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Seery V, Raiden S, Penedo JMG, Borda M, Herrera L, Uranga M, Marcó Del Pont M, Chirino C, Erramuspe C, Alvarez LS, Lenoir M, Morales LD, Davenport C, Huespe Auchter S, Monsalvo L, Sastoque L, Gavazzi M, Russo C, Sananez I, Pando MDLÁ, Laufer N, Muiños R, Ferrero F, Geffner J, Arruvito L. Persistent symptoms after COVID-19 in children and adolescents from Argentina. Int J Infect Dis 2023; 129:49-56. [PMID: 36736574 PMCID: PMC9892252 DOI: 10.1016/j.ijid.2023.01.031] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/10/2023] [Accepted: 01/24/2023] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Although long COVID-19 is widely recognized in adults, less information is available about this condition in children, especially in developing countries. Here, we studied the long-term symptoms of SARS-CoV-2 infection beyond 3 months and the associated risk factors in a pediatric population. METHODS This observational study included 639 Argentinian children and adolescents with previously confirmed COVID-19 from June 2020-June 2021 and 577 children without previous COVID-19. Parents completed a survey about symptoms that their child had for >3 months after the diagnosis of SARS-CoV-2 infection. RESULTS At least one persistent symptom was observed more frequently in children with previous COVID-19 than in the non-COVID-19 group (34% vs 13%, P <0.0001). SARS-CoV-2 infection increased the risk of headache, dizziness, loss of taste, dyspnea, cough, fatigue, muscle pain, and loss of weight by three- to seven-fold. The loss of smell was only reported in infected children. After controlling for the other variables, older age, symptomatic COVID-19, and comorbidities were independent predictors of long-term symptoms. CONCLUSIONS One-third of children experienced persistent symptoms after COVID-19. Older age, symptomatic infection, and comorbidities were shown to be risk factors for long COVID-19. Pediatric long COVID-19 is a new condition that requires further investigation.
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Affiliation(s)
- Vanesa Seery
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Silvina Raiden
- Hospital General de Niños Pedro de Elizalde, Av. Montes de Oca 40, C1270 CABA, Argentina
| | - Juan Martín Gómez Penedo
- Laboratorio de Análisis Estadísticos, Secretaría de Investigaciones, Facultad de Psicología. UBA- CONICET. Av. Hipólito Yrigoyen 3242, C1207ABR CABA, Argentina
| | - Mauricio Borda
- Hospital Pediátrico Juan Pablo II, Av. Artigas 1435, W3400, Corrientes, Argentina
| | - Largión Herrera
- Hospital Dr. Salvador Mazza, Sta. Josefa Rosello 356, H3540, Chaco, Argentina
| | - Macarena Uranga
- Hospital Universitario Austral, Av. Juan Domingo Perón 1500, B1629, Buenos Aires, Argentina
| | - María Marcó Del Pont
- Hospital Universitario Austral, Av. Juan Domingo Perón 1500, B1629, Buenos Aires, Argentina
| | - Carina Chirino
- Policlínico Regional Juan Domingo Perón, Maipú 450, D5732, San Luis, Argentina
| | - Constanza Erramuspe
- Policlínico Regional Juan Domingo Perón, Maipú 450, D5732, San Luis, Argentina
| | - Laura Silvana Alvarez
- Hospital Universitario Austral, Av. Juan Domingo Perón 1500, B1629, Buenos Aires, Argentina
| | - Melisa Lenoir
- Hospital Universitario Austral, Av. Juan Domingo Perón 1500, B1629, Buenos Aires, Argentina
| | | | - Carolina Davenport
- Hospital General de Niños Pedro de Elizalde, Av. Montes de Oca 40, C1270 CABA, Argentina
| | | | - Liliana Monsalvo
- Hospital Dr. Salvador Mazza, Sta. Josefa Rosello 356, H3540, Chaco, Argentina
| | - Laura Sastoque
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Magalí Gavazzi
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Constanza Russo
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Inés Sananez
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - María de Los Ángeles Pando
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Natalia Laufer
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Roberto Muiños
- Laboratorio de Análisis Estadísticos, Secretaría de Investigaciones, Facultad de Psicología. UBA- CONICET. Av. Hipólito Yrigoyen 3242, C1207ABR CABA, Argentina
| | - Fernando Ferrero
- Hospital General de Niños Pedro de Elizalde, Av. Montes de Oca 40, C1270 CABA, Argentina
| | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Lourdes Arruvito
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina.
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Arruvito L, Sananez I, Seery V, Russo C, Geffner J. Purinergic signaling pathway in severe COVID-19. Curr Opin Pharmacol 2023; 70:102379. [PMID: 37087844 PMCID: PMC10091870 DOI: 10.1016/j.coph.2023.102379] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 02/19/2023] [Accepted: 03/16/2023] [Indexed: 04/05/2023]
Abstract
Substantial efforts have been made to understand the immune response during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, in order to identify and characterize risk factors, immune mechanisms responsible for the induction of tissue injury and potential therapeutic targets. Purinergic signaling pathway has shown to modulate the inflammatory processes in the course of several infectious diseases, but its role in the coronavirus disease 2019 (COVID-19) has not been clearly defined. Inflammation is usually associated to the release of ATP from different cell types, starting a cascade of events through the activation of a set of different purinergic receptors. This review summarizes the evidence showing the involvement of the purinergic system in the inflammatory condition that characterizes severe COVID-19.
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Affiliation(s)
- Lourdes Arruvito
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina.
| | - Inés Sananez
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Vanesa Seery
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Constanza Russo
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
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Seery V, Raiden S, Russo C, Borda M, Herrera L, Uranga M, Varese A, Marcó Del Pont M, Chirino C, Erramuspe C, Álvarez LS, Lenoir M, Morales LD, Davenport C, Alarcón Flores A, Huespe Auchter S, Ruiz Y, Monsalvo L, Sastoque L, Gavazzi M, Mazzitelli I, Di Diego F, Longueira Y, Mazzitelli B, Sananez I, De Carli N, Biglione MM, Gómez Penedo JM, Ceballos A, Laufer N, Ferrero F, Geffner J, Arruvito L. Antibody response against SARS-CoV-2 variants of concern in children infected with pre-Omicron variants: An observational cohort study. EBioMedicine 2022; 83:104230. [PMID: 35988465 PMCID: PMC9387350 DOI: 10.1016/j.ebiom.2022.104230] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 04/13/2022] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 12/27/2022] Open
Abstract
Background Despite that pediatric COVID-19 is usually asymptomatic or mild, SARS-CoV-2 infection typically results in the development of an antibody response. Contradictory observations have been reported when the antibody response of children and adults were compared in terms of strength, specificity and perdurability. Methods This observational study includes three cohorts infected with SARS-CoV-2 between March 2020-July 2021: unvaccinated infected children (n=115), unvaccinated infected adults (n=62), and vaccinated infected children (n=76). Plasma anti-spike IgG antibodies and neutralising activity against Wuhan, Delta and Omicron variants after 7-17 months post-infection were analysed. Findings More than 95% of unvaccinated infected children and adults remained seropositive when evaluated at 382-491 and 386-420 days after infection, respectively. Anti-spike IgG titers and plasma neutralising activity against Wuhan, Delta and Omicron variants were higher in children compared to adults. No differences were found when unvaccinated infected children were stratified by age, gender or presence/absence of symptoms in the acute phase of SARS-CoV-2 infection, but a slight decrease in the antibody response was observed in those with comorbidities. Vaccination of previously infected children with two doses of the inactivated BBIBP-CorV or the mRNA vaccines, BNT162b2 and/or mRNA-1273, further increased anti-spike IgG titers and neutralising activity against Wuhan, Delta and Omicron variants. Interpretation Unvaccinated infected children mount a more potent and sustained antibody response compared with adults, which is significantly increased after vaccination. Further studies including not only the analysis of the immune response but also the effectiveness to prevent reinfections by the different Omicron lineages are required to optimise vaccination strategy in children. Funding National Agency for Scientific and Technological Promotion from Argentina (PICTO-COVID-SECUELAS-00007 and PMO-BID-PICT2018-2548).
