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Silva TS, Horvath JDC, Pereira MP, David CND, Vargas DF, Rigoni LDC, Sartor ITS, Kern LB, da Silva PDO, Paz AA, Daudt LE, Astigarraga CC. Impact of waitlist time on post-HSCT survival: a cohort study at a hospital in southern Brazil. Hematol Transfus Cell Ther 2023:S2531-1379(23)00088-3. [PMID: 37277257 DOI: 10.1016/j.htct.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 06/22/2022] [Accepted: 03/30/2023] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION The time elapsed from diagnosis to hematopoietic stem cell transplantation (HSCT) is influenced by numerous factors. In Brazil, patients using the public health system are also dependent on the availability of HSCT-specific beds in the hematology ward. OBJECTIVE AND METHODS We conducted a cohort study of listed patients who underwent allogeneic HSCT at a Brazilian public hospital to investigate the impact of the waitlist time on post-HSCT survival. RESULTS The median time from diagnosis to HSCT was 19 months (IQR, 10 - 43), of which 6 months (IQR, 3 - 9) were spent on the waitlist. The time on the waitlist for HSCT appeared to influence mainly the survival of adult patients (≥ 18 years), with an increasing risk according to this time (RR, 3.53 and 95%CI, 1.81 - 6.88 for > 3 and ≤ 6 months; RR 5.86 and 95%CI, 3.26 - 10.53 for > 6 and ≤ 12 months, and; RR 4.24 and 95%CI, 2.32 - 7.75 for > 12 months). CONCLUSION Patients who remained on the waitlist for less than 3 months had the highest survival (median survival, 856 days; IQR, 131 - 1607). The risk of reduced survival was about 6-fold higher (95%CI, 2.8 - 11.5) in patients with malignancies.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Liane Esteves Daudt
- Faculdade de Medicina da Universidade Federal do Rio Grande do Sul (FAMED UFRGS), Porto Alegre, RS, Brazil
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Varela FH, Sartor ITS, Polese-Bonatto M, Azevedo TR, Kern LB, Fazolo T, de David CN, Zavaglia GO, Fernandes IR, Krauser JRM, Stein RT, Scotta MC. Rhinovirus as the main co-circulating virus during the COVID-19 pandemic in children. J Pediatr (Rio J) 2022; 98:579-586. [PMID: 35490727 PMCID: PMC9015957 DOI: 10.1016/j.jped.2022.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/10/2022] [Accepted: 02/28/2022] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Changes in the epidemiology of respiratory infections during the restrictions imposed as a response to the coronavirus disease 2019 (COVID-19) pandemic have been reported elsewhere. The present study's aim was to describe the prevalence of a large array of respiratory pathogens in symptomatic children and adolescents during the pandemic in Southern Brazil. METHODS Hospitalized and outpatients aged 2 months to 18 years with signs and symptoms of acute COVID-19 were prospectively enrolled in the study from May to November 2020 in two hospitals in a large metropolitan area in a Brazilian city. All participants performed a real-time PCR panel assessing 20 respiratory pathogens (three bacteria and 17 viruses). RESULTS 436 participants were included, with 45 of these hospitalized. Rhinovirus was the most prevalent pathogen (216/436) followed by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, 97/436), with a coinfection of these two viruses occurring in 31/436 participants. The remaining pathogens were found in 24 symptomatic participants (adenovirus, n = 6; Chlamydophila pneumoniae, n = 1; coronavirus NL63, n = 2; human enterovirus, n = 7; human metapneumovirus, n = 2; Mycoplasma pneumoniae, n = 6). Hospitalization was more common among infants (p = 0.004) and those with pathogens other than SARS-CoV-2 (p = 0.001). CONCLUSION During the period of social distancing in response to COVID-19, the prevalence of most respiratory pathogens was unusually low. Rhinovirus remained as the main virus co-circulating with SARS-CoV-2. COVID-19 in symptomatic children was less associated with hospitalization than with other respiratory infections in children and adolescents.
