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1. Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study

Author

Arifa Parker, Linda Boloko, Muhammad S. Moolla, Nabilah Ebrahim, Birhanu T. Ayele, Alistair G. B. Broadhurst, Boitumelo Mashigo, Gideon Titus, Timothy de Wet, Nicholas Boliter, Michael-Jon Rosslee, Nectarios Papavarnavas, Riezaah Abrahams, Marc Mendelson, Sipho Dlamini, Jantjie J. Taljaard, Hans W. Prozesky, Abdurasiet Mowlana, Abraham J. Viljoen, Neshaad Schrueder, Brian W. Allwood, Usha Lalla, Joel A. Dave, Greg Calligaro, Dion Levin, Deborah Maughan, Ntobeko A. B. Ntusi, Peter S. Nyasulu, Graeme Meintjes, Coenraad F. N. Koegelenberg, Ayanda T. Mnguni, and Sean Wasserman

Subjects
HIV, COVID-19, Tuberculosis, Obesity, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). Methods We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. Results PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02–1.03, p

Published
2022
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2. The utility of high-flow nasal oxygen for severe COVID-19 pneumonia in a resource-constrained setting: A multi-centre prospective observational study

Author

Gregory L. Calligaro, Usha Lalla, Gordon Audley, Phindile Gina, Malcolm G. Miller, Marc Mendelson, Sipho Dlamini, Sean Wasserman, Graeme Meintjes, Jonathan Peter, Dion Levin, Joel A. Dave, Ntobeko Ntusi, Stuart Meier, Francesca Little, Desiree L. Moodley, Elizabeth H. Louw, Andre Nortje, Arifa Parker, Jantjie J. Taljaard, Brian W. Allwood, Keertan Dheda, and Coenraad F.N. Koegelenberg

Subjects
COVID-19, Ventilation, High flow nasal oxygen, Pneumonia, Medicine (General), R5-920
Abstract

Background: The utility of heated and humidified high-flow nasal oxygen (HFNO) for severe COVID-19-related hypoxaemic respiratory failure (HRF), particularly in settings with limited access to intensive care unit (ICU) resources, remains unclear, and predictors of outcome have been poorly studied. Methods: We included consecutive patients with COVID-19-related HRF treated with HFNO at two tertiary hospitals in Cape Town, South Africa. The primary outcome was the proportion of patients who were successfully weaned from HFNO, whilst failure comprised intubation or death on HFNO. Findings: The median (IQR) arterial oxygen partial pressure to fraction inspired oxygen ratio (PaO2/FiO2) was 68 (54–92) in 293 enroled patients. Of these, 137/293 (47%) of patients [PaO2/FiO2 76 (63–93)] were successfully weaned from HFNO. The median duration of HFNO was 6 (3–9) in those successfully treated versus 2 (1–5) days in those who failed (p

Published
2020
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3. Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study

Author

Arifa Parker, Linda Boloko, Muhammad S. Moolla, Nabilah Ebrahim, Birhanu T. Ayele, Alistair G. B. Broadhurst, Boitumelo Mashigo, Gideon Titus, Timothy de Wet, Nicholas Boliter, Michael-Jon Rosslee, Nectarios Papavarnavas, Riezaah Abrahams, Marc Mendelson, Sipho Dlamini, Jantjie J. Taljaard, Hans W. Prozesky, Abdurasiet Mowlana, Abraham J. Viljoen, Neshaad Schrueder, Brian W. Allwood, Usha Lalla, Joel A. Dave, Greg Calligaro, Dion Levin, Deborah Maughan, Ntobeko A. B. Ntusi, Peter S. Nyasulu, Graeme Meintjes, Coenraad F. N. Koegelenberg, Ayanda T. Mnguni, Sean Wasserman, Department of Medicine, and Faculty of Health Sciences

Subjects
Adult, Male, HIV, COVID-19, HIV Infections, Overweight, Cohort Studies, Hospitalization, South Africa, Infectious Diseases, Prevalence, Humans, Tuberculosis, Obesity
Abstract

Background There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). Methods We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. Results PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02–1.03, p 3, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. Conclusion In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population.

Published
2021

4. Composite adrenal phaeochromocytoma-ganglioneuroma causing watery diarrhoea, hypokalaemia and achlorhydria syndrome

Author

Ian L. Ross, Cornelli Dittrich, Dion Levin, Jake E. J. Krige, John Shaw, David Epstein, Deepu J. George, Matshiko Setshedi, Barbara U. Scholz, Gill Watermeyer, and Michael Locketz

Subjects
Diarrhea, medicine.medical_specialty, Vasoactive intestinal peptide, Adrenal Gland Neoplasms, Hypokalemia, Pheochromocytoma, Achlorhydria, Gastroenterology, Young Adult, Internal medicine, Watery diarrhoea, medicine, Humans, Ganglioneuroma, Young female, Hepatology, business.industry, digestive, oral, and skin physiology, nutritional and metabolic diseases, Secretory diarrhoea, medicine.disease, Female, business, Vasoactive Intestinal Peptide
Abstract

The watery diarrhoea, hypokalaemia and achlorhydria syndrome is a rare cause of secretory diarrhoea. In this case report, we highlight a young female with watery diarrhoea, hypokalaemia and achlorhydria syndrome as a consequence of a vasoactive intestinal peptide producing composite adrenal phaeochromocytoma-ganglioneuroma. She made a complete recovery after curative surgical resection.

Published
2010

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