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Affiliation(s)
- Vanesa Seery
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - Silvina Raiden
- Hospital General de Niños Pedro de Elizalde, Av. Montes de Oca 40, C1270 CABA, Argentina
| | - Constanza Russo
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - Mauricio Borda
- Hospital Pediátrico Juan Pablo II, Av. Artigas 1435, W3400 Corrientes, Argentina
| | - Largión Herrera
- Hospital Dr. Salvador Mazza, Sta. Josefa Rosello 356, H3540 Chaco, Argentina
| | - Macarena Uranga
- Hospital Universitario Austral, Av. Juan Domingo Perón 1500, B1629 Buenos Aires, Argentina
| | - Augusto Varese
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - María Marcó Del Pont
- Hospital Universitario Austral, Av. Juan Domingo Perón 1500, B1629 Buenos Aires, Argentina
| | - Carina Chirino
- Policlínico Regional Juan Domingo Perón, Maipú 450, D5732 San Luis, Argentina
| | - Constanza Erramuspe
- Policlínico Regional Juan Domingo Perón, Maipú 450, D5732 San Luis, Argentina
| | - Laura Silvana Álvarez
- Hospital Universitario Austral, Av. Juan Domingo Perón 1500, B1629 Buenos Aires, Argentina
| | - Melisa Lenoir
- Hospital Universitario Austral, Av. Juan Domingo Perón 1500, B1629 Buenos Aires, Argentina
| | | | - Carolina Davenport
- Hospital General de Niños Pedro de Elizalde, Av. Montes de Oca 40, C1270 CABA, Argentina
| | | | | | - Yanina Ruiz
- Hospital Dr. Salvador Mazza, Sta. Josefa Rosello 356, H3540 Chaco, Argentina
| | - Liliana Monsalvo
- Hospital Dr. Salvador Mazza, Sta. Josefa Rosello 356, H3540 Chaco, Argentina
| | - Laura Sastoque
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - Magalí Gavazzi
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - Ignacio Mazzitelli
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - Facundo Di Diego
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - Yesica Longueira
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - Bianca Mazzitelli
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - Inés Sananez
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - Norberto De Carli
- Clínica del Niño de Quilmes, Av. Lamadrid 444, B1878 Buenos Aires, Argentina
| | - Mirna Marcela Biglione
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | | | - Ana Ceballos
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - Natalia Laufer
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - Fernando Ferrero
- Hospital General de Niños Pedro de Elizalde, Av. Montes de Oca 40, C1270 CABA, Argentina
| | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina
| | - Lourdes Arruvito
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina.
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Russo C, Raiden S, Algieri S, De Carli N, Davenport C, Sarli M, Bruera MJ, Seery V, Sananez I, Simaz N, Bayle C, Nivela V, Ferrero F, Geffner J, Arruvito L. Extracellular ATP and Imbalance of CD4+ T Cell Compartment in Pediatric COVID-19. Front Cell Infect Microbiol 2022; 12:893044. [PMID: 35663467 PMCID: PMC9157541 DOI: 10.3389/fcimb.2022.893044] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/01/2022] [Indexed: 12/12/2022] Open
Abstract
Severe COVID-19 in children is rare, but the reasons underlying are unclear. Profound alterations in T cell responses have been well characterized in the course of adult severe COVID-19, but little is known about the T cell function in children with COVID-19. Here, we made three major observations in a cohort of symptomatic children with acute COVID-19: 1) a reduced frequency of circulating FoxP3+ regulatory T cells, 2) the prevalence of a TH17 polarizing microenvironment characterized by high plasma levels of IL-6, IL-23, and IL17A, and an increased frequency of CD4+ T cells expressing ROR-γt, the master regulator of TH17 development, and 3) high plasma levels of ATP together with an increased expression of the P2X7 receptor. Moreover, that plasma levels of ATP displayed an inverse correlation with the frequency of regulatory T cells but a positive correlation with the frequency of CD4+ T cells positive for the expression of ROR-γt. Collectively, our data indicate an imbalance in CD4+ T cell profiles during pediatric COVID-19 that might favor the course of inflammatory processes. This finding also suggests a possible role for the extracellular ATP in the acquisition of an inflammatory signature by the T cell compartment offering a novel understanding of the involved mechanisms.
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Affiliation(s)
- Constanza Russo
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, Facultad de Medicina, Universidad de Buenos Aires- Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvina Raiden
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvia Algieri
- Servicio de Pediatría, Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - Norberto De Carli
- Servicio de Pediatría Clínica del Niño de Quilmes, Buenos Aires, Argentina
| | - Carolina Davenport
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariam Sarli
- Unidad de Terapia Intensiva Pediátrica, Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - María José Bruera
- Unidad de Terapia Intensiva Pediátrica, Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - Vanesa Seery
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, Facultad de Medicina, Universidad de Buenos Aires- Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Inés Sananez
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, Facultad de Medicina, Universidad de Buenos Aires- Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Nancy Simaz
- Servicio de Pediatría, Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - Carola Bayle
- Departamento de Emergencias Pediátrica, Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - Valeria Nivela
- Departamento de Emergencias Pediátrica, Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - Fernando Ferrero
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina
| | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, Facultad de Medicina, Universidad de Buenos Aires- Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lourdes Arruvito
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, Facultad de Medicina, Universidad de Buenos Aires- Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
- *Correspondence: Lourdes Arruvito,
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5
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Torres C, Mojsiejczuk L, Acuña D, Alexay S, Amadio A, Aulicino P, Debat H, Fay F, Fernández F, Giri AA, Goya S, König G, Lucero H, Nabaes Jodar M, Pianciola L, Sfalcin JA, Acevedo RM, Bengoa Luoni S, Bolatti EM, Brusés B, Cacciabue M, Casal PE, Cerri A, Chouhy D, Dus Santos MJ, Eberhardt MF, Fernandez A, Fernández PDC, Fernández Do Porto D, Formichelli L, Gismondi MI, Irazoqui M, Campos ML, Lusso S, Marquez N, Muñoz M, Mussin J, Natale M, Oria G, Pisano MB, Posner V, Puebla A, Re V, Sosa E, Villanova GV, Zaiat J, Zunino S, Acevedo ME, Acosta J, Alvarez Lopez C, Álvarez ML, Angeleri P, Angelletti A, Arca M, Ayala NA, Barbas G, Bertone A, Bonnet A, Bourlot I, Cabassi V, Castello A, Castro G, Cavatorta AL, Ceriani C, Cimmino C, Cipelli J, Colmeiro M, Cordero A, Cristina C, Di Bella S, Dolcini G, Ercole R, Espasandin Y, Espul C, Falaschi A, Fernandez Moll F, Foussal MD, Gatelli A, Goñi S, Jofré ME, Jaramillo J, Labarta N, Lacaze MA, Larreche R, Leiva V, Levin G, Luczak E, Mandile M, Marino G, Massone C, Mazzeo M, Medina C, Monaco B, Montoto L, Mugna V, Musto A, Nadalich V, Nieto MV, Ojeda G, Piedrabuena AC, Pintos C, Pozzati M, Rahhal M, Rechimont C, Remes Lenicov F, Rompato G, Seery V, Siri L, Spina J, Streitenberger C, Suárez A, Suárez J, Sujansky P, Talia JM, Theaux C, Thomas G, Ticeira M, Tittarelli E, Toro R, Uez O, Zaffanella MB, Ziehm C, Zubieta M. Cost-Effective Method to Perform SARS-CoV-2 Variant Surveillance: Detection of Alpha, Gamma, Lambda, Delta, Epsilon, and Zeta in Argentina. Front Med (Lausanne) 2021; 8:755463. [PMID: 34957143 PMCID: PMC8703000 DOI: 10.3389/fmed.2021.755463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/08/2021] [Accepted: 11/02/2021] [Indexed: 11/23/2022] Open
Abstract
SARS-CoV-2 variants with concerning characteristics have emerged since the end of 2020. Surveillance of SARS-CoV-2 variants was performed on a total of 4,851 samples from the capital city and 10 provinces of Argentina, during 51 epidemiological weeks (EWs) that covered the end of the first wave and the ongoing second wave of the COVID-19 pandemic in the country (EW 44/2020 to EW 41/2021). The surveillance strategy was mainly based on Sanger sequencing of a Spike coding region that allows the identification of signature mutations associated with variants. In addition, whole-genome sequences were obtained from 637 samples. The main variants found were Gamma and Lambda, and to a lesser extent, Alpha, Zeta, and Epsilon, and more recently, Delta. Whereas, Gamma dominated in different regions of the country, both Gamma and Lambda prevailed in the most populated area, the metropolitan region of Buenos Aires. The lineages that circulated on the first wave were replaced by emergent variants in a term of a few weeks. At the end of the ongoing second wave, Delta began to be detected, replacing Gamma and Lambda. This scenario is consistent with the Latin American variant landscape, so far characterized by a concurrent increase in Delta circulation and a stabilization in the number of cases. The cost-effective surveillance protocol presented here allowed for a rapid response in a resource-limited setting, added information on the expansion of Lambda in South America, and contributed to the implementation of public health measures to control the disease spread in Argentina.
