CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

Conclusion: Overall, the cumulative incidence and hazard of in-hospital mortality rates decreased throughout the study period, particularly during the Omicron period. However, contrasts varied by age, especially for those relative to the Alpha variant. BA.1 carried a higher risk of death than that seen with the more recently circulating BA.2 and BA.5 sublineages.

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The Effect of COVID-19 Infection on Fat, Lean Mass, and Bone Mineral Density Ornina Atieh 1 , Jared Durieux 2 , jhony baissary 1 , Christian F. Mouchati 1 , Danielle Labbato 2 , Grace A. McComsey 1 1 Case Western Reserve University, Cleveland, OH, USA, 2 University Hospitals Cleveland Medical Center, Cleveland, OH, USA Background: The effect of COVID-19 infection, versus the indirect effect of the COVID pandemic, on changes in body composition remains unclear. This study aims to investigate long-term changes in lean body mass (LBM), total bone mineral density (BMD), and total and trunk fat in COVID – 19 survivors compared to a control group. Methods: This is a prospective study involving adult individuals who had a pre-pandemic whole body DXA scan (DXA#1) performed between 2017-2019 as part of involvement in ongoing metabolic studies. Participants were asked to return for a repeat whole body DXA scan (DXA #2) on the same machine as DXA #1. Detailed data were collected including demographics, lifestyle factors, medications, and detailed COVID history (by diagnoses and testing). In addition, all participants underwent SARS-Co-V2 antibody testing at the time of DEXA scan. For those participants who had a COVID infection between the 2 DXA scanning, their DXA#2 was acquired at least one year after the COVID-19 infection. Results: Overall, 128 adults were enrolled; mean age 41.7 ± 14.6 years, 55.5% non-white race, and 28% female, without differences at baseline between those who ended up COVID+ and those who did not. Half (n=64) of the participants had documented COVID infection between their 2 DXA scans (COVID+ group), and the other 50% never had COVID infection or symptoms suggestive of COVID, their SARS-Co-V2 nucleocapsid antibodies were negative and spike antibodies negative in those unimmunized (COVID-negative group). Between DXA#1 and DEXA#2, the COVID+ group had 1.3 kg gain in total fat (0.0002), 1 kg gain in trunk fat (p = 0.002) and 2 Kg weight gain (p = 0.01) without change in BMD (p = 0.45). Similar changes were found within the COVID- group without difference in the annualized rate of change between the two groups. However, the annualized change in LBM was different between COVID+ and COVID- groups (p=0.04). COVID+ adults have more than three times the risk [HR: 3.3 (95% Cis: 1.7, 6.5)] of decreasing LBM following COVID infection (log-rank, p=0.01) when compared to COVID- adults. Conclusion: COVID – 19 infected individuals had similar changes in weight, total and trunk fat, total bone BMD compared to the COVID-negative group. Despite the lack of differences in weight and fat depots, participants who had COVID during the study experienced sarcopenia when compared to those who never had COVID. Longer term studies are needed to understand the impact of the loss of lean mass.

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Effects of Pitavastatin on COVID-19 Incidence and Seriousness Among People With HIV Markella Zanni 1 , Triin Umbleja 2 , Carl J. Fichtenbaum 3 , Kathleen V. Fitch 1 , Sara McCallum 1 , Judith A. Aberg 4 , Edgar T. Overton 5 , Carlos D. Malvestutto 6 , Gerald S. Bloomfield 7 , Judith S. Currier 8 , Samuel R. Schnittman 1 , Michael T. Lu 1 , Pamela S. Douglas 9 , Heather J. Ribaudo 2 , Steven Grinspoon 1 1 Massachusetts General Hospital, Boston, MA, USA, 2 Harvard TH Chan School of Public Health, Boston, MA, USA, 3 University of Cincinnati, Cincinnati, OH, USA, 4 Icahn School of Medicine at Mt Sinai, New York, NY, USA, 5 University of Alabama at Birmingham, Birmingham, AL, USA, 6 The Ohio State University, Columbus, OH, USA, 7 Duke University School of Medicine, Durham, NC, USA, 8 University of California Los Angeles, Los Angeles, CA, USA, 9 Duke University, Durham, NC, USA Background: Among people with HIV (PWH), COVID-19 is common and potentially severe. We leveraged data from the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) to assess effects of pitavastatin on COVID-19 outcomes (incidence and serious cases) among a global cohort of PWH. Statin therapy was a priori hypothesized to reduce serious COVID-19 by 35%, with 200 anticipated serious COVID-19 events. Methods: COVID-19 data collection was implemented in REPRIEVE in April 2020 to capture all events from the start of 2020. COVID-19 was defined by positive test or clinical diagnosis; serious COVID-19 according to ICH definition, including life-threatening events or those resulting in hospitalization or death. Among participants in follow-up on January 1, 2020, Cox proportional hazards modeling was used to estimate the hazard ratio (HR) of COVID-19 (pitavastatin/ placebo), stratified by global burden of disease region. Modification of statin effect following COVID-19 vaccination was evaluated via interaction with time updated vaccination status. Results: Among 6909 PWH, 32% were natal females and 41% were Black or African-American. Median age was 53 years and median 10-year ASCVD risk score 4.5%. HIV-1 viremia was suppressed in 87%, 30% had CD4 <500 cells/ mm 3 , 23% BMI ≥30 kg/m 2 , 45% hypertension, and 3% diabetes. Treatment groups were balanced on baseline characteristics. COVID-19 was reported in 1689 participants, including 117 serious cases (Figure 1). Statin therapy did not reduce COVID-19 incidence (HR 1.05, 95% CI: 0.95-1.15) but appeared to reduce incidence of serious COVID-19 (0.75, 0.52-1.09). Among the 1689 with COVID-19, the relative risk (pitavastatin/placebo) for serious COVID-19 was 0.73 (0.52-1.03). Treatment effect size for serious COVID-19 fell within the hypothesized range, but CI crossed 1 given fewer-than-anticipated cases (117 vs. 200). 83% reported COVID-19 vaccination by end-of-study, with a strong protective effect on serious COVID-19 (HR 0.28, p<0.0001). Protective statin effect was observed prior to vaccination (0.74, 0.50-1.10; 42/58 cases), with only 17 cases observed following vaccination (0.87, 0.33-2.24; 8/9). Conclusion: In a global cohort of PWH, statin therapy had no effect on COVID-19 incidence but showed potential to reduce the risk of serious COVID-19 prior to COVID-19 vaccination. Vaccination was protective for serious COVID-19. Additional research is needed to understand and harness potential mechanisms of protective statin effects on serious COVID-19.

Poster Abstracts

CROI 2024 267