Background Ventricular tachycardia (VT) and premature ventricular complexes (PVC) most frequently occur in the context of structural heart disease. However, the burden of idiopathic ventricular arrhythmias (VA) in the general population is unknown. Methods and Results We identified incident cases of idiopathic VA between 2005and 2013 from Olmsted County, MN using the Rochester Epidemiology Project database. For PVC cohorts, we included those with frequent (defined as ≥100 PVC/24 hours) symptomatic PVCs. We defined idiopathic VA-associated cardiomyopathy as an EF drop of ≥10% from baseline. Between 2005 and 2013, we identified 614 individuals with incident idiopathic VA. (229 [37.3%] were male, average age was 52.1 ± 17.2 years). Of these, 177 (28.8%) had idiopathic VT, 408 (66.5%) had symptomatic PVCs and 29 (4.7%) had idiopathic VA-associated cardiomyopathy. The age- and sex- adjusted incidence rates in 2005–2007, 2008–2010 and 2011–2013 were 44.9 per 100,000 (95% CI 38.0–51.8), 47.6 per 100,000 (95% CI 40.8–54.5) and 62.0 per 100,000 (95% CI 54.4–69.6), respectively. In idiopathic VT, there was an increase in incidence rate with age s (P<0.001) but not between sexes (P=0.12). The age-adjusted incidence of symptomatic PVC was higher in females than males (46.2 per 100,000 [95% CI 40.9–51.6] versus 20.5 per 100,000 [95% CI 16.8–24.3], p<0.001). The small number of individuals with idiopathic VA-associated cardiomyopathy precluded any formal testing. Conclusions The incidence of idiopathic VA is increasing. Furthermore, overall incidence increases with age. While the rate of idiopathic VT is similar across genders, women have a higher incidence of symptomatic PVC.

The Bronx was an early epicenter of the COVID-19 pandemic in the USA. We conducted temporal genomic surveillance of SARS-CoV-2 genomes across the Bronx from March-October 2020. Although the local structure of SARS-CoV-2 lineages mirrored those of New York City and New York State, temporal sampling revealed a dynamic and changing landscape of SARS- CoV-2 genomic diversity. Mapping the trajectories of variants, we found that while some have become 'endemic' to the Bronx, other, novel variants rose in prevalence in the late summer/early fall. Geographically resolved genomes enabled us to distinguish between a case of reinfection and a case of persistent infection. We propose that limited, targeted, temporal genomic surveillance has clinical and epidemiological utility in managing the ongoing COVID pandemic.

Background Since the start of the pandemic there has been limited data on mortality in people living with HIV (PLWH) who have Coronavirus Disease 2019 (COVID-19) in the United States (US). We conducted a retrospective review to investigate potential risk factors associated with survival and need for medical ventilation for PLWH and COVID-19. Methods This is a retrospective observational cohort from a large academic center across three campuses, conducted from January 1, 2020 to April 30, 2020. Thirty day readmissions were observed from January 1, 2020 to May 31, 2020. Our patients were identified by an ICD-10 code (B20) corresponding to HIV and positive SARS-CoV-2 PCR test. As a primary endpoint, we compared survivors vs. non-survivors. As a secondary endpoint, we compared patients who needed mechanical ventilator (MV) vs. those who did not need MV. Results Seventy two PLWH (28 female patients (39%), median [IQR] age was 62 [-/+16] years) had positive SARS-CoV-2 PCR tests during this retrospective review. Median CD4+ count was 235 cells/ul and 11 (15%) had an HIV viral load &gt;200 copies/mL. The median length of stay was 5 days and 6 patients were directly discharged from the emergency department. Ten patients were readmitted within 30 days with SARS-CoV-2 – like symptoms and 2 are still inpatient. Twenty patients (27.8%) have expired. All non-survivors that expired had an undetectable HIV viral load (0%, p=0.02). The 11 patients with unsuppressed HIV viral loads at the start of the study period all survived, p=0.02. Non-survivors were more likely to have chronic kidney disease CKD (p&lt; 0.01) acute kidney injury (p&lt; 0.01), higher absolute neutrophils (p&lt; 0.01), and elevated IL-6 levels (p&lt; 0.01) compared to survivors. Fifteen patients (20.8%) required mechanical ventilation (MV), 3 (4.1%) of those patients survived. Patients that required MV were more likely to be male (p=0.01) obese (p&lt; 0.01) and had higher absolute neutrophil counts (p=0.01) versus those that did not need MV. Patients with lower CD4 counts (&lt; 200 cells/uL) did not require more mechanical ventilation (p=0.04). Table 1: Demographics, Primary and Secondary Outcome Results Conclusion PLWH who had COVID-19 had a high mortality rate. Since all the patients who died had an undetectable HIV viral load across CD4 counts, our study suggests that patients with uncontrolled HIV are not at an increased risk of mortality. Disclosures All Authors: No reported disclosures

The Bronx was an early epicenter of the COVID-19 pandemic in the USA. We conducted temporal genomic surveillance of 104 SARS-CoV-2 genomes across the Bronx from March October 2020. Although the local structure of SARS-CoV-2 lineages mirrored those of New York City and New York State, temporal sampling revealed a dynamic and changing landscape of SARS-CoV-2 genomic diversity. Mapping the trajectories of mutations, we found that while some became 'endemic' to the Bronx, other, novel mutations rose in prevalence in the late summer/early fall. Geographically resolved genomes enabled us to distinguish between cases of reinfection and persistent infection in two pediatric patients. We propose that limited, targeted, temporal genomic surveillance has clinical and epidemiological utility in managing the ongoing COVID pandemic.