José L. Forero-Peña’s research while affiliated with Simón Bolívar University and other places

Background In Venezuela, the predominant vaccines administered are BBIBP-CorV and Gam-COVID-Vac. Despite robust evidence from randomized clinical trials validating the effectiveness of COVID-19 vaccines in mitigating hospitalization and mortality, there is still a lack of post-authorization safety studies conducted within this demographic population. Methods A prospective observational study from October 5, 2021 to March 31, 2022 encompassed COVID-19 vaccinated and unvaccinated patients from four sentinel hospitals in Venezuela. Patient lethality was predicted using Charlson Comorbidity index. Clinical outcomes were assessed through WHO’s COVID-19 Clinical Progression Scale. Results Out of the 175 patients assessed, 85 (48.6%) were vaccinated. The median Charlson Comorbidity index was 3 points, with no statistically significant differences observed between the groups (p = 0.2). A total of 50 (28.6%) patients died during the study period, with higher proportion of deaths in unvaccinated patients (35.6% vs. 21.2%, p = 0.035). Advanced age (OR = 1.043, 95% CI = 1.015–1.071, p = 0.002) was associated with increased death risk, whereas vaccination against COVID-19 (OR = 0.428, 95% CI = 0.185–0.99, p = 0.047), high oxygen saturation (OR = 0.964, 95% CI = 0.934–0.995, p = 0.024), and enoxaparin administration (OR = 0.292, 95% CI = 0.093–0.917, p = 0.035) were associated with decreased death risk. Conclusion During the third and fourth waves of the pandemic, COVID-19 vaccination was associated with a 57% reduction in lethality among patients in four public hospitals in Venezuela.

Background The coronavirus disease 2019 (COVID-19) pandemic has disrupted multiple health services, including human immunodeficiency virus (HIV) testing, care, and treatment services, jeopardizing the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 global target. While there are limited studies assessing the impact of the COVID-19 pandemic on people living with HIV (PLHIV) in Latin America, there are none, to our knowledge, in Venezuela. This study aims to assess the impact of the COVID-19 pandemic among PLHIV seen at the outpatient clinic of a reference hospital in Venezuela. Methods We conducted a cross-sectional study among PLHIV aged 18 years and over seen at the Infectious Diseases Department of the University Hospital of Caracas, Venezuela between March 2021 and February 2022. Results A total of 238 PLHIV were included in the study. The median age was 43 (IQR 31–55) years, and the majority were male (68.9%). Most patients (88.2%, n = 210) came for routine check-ups, while 28 (11.3%) were newly diagnosed. The majority of patients (96.1%) were on antiretroviral therapy (ART), but only 67.8% had a viral load test, with almost all (95.6%) being undetectable. Among those who attended regular appointments, 11.9% reported missing at least one medical consultation, and 3.3% reported an interruption in their ART refill. More than half of the patients (55.5%) had received at least one dose of the COVID-19 vaccine, while the rest expressed hesitancy to get vaccinated. Most patients with COVID-19 vaccine hesitancy were male (65.1%), younger than 44 years (57.5%), employed (47.2%), and had been diagnosed with HIV for less than one year (33%). However, no statistically significant differences were found between vaccinated patients and those with COVID-19 vaccine hesitancy. Older age was a risk factor for missing consultations, while not having an alcoholic habit was identified as a protective factor against missing consultations. Conclusion This study found that the COVID-19 pandemic had a limited impact on adherence to medical consultations and interruptions in ART among PLHIV seen at the University Hospital of Caracas, Venezuela.