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Affiliation(s)
- Fernanda Hammes Varela
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil; Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | | | | - Tiago Fazolo
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | | | | | | | | | - Renato T Stein
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil; Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marcelo Comerlato Scotta
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil; Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Sartor ITS, de David CN, Telo GH, Zavaglia GO, Fernandes IR, Kern LB, Polese-Bonatto M, Azevedo TR, Santos AP, de Almeida WAF, Porto VBG, Varela FH, Scotta MC, Rosa RG, Stein RT. Association between obesity and hospitalization in mild COVID-19 adult outpatients in Brazil: a prospective cohort study. Arch Endocrinol Metab 2022; 66:512-521. [PMID: 36074943 PMCID: PMC10697638 DOI: 10.20945/2359-3997000000486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/19/2022] [Indexed: 06/15/2023]
Abstract
Objective To evaluate the association between obesity and hospitalization in mild COVID-19 adult outpatients in Brazil. Methods Adults with signs and symptoms suggestive of acute SARS-CoV-2 infection who sought treatment in two hospital (public and private) emergency departments were prospectively enrolled. Patients with confirmed COVID-19 at inclusion were followed by phone calls at days D7, D14 and D28. Multivariable logistic regression models were employed to explore the association between obesity and other potential predictors for hospitalization. Results A total of 1,050 participants were screened, and 297 completed the 28-day follow-up and were diagnosed with COVID-19 by RT-PCR. The median age was 37.2 (IQR 29.7-44.6) years, and 179 (60.0%) were female. The duration of symptoms was 3.0 (IQR 2.0-5.0) days, and 10.0 (IQR 8.0-12.0) was the median number of symptoms at inclusion. Ninety-five (32.0%) individuals had obesity, and 233 (78.5%) had no previous medical conditions. Twenty-three participants (7.7%) required hospitalization during the follow-up period. After adjusting, obesity (BMI ≥ 30.0 kg/m2) (OR = 2.69, 95% CI 1.63-4.83, P < 0.001) and older age (OR = 1.05, 95% CI 1.01-1.09, P < 0.001) were significantly associated with higher risks of hospitalization. Conclusion Obesity, followed by aging, was the main factor associated with hospital admission for COVID-19 in a young population in a low-middle income country. Our findings highlighted the need to promote additional protection for individuals with obesity, such as vaccination, and to encourage lifestyle changes.
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Affiliation(s)
| | | | - Gabriela Heiden Telo
- Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | | | | | | | | | - Thaís Raupp Azevedo
- Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | - Amanda Paz Santos
- Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | | | | | - Fernanda Hammes Varela
- Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Marcelo Comerlato Scotta
- Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Regis Goulart Rosa
- Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | - Renato T Stein
- Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
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Scotta MC, Kern LB, Polese-Bonatto M, Azevedo TR, Varela FH, Zavaglia GO, Fernandes IR, de David CN, Fazolo T, da Costa MSC, de Carvalho FC, Sartor ITS, Zavascki AP, Stein RT. Impact of rhinovirus on hospitalization during the COVID-19 pandemic: a prospective cohort study. J Clin Virol 2022; 156:105197. [PMID: 35691819 PMCID: PMC9170614 DOI: 10.1016/j.jcv.2022.105197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 12/01/2022]
Abstract
Background Although the clinical course of the COVID-19 in adults has been extensively described, the impact of the co-detection of SARS-CoV-2 and rhinovirus on severity outcomes is not understood. Objectives This study aimed to compare the risk of hospitalization of outpatients with COVID-19 with and without the co-detection of rhinovirus in southern Brazil. Secondarily, such risk was also compared between all individuals with COVID-19 and those with single rhinovirus infection. Study design Outpatients (>18 years) with acute signs of cough, fever, or sore throat were prospectively enrolled at two emergency departments from May to September 2020. Sample collection was performed to detect SARS-CoV-2 and other 20 respiratory pathogens. Participants were followed for 28 days through telephone interviews. Results 1,047 participants were screened and 1,044 were included. Of these, 4.9% were lost during follow-up, and 993/1,044 (95.1%) were included in severity-related analysis. Rhinovirus was the most prevalent pathogen (25.0%, 248/993), followed by SARS-CoV-2 (22.6%, 224/993), with coinfection of these two viruses occurring in 91/993 (9.2%) participants. The risk of COVID-19-related hospitalizations were not different between individuals with and without co-detection of rhinovirus (9.9% vs. 7.6%, respectively, P = 0.655). Conversely, subjects with COVID-19 had a higher hospitalization risk than single rhinovirus infection (8.3 vs 0.4%, respectively, P < 0.001). Conclusions The co-detection of SARS-CoV-2 and rhinovirus did not change the risk of hospitalizations in adults. Furthermore, COVID-19 was more severe than single rhinovirus infection.
