Both moderate-intensity and high-intensity exercise resulted in significant improvements in physical function; high-intensity exercise may impart greater strength benefits to PLWH.

Background: People with HIV (PWH) have increased risk for adiposity and sarcopenia, despite effective antiretroviral therapy. Our objective was to compare the effects of prescribed exercise on body composition in older PWH and uninfected controls. Setting: Academic medical centerMethods: Sedentary PWH (n=27) and uninfected controls (n=28) aged 50-75 completed 24 weeks of cardiovascular and resistance exercise. Participants completed 12 weeks of moderateintensity exercise then were randomized to moderate-or high-intensity exercise for 12 additional weeks. Total lean (LEAN) and fat mass (FAT) and visceral adipose tissue area (VAT) were measured using DXA at baseline and 24 weeks; baseline and intervention differences were

Rationale: Prognostic tools for aiding in the treatment of hospitalized COVID-19 patients could help improve outcome by identifying patients at higher or lower risk of severe disease. The study objective was to develop models to stratify patients by risk of severe outcomes during COVID-19 hospitalization using readily available information at hospital admission. Methods Hierarchical ensemble classification models were trained on a set of 229 patients hospitalized with COVID-19 to predict severe outcomes, including ICU admission, development of acute respiratory distress syndrome, or intubation, using easily attainable attributes including basic patient characteristics, vital signs at admission, and basic lab results collected at time of presentation. Each test stratifies patients into groups of increasing risk. An additional cohort of 330 patients was used for blinded, independent validation. Shapley value analysis evaluated which attributes contributed most to the models’ predictions of risk. Main Results: Test performance was assessed using precision (positive predictive value) and recall (sensitivity) of the final risk groups. All test cut-offs were fixed prior to blinded validation. In development and validation, the tests achieved precision in the lowest risk groups near or above 0.9. The proportion of patients with severe outcomes significantly increased across increasing risk groups. While the importance of attributes varied by test and patient, C-reactive protein, lactate dehydrogenase, and D-dimer were often found to be important in the assignment of risk. Conclusions Risk of severe outcomes for patients hospitalized with COVID-19 infection can be assessed using machine learning-based models based on attributes routinely collected at hospital admission.

Background We investigated whether higher intensity exercise provided greater overall decrease in key markers of inflammation, and whether responses to exercise intensity differed by HIV serostatus. Methods People with HIV (PWH; n=32) and controls (n=37) aged 50-75 completed 12 weeks of moderate-intensity combined exercise then were randomized to moderate- or high-intensity exercise for 12 additional weeks (n=27 and 29, respectively). Inflammation biomarkers were measured at 0, 12, 24 weeks. Mixed and multiple regression models were adjusted for baseline inflammation, age and BMI. Results Baseline TNF-α, sTNFR2, and sCD14 were significantly higher among PWH than controls (p<0.04). From week 0-12, changes in IL-6, TNF-α, sTNFR1 were not significantly different by HIV serostatus. We found no significant interaction between HIV serostatus/exercise intensity on week 12-24 changes in IL-6, TNF-α, sTNFR1. Among high-intensity exercisers, both PWH and controls had significant increases in sCD14 (p≤0.003), controls had significant increases in IL-10 (p=0.01), PWH had a non-significant decrease in hsCRP (p=0.07). Other markers were not significantly different by serostatus and exercise intensity. Discussion Moderate and high-intensity exercise elicited similar effects on inflammation among PWH and controls, with additional beneficial effects seen only among the high-intensity exercisers. Increase in sCD14 and attenuated IL-10 increase (PWH only) merit further study.