Abstract Background: Severe and critical forms of COVID-19 require early conventional oxygen therapy. Objective: The aim of this study was to analyze the evolution of Severe and critical COVID-19 patients treated at the University Hospital of Kinshasa according to News score. Methods: This was a historical cohort study carried out at the COVID-19 Treatment Center (of the University Hospital of Kinshasa (UHK) from March 24, 2020 to December 12, 2022. The target population was all patients (1159) admitted to the intensive care unit of the COVID-19 Treatment Center of the UHK. All tests were two-tailed with 95% CI and considered significant when P-value was < 0.05. Results: Of a total of 1159 patients, severe and critical forms accounted for 84.2% (n=976), with the age category of patients over 60 years the most represented at 52.2% (n=605), with a mean age of 58.1±17.3 years. Severe and critical patients with at least one comorbidity 74.2% (n=724) were admitted to CTCO CUK and 84.6% (n=981) of these patients required respiratory support with conventional oxygen therapy. Factors predictive of lethality were the use of CPAP and mechanical ventilation with HRa (95% CI) of 0.001 and 0.002 respectively, age> 60 years and late referral to UHK. Conclusion: Ultimately, this study showed that severe COVID-19 patients require early and effective management.

Introduction: After 2016, the World Health Organization (WHO) proposed Dolutegravir (DTG) as an alternative first-line treatment for adults. Thus, the purpose of this study was to identify biomarkers of cardiometabolic risk capable of demonstrating the beneficial effect of Dolutegravir (DTG) compared to other antiretrovirals in predicting atherosclerosis in people living with HIV (PLHIV) and hospitalized in Kinshasa Hospital. Methods: we conducted an interventional study of people living with HIV who had received antiretroviral therapy (ART) for at least 6 months and were treated in the structures of the network coordinated by the Catholic Church (BDOM-Bureau Diocesain des Oeuvres Medicales) and of the University Clinics of Kinshasa (CUK) between January 2017 and December 2021. Subclinical atherosclerosis was defined as Pulsed Pressure (PP) & GE;60 mm Hg; Carotid Intima-Media Thickness (CIMT) > 0.8 mm; and Systolic Pressure Index (SPI) < 0.9. Logistic regression was used in the statistical analysis of associations. Results: a total of 334 PLHIV were recruited, of whom 96.1% (n=321) were on ART and 13.9% (n=13) were ART naive patients. The mean age of PLHIV was 51 & PLUSMN;12 years with a female predominance (70.4%; n=235); the independent determinants of subclinical atherosclerosis were marital status (aOR: 4. 95% CI 1.5-10.5; p<0.006), low socioeconomic level (aOR: 10.7, 95% CI 2.3-48.7 p<0.002), duration of HIV infection (aOR: 6.6, 95% CI 2.8-16; p<0.0001), duration of antiretroviral therapy & GE;9 years (aOR: 0.3, 95% CI 0.2-0.7; p<0.005) and total cholesterol ratio/high-density lipoprotein-cholesterol (CT/HDL-c)(aOR: 2, 95% CI 1.1-3.6; p= 0.034). The mean values of traditional and emergent variables were significantly higher in the previous ART regimen without DTG than in the new regimen with DTG. However, dyslipidemia was detected during the new DTG-based regimen. Conclusion: dyslipidemia was common during the DTG-based regimen. Marital status, low socioeconomic level, duration of HIV infection, duration of antiretroviral treatment beyond 9 years and the TC/HDL-c ratio were identified as determinants of subclinical atherosclerosis in PLHIV on ART hospitalized in the Kinshasa hospital.

After 2016, the World Health Organization (WHO) proposed Dolutegravir (DTG) as an alternative first-line treatment for adults. Thus, the purpose of this study was to identify biomarkers of cardiometabolic risk capable of demonstrating the beneficial effect of Dolutegravir (DTG) compared to other antiretrovirals in predicting atherosclerosis in people living with HIV (PLHIV) and hospitalized in Kinshasa Hospital.we conducted an interventional study of people living with HIV who had received antiretroviral therapy (ART) for at least 6 months and were treated in the structures of the network coordinated by the Catholic Church (BDOM-Bureau Diocésain des Oeuvres Médicales) and of the University Clinics of Kinshasa (CUK) between January 2017 and December 2021. Subclinical atherosclerosis was defined as Pulsed Pressure (PP) ≥60 mm Hg; Carotid Intima-Media Thickness (CIMT) > 0.8 mm; and Systolic Pressure Index (SPI) < 0.9. Logistic regression was used in the statistical analysis of associations.a total of 334 PLHIV were recruited, of whom 96.1% (n=321) were on ART and 13.9% (n=13) were ART naïve patients. The mean age of PLHIV was 51±12 years with a female predominance (70.4%; n=235); the independent determinants of subclinical atherosclerosis were marital status (aOR: 4. 95% CI 1.5-10.5; p<0.006), low socioeconomic level (aOR: 10.7, 95% CI 2.3-48.7 p<0.002), duration of HIV infection (aOR: 6.6, 95% CI 2.8-16; p<0.0001), duration of antiretroviral therapy ≥9 years (aOR: 0.3, 95% CI 0.2-0.7; p<0.005) and total cholesterol ratio/high-density lipoprotein-cholesterol (CT/HDL-c)(aOR: 2, 95% CI 1.1-3.6; p= 0.034). The mean values of traditional and emergent variables were significantly higher in the previous ART regimen without DTG than in the new regimen with DTG. However, dyslipidemia was detected during the new DTG-based regimen.dyslipidemia was common during the DTG-based regimen. Marital status, low socioeconomic level, duration of HIV infection, duration of antiretroviral treatment beyond 9 years and the TC/HDL-c ratio were identified as determinants of subclinical atherosclerosis in PLHIV on ART hospitalized in the Kinshasa hospital.

