium tuberculosis (6 SARI group vs. 7 non-SARI group), Pneumocystis jirovecii (4 SARI vs. 1 non-SARI), Cryptococcus neoformans (1 SARI vs. 3 non-SARI), and influenza A (1 SARI vs. 2 non-SARI). Dyspnea was statistically more prevalent in SARI (78% vs. 36%, p = 0.011) but the risk of death was higher in the non-SARI (4% vs. 36%, p = 0.0067). In the severely immunocompromised PLWH, severe acute respiratory infection can be caused by multiple pathogens and codetection is a common feature.

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Clinical characteristics and outcomes of people living with HIV hospitalized with COVID-19: a nationwide experience

International Journal of STD & AIDS ◽

10.1177/0956462420973106 ◽

2021 ◽

Vol 32 (5) ◽

pp. 435-443

Author(s):

Maria Elena Ceballos ◽

Patricio Ross ◽

Martin Lasso ◽

Isabel Dominguez ◽

Marcela Puente ◽

...

Keyword(s):

Mechanical Ventilation ◽

Intensive Care ◽

General Population ◽

Clinical Characteristics ◽

Cd4 Count ◽

People Living With Hiv ◽

Hiv Diagnosis ◽

Hiv Viral Load ◽

Risk Of Death ◽

Living With Hiv

In this prospective, multicentric, observational study, we describe the clinical characteristics and outcomes of people living with HIV (PLHIV) requiring hospitalization due to COVID-19 in Chile and compare them with Chilean general population admitted with SARS-CoV-2. Consecutive PLHIV admitted with COVID-19 in 23 hospitals, between 16 April and 23 June 2020, were included. Data of a temporally matched-hospitalized general population were used to compare demography, comorbidities, COVID-19 symptoms, and major outcomes. In total, 36 PLHIV subjects were enrolled; 92% were male and mean age was 44 years. Most patients (83%) were on antiretroviral therapy; mean CD4 count was 557 cells/mm3. Suppressed HIV viremia was found in 68% and 56% had, at least, one comorbidity. Severe COVID-19 occurred in 44.4%, intensive care was required in 22.2%, and five patients died (13.9%). No differences were seen between recovered and deceased patients in CD4 count, HIV viral load, or time since HIV diagnosis. Hypertension and cardiovascular disease were associated with a higher risk of death ( p = 0.02 and 0.006, respectively). Compared with general population, the HIV cohort had significantly more men (OR 0.15; IC 95% 0.07–0.31) and younger age (OR 8.68; IC 95% 2.66–28.31). In PLHIV, we found more intensive care unit admission (OR 2.31; IC 95% 1.05–5.07) but no differences in the need for mechanical ventilation or death. In this cohort of PLHIV hospitalized with COVID-19, hypertension and cardiovascular comorbidities, but not current HIV viro-immunologic status, were the most important risk factors for mortality. No differences were found between PLHIV and general population in the need for mechanical ventilation and death.

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Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014–2015 and 2015–2016

Epidemiology and Infection ◽

10.1017/s0950268818001486 ◽

2018 ◽

Vol 146 (11) ◽

pp. 1350-1358 ◽

Cited By ~ 7

Author(s):

H. E. Segaloff ◽

J. G. Petrie ◽

R. E. Malosh ◽

C. K. Cheng ◽

E. J. McSpadden ◽

...

Keyword(s):

Respiratory Infection ◽

Acute Respiratory Infection ◽

Influenza A ◽

Hospital Length Of Stay ◽

Charlson Score ◽

Neuraminidase Inhibitors ◽

Icu Admission ◽

Hospitalised Patients ◽

Severe Acute Respiratory Infection ◽

The Impact

AbstractOur objective was to identify predictors of severe acute respiratory infection in hospitalised patients and understand the impact of vaccination and neuraminidase inhibitor administration on severe influenza. We analysed data from a study evaluating influenza vaccine effectiveness in two Michigan hospitals during the 2014–2015 and 2015–2016 influenza seasons. Adults admitted to the hospital with an acute respiratory infection were eligible. Through patient interview and medical record review, we evaluated potential risk factors for severe disease, defined as ICU admission, 30-day readmission, and hospital length of stay (LOS). Two hundred sixteen of 1119 participants had PCR-confirmed influenza. Frailty score, Charlson score and tertile of prior-year healthcare visits were associated with LOS. Charlson score >2 (OR 1.5 (1.0–2.3)) was associated with ICU admission. Highest tertile of prior-year visits (OR 0.3 (0.2–0.7)) was associated with decreased ICU admission. Increasing tertile of visits (OR 1.5 (1.2–1.8)) was associated with 30-day readmission. Frailty and prior-year healthcare visits were associated with 30-day readmission among influenza-positive participants. Neuraminidase inhibitors were associated with decreased LOS among vaccinated participants with influenza A (HR 1.6 (1.0–2.4)). Overall, frailty and lack of prior-year healthcare visits were predictors of disease severity. Neuraminidase inhibitors were associated with reduced severity among vaccine recipients.