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Affiliation(s)
- Marcelo Comerlato Scotta
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, Brazil; School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
| | | | | | | | - Fernanda Hammes Varela
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, Brazil; School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | - Tiago Fazolo
- Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Felipe Cotrim de Carvalho
- General Coordination, Health Surveillance Secretariat, Brazilian Ministry of Health, Brasilia, Brazil
| | | | - Alexandre Prehn Zavascki
- Infectious Diseases Service, Hospital Moinhos de Vento, Porto Alegre, Brazil; Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Renato T Stein
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, Brazil; School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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Scotta MC, David CND, Varela FH, Sartor ITS, Polese-Bonatto M, Fernandes IR, Zavaglia GO, Ferreira CF, Kern LB, Santos AP, Krauzer JRM, Pitrez PM, Almeida WAFD, Porto VBG, Stein RT. Low performance of a SARS-CoV-2 point-of-care lateral flow immunoassay in symptomatic children during the pandemic. J Pediatr (Rio J) 2022; 98:136-141. [PMID: 34153236 PMCID: PMC8173459 DOI: 10.1016/j.jped.2021.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/16/2021] [Accepted: 04/27/2021] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE to evaluate the accuracy of an antibody point-of-care lateral flow immunoassay (LFI - Wondfo Biotech Co., Guangzhou, China) in a pediatric population. METHODS children and adolescents (2 months to 18 years) with signs and symptoms suggestive of acute SARS-CoV-2 infection were prospectively investigated with nasopharyngeal RT-PCR and LFI at the emergency room. RT-PCR was performed at baseline, and LFI at the same time or scheduled for those with less than 7 days of the clinical picture. Overall accuracy, sensitivity and specificity were assessed, as well as according to the onset of symptoms (7-13 or ≥14 days) at the time of the LFI test. RESULTS In 175 children included, RT-PCR and LFI were positive in 51 (29.14%) and 36 (20.57%), respectively. The overall sensitivity, specificity, positive and negative predictive value was 70.6% (95%CI 56.2-82.5), 96.8% (95%CI 91.9-99.1), 90.0% (95%CI 77.2-96.0), and 88.9% (95%CI 83.9-92.5), respectively. At 7-13 and ≥14 days after the onset of symptoms, sensitivity was 60.0% (95%CI 26.2-87.8) and 73.2% (95%CI 57.1-85.8) and specificity was 97.9% (95%CI 88.7-99.9) and 96.1% (95%CI 89.0-99.2), respectively. CONCLUSION Despite its high specificity, in the present study the sensitivity of LFI in children was lower (around 70%) than most reports in adults. Although a positive result is informative, a negative LFI test cannot rule out COVID-19 in children.
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Affiliation(s)
- Marcelo Comerlato Scotta
- Hospital Moinhos de Vento, Responsabilidade Social - PROADI-SUS, Porto Alegre, RS, Brazil; Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Medicina, Porto Alegre, RS, Brazil.
| | | | - Fernanda Hammes Varela
- Hospital Moinhos de Vento, Responsabilidade Social - PROADI-SUS, Porto Alegre, RS, Brazil; Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Medicina, Porto Alegre, RS, Brazil.
| | | | - Márcia Polese-Bonatto
- Hospital Moinhos de Vento, Responsabilidade Social - PROADI-SUS, Porto Alegre, RS, Brazil
| | | | | | | | - Luciane Beatriz Kern
- Hospital Moinhos de Vento, Responsabilidade Social - PROADI-SUS, Porto Alegre, RS, Brazil
| | - Amanda Paz Santos
- Hospital Moinhos de Vento, Responsabilidade Social - PROADI-SUS, Porto Alegre, RS, Brazil
| | | | - Paulo Márcio Pitrez
- Hospital Moinhos de Vento, Responsabilidade Social - PROADI-SUS, Porto Alegre, RS, Brazil
| | | | | | - Renato T Stein
- Hospital Moinhos de Vento, Responsabilidade Social - PROADI-SUS, Porto Alegre, RS, Brazil; Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Medicina, Porto Alegre, RS, Brazil
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de David CN, Ziegelmann PK, Goveia P, Silvani J, da Silveira LRP, Fuchs SC. The effect of mobile health focused on diet and lifestyle on blood pressure: a systematic review and Meta-analysis. Eur J Prev Cardiol 2022; 29:1142-1155. [DOI: 10.1093/eurjpc/zwac017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/01/2021] [Accepted: 01/24/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
To determine the effect of mobile health (mHealth) focused on diet and lifestyle on blood pressure (BP).