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Affiliation(s)
- Carolina Torres
- Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Universidad de Buenos Aires, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Laura Mojsiejczuk
- Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Universidad de Buenos Aires, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Dolores Acuña
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Sofía Alexay
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Ariel Amadio
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Investigación de la Cadena Láctea (IDICAL) INTA-CONICET, Rafaela, Argentina
| | - Paula Aulicino
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Laboratorio de Biología Celular y Retrovirus, Hospital de Pediatría “Prof. Juan P. Garrahan”, Buenos Aires, Argentina
| | - Humberto Debat
- Instituto de Patología Vegetal – Centro de Investigaciones Agropecuarias – Instituto Nacional de Tecnología Agropecuaria (IPAVE-CIAP-INTA), Córdoba, Argentina
| | | | - Franco Fernández
- Instituto de Patología Vegetal – Centro de Investigaciones Agropecuarias – Instituto Nacional de Tecnología Agropecuaria (IPAVE-CIAP-INTA), Córdoba, Argentina
| | - Adriana A. Giri
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Grupo Virología Humana, Instituto de Biología Molecular y Celular de Rosario CONICET, Rosario, Argentina
| | - Stephanie Goya
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Guido König
- Instituto de Biotecnología/Instituto de Agrobiotecnología y Biología Molecular INTA-CONICET, Hurlingham, Argentina
| | - Horacio Lucero
- Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | - Mercedes Nabaes Jodar
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Luis Pianciola
- Laboratorio Central Ciudad de Neuquén, Ministerio de Salud, Neuquén, Argentina
| | | | - Raúl M. Acevedo
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Botánica del Nordeste, Universidad Nacional del Nordeste-CONICET, Resistencia, Argentina
| | - Sofía Bengoa Luoni
- Instituto de Biotecnología/Instituto de Agrobiotecnología y Biología Molecular INTA-CONICET, Hurlingham, Argentina
| | - Elisa M. Bolatti
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Grupo Virología Humana, Instituto de Biología Molecular y Celular de Rosario CONICET, Rosario, Argentina
| | - Bettina Brusés
- Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | - Marco Cacciabue
- Instituto de Biotecnología/Instituto de Agrobiotecnología y Biología Molecular INTA-CONICET, Hurlingham, Argentina
| | - Pablo E. Casal
- Grupo Virología Humana, Instituto de Biología Molecular y Celular de Rosario CONICET, Rosario, Argentina
| | - Agustina Cerri
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Grupo Virología Humana, Instituto de Biología Molecular y Celular de Rosario CONICET, Rosario, Argentina
| | - Diego Chouhy
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Grupo Virología Humana, Instituto de Biología Molecular y Celular de Rosario CONICET, Rosario, Argentina
| | - María José Dus Santos
- Instituto de Virología e Innovaciones Tecnológicas INTA-CONICET, Hurlingham, Argentina
- Laboratorio de Diagnóstico-UNIDAD COVID- Universidad Nacional de Hurlingham, Hurlingham, Argentina
| | - María Florencia Eberhardt
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Investigación de la Cadena Láctea (IDICAL) INTA-CONICET, Rafaela, Argentina
| | - Ailen Fernandez
- Laboratorio Central Ciudad de Neuquén, Ministerio de Salud, Neuquén, Argentina
| | - Paula del Carmen Fernández
- Instituto de Biotecnología/Instituto de Agrobiotecnología y Biología Molecular INTA-CONICET, Hurlingham, Argentina
| | - Darío Fernández Do Porto
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Cálculo, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Laura Formichelli
- Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | - María Inés Gismondi
- CIBIC Laboratorio, Rosario, Argentina
- Departamento de Ciencias Básicas, Universidad Nacional de Luján, Luján, Argentina
| | - Matías Irazoqui
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Investigación de la Cadena Láctea (IDICAL) INTA-CONICET, Rafaela, Argentina
| | - Melina Lorenzini Campos
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | - Silvina Lusso
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Nathalie Marquez
- Instituto de Patología Vegetal – Centro de Investigaciones Agropecuarias – Instituto Nacional de Tecnología Agropecuaria (IPAVE-CIAP-INTA), Córdoba, Argentina
| | - Marianne Muñoz
- Unidad de Genómica del Instituto de Biotecnología/Instituto de Agrobiotecnología y Biología Molecular, INTA-CONICET, Hurlingham, Argentina
| | - Javier Mussin
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | - Mónica Natale
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Griselda Oria
- Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | - María Belén Pisano
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Victoria Posner
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Laboratorio Mixto de Biotecnología Acuática, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina
| | - Andrea Puebla
- Unidad de Genómica del Instituto de Biotecnología/Instituto de Agrobiotecnología y Biología Molecular, INTA-CONICET, Hurlingham, Argentina
| | - Viviana Re
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ezequiel Sosa
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), CONICET, Ciudad Universitaria, Buenos Aires, Argentina
| | - Gabriela V. Villanova
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Laboratorio Mixto de Biotecnología Acuática, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina
| | - Jonathan Zaiat
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), CONICET, Ciudad Universitaria, Buenos Aires, Argentina
| | - Sebastián Zunino
- Laboratorio Central Ciudad de Neuquén, Ministerio de Salud, Neuquén, Argentina
- Laboratorio de Virología Molecular, Hospital Blas L. Dubarry, Mercedes, Argentina
| | - María Elina Acevedo
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Julián Acosta
- Centro de Tecnología en Salud Pública, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina
| | - Cristina Alvarez Lopez
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - María Laura Álvarez
- Laboratorio del Hospital Zonal Dr. Ramón Carrillo, San Carlos de Bariloche, Argentina
| | - Patricia Angeleri
- Comité Operativo de Emergencia COVID, Ministerio de Salud de la Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Andrés Angelletti