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Epidemiology of Severe Acute Respiratory Infection (SARI) Cases at a sentinel site in Egypt, 2013–15

Journal of Public Health ◽

10.1093/pubmed/fdz053 ◽

2019 ◽

Vol 42 (3) ◽

pp. 525-533 ◽

Cited By ~ 2

Author(s):

Mohamed M Elhakim ◽

Sahar K Kandil ◽

Khaled M Abd Elaziz ◽

Wagida A Anwar

Keyword(s):

Respiratory Infection ◽

Acute Respiratory Infection ◽

Influenza A ◽

Case Definition ◽

Quality Data ◽

Influenza B ◽

Sentinel Site ◽

Influenza A Viruses ◽

High Quality Data ◽

Severe Acute Respiratory Infection

Abstract Background Sentinel surveillance for severe acute respiratory infection (SARI) in Egypt began in 2006 and occurs at eight sites. Avian influenza is endemic, and human cases of influenza A (H5N1) have been reported annually since 2006. This study aimed to describe the epidemiology of SARI at a major sentinel site in the country. Methods Data included in the study were collected from a major SARI sentinel site in Egypt during three consecutive years (2013–15). Results A total of 1254 SARI patients conforming to the WHO case definition were admitted to the sentinel site, representing 5.6% of admitted patients for all causes and 36.6% of acute respiratory infection patients. A total of 99.7% of the patients were tested, and 21.04% tested positive; 48.7% of cases involved influenza A viruses, while 25% involved influenza B. The predominant age group was under 5 years of age, accounting for 443 cases. The seasonality of the influenza data conformed to the Northern Hemisphere pattern. Conclusions The present study’s results show that SARI leads to substantial morbidity in Egypt. There is a great need for high-quality data from the SARI surveillance system in Egypt, especially with endemic respiratory threats such as influenza A (H5N1) in Egypt.

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Microbiological Case Report: Epidemiological Characteristics and Update of Covid-19 Cases in St. Lucia

Journal of Infectious Diseases & Case Reports ◽

10.47363/jidscr/2020(1)104 ◽

2020 ◽

pp. 1-5

Author(s):

Sambasivarao Yaragalla Yaragalla ◽

◽

Lydia Atkins ◽

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Case Report ◽

Respiratory Infection ◽

Symptom Severity ◽

Acute Respiratory Infection ◽

Distress Syndrome ◽

Clinical Presentation ◽

Wuhan City ◽

Severe Acute Respiratory Infection ◽

Epidemiological Characteristics

Coronavirus disease 2019 (COVID-19) is a potentially severe acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2.The virus was identified as the cause of an outbreak of pneumonia of unknown cause in Wuhan City, Hubei Province, China, in December 2019. The clinical presentation is that of a respiratory infection with a symptom severity ranging from a mild common cold-like illness, to a severe viral pneumonia leading to acute respiratory distress syndrome that is potentially fatal [1,2].

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Mortality, Severe Acute Respiratory Infection, and Influenza-Like Illness Associated with Influenza A(H1N1)pdm09 in Argentina, 2009

PLoS ONE ◽

10.1371/journal.pone.0047540 ◽

2012 ◽

Vol 7 (10) ◽

pp. e47540 ◽

Cited By ~ 12

Author(s):

Eduardo Azziz-Baumgartner ◽

Ana María Cabrera ◽

Loretta Chang ◽

Rogelio Calli ◽

Gabriela Kusznierz ◽

...

Keyword(s):

Respiratory Infection ◽

Acute Respiratory Infection ◽

Influenza A ◽

Influenza Like Illness ◽

Severe Acute Respiratory Infection ◽

Influenza A H1n1

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Transgender people living with HIV: characteristics and comparison to homosexual and heterosexual cisgender patients in two Italian teaching hospitals

International Journal of STD & AIDS ◽

10.1177/0956462420950573 ◽

2020 ◽

pp. 095646242095057

Author(s):

Chiara Papalini ◽

Filippo Lagi ◽

Elisabetta Schiaroli ◽

Gaetana Sterrantino ◽

Daniela Francisci

Keyword(s):

Latin American ◽

Sex Workers ◽

Viral Suppression ◽

Teaching Hospitals ◽

People Living With Hiv ◽

Hiv Diagnosis ◽

Sexually Transmitted ◽

And Gender ◽

Living With Hiv ◽

Epidemiological Characteristics

Regarding people living with HIV (PLHIV), little is known about the epidemiological characteristics and management decisions for transgender individuals. This retrospective study compared transgender and cisgender (homosexual and heterosexual) PLHIV at both the S. Maria della Misericordia of Perugia and Careggi of Firenze Teaching Hospitals from 2000 to 2018. Multivariate logistic regression was performed to analyse possible relationships between viral suppression (dependent variable) and age, sexually transmitted infections (STIs), and hepatitis diagnosis (independent variables). After analysing and comparing epidemiological and clinical data for 124 transgender, 180 homosexual cisgender and 188 heterosexual cisgender PLHIV, we found that transgender PLHIV, mostly Latin American sex workers, were more likely to have other STIs. Likewise, this subgroup, on average, was younger at the time of HIV diagnosis and more likely to be less adherent to care, consequently jeopardizing the achievement of viral suppression. Finally, the use of hormone therapy and gender confirmation surgery in transgender PLHIV contributed to specific management issues. To date, major attention has focused on studying the epidemiological characteristics of homosexual and heterosexual PLHIV. Our analysis found that transgender PLHIV were the least likely group to be adequately retained in the continuum of care and presented specific issues in part due to social and behavioural realities.