Objective: This study aimed to determine searching for the determinants of regional obesity (visceral and subcutaneous obesity) within the cardiovascular risk factors (CVRF) in patients followed in cardiology at the University Clinics of Kinshasa (UCK) in the Democratic Republic of Congo (DRC). Material and Methods: Cross-sectional and analytical study had sought the determinants of regional obesity (visceral and subcutaneous obesity) by bio-impedance inside the CVRF during the period from July 1 to September 31, 2014. The multivariate analysis (logistic regression) has established the levels of association between regional obesity and CVRF. The statistical significance threshold was set at p Results: A total of 642 patients participated in the present study. The frequencies of visceral and subcutaneous obesity were respectively 45.5% (without significant distinction between the two sexes: Men 48% n = 92/188 vs. Women 44.1 n = 200/454; p = 0.148) and 60.7% with a predominance in women (36.2 n = 68/188 vs. 70.9% n = 322/454; p that alongside regional obesity was: advanced age, tobacco use, alcohol use, physical inactivity, high blood pressure (HBP), diabetes mellitus (DM) and Chronic renal failure (CRF) in the respective proportions of 50.8%, 13.4%, 44.2%, 86.3%, 10.7%, 13.4% and 0.3%. The determinants of regional obesity were advanced age, smoking and obesity on body mass index (BMI) for visceral obesity; advanced age, female gender, alcohol intake and obesity on BMI and waist circumference (WC) as well as hypertriglyceridemia for subcutaneous obesity. Conclusion: This study showed a significant frequency of regional obesity with the following determinants: advanced age, female gender, smoking, alcohol, BMI/WC obesity and hypertriglyceridemia.

Background and Objective: 24-h ambulatory blood pressure monitoring (ABPM) aids to precisely identify patients with true resistant hypertension (tRH). The present study was aimed to assess the frequency and correlates of tRH among patients with clinically suspected RH. Methods: Medical records of treated hypertensive patients referred in four healthcare centers for BP control evaluation by 24-h ABPM were reviewed to assess the prevalence of tRH. Inclusion criteria were age ≥ 18 years, clinical diagnosis of RH. Data on demographic, clinical, laboratory, 2D-echocardiography and 24-h ABPM parameters were retrieved from patient’s medical records. True RH (tRH) was defined as office blood pressure (BP) ≥ 140/90 mmHg and 24-h ambulatory BP ≥ 130/80 mmHg. Simple and multiple linear regression analyses were used to assess factors associated with systolic BP (SBP) as a proxy of RH among patients with tRH. P 0.05 defined the level of statistical significance. Results: Of 636 patients referred for BP control evaluation by 24-h ABPM, 75 (11.7%) had suspected RH by office BP measurements. After 24-h ABPM, pseudo or apparent RH (aRH) and tRH were observed in 15 (2.3%) and 60 (9.4%) patients, respectively. BMI (p = 0.007) and blood glucose (p = 0.024) were positively associated with SBP whereas a negative association was observed with eGFR (p = 0.022) among tRH hypertensive patients in multiple regression analysis. Conclusion: True RH was a common finding among patients with clinical RH and associated with obesity and silent target organ, especially kidney dysfunction. The present study highlights the diagnostic and prognostic importance of 24-h ABPM among patients with clinical RH.

Although the “triglyceride paradox” states that hypertriglyceridemia is less frequent in Blacks and the risk of pancreatitis increases with severe hypertriglyceridemia, we herein report on a case of moderate hypertriglyceridemia revealed by an acute chest syndrome and a milky appearance serum in a 47-year-old type 2 diabetes black patient with prior history of recurrent acute pancreatitis. In addition to insulin therapy and coronary angioplasty, the combination of a statin and a fibrate resulted two months later in a substantial improvement in triglyceride levels and a normal serum appearance.