Background While rigorous randomized clinical trials have substantiated the efficacy of COVID-19 vaccines in reducing hospitalization and mortality rates, there is a paucity of post-authorization analyses conducted in real-world settings. In Venezuela, the primary vaccines administered are BBIBP-CorV (Sinopharm) and Gam-COVID-Vac (Sputnik-V). However, the performance and effectiveness of these vaccines within this specific population remain to be thoroughly investigated. Methods A prospective cohort study was undertaken from October 5, 2021, to March 31, 2022, across four sentinel hospitals in Venezuela. The outcomes were evaluated at two time points: day 28 and day 48, utilizing the WHO’s COVID-19 Clinical Progression Scale. For the purpose of analysis, patients were classified into two groups: vaccinated and unvaccinated. Results The study included a total of 175 patients, of which 85 (48.6%) were categorized as vaccinated, with the majority (76.5%) having received two doses. The median age of the patients was 68 years, with a slight predominance of females (53.1%), and the majority being unemployed/retired (60.6%). Hypertension (53.1%) and diabetes (18.3%) were the most prevalent comorbidities. The median Charlson index of the patients was 3 points, with no statistically significant differences observed between the groups (p = 0.2). Upon admission, dyspnea was more commonly observed in unvaccinated patients compared to vaccinated patients (76.7% vs. 62.4%, p = 0.039). Almost all laboratory parameters were comparable in both groups, with the exception of the median D-dimer level, which was significantly higher in unvaccinated patients (7.6 vs. 1.4 µg/mL, p = 0.015). A total of 50 patients (28.6%) died of the disease, with a higher proportion of deaths observed in unvaccinated patients compared to vaccinated patients (35.6% vs. 21.2%, p = 0.035). Factors such as advanced age (OR = 1.043, 95%CI = 1.015–1.071, p = 0.002) were associated with increased odds of death, while factors such as vaccination against COVID-19 (OR = 0.428, 95%CI = 0.185–0.99, p = 0.047), high oxygen saturation (OR = 0.964, 95%CI = 0.934–0.995, p = 0.024), and enoxaparin administration (OR = 0.292, 95%CI = 0.093–0.917, p = 0.035) were associated with decreased odds of death. Conclusion In the course of the third and fourth waves of the pandemic, vaccination against COVID-19 was found to be associated with a 57% reduction in lethality among patients treated in four public hospitals in Venezuela.

Background Persistent headache is a frequent symptom after coronavirus disease 2019 (COVID-19) and there is currently limited knowledge about its clinical spectrum and predisposing factors. A subset of patients may be experiencing new daily persistent headache (NDPH) after COVID-19, which is among the most treatment-refractory primary headache syndromes. Methods We conducted a cross-sectional study in Latin America to characterize individuals with persistent headache after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to identify factors associated with NDPH. Participants over 18 years old who tested positive for SARS-CoV-2 infection and reported persistent headache among their symptoms completed an online survey that included demographics, past medical history, persistent headache clinical characteristics, and COVID-19 vaccination status. Based on participants’ responses, NDPH diagnostic criteria were used to group participants into NDPH and non-NDPH groups. Participant data was summarized by descriptive statistics. Student’s t and Mann–Whitney U tests were used according to the distribution of quantitative variables. For categorical variables, Pearson’s chi-square and Fisher’s exact tests were used according to the size of expected frequencies. Binomial logistic regression using the backward stepwise selection method was performed to identify factors associated with NDPH. Results Four hundred and twenty-one participants from 11 Latin American countries met the inclusion criteria. One in four participants met the NDPH diagnostic criteria. The mean age was 40 years, with most participants being female (82%). Over 90% of the participants reported having had mild/moderate COVID-19. Most participants had a history of headache before developing COVID-19 (58%), mainly migraine type (32%). The most predominant clinical characteristics in the NDPH group were occipital location, severe/unbearable intensity, burning character, and radiating pain (p < 0.05). A higher proportion of anxiety symptoms, sleep problems, myalgia, mental fog, paresthesia, nausea, sweating of the face or forehead, and ageusia or hypogeusia as concomitant symptoms were reported in participants with NDPH (p < 0.05). Palpebral edema as a concomitant symptom during the acute phase of COVID-19, occipital location, and burning character of the headache were risk factors associated with NDPH. Conclusion This is the first study in Latin America that explored the clinical spectrum of NDPH after SARS-CoV-2 infection and its associated factors. Clinical evaluation of COVID-19 patients presenting with persistent headache should take into consideration NDPH.

Background While rigorous randomized clinical trials have substantiated the efficacy of COVID-19 vaccines in reducing hospitalization and mortality rates, there is a paucity of post-authorization analyses conducted in real-world settings. In Venezuela, the primary vaccines administered are Sinopharm and Sputnik-V. However, the performance and effectiveness of these vaccines within this specific population remain to be thoroughly investigated. Methods A prospective cohort study was undertaken from October 5, 2021, to March 31, 2022, across four sentinel hospitals in Venezuela. The outcomes were evaluated at two time points: day 28 and day 48, utilizing the WHO’s COVID-19 Clinical Progression Scale. For the purpose of analysis, patients were classified into two groups: vaccinated and unvaccinated. Results The study included a total of 175 patients, of which 85 (48.6%) were categorized as vaccinated, with the majority (76.5%) having received two doses. The median age of the patients was 68 years, with a slight predominance of females (53.1%), and the majority being unemployed/retired (60.6%). Hypertension (53.1%) and diabetes (18.3%) were the most prevalent comorbidities. The median Charlson index of the patients was 3 points, with no statistically significant differences observed between the groups (p = 0.2). Upon admission, dyspnea was more commonly observed in unvaccinated patients compared to vaccinated patients (76.7% vs. 62.4%, p = 0.039). Almost all laboratory parameters were comparable in both groups, with the exception of the median D-dimer level, which was significantly higher in unvaccinated patients (7.6 vs. 1.4 µg/mL, p = 0.015). A total of 50 patients (28.6%) died of the disease, with a higher proportion of deaths observed in unvaccinated patients compared to vaccinated patients (35.6% vs. 21.2%, p = 0.035). Factors such as advanced age (OR = 1.043, 95%CI = 1.015–1.071, p = 0.002) were associated with increased odds of death, while factors such as vaccination against COVID-19 (OR = 0.428, 95%CI = 0.185–0.99, p = 0.047), high oxygen saturation (OR = 0.964, 95%CI = 0.934–0.995, p = 0.024), and enoxaparin administration (OR = 0.292, 95%CI = 0.093–0.917, p = 0.035) were associated with decreased odds of death. Conclusion In the course of the third and fourth waves of the pandemic, vaccination against COVID-19 was found to be associated with a 57% reduction in mortality among patients treated in four public hospitals in Venezuela.