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Surveillance for Severe Acute Respiratory Infection as one approach to enhance Global Health Security in Indonesia

Health Science Journal of Indonesia ◽

10.22435/hsji.v9i1.473 ◽

2018 ◽

Vol 9 (1) ◽

pp. 8-13

Author(s):

Ira Wignjadiputro ◽

Ni Ketut Susilarini ◽

Catharina Yekti Praptiningsih ◽

Elvieda Sariwati ◽

Vivi Setiawaty ◽

...

Keyword(s):

Global Health ◽

Respiratory Infection ◽

Surveillance System ◽

Acute Respiratory Infection ◽

Influenza A ◽

Influenza Surveillance ◽

Influenza B ◽

Global Health Security ◽

Health Security ◽

Severe Acute Respiratory Infection

Latar Belakang: Sistem surveilans nasional untuk infeksi saluran pernafasan akut berat (SARI) dapatmemberikan informasi penting tentang sirkulasi virus influenza, menyediakan sistem untuk mengendalikankejadian luar biasa yang mengancam keamanan dan keselamatan masyarakat serta menyediakandata untuk sistem surveilans influenza global (GISRS). Kemampuan Indonesia untuk mendeteksi dan mengendalikanpenyakit menular penting untuk keamanan kesehatan dunia. Penelitian ini bertujuan untukmenilai sistem surveilans ISPA berat Indonesia (SIBI) dan pemanfaatan untuk memantau patogen prioritaslainnya sebagai upaya meningkatkan keamanan kesehatan global. Metode: penilaian atribut surveilans melalui review laporan, analisis data dan interview staff yang terlibatdalam sistem surveilans. Semua kasus yang memenuhi kriteria SARI pada bulan Mei 2013 – April 2015 ikutserta dalam penelitian. Data epidemiologi dan virologi dianalisis. Kelengkapan dan kemudahan sistem untukmencapai tujuan surveilans influenza dan mendukung surveilans penyakit infeksi baru (emerging) dikaji. Hasil: Sebanyak 1,806 kasus SARI dan 1,697 (94%) spesimen dilakukan pemeriksaan virus influenza.Sebanyak 200 (12%) positif influenza, terdiri dari 46% influenza A(H3N2), 18% A(H1N1)pdm09 dan 37%influenza B. Hasil penilaian terhadap sistem surveilans didapatkan kesesuaian pelaksanaan untuk semuaatribut surveilans melebihi target >80%, kelengkapan laporan online 95%, kesesuaian kasus terhadapdefinisi kasus 100%, kasus yang diambil spesimen 94% dan hasil laboratorium diinput ke database secaraonline 100%. Sistem surveilans untuk dengue dan infeksi arbovirus lainnya sudah terlaksana di unitrawat jalan dan gawat darurat di sentinel SARI surveilans. Kesimpulan: SIBI dapat disesuaikan untuk menggabungkan surveilans penyakit lain yang menunjukkankegunaan dan fleksibilitas dalam mendukung keamanan kesehatan global. Kata kunci: keamanan kesehatan global, surveilans, influenza, Indonesia AbstractBackground: The existing national surveillance system for severe acute respiratory infection (SARI) providescritical information on influenza virus circulation, provides a system to control influenza outbreaks that threatenthe safety and security of the population and feeds data into the global influenza surveillance and responsesystem (GISRS). Indonesia’s ability to detect and control communicable diseases is critical for global healthsecurity. The aim of this study was to assess the SARI surveillance system and utility for monitoring other prioritypathogens as an effort to enhance global health security. Methods: Surveillance attributes were assessed by reviewing records, data analysis and through interviewedwith staffs involved in the surveillance system. All patients at six sentinel hospitals who meet the SARI casedefinition during May 2013 – April 2015 were enrolled. Epidemiological and virological data were analyzed.The surveillance system utility for its influenza surveillance objectives and flexibility to support surveillance ofemerging infectious diseases were assessed. Resuts: A total of 1,806 SARI cases were reported of which 1,697 (94%) had specimens tested for influenza viruses.Of those tested, 200 (12%) were positive, of which 46% were influenza A(H3N2), 18% A(H1N1)pdm09and 37% influenza B viruses. The system exceeded the targets of >80% adherence for most attributes: 95% forcompleteness of online reporting, 100% for cases adhering to the case definition, 94% for cases with specimenscollected and 100% of laboratory results uploaded to the online database. A surveillance system for dengue andother arbovirus infections was established in the outpatient/emergency units at the SARI surveillance sentinel.Conclusion: SIBI was adjusted to incorporate surveillance for other priority diseases indicating its utility andflexibility to support global health security Keywords: Global Health Security, surveillance, influenza, Indonesia

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