- Laboratorio de Salud Pública, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
- Laboratorio de Virología, HIEAyC “San Juan de Dios”, La Plata, Argentina
| | - Manuel Arca
- Laboratorio de Virología del Hospital JJ Urquiza, Concepción del Uruguay, Argentina
| | - Natalia A. Ayala
- Laboratorio Central de Salud Pública del Chaco, Resistencia, Argentina
| | - Gabriela Barbas
- Secretaria de Prevención y Promoción, Ministerio de Salud de la Provincia de Córdoba, Córdoba, Argentina
| | - Ana Bertone
- Laboratorio de la Dirección de Epidemiología, Santa Rosa, Argentina
| | - Agustina Bonnet
- Laboratorio de Virología del Hospital JJ Urquiza, Concepción del Uruguay, Argentina
| | - Ignacio Bourlot
- Laboratorio de Biología Molecular del Hospital Centenario, Gualeguaychú, Argentina
| | - Victoria Cabassi
- Laboratorio de Salud Pública, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
| | - Alejandro Castello
- Unidad de Emergencia COVID-19, Plataforma de Servicios Biotecnológicos, Universidad Nacional de Quilmes, Bernal, Argentina
| | - Gonzalo Castro
- Laboratorio Central de la Provincia de Córdoba, Ministerio de Salud la Provincia de Córdoba, Córdoba, Argentina
| | - Ana Laura Cavatorta
- Centro de Tecnología en Salud Pública, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina
| | - Carolina Ceriani
- Laboratorio de Virología, Facultad de Veterinaria, Universidad Nacional del Centro de la Provincia de Buenos Aires, Buenos Aires, Argentina
| | - Carlos Cimmino
- Instituto Nacional de Epidemiología “Dr. Jara”, Mar del Plata, Argentina
| | - Julián Cipelli
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - María Colmeiro
- Laboratorio de Virología, HIEAyC “San Juan de Dios”, La Plata, Argentina
| | - Andrés Cordero
- Laboratorio de Salud Pública, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
| | - Carolina Cristina
- Centro de Investigaciones Básicas y Aplicadas, Universidad Nacional del Noroeste de la Provincia de Buenos Aires, Junín, Argentina
| | - Sofia Di Bella
- Laboratorio de Virología, HIEAyC “San Juan de Dios”, La Plata, Argentina
| | - Guillermina Dolcini
- Laboratorio de Virología, Facultad de Veterinaria, Universidad Nacional del Centro de la Provincia de Buenos Aires, Buenos Aires, Argentina
| | - Regina Ercole
- Laboratorio de Virología, HIEAyC “San Juan de Dios”, La Plata, Argentina
| | - Yesica Espasandin
- Laboratorio del Hospital Zonal Dr. Ramón Carrillo, San Carlos de Bariloche, Argentina
| | - Carlos Espul
- Dirección de Epidemiología y Red de Laboratorios del Ministerio de Salud de la Provincia de Mendoza, Mendoza, Argentina
| | - Andrea Falaschi
- Dirección de Epidemiología y Red de Laboratorios del Ministerio de Salud de la Provincia de Mendoza, Mendoza, Argentina
| | - Facundo Fernandez Moll
- Centro de Investigaciones Básicas y Aplicadas, Universidad Nacional del Noroeste de la Provincia de Buenos Aires, Junín, Argentina
| | - María Delia Foussal
- Servicio de Inmunología, Hospital Dr. Julio C Perrando, Resistencia, Argentina
| | - Andrea Gatelli
- Laboratorio de Virología, HIEAyC “San Juan de Dios”, La Plata, Argentina
| | - Sandra Goñi
- Unidad de Emergencia COVID-19, Plataforma de Servicios Biotecnológicos, Universidad Nacional de Quilmes, Bernal, Argentina
| | | | - José Jaramillo
- Laboratorio de Virología Molecular, Hospital Blas L. Dubarry, Mercedes, Argentina
| | - Natalia Labarta
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - María Agustina Lacaze
- Programa Laboratorio de Salud Pública “Dr Dalmiro Pérez Laborda”, Ministerio de Salud de la Provincia de San Luis, San Luis, Argentina
| | - Rocio Larreche
- Laboratorio de Biología Molecular Bolívar, LABBO, Bolívar, Argentina
| | | | - Gustavo Levin
- Laboratorio de Biología Molecular del Hospital Centenario, Gualeguaychú, Argentina
| | - Erica Luczak
- Laboratorio del Hospital Interzonal General de Agudos “Evita”, Lanús, Argentina
| | - Marcelo Mandile
- Unidad de Emergencia COVID-19, Plataforma de Servicios Biotecnológicos, Universidad Nacional de Quilmes, Bernal, Argentina
| | - Gioia Marino
- Laboratorio Pediátrico Avelino Castelán, Resistencia, Argentina
| | - Carla Massone
- Laboratorio de Virología Molecular, Hospital Blas L. Dubarry, Mercedes, Argentina
| | - Melina Mazzeo
- Laboratorio Central Ciudad de Neuquén, Ministerio de Salud, Neuquén, Argentina
| | - Carla Medina
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Belén Monaco
- Laboratorio de Virología Molecular, Hospital Blas L. Dubarry, Mercedes, Argentina
| | - Luciana Montoto
- Laboratorio de Biología Molecular Hospital Pedro de Elizalde, Buenos Aires, Argentina
| | | | | | - Victoria Nadalich
- Laboratorio de Salud Pública, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
| | - María Victoria Nieto
- Laboratorio de Virología, Facultad de Veterinaria, Universidad Nacional del Centro de la Provincia de Buenos Aires, Buenos Aires, Argentina
| | | | - Andrea C. Piedrabuena
- Servicio de Microbiología, Hospital 4 de Junio, Presidencia Roque Saenz Peña, Argentina
| | - Carolina Pintos
- Laboratorio Central Ciudad de Neuquén, Ministerio de Salud, Neuquén, Argentina
| | - Marcia Pozzati
- Laboratorio de Biología Molecular, Hospital Cosme Argerich, Buenos Aires, Argentina
| | - Marilina Rahhal
- Laboratorio de Hospital El Cruce Dr. Néstor C. Kirchner, Florencio Varela, Argentina
| | | | - Federico Remes Lenicov
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida, CONICET-UBA, Buenos Aires, Argentina
| | | | - Vanesa Seery
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida, CONICET-UBA, Buenos Aires, Argentina
| | - Leticia Siri
- Laboratorio de Biología Molecular del Hospital Centenario, Gualeguaychú, Argentina
| | - Julieta Spina
- Laboratorio de Biología Molecular, Hospital Dr. Héctor Cura, Olavarría, Argentina
| | - Cintia Streitenberger
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Ariel Suárez
- Departamento de Biología y Genética Molecular; IACA Laboratorios, Bahía Blanca, Argentina
| | - Jorgelina Suárez
- Centro de Investigaciones Básicas y Aplicadas, Universidad Nacional del Noroeste de la Provincia de Buenos Aires, Junín, Argentina
| | - Paula Sujansky
- Comité Operativo de Emergencia COVID, Ministerio de Salud de la Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Juan Manuel Talia
- Programa Laboratorio de Salud Pública “Dr Dalmiro Pérez Laborda”, Ministerio de Salud de la Provincia de San Luis, San Luis, Argentina
| | - Clara Theaux
- Laboratorio de Biología Molecular del Hospital General de Agudos Dr. Carlos G. Durand, Buenos Aires, Argentina
