467. COVID-19 Infection in Persons Living with HIV in a Network of Community Health Centers in New York

Background COVID-19 infection amongst persons living with HIV (PLWH) at Federally Qualified Healthcare Centers (FQHC) is not yet well understood. FQHC patients are frequently impoverished and marginalized due to socioeconomic instability and structural inequities. The virus has a wide-ranging clinical presentation, and little is known about how it affects specific populations such as PLWH and whether specific patterns of immunocompromise confer increased risk. Patients in community health centers and those living with HIV are often underrepresented from clinical trials. Patients seen at FQHC’s are more likely to be uninsured or living in poverty, or of Black or Latinx racial and ethnic backgrounds. Sun River Health is a not-for-profit, New York State licensed Article 28 Diagnostic & Treatment Center and FQHC. Sun River Health provides HIV primary care and supportive services caring for more than 2,500 PLWH primarily concentrated in 16 sites throughout the region. This study is a retrospective analysis of a vulnerable community at the heart of this pandemic. Methods We gathered COVID-19 diagnosis related data from the clinic’s electronic medical record and the New York State Health Information Exchange (HIE). We did chart reviews on 122 PLWH who had positive COVID PCR or antibody test between March 10 2020 and June 10 2020. Data collected included presence of symptoms, presence of comorbidities, CD4 counts, Hospitalization rate, ICU admission, and number of deaths. Results 71.3% of cases occurred between the ages of 40-69 years. There were 85 cases (69.7%) in men and 37 cases (30.3%) in women. 54 cases (44.3%) occurred in African Americans, and 46 cases (37.7%) in Caucasians. 48 cases (39.3%) occurred in Latinx individuals, and 68 cases (55.7%) in Non-Hispanics. 91 cases (74.6%) were symptomatic and had either a positive COVID-19 PCR or antibody test. Symptomatic COVID-19 was present at higher rates in those with multiple predisposing comorbidities. 101 cases (82.8%) were virally suppressed. 89 cases (72.9%) were not hospitalized while 27 cases (22.1%) were hospitalized. Conclusion Most PLWH with COVID-19 were managed on an outpatient basis. PLWH with COVID-19 are not at a greater risk of severe disease or death as compared to HIV negative patients. Disclosures Christine A. Kerr, MD, Galileo Health (Employee, Shareholder)

Global syndromes induced by changes in solutes of the world’s large rivers

Solute-induced river syndromes have grown in intensity in recent years. Here we investigate seven such river syndromes (salinization, mineralization, desalinization, acidification, alkalization, hardening, and softening) associated with global trends in major solutes (Ca2+, Mg2+, Na+, K+, SO42−, Cl−, HCO3−) and dissolved silica in the world’s large rivers (basin areas ≥ 1000 km2). A comprehensive dataset from 600 gauge stations in 149 large rivers reveals nine binary patterns of co-varying trends in runoff and solute concentration. Solute-induced river syndromes are associated with remarkable increases in total dissolved solids (68%), chloride (81%), sodium (86%) and sulfate (142%) fluxes from rivers to oceans worldwide. The syndromes are most prevalent in temperate regions (30~50°N and 30~40°S based on the available data) where severe rock weathering and active human interferences such as urbanization and agricultural irrigation are concentrated. This study highlights the urgency to protect river health from extreme changes in solute contents.

Positive effects of COVID-19 lockdown on river water quality: evidence from River Damodar, India

The global economic activities were completely stopped during COVID-19 lockdown and continuous lockdown partially brought some positive effects for the health of the total environment. The multiple industries, cities, towns and rural people are completely depending on large tropical river Damodar (India) but in the last few decades the quality of the river water is being significantly deteriorated. The present study attempts to investigate the river water quality (RWQ) particularly for pre- lockdown, lockdown and unlock period. We considered 20 variables per sample of RWQ data and it was analyzed using novel Modified Water Quality Index (MWQI), Trophic State Index (TSI), Heavy Metal Index (HMI) and Potential Ecological Risk Index (RI). Principal component analysis (PCA) and Pearson’s correlation (r) analysis are applied to determine the influencing variables and relationship among the river pollutants. The results show that during lockdown 54.54% samples were brought significantly positive changes applying MWQI. During lockdown, HMI ranged from 33.96 to 117.33 with 27.27% good water quality which shows the low ecological risk of aquatic ecosystem due to low mixing of toxic metals in the river water. Lockdown effects brought river water to oligotrophic/meso-eutrophic condition from eutrophic/hyper-eutrophic stage. Rejuvenation of river health during lockdown offers ample scope to policymakers, administrators and environmentalists for restoration of river health from huge anthropogenic stress.