Background Persistent headache is a frequent symptom after coronavirus disease 2019 (COVID-19) and there is currently limited knowledge about its clinical spectrum and predisposing factors. A subset of patients may be experiencing new daily persistent headache (NDPH) after COVID-19, which is among the most treatment-refractory primary headache syndromes. Methods We conducted a cross-sectional study in Latin America to characterize individuals with persistent headache after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and identify risk factors associated with NDPH. Participants over 18 years old who tested positive for SARS-CoV-2 infection and reported persistent headache among their symptoms completed an online survey that included demographics, past medical history, persistent headache clinical characteristics, and COVID-19 vaccination status. Based on participants’ responses, NDPH diagnostic criteria were used to group participants into NDPH and non-NDPH groups. Results Four hundred and twenty-one participants from 11 Latin American countries met the inclusion criteria. One in four participants met the diagnostic criteria for NDPH. The mean age was 40 years, with most participants being female (82%). Over 90% of the participants reported having had mild/moderate COVID-19. Most participants had a history of headache before developing COVID-19 (58%), mainly migraine type (32%). The most predominant clinical characteristics in the NDPH group were occipital location, severe/unbearable intensity, burning character, and radiating pain (p < 0.05). A higher proportion of anxiety symptoms, sleep problems, myalgia, mental fog, paresthesia, nausea, sweating of the face or forehead, and ageusia or hypogeusia as concomitant symptoms were reported in participants with NDPH (p < 0.05). Palpebral edema as a concomitant symptom during the acute phase of COVID-19, occipital location, and burning character of the headache were risk factors associated with NDPH. Conclusion This is the first study in Latin America that explored the clinical spectrum of NDPH after SARS-CoV-2 infection and its risk factors. Clinical evaluation of COVID-19 patients presenting with persistent headache should take into consideration NDPH.

Background The COVID-19 pandemic has disrupted multiple health services, including HIV testing, care, and treatment services, jeopardizing the achievement of the UNAIDS 90-90-90 global target. While there are limited studies assessing the impact of the COVID-19 pandemic on people living with HIV (PLHIV) in Latin America, there are none, to our knowledge, in Venezuela. This study aims to assess the impact of the pandemic and COVID-19 vaccine hesitancy among PLHIV seen at the outpatient clinic of a reference hospital in Venezuela. Methods We conducted a cross-sectional study among PLHIV aged 18 years and over seen at the Infectious Diseases Department of the University Hospital of Caracas, Venezuela between March 2021 and February 2022. Results A total of 238 PLHIV were included in the study. The median age was 43 years (IQR 24), and the majority were male (68.9%). Most patients (88.2%; n = 210) came for routine check-ups, while 28 (11.3%) were newly diagnosed. The majority of patients (96.1%) were on antiretroviral therapy (ART), but only 67.8% had a viral load test, with almost all (95.6%) being undetectable. Among those who attended regular appointments, 11.9% reported missing at least one medical consultation, and 3.3% reported an interruption in their ART refill. More than half of the patients (55.5%) had received at least one dose of the COVID-19 vaccine, while the rest expressed hesitancy to get vaccinated. Most patients with COVID-19 vaccine hesitancy were male (65.1%), younger than 44 years (57.5%), employed (47.2%), and had been diagnosed with HIV for less than one year (33%). However, no statistically significant differences were found between vaccinated patients and those with COVID-19 vaccine hesitancy. Age was a risk factor for missing consultations, while not having an alcoholic habit was identified as a protective factor against missing consultations. Conclusion This study found that the pandemic had a limited impact on adherence to medical consultations and interruptions in ART. However, it documented a high rate of COVID-19 vaccine hesitancy among PLHIV seen at the University Hospital of Caracas.