| | - Guillermo Thomas
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Marina Ticeira
- Laboratorio de Biología Molecular Bolívar, LABBO, Bolívar, Argentina
| | - Estefanía Tittarelli
- Departamento de Biología y Genética Molecular; IACA Laboratorios, Bahía Blanca, Argentina
| | - Rosana Toro
- Laboratorio de Salud Pública, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
| | - Osvaldo Uez
- Instituto Nacional de Epidemiología “Dr. Jara”, Mar del Plata, Argentina
| | | | - Cecilia Ziehm
- Laboratorio Central Ciudad de Neuquén, Ministerio de Salud, Neuquén, Argentina
| | - Martin Zubieta
- Laboratorio de Hospital El Cruce Dr. Néstor C. Kirchner, Florencio Varela, Argentina
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6
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Sananez I, Raiden SC, Algieri SC, Uranga M, Grisolía NA, Filippo D, De Carli N, Lalla SD, Cairoli H, Chiolo MJ, Meregalli CN, Cohen E, Mosquera G, Marcó Del Pont M, Giménez LI, Gregorio G, Sarli M, Alcalde AL, Davenport C, Bruera MJ, Simaz N, Pérez MF, Nivela V, Bayle C, Alvarez L, Revetria M, Tuccillo P, Agosta MT, Pérez H, Nova SV, Suárez P, Takata EM, García M, Lattner J, Rolón MJ, Coll P, Salvatori M, Piccardo C, Russo C, Varese A, Seery V, Holgado MP, Polo ML, Ceballos A, Nuñez M, Penedo JMG, Ferrero F, Geffner J, Arruvito L. A poor and delayed anti-SARS-CoV2 IgG response is associated to severe COVID-19 in children. EBioMedicine 2021; 72:103615. [PMID: 34649078 PMCID: PMC8502533 DOI: 10.1016/j.ebiom.2021.103615] [Citation(s) in RCA: 12] [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: 05/31/2021] [Revised: 09/10/2021] [Accepted: 09/21/2021] [Indexed: 12/15/2022] Open
Abstract
Background Most children and youth develop mild or asymptomatic disease during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, a very small number of patients suffer severe Coronavirus induced disease 2019 (COVID-19). The reasons underlying these different outcomes remain unknown. Methods We analyzed three different cohorts: children with acute infection (n=550), convalescent children (n=138), and MIS-C (multisystem inflammatory syndrome in children, n=42). IgG and IgM antibodies to the spike protein of SARS-CoV-2, serum-neutralizing activity, plasma cytokine levels, and the frequency of circulating Follicular T helper cells (cTfh) and plasmablasts were analyzed by conventional methods. Findings Fifty-eight percent of the children in the acute phase of infection had no detectable antibodies at the time of sampling while a seronegative status was found in 25% and 12% of convalescent and MIS-C children, respectively. When children in the acute phase of the infection were stratified according disease severity, we found that contrasting with the response of children with asymptomatic, mild and moderate disease, children with severe COVID-19 did not develop any detectable response. A defective antibody response was also observed in the convalescent cohort for children with severe disease at the time of admission. This poor antibody response was associated to both, a low frequency of cTfh and a high plasma concentration of inflammatory cytokines. Interpretation A weak and delayed kinetic of antibody response to SARS-CoV-2 together with a systemic pro-inflammatory profile characterize pediatric severe COVID-19. Because comorbidities are highly prevalent in children with severe COVID-19, further studies are needed to clarify their contribution in the weak antibody response observed in severe disease. Funding National Agency for Scientific and Technological Promotion from Argentina (IP-COVID-19-0277 and PMO-BID-PICT2018-2548).
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Affiliation(s)
- Inés Sananez
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Facultad de Medicina. UBA-CONICET. Paraguay 2155, C1121ABG CABA, Argentina
| | - Silvina C Raiden
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, C1270 CABA, Argentina
| | - Silvia C Algieri
- Servicio de Pediatría, Hospital Nacional Profesor Alejandro Posadas. Marconi Morón 386, B1684 Buenos Aires, Argentina
| | - Macarena Uranga
- Sector Infectología infantil, Departamento Materno Infantil, Hospital Universitario Austral. Av. Juan Domingo Perón 1500, B1629 Buenos Aires, Argentina
| | - Nicolás A Grisolía
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, C1270 CABA, Argentina
| | - Daniela Filippo
- Servicio de Pediatría, Hospital Municipal Diego Thompson. Avellaneda 33, B1650 Buenos Aires, Argentina
| | - Norberto De Carli
- Servicio de Pediatría, Clínica del Niño de Quilmes. Av. Lamadrid 444, B1878 Buenos Aires, Argentina
| | - Sandra Di Lalla
- Departamento de Consultorios Externos, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, C1270 CABA, Argentina
| | - Héctor Cairoli
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, C1270 CABA, Argentina
| | - María J Chiolo
- Departamento de Cirugía, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, C1270 CABA, Argentina
| | - Claudia N Meregalli
- Unidad de Terapia Intensiva Pediátrica, Departamento de Urgencias, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, C1270 CABA, Argentina
| | - Emilia Cohen
- Servicio de Pediatría, Hospital HIGA Eva Perón. Av. Dr Ricardo Balbín 3200, B1650 Buenos Aires, Argentina
| | - Graciela Mosquera
- Servicio de Pediatría, Hospital HIGA Eva Perón. Av. Dr Ricardo Balbín 3200, B1650 Buenos Aires, Argentina
| | - María Marcó Del Pont
- Sector Infectología infantil, Departamento Materno Infantil, Hospital Universitario Austral. Av. Juan Domingo Perón 1500, B1629 Buenos Aires, Argentina
| | - Lorena I Giménez
- Servicio de Pediatría, Hospital Municipal Diego Thompson. Avellaneda 33, B1650 Buenos Aires, Argentina
| | - Gabriela Gregorio
- Servicio de Pediatría, Hospital Nacional Profesor Alejandro Posadas. Marconi Morón 386, B1684 Buenos Aires, Argentina
| | - Mariam Sarli
- Unidad de Terapia Intensiva Pediátrica, Hospital Nacional Profesor Alejandro Posadas. Marconi Morón 386, B1684 Buenos Aires, Argentina
| | - Ana L Alcalde
- Servicio de Pediatría, Hospital Nacional Profesor Alejandro Posadas. Marconi Morón 386, B1684 Buenos Aires, Argentina
| | - Carolina Davenport
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, C1270 CABA, Argentina
| | - María J Bruera
- Unidad de Terapia Intensiva Pediátrica, Hospital Nacional Profesor Alejandro Posadas. Marconi Morón 386, B1684 Buenos Aires, Argentina
| | - Nancy Simaz