Methods
We performed a systematic review with meta-analysis using the mean difference (MD) of change from baseline as an effect measure. MEDLINE via PubMed, Cochrane Central, and EMBASE were reviewed until May 6, 2020. We included randomized controlled trials of adults who participated in mHealth focused on diet and lifestyle. Interventions were grouped according to the presence of health professional intervention (PI) (PI+mHealth or mHealth only). Eligible controls did not participate in mHealth and were classified as active comparator (PI) or no intervention (NI). Subgroup analyses were performed according to the presence of prior cardiovascular disease and hypertension status.
Results
We included 44 trials involving 24,692 participants. Mobile health interventions were superior to NI in reducing SBP in both situations: alone (MD = −1.8 mmHg; 95%CI: −3.6; 0.0) or with PI (MD = −5.3 mmHg; 95%CI: −7.5;−3.1), with a greater effect size in the latter group (p = 0.016). This benefit was not observed when the control was PI. DBP and SBP had consistent results. There was a marked effect of PI+mHealth vs. NI on the BP reduction among hypertensive participants.
Conclusions
Current evidence shows that mHealth focused on diet and lifestyle can reduce BP, especially when implemented in hypertensive participants, and PI may provide additional benefit.
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Affiliation(s)
- Caroline Nespolo de David
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil)
- Professional Master's in Clinical Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil)
| | - Patricia K Ziegelmann
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil)
- Postgraduate Studies Program in Cardiology, Hospital de Clínicas de Porto Alegre, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil)
- Statistics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil)
| | - Pâmella Goveia
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil)
| | - Juliana Silvani
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil)
| | - Letícia Ribeiro P da Silveira
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil)
| | - Sandra C Fuchs
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil)
- Postgraduate Studies Program in Cardiology, Hospital de Clínicas de Porto Alegre, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil)
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David CND, Varela FH, Sartor ITS, Polese-Bonatto M, Fernandes IR, Zavaglia GO, Kern LB, Ferreira CF, Bastos GAN, Pitrez PM, Almeida WAFD, Porto VBG, Zavascki AP, Stein RT, Scotta MC. Diagnostic accuracy of a SARS-CoV-2 rapid test and optimal time for seropositivity according to the onset of symptoms. CAD SAUDE PUBLICA 2022; 38:e00069921. [DOI: 10.1590/0102-311x00069921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/02/2021] [Indexed: 11/22/2022] Open
Abstract
Point-of-care serological tests for SARS-CoV-2 have been used for COVID-19 diagnosis. However, their accuracy over time regarding the onset of symptoms is not fully understood. We aimed to assess the accuracy of a point-of-care lateral flow immunoassay (LFI). Subjects, aged over 18 years, presenting clinical symptoms suggestive of acute SARS-CoV-2 infection were tested once by both nasopharyngeal and oropharyngeal RT-PCR and LFI. The accuracy of LFI was assessed in periodic intervals of three days in relation to the onset of symptoms. The optimal cut-off point was defined as the number of days required to achieve the best sensitivity and specificity. This cut-off point was also used to compare LFI accuracy according to participants’ status: outpatient or hospitalized. In total, 959 patients were included, 379 (39.52%) tested positive for SARS-CoV-2 with RT-PCR, and 272 (28.36%) tested positive with LFI. LFI best performance was achieved after 10 days of the onset of symptoms, with sensitivity and specificity of 84.9% (95%CI: 79.8-89.1) and 94.4% (95%CI: 91.0-96.8), respectively. Although the specificity was similar (94.6% vs. 88.9%, p = 0.051), the sensitivity was higher in hospitalized patients than in outpatients (91.7% vs. 82.1%, p = 0.032) after 10 days of the onset of symptoms. Best sensitivity of point-of-care LFI was found 10 days after the onset of symptoms which may limit its use in acute care. Specificity remained high regardless of the number of days since the onset of symptoms.
