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This study uses electronic medical record data to describe monkeypox infections after a single dose of Modified Vaccinia Ankara-Bavarian Nordic vaccine, a live, nonreplicating vaccine indicated for prevention of smallpox and monkeypox infection in adults.

The risk of COVID-19 among people living with HIV (PLWH) is largely unknown and there have been very few reported cases in the literature. We report a case series of five PLWH with COVID-19. We identified all patients with a diagnosis of HIV who tested positive for SARS-CoV-2 at University of Chicago Medicine between March 1, 2020, and April 7, 2020. We retrospectively collected data regarding demographics, comorbidities, medications, laboratory test results, radiology results, and outcomes associated with COVID-19. All five PLWH with COVID-19 were African American; 80% (4/5) were cisgender females. The mean age of patients was 48 years old (range 38-53). The majority of patients presented with cough, fever, and shortness of breath. Three patients had diarrhea. One patient presented with predominantly cardiac symptoms. All were taking antiretroviral therapy (ART) with CD4 count >200 cells/mm 3 and suppressed HIV viral loads at the time of COVID-19 diagnosis. All five patients were hospitalized, two required supplemental oxygen, and none required mechanical ventilation. Four patients were treated with azithromycin and a cephalosporin and two were also treated with hydroxychloroquine. The median length of stay was 3 days (range 2-7). All patients recovered. More research is needed to understand the risks of COVID-19 among PLWH and the impact of ART on outcomes for patients with COVID-19.

Background Remdesivir (RDV) is US FDA approved for coronavirus disease 2019 (COVID-19) but not recommended in severe renal impairment (SRI, Creatinine clearance <30mL/min or requiring renal replacement therapy). Few studies have evaluated RDV in patients with SRI. Methods Hospitalized patients who received RDV between 1 May 2020 and 31 October 2020 were analyzed in a retrospective chart review. We compared incident adverse events (AEs) in patients with and without SRI, including hepatotoxicity, nephrotoxicity, any reported AE, mortality, and length of stay. Results Of a total of 135 patients, 20 had SRI. Patients with SRI were significantly older (70 vs 54 years, P = .0001). The incidence of possible AEs was 30% among those with SRI vs 11% without (P = .06). Liver function test (LFT) elevations occurred in 10% vs 4% (P = .28), and serum creatinine (SCr) elevations in 27% vs 6% (P = .02) of patients with SRI vs without, respectively. LFT and SCr elevations were not attributed to RDV in either group. Mortality and length of stay were consistent with historical controls. Conclusions RDV AEs occurred infrequently and overall were not significantly different between those with and without SRI. While more of patients with SRI experienced SCr elevations, 3 (75%) patients had acute kidney injury prior to RDV. The use of RDV in this small series of patients with SRI appeared to be relatively safe, and the potential benefit outweighed the theoretical risk of liver or renal toxicity. Additional studies are needed to confirm this finding.

Background: With syphilis rates rising rapidly in the United States, novel means of reaching high-risk populations for screening and treatment are needed. Building on successful models for emergency department (ED) HIV screening, a routine opt-out syphilis screening program was implemented in a large, urban, tertiary care hospital ED in May 2019. This study aims to assess the prevalence of syphilis in this population and to evaluate the routine, opt-out syphilis screening model.Methods: A retrospective chart review was performed of all patients screened for syphilis in the ED from June to December 2019. Demographic information, HIV status, chief complaint, and follow-up visits were examined.Results: During the study period, 9198 people aged 18 to 64 years were screened for syphilis. Of these, 97 (1.1%) had presumed active syphilis infection (PAI), 354 (3.8%) were presumed not to have active syphilis, and 8747 (95.1%) were negative for infection. Patients with PAI were more likely to be male (67%; adjusted odds ratio, 3.5; 95% confidence interval, 2.3-5.3; P < 0.001), although the percentage of women was considerably higher than the nationally reported rate, and most were non-Hispanic Black (93.8%). Among patients with PAI, 23 (23.7%) were HIV positive. Only 18.6% of patients with PAI presented with complaints related to sexually transmitted infections.Conclusions: Syphilis rates in this community are very high, and many infections were found in populations traditionally considered at lower risk by demographic or presenting complaint, indicating that universal screening is needed. Routine ED syphilis screening in high-prevalence communities will be critical to addressing the syphilis epidemic.