- Servicio de Pediatría, Hospital Nacional Profesor Alejandro Posadas. Marconi Morón 386, B1684 Buenos Aires, Argentina
| | - Mariela F Pérez
- Servicio de Pediatría, Hospital Nacional Profesor Alejandro Posadas. Marconi Morón 386, B1684 Buenos Aires, Argentina
| | - Valeria Nivela
- Departamento de Emergencias Pediátrica, Hospital Nacional Profesor Alejandro Posadas. Marconi Morón 386, B1684 Buenos Aires, Argentina
| | - Carola Bayle
- Departamento de Emergencias Pediátrica, Hospital Nacional Profesor Alejandro Posadas. Marconi Morón 386, B1684 Buenos Aires, Argentina
| | - Laura Alvarez
- Departamento Laboratorio, Hospital Universitario Austral. Av. Juan Domingo Perón 1500, B1629 Buenos Aires, Argentina
| | - María Revetria
- Departamento Laboratorio, Hospital Universitario Austral. Av. Juan Domingo Perón 1500, B1629 Buenos Aires, Argentina
| | - Patricia Tuccillo
- Servicio de Pediatría, Hospital Naval Cirujano Mayor Dr. Pedro Mallo. Av. Patricias Argentinas 351, C1405 CABA, Argentina
| | - María T Agosta
- Servicio de Pediatría, Hospital Naval Cirujano Mayor Dr. Pedro Mallo. Av. Patricias Argentinas 351, C1405 CABA, Argentina
| | - Hernán Pérez
- Servicio de Pediatría, Hospital Naval Cirujano Mayor Dr. Pedro Mallo. Av. Patricias Argentinas 351, C1405 CABA, Argentina
| | - Susana Villa Nova
- Servicio de Pediatría, Hospital General de Agudos Dr. Juan A. Fernández. Av. Cerviño 3356, C1425 CABA, Argentina
| | - Patricia Suárez
- Servicio de Pediatría, Hospital General de Agudos Dr. Juan A. Fernández. Av. Cerviño 3356, C1425 CABA, Argentina
| | - Eugenia M Takata
- Servicio de Pediatría, Hospital General de Agudos Dr. Juan A. Fernández. Av. Cerviño 3356, C1425 CABA, Argentina
| | - Mariela García
- Servicio de Pediatría, Hospital General de Agudos Dr. Juan A. Fernández. Av. Cerviño 3356, C1425 CABA, Argentina
| | - Jorge Lattner
- Servicio de Infectología Pediátrica, Hospital Naval Cirujano Mayor Dr. Pedro Mallo. Av. Patricias Argentinas 351, C1405 CABA, Argentina
| | - María J Rolón
- División Infectología, Hospital General de Agudos Dr. Juan A. Fernández. Av. Cerviño 3356, C1425 CABA, Argentina
| | - Patricia Coll
- División Infectología, Hospital General de Agudos Dr. Juan A. Fernández. Av. Cerviño 3356, C1425 CABA, Argentina
| | - Melina Salvatori
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Facultad de Medicina. UBA-CONICET. Paraguay 2155, C1121ABG CABA, Argentina
| | - Claudio Piccardo
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Facultad de Medicina. UBA-CONICET. Paraguay 2155, C1121ABG CABA, Argentina
| | - Constanza Russo
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Facultad de Medicina. UBA-CONICET. Paraguay 2155, C1121ABG CABA, Argentina
| | - Augusto Varese
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Facultad de Medicina. UBA-CONICET. Paraguay 2155, C1121ABG CABA, Argentina
| | - Vanesa Seery
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Facultad de Medicina. UBA-CONICET. Paraguay 2155, C1121ABG CABA, Argentina
| | - María P Holgado
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Facultad de Medicina. UBA-CONICET. Paraguay 2155, C1121ABG CABA, Argentina
| | - María L Polo
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Facultad de Medicina. UBA-CONICET. Paraguay 2155, C1121ABG CABA, Argentina
| | - Ana Ceballos
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Facultad de Medicina. UBA-CONICET. Paraguay 2155, C1121ABG CABA, Argentina
| | - Myriam Nuñez
- Cátedra de Matemática. Facultad de Farmacia y Bioquímica. UBA. Junín 954, C1113 AAD CABA, Argentina
| | - Juan Martín Gómez Penedo
- Laboratorio de Análisis Estadísticos, Secretaría de Investigaciones. Facultad de Psicología. UBA- CONICET. Av. Hipólito Yrigoyen 3242, C1207 ABR CABA, Argentina
| | - Fernando Ferrero
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, C1270 CABA, Argentina
| | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Facultad de Medicina. UBA-CONICET. Paraguay 2155, C1121ABG CABA, Argentina
| | - Lourdes Arruvito
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA. Facultad de Medicina. UBA-CONICET. Paraguay 2155, C1121ABG CABA, Argentina.
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Seery V, Raiden SC, Algieri SC, Grisolía NA, Filippo D, De Carli N, Di Lalla S, Cairoli H, Chiolo MJ, Meregalli CN, Gimenez LI, Gregorio G, Sarli M, Alcalde AL, Davenport C, Bruera MJ, Simaz N, Pérez MF, Nivela V, Bayle C, Tuccillo P, Agosta MT, Pérez H, Villa Nova S, Suárez P, Takata EM, García M, Lattner J, Rolón MJ, Coll P, Sananez I, Holgado MP, Ferrero F, Geffner J, Arruvito L. Blood neutrophils from children with COVID-19 exhibit both inflammatory and anti-inflammatory markers. EBioMedicine 2021; 67:103357. [PMID: 33979758 PMCID: PMC8153212 DOI: 10.1016/j.ebiom.2021.103357] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 01/27/2021] [Revised: 03/10/2021] [Accepted: 04/12/2021] [Indexed: 12/15/2022] Open
Abstract
Background Perhaps reflecting that children with COVID-19 rarely exhibit severe respiratory symptoms and often remain asymptomatic, little attention has been paid to explore the immune response in pediatric COVID-19. Here, we analyzed the phenotype and function of circulating neutrophils from children with COVID-19. Methods An observational study including 182 children with COVID-19, 21 children with multisystem inflammatory syndrome (MIS-C), and 40 healthy children was performed in Buenos Aires, Argentina. Neutrophil phenotype was analyzed by flow cytometry in blood samples. Cytokine production, plasma levels of IgG antibodies directed to the spike protein of SARS-CoV-2 and citrullinated histone H3 were measured by ELISA. Cell-free DNA was quantified by fluorometry. Findings Compared with healthy controls, neutrophils from children with COVID-19 showed a lower expression of CD11b, CD66b, and L-selectin but a higher expression of the activation markers HLA-DR, CD64 and PECAM-1 and the inhibitory receptors LAIR-1 and PD-L1. No differences in the production of cytokines and NETs were observed. Interestingly, the expression of CD64 in neutrophils and the serum concentration of IgG antibodies directed to the spike protein of SARS-CoV-2 distinguished asymptomatic from mild and moderate COVID-19. Interpretation Acute lung injury is a prominent feature of severe COVID-19 in adults. A low expression of adhesion molecules together with a high expression of inhibitory receptors in neutrophils from children with COVID-19 might prevent tissue infiltration by neutrophils preserving lung function.