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Affiliation(s)
| | - Fernanda Hammes Varela
- Hospital Moinhos de Vento, Brasil; Pontifícia Universidade Católica do Rio Grande do Sul, Brasil
| | | | | | | | | | | | | | | | | | | | | | | | | | - Marcelo Comerlato Scotta
- Hospital Moinhos de Vento, Brasil; Pontifícia Universidade Católica do Rio Grande do Sul, Brasil
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Sartor ITS, Varela FH, Meireles MR, Kern LB, Azevedo TR, Giannini GLT, da Silva MS, Demoliner M, Gularte JS, de Almeida PR, Fleck JD, Zavaglia GO, Fernandes IR, de David CN, Santos AP, de Almeida WAF, Porto VBG, Scotta MC, Vieira GF, Spilki FR, Stein RT, Polese-Bonatto M. Y380Q novel mutation in receptor-binding domain of SARS-CoV-2 spike protein together with C379W interfere in the neutralizing antibodies interaction. Diagn Microbiol Infect Dis 2022; 102:115636. [PMID: 35219552 PMCID: PMC8761118 DOI: 10.1016/j.diagmicrobio.2022.115636] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/14/2021] [Accepted: 01/09/2022] [Indexed: 11/30/2022]
Abstract
We aimed to describe the SARS-CoV-2 lineages circulating early pandemic among samples with S gene dropout and characterize the receptor-binding domain (RBD) of viral spike protein. Adults and children older than 2 months with signs and symptoms of COVID-19 were prospectively enrolled from May to October in Porto Alegre, Brazil. All participants performed RT-PCR assay, and samples with S gene dropout and cycle threshold < 30 were submitted to high-throughput sequencing (HTS). 484 out of 1,557 participants tested positive for SARS-CoV-2. The S gene dropout was detected in 7.4% (36/484) and a peak was observed in August. The B.1.1.28, B.1.91 and B.1.1.33 lineages were circulating in early pandemic. The RBD novel mutation (Y380Q) was found in one sample occurring simultaneously with C379W and V395A, and the B.1.91 lineage in the spike protein. The Y380Q and C379W may interfere with the binding of neutralizing antibodies (CR3022, EY6A, H014, S304).
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Affiliation(s)
| | - Fernanda Hammes Varela
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, Brazil; School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Mariana Rost Meireles
- Genetics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | | | - Meriane Demoliner
- Laboratory of Molecular Microbiology, Universidade FEEVALE, Novo Hamburgo, Brazil
| | | | | | - Juliane Deise Fleck
- Laboratory of Molecular Microbiology, Universidade FEEVALE, Novo Hamburgo, Brazil
| | | | | | | | - Amanda Paz Santos
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | | | | | - Marcelo Comerlato Scotta
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, Brazil; School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gustavo Fioravanti Vieira
- Genetics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Post-Graduation Program in Health and Human Development, Universidade La Salle, Canoas, Brazil
| | | | - Renato T Stein
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, Brazil; School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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Vargas DF, Pereira MP, Silva TS, de David CN, Paz AA, Astigarraga CC. Extracorporeal photopheresis in chronic graft-versus-host disease: clinical description and economic study. Hematol Transfus Cell Ther 2021:S2531-1379(21)01319-5. [DOI: 10.1016/j.htct.2021.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 06/30/2021] [Accepted: 08/23/2021] [Indexed: 10/19/2022] Open
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Polese-Bonatto M, Sartor ITS, Varela FH, Giannini GLT, Azevedo TR, Kern LB, Fernandes IR, Zavaglia GO, de David CN, Santos AP, de Almeida WAF, Porto VBG, Scotta MC, Stein RT. Children Have Similar Reverse Transcription Polymerase Chain Reaction Cycle Threshold for Severe Acute Respiratory Syndrome Coronavirus 2 in Comparison With Adults. Pediatr Infect Dis J 2021; 40:e413-e417. [PMID: 34596626 PMCID: PMC8505158 DOI: 10.1097/inf.0000000000003300] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The viral dynamics and the role of children in the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are not completely understood. Our aim was to evaluate reverse transcription polymerase chain reaction (RT-PCR) cycle threshold (Ct) values among children with confirmed SARS-CoV-2 compared with that of adult subjects. METHODS Patients (from 2 months to ≤18 years of age and adults) with signs and symptoms of acute SARS-CoV-2 infection for less than 7 days were prospectively enrolled in the study from May to November 2020. All participants performed RT-PCR assay for SARS-CoV-2 detection; Ct values of ORF1ab, N and S gene targets and the average of all the 3 probes were used as surrogates of viral load. RESULTS There were 21 infants (2 months to <2 years), 40 children (≥2 to <12 years), 22 adolescents (≥12 to <18 years) and 293 adults of 376 participants with confirmed SARS-CoV-2 infections. RT-PCR Ct values from all participants less than 18 years of age, as well as from all childhood subgroups, were not significantly different from adults, comparing ORF1ab, N, S and all the gene targets together (P = 0.453). CONCLUSIONS Ct values for children were comparable with that of adults. Although viral load is not the only determinant of SARS-CoV-2 transmission, children may play a role in the spread of coronavirus disease 2019 in the community.
