321. Clinical Characteristics of Hospitalized HIV Patients with COVID-19 in Miami

Abstract Background HIV is a significant risk factor for acquiring SARS-CoV-2 infection and is associated with increased risk of mortality from COVID-19. Information on the clinical characteristics of persons living with HIV(PLWH) hospitalized due to COVID-19 infection are inconsistent and sparse. As Miami area is currently the epicenter of new HIV infection, an understanding of the clinical characteristics of COVID-19 in hospitalized HIV patients in South Florida is needful. Methods This is a single center retrospective case series analysis of individuals with HIV hospitalized with COVID-19 from March 1, 2020 to March 31, 2021. We analyzed relevant data related to demographics, comorbidities, clinical presentation, HIV viral load and CD4 profiles, serum inflammatory markers, COVID-19 treatment and survival. Results 25 patients were identified. The demographic, socioeconomic and clinical data are described in Table 1. 88% of subjects. were on HIV antiretroviral treatment (ART) but only 60% had CD4 counts > 200cells/mm3. More study results are shown in Figures 1 and 2. The serum ferritin ranged from 29 to 40,577ng/mL while serum creatinine ranged from 0.51 to 2.8mg/dL, mean 1.04± 0.46 mg/dL. The Pearson correlation between serum ferritin and serum creatinine (SCreat) was 0.715, p 200 cells/mm3. Figure 1. Bar chart showing month and year of hospital admission for COVID-19 in HIV infected persons Table 1 Figure 2. Bar chart showing different percentages of the cohort who received the different COVID-19 treatment illustrated Conclusion This first case series of hospitalized COVID-19 patients in PLWH illustrate important demographic and socioeconomic trends with an imbalance towards African Americans. The group mortality rate appear to be higher compared to the overall mortality rate of COVID-19 reported in the general population or other published HIV-COVID-19 coinfection case series. This is not surprising given the fact that only 64% of the cohort had undetected viral load and only 60% had CD4 counts > 200 despite reported 88% ART use. Correlations between lymphopenia and serum ferritin on one hand and serum creatinine on the other hand should be further explored in a larger case series or prospective study. Since COVID-19 mortality is related to HIV severity, improving socioeconomic status and ART compliance could play a big role in positively improving outcome of hospitalized HIV-COVID 19 patients. Disclosures All Authors: No reported disclosure

Identification of a Novel, Intraperoxisomal Pex14-Binding Site in Pex13: Association of Pex13 with the Docking Complex Is Essential for Peroxisomal Matrix Protein Import

The peroxisomal docking complex is a key component of the import machinery for matrix proteins. The core protein of this complex, Pex14, is thought to represent the initial docking site for the import receptors Pex5 and Pex7. Associated with this complex is a fraction of Pex13, another essential component of the import machinery. Here we demonstrate that Pex13 directly binds Pex14 not only via its SH3 domain but also via a novel intraperoxisomal site. Furthermore, we demonstrate that Pex5 also contributes to the association of Pex13 with Pex14. Peroxisome function was affected only mildly by mutations within the novel Pex14 interaction site of Pex13 or by the non-Pex13-interacting mutant Pex5(W204A). However, when these constructs were tested in combination, PTS1-dependent import and growth on oleic acid were severely compromised. When the SH3 domain-mediated interaction of Pex13 with Pex14 was blocked on top of that, PTS2-dependent matrix protein import was completely compromised and Pex13 was no longer copurified with the docking complex. We conclude that the association of Pex13 with Pex14 is an essential step in peroxisomal protein import that is enabled by two direct interactions and by one that is mediated by Pex5, a result which indicates a novel, receptor-independent function of Pex5

Recovery does not always signal the end of the battle: A case of post SARS-CoV-2 multisystem inflammatory syndrome in an adult

We describe a case of SARS-CoV-2 post-infectious inflammatory syndrome in an adult who presented with multiorgan failure two months following his initial diagnosis of SARS-CoV-2 infection. This case highlights clinician’s early recognition of this devastating sequela and challenges in appropriate management of this patient