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Affiliation(s)
- Vanesa Seery
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Silvina C Raiden
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, CABA C1270, Argentina
| | - Silvia C Algieri
- Servicio de Pediatría, Hospital Nacional Profesor Alejandro Posadas, Marconi Morón 386, Buenos Aires B1684, Argentina
| | - Nicolás A Grisolía
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, CABA C1270, Argentina
| | - Daniela Filippo
- Servicio de Pediatría, Hospital Municipal Diego Thompson. Avellaneda 33, Buenos Aires B1650, Argentina
| | - Norberto De Carli
- Servicio de Pediatría, Clínica del Niño de Quilmes, Av. Lamadrid 444, Buenos Aires B1878, Argentina
| | - Sandra Di Lalla
- Departamento de Consultorios Externos, Hospital General de Niños Pedro de Elizalde, Av. Montes de Oca 40, CABA C1270, Argentina
| | - Héctor Cairoli
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, CABA C1270, Argentina
| | - María J Chiolo
- Departamento de Cirugía, Hospital General de Niños Pedro de Elizalde, Av. Montes de Oca 40, CABA C1270, Argentina
| | - Claudia N Meregalli
- Unidad de Terapia Intensiva Pediátrica, Departamento de Urgencias, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, CABA C1270, Argentina
| | - Lorena I Gimenez
- Servicio de Pediatría, Hospital Municipal Diego Thompson. Avellaneda 33, Buenos Aires B1650, Argentina
| | - Gabriela Gregorio
- Servicio de Pediatría, Hospital Nacional Profesor Alejandro Posadas, Marconi Morón 386, Buenos Aires B1684, Argentina
| | - Mariam Sarli
- Unidad de Terapia Intensiva Pediátrica, Hospital Nacional Profesor Alejandro Posadas, Marconi Morón 386, Buenos Aires B1684, Argentina
| | - Ana L Alcalde
- Servicio de Pediatría, Hospital Nacional Profesor Alejandro Posadas, Marconi Morón 386, Buenos Aires B1684, Argentina
| | - Carolina Davenport
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, CABA C1270, Argentina
| | - María J Bruera
- Unidad de Terapia Intensiva Pediátrica, Hospital Nacional Profesor Alejandro Posadas, Marconi Morón 386, Buenos Aires B1684, Argentina
| | - Nancy Simaz
- Servicio de Pediatría, Hospital Nacional Profesor Alejandro Posadas, Marconi Morón 386, Buenos Aires B1684, Argentina
| | - Mariela F Pérez
- Servicio de Pediatría, Hospital Nacional Profesor Alejandro Posadas, Marconi Morón 386, Buenos Aires B1684, Argentina
| | - Valeria Nivela
- Departamento de Emergencias Pediátrica, Hospital Nacional Profesor Alejandro Posadas, Marconi Morón 386, Buenos Aires B1684, Argentina
| | - Carola Bayle
- Departamento de Emergencias Pediátrica, Hospital Nacional Profesor Alejandro Posadas, Marconi Morón 386, Buenos Aires B1684, Argentina
| | - Patricia Tuccillo
- Servicio de Pediatría, Hospital Naval Cirujano Mayor Dr. Pedro Mallo, Av. Patricias Argentinas 351, CABA C1405, Argentina
| | - María T Agosta
- Servicio de Pediatría, Hospital Naval Cirujano Mayor Dr. Pedro Mallo, Av. Patricias Argentinas 351, CABA C1405, Argentina
| | - Hernán Pérez
- Servicio de Pediatría, Hospital Naval Cirujano Mayor Dr. Pedro Mallo, Av. Patricias Argentinas 351, CABA C1405, Argentina
| | - Susana Villa Nova
- Servicio de Pediatría, Hospital General de Agudos Dr. Juan A. Fernández, Av. Cerviño 3356, CABA C1425, Argentina
| | - Patricia Suárez
- Servicio de Pediatría, Hospital General de Agudos Dr. Juan A. Fernández, Av. Cerviño 3356, CABA C1425, Argentina
| | - Eugenia M Takata
- Servicio de Pediatría, Hospital General de Agudos Dr. Juan A. Fernández, Av. Cerviño 3356, CABA C1425, Argentina
| | - Mariela García
- Servicio de Pediatría, Hospital General de Agudos Dr. Juan A. Fernández, Av. Cerviño 3356, CABA C1425, Argentina
| | - Jorge Lattner
- Servicio de Infectología Pediátrica, Hospital Naval Cirujano Mayor Dr. Pedro Mallo, Av. Patricias Argentinas 351, CABA C1405, Argentina
| | - María J Rolón
- División Infectología, Hospital General de Agudos Dr. Juan A. Fernández, Av. Cerviño 3356, CABA C1425, Argentina
| | - Patricia Coll
- División Infectología, Hospital General de Agudos Dr. Juan A. Fernández, Av. Cerviño 3356, CABA C1425, Argentina
| | - Inés Sananez
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - María P Holgado
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Fernando Ferrero
- Departamento de Medicina, Hospital General de Niños Pedro de Elizalde. Av. Montes de Oca 40, CABA C1270, Argentina
| | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Lourdes Arruvito
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina.
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Holgado MP, Raiden S, Sananez I, Seery V, De Lillo L, Maldonado LL, Kamenetzky L, Geffner J, Arruvito L. Fcγ Receptor IIa (FCGR2A) Polymorphism Is Associated With Severe Respiratory Syncytial Virus Disease in Argentinian Infants. Front Cell Infect Microbiol 2021; 10:607348. [PMID: 33392111 PMCID: PMC7775358 DOI: 10.3389/fcimb.2020.607348] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/19/2020] [Indexed: 12/02/2022] Open
Abstract
Background Most patients with respiratory syncytial virus (RSV) infection requiring hospitalization have no risk factors for severe disease. Genetic variation in the receptor for the Fc portion of IgG (FcγR) determines their affinity for IgG subclasses driving innate and adaptive antiviral immunity. We investigated the relationship between FcγRIIa-H131R polymorphism and RSV disease. Methods Blood samples were collected from 182 infants ≤24-month-old (50 uninfected, 114 RSV-infected with moderate course and 18 suffering severe disease). FcγRIIa-H131R SNP genotypic frequencies (HH, HR, RR) and anti-RSV IgG1, IgG2 and IgG3 levels were studied. Results Genotypic frequencies for FcγRIIa-H131R SNP were comparable between uninfected and RSV-infected infants. In contrast, we found a significant higher frequency of HH genotype in severe RSV-infected children compared to moderate patients. Among severe group, HH infants presented more factors associated to severity than HR or RR patients did. Furthermore, compared to moderate RSV-infected infants, severe patients showed higher levels of anti-RSV IgG1 and IgG3. Conclusions We found an association between an FcγRIIa (H131) polymorphism and severe RSV disease, which points towards a critical role for interactions between FcγRs and immune complexes in RSV pathogenesis. This genetic factor could also predict the worse outcome and identify those infants at risk during hospitalization.
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Affiliation(s)
- María Pía Holgado
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Universidad de Buenos Aires, CONICET, Ciudad de Autónoma Buenos Aires, Argentina
| | - Silvina Raiden
- Hospital General de Niños "Pedro de Elizalde", Ciudad Autónoma de Buenos Aires, Argentina
| | - Inés Sananez
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Universidad de Buenos Aires, CONICET, Ciudad de Autónoma Buenos Aires, Argentina
| | - Vanesa Seery
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Universidad de Buenos Aires, CONICET, Ciudad de Autónoma Buenos Aires, Argentina
| | - Leonardo De Lillo
- Hospital General de Niños "Pedro de Elizalde", Ciudad Autónoma de Buenos Aires, Argentina
| | - Lucas L Maldonado
- IMPaM, CONICET, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Laura Kamenetzky
- IMPaM, CONICET, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Universidad de Buenos Aires, CONICET, Ciudad de Autónoma Buenos Aires, Argentina
| | - Lourdes Arruvito
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Universidad de Buenos Aires, CONICET, Ciudad de Autónoma Buenos Aires, Argentina
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Sananez I, Raiden S, Holgado MP, Seery V, De Lillo L, Davenport C, Ferrero F, Peeples ME, Geffner J, Arruvito L. Upregulation of CD32 in T Cells from Infants with Severe Respiratory Syncytial Virus Disease: A New Costimulatory Pathway? Am J Respir Cell Mol Biol 2020; 63:133-136. [PMID: 32609012 DOI: 10.1165/rcmb.2020-0025le] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Inés Sananez
- Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y Sida.,Consejo Nacional de Investigaciones Científicas y TécnicasBuenos Aires, Argentina
| | - Silvina Raiden
- Consejo Nacional de Investigaciones Científicas y TécnicasBuenos Aires, Argentina.,Hospital General de Niños "Pedro de Elizalde"Buenos Aires, Argentinaand
| | - María P Holgado
- Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y Sida.,Consejo Nacional de Investigaciones Científicas y TécnicasBuenos Aires, Argentina
| | - Vanesa Seery
- Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y Sida.,Consejo Nacional de Investigaciones Científicas y TécnicasBuenos Aires, Argentina
| | - Leonardo De Lillo
- Hospital General de Niños "Pedro de Elizalde"Buenos Aires, Argentinaand
| | | | - Fernando Ferrero
- Hospital General de Niños "Pedro de Elizalde"Buenos Aires, Argentinaand
| | - Mark E Peeples
- Abigail Wexner Research Institute at Nationwide Children's HospitalColumbus, Ohio
| | - Jorge Geffner
- Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y Sida.,Consejo Nacional de Investigaciones Científicas y TécnicasBuenos Aires, Argentina
| | - Lourdes Arruvito
- Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y Sida.,Consejo Nacional de Investigaciones Científicas y TécnicasBuenos Aires, Argentina
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Frankenthaler A, Lee M, Seery V, Renzi S, Kinnaman M, Liu V, Friedman E, Atkins MB. Impact of concomitant immunosuppression on the presentation and prognosis of patients with melanoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9070] [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] [Indexed: 11/20/2022] Open
Abstract
9070 Background: Melanoma has been reported to be susceptible to immune control. Therefore, we hypothesized that concomitant immune suppression might impact the course of the disease. Methods: We examined the Beth Israel Deaconess Medical Center Cutaneous Oncology Program database for pts with immune suppression at the time of melanoma diagnosis. The demographics and stage of these pts were compared to those in the database as a whole. In addition, 3 controls matched for age, gender, stage and tumor location were identified for each case and disease outcome was compared between cases and controls. Results: 19 pts were identified with melanoma and concomitant immune suppression in a database of 1820 melanoma pts. Other diagnoses included renal transplant (4) inflammatory arthritis (8), Multiple Sclerosis (2), and ulcerative colitis (3). Immunosuppressive meds included methotrexate, azothioprine, cyclosporine, prednisone, infliximab, and natalizumab. Melanoma stages at diagnosis were in situ 1, IB 7, IIA 1, IIB 1, IIIB 3, IIIC 5, and IV 1. Compared to the database as a whole, cases were more likely to be female (84% vs 45%) and have a higher disease stage (42% stage IIIB/C vs 26%). In addition, more cases appeared to have an amelanotic primary (21% vs. 5.4%) or an atypical mole syndrome (21% vs 10.2%). For pts who relapsed, the cases had a shorter disease free interval (DFI) (2.1 vs 9.7 yrs) than the controls. At a median f/up of 52 mos, 37% of the cases had relapsed and all of these pts had died. At a median f/up of 76 mos, 30% of the controls had relapsed yet only 47% of these pts had died. As a consequence, cases appeared more likely to have died of their disease than controls (42% vs 23%) (p=0.10). Conclusions: Compared to the general melanoma population, pts with concomitant immune suppression appear more likely to be female, have an amelanotic primary or atypical mole syndrome and more advanced disease at presentation. Although pts with concomitant immune suppression are equally likely to relapse compared to matched controls, those that relapse appear to have a shorter DFI and to be less likely to be salvaged, suggesting more aggressive tumor behavior in this setting. Thus, diagnosis and treatment of a primary melanoma at an early stage appears especially important in an immunosuppressed population. No significant financial relationships to disclose.
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Affiliation(s)
| | - M. Lee
- Beth Israel Deaconess Medical Center, Boston, MA
| | - V. Seery
- Beth Israel Deaconess Medical Center, Boston, MA
| | - S. Renzi
- Beth Israel Deaconess Medical Center, Boston, MA
| | - M. Kinnaman
- Beth Israel Deaconess Medical Center, Boston, MA
| | - V. Liu
- Beth Israel Deaconess Medical Center, Boston, MA
| | - E. Friedman
- Beth Israel Deaconess Medical Center, Boston, MA
| | - M. B. Atkins
- Beth Israel Deaconess Medical Center, Boston, MA
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11
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Schwarzberg T, Regan MM, Liu V, Mier JW, Cho D, Koon H, Bhatt RS, Seery V, Bradley K, Atkins MB, McDermott DF. Retrospective analysis of interleukin-2 therapy in patients with metastatic renal cell carcinoma who had received prior antiangiogenic therapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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McDermott DF, Cho DC, Merchan JR, Bhatt RS, Seery V, Mosher JL, Farquhar MB, Mier JW, Atkins MB, Sukhatme VP. A phase II pilot trial of low dose, continuous infusion, or “metronomic”, paclitaxel and oral celecoxib in patients with metastatic melanoma. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.8010] [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] [Indexed: 11/20/2022] Open
Abstract
8010 Background: In patients (pts) with metastatic melanoma (MM), tumor angiogenesis has been associated with tumor progression and survival (Ugurel et al, JCO 19:577). Microtubule and cyclooxygenase (COX)-2 inhibitors, both alone and in combination, have been shown to have inhibitory effects on endothelial cells and tumor angiogenesis both in vitro and in vivo (Merchan et al, Int J Ca 113:490. Jones et al, Nat Med 5:1418). We tested the safety and efficacy of a regimen involving low dose, continuous infusion (CIV) paclitaxel and oral celecoxib in pts with MM. Methods: Pts received paclitaxel 10mg/m2 for 96 hours weekly by CIV and Celecoxib 400 mg po/bid. Systemic tumor response was assessed at 6 wk intervals (1 cycle (C)). Pts without unacceptable toxicity or clinically significant disease progression (PD) received additional cycles. Pts exhibiting PD after C 2 relative to end of C 1 were removed from study. Pts on anticoagulants, with recent MI or untreated brain metastases were ineligible. Results: 20 pts (12 M/ 8 F), median age 55 (range 44–65), ECOG PS 0/1/2 (5/13/2), M1a/M1b/M1c: 1/1/18 (90%), and prior systemic therapy regimens 0/1/2/3+: 1/7/5/7 were enrolled in the protocol. Sites of systemic disease included: lung (13 pts), LN (14), soft tissue (13), liver (9), bone (4), brain (6), other (11). 3 pts came of study prior to treatment with rapid disease progression. Treatment related grade 3–4 toxicities included line related (LR) bacteremia (3 pts), LR DVT (3 pts), LR PE (3). There were no grade 3–4 toxicities attributed to paclitaxel or celecoxib. No pt exhibited a major tumor response; 6/20 (30%) pts had stable disease for 17, 18, 18, 18+, 30+, 60 wks. Median TTP was 6 wks (range 3- 60); median overall survival was 6 months (range 1–29). Conclusions: Low-dose, CIV paclitaxel and oral celecoxib leads to disease stabilization in a significant portion of previously treated pts with MM. This suggests a role for combination anti-angiogenic therapy in MM. The incidence of LR toxicities indicates that alternative microtubule inhibitors, such as oral taxanes, should be considered in combination with COX-2 inhibitors for future studies. Results of biomarker studies will be presented at the meeting. Supported by Pfizer Inc. and NIH R21 CA097730. [Table: see text]
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Affiliation(s)
- D. F. McDermott
- Beth Israel Deaconess Medical Center, Boston, MA; Mayo Clinic, Rochester, MN
| | - D. C. Cho
- Beth Israel Deaconess Medical Center, Boston, MA; Mayo Clinic, Rochester, MN
| | - J. R. Merchan
- Beth Israel Deaconess Medical Center, Boston, MA; Mayo Clinic, Rochester, MN
| | - R. S. Bhatt
- Beth Israel Deaconess Medical Center, Boston, MA; Mayo Clinic, Rochester, MN
| | - V. Seery
- Beth Israel Deaconess Medical Center, Boston, MA; Mayo Clinic, Rochester, MN
| | - J. L. Mosher
- Beth Israel Deaconess Medical Center, Boston, MA; Mayo Clinic, Rochester, MN
| | - M. B. Farquhar
- Beth Israel Deaconess Medical Center, Boston, MA; Mayo Clinic, Rochester, MN
| | - J. W. Mier
- Beth Israel Deaconess Medical Center, Boston, MA; Mayo Clinic, Rochester, MN
| | - M. B. Atkins
- Beth Israel Deaconess Medical Center, Boston, MA; Mayo Clinic, Rochester, MN
| | - V. P. Sukhatme
- Beth Israel Deaconess Medical Center, Boston, MA; Mayo Clinic, Rochester, MN
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