Clinical features and outcome of COVID-19 among PLHIV in Gujarat, India: A case series.

Information on people living with HIV (PLHIV) and current COVID-19 pandemic is still scarce in Indian setting. This case series of PLHIV with COVID-19 describes clinical characteristics and outcome in this special group of patients. This case series included 11 confirmed cases of COVID-19 among PLHIV admitted at a tertiary care hospital in Gujarat, India during April-December 2020. This retrospective study was conducted by doing secondary data analysis from case records of patients for various variables including demographic, clinical characteristics, HIV-related parameters, and outcome (discharged/death). The mean age of patients was 39.2 years ranging from 20 to 55 years. Nearly, 18% (2/11) of patients had major comorbidities like diabetes and hypertension. All were taking antiretroviral therapy drugs with >95% drug adherence and had CD4 count ranging from 79/cu.mm. to 1189/cu.mm. Majority (91%) of patients recovered and were discharged while only one patient (9%) died during course of COVID-19 treatment. COVID-19 showed a similar clinical and epidemiological profile among PLHIV like other group of people. Further studies with large-sample size are recommended to find risks of COVID-19 among PLHIV and its impact on treatment outcomes.

Impact of Electrophysiological and Clinical Variants, and Timing of Plasmapheresis on Outcome of Guillain-Barré Syndrome.

INTRODUCTION: Guillain-Barré syndrome (GBS) is an autoimmune polyneuropathy causing acute flaccid paralysis and it is known to improve with plasmapheresis. OBJECTIVE: To study effects of electrophysiological type of GBS, clinical variant of GBS and time taken for initiation of plasmapheresis on outcome of disease. METHODS: 50 consecutive patients of GBS attending tertiary care hospital underwent clinical examination and electrophysiological studies. Disability grade was calculated and patients were observed for full functional recovery for 6 months. RESULTS: In this study, patients in whom plasmapheresis was started within 7 days (n=39) were observed to have significantly better improvement in terms of smaller peak disability and rapid functional recovery compared to those in whom plasmapheresis was started after 7 days (n=11). (p<0.002). Demyelinating pattern on electrophysiology was observed to have better outcome in terms of all parameters compared to axonal. AIDP variant was observed to have best outcome and AMSAN variant was associated with worst outcome. CONCLUSIONS: Rapid institution of plasmapheresis is the most important outcome determining factor. Irrespective of the variant specific comorbidity, early plasmapheresis improves outcome in all parameters.