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Affiliation(s)
| | | | - Fernanda Hammes Varela
- From the Social Responsibility – PROADI-SUS, Hospital Moinhos de Vento
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul
| | | | | | | | | | | | | | - Amanda Paz Santos
- From the Social Responsibility – PROADI-SUS, Hospital Moinhos de Vento
| | | | | | - Marcelo Comerlato Scotta
- From the Social Responsibility – PROADI-SUS, Hospital Moinhos de Vento
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul
| | - Renato T. Stein
- From the Social Responsibility – PROADI-SUS, Hospital Moinhos de Vento
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul
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de David CN, Deligne LDMC, da Silva RS, Malta DC, Duncan BB, Passos VMDA, Cousin E. The burden of low back pain in Brazil: estimates from the Global Burden of Disease 2017 Study. Popul Health Metr 2020; 18:12. [PMID: 32993673 PMCID: PMC7526352 DOI: 10.1186/s12963-020-00205-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The prevalence and burden of musculoskeletal (MSK) conditions are growing around the world, and low back pain (LBP) is the most significant of the five defined MSK disorders in the Global Burden of Disease (GBD) study. LBP has been the leading cause of non-fatal health loss for the last three decades. The objective of this study is to describe the current status and trends of the burden due to LBP in Brazil based on information drawn from the GBD 2017 study. METHODS We estimated prevalence and years lived with disability (YLDs) for LBP by Brazilian federative units, sex, age group, and age-standardized between 1990 and 2017 and conducted a decomposition analysis of changes in age- and sex-specific YLD rates attributable to total population growth and population ageing for the purpose of understanding the drivers of changes in LBP YLDs rates in Brazil. Furthermore, we analyzed the changes in disability-adjusted life years (DALYs) rankings for this disease over the period. RESULTS The results show high prevalence and burden of LBP in Brazil. LBP prevalence increased 26.83% (95% UI 23.08 to 30.41) from 1990 to 2017. This MSK condition represents the most important cause of YLDs in Brazil, where the increase in burden is mainly related to increase in population size and ageing. The LBP age-standardized YLDs rate are similar among Brazilian federative units. LBP ranks in the top three causes of DALYs in Brazil, even though it does not contribute to mortality. CONCLUSIONS Findings from this study show LBP to be the most important cause of YLDs and the 3rd leading cause of DALYs in Brazil. The Brazilian population is ageing, and the country has been experiencing a rapid epidemiological transition, which generates an increasing number of people who need chronic care. In this scenario, more attention should be paid to the burden of non-fatal health conditions.
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Affiliation(s)
- Caroline Nespolo de David
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2600 Sala 414, Bairro Santa Cecilia, Porto Alegre, 90035-003, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Rodolfo Souza da Silva
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2600 Sala 414, Bairro Santa Cecilia, Porto Alegre, 90035-003, Brazil.,Telehealth Centre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Bruce B Duncan
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2600 Sala 414, Bairro Santa Cecilia, Porto Alegre, 90035-003, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Ewerton Cousin
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2600 Sala 414, Bairro Santa Cecilia, Porto Alegre, 90035-003, Brazil.
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