Características epidemiológicas y clínicas de pacientes internados con COVID-19 en la Ciudad de Buenos Aires / Epidemiological and clinical characteristics of patients hospitalized with COVID-19 in Buenos Aires cityEsta obra está bajo una licencia de CreativeCommons Reconocimiento-NoComercial 4.0Internacionalhttps://creativecommons.org/licenses/by-nc/4.0/i

Introducción: La pandemia de COVID-19 representa un desafío para la salud mundial y continúa en investigación. Objetivo: Describir las características epidemiológicas, demográficas, clínicas y la mortalidad por todas las causas de pacientes internados con COVID-19 en un establecimiento de salud privado de la Ciudad de Buenos Aires. Materiales y métodos: Se realizó un estudio retrospectivo, de corte transversal y descriptivo entre el 3 de marzo y el 8 de julio de 2020. Se incluyeron pacientes adultos con diagnóstico confirmado de COVID-19 por RT-PCR de hisopado nasofaríngeo internados en sala general y unidad de terapia intensiva (UTI) del Sanatorio San José. Se analizaron las características epidemiológicas, demográficas (edad, sexo, ocupación, procedencia, residencia), clínicas y mortalidad por todas las causas. Las variables continuas fueron descriptas con mediana y rango intercuartilo (RIC) y las variables categóricas con número y porcentaje. Se utilizó el programa STATA v 13.0.Resultados: Se incluyeron 118 pacientes. La mediana de edad fue de 50 años, 51% varones. Las comorbilidades más prevalentes fueron hipertensión arterial 31,4%, enfermedad neurológica crónica 27,1%, enfermedad cardiovascular 14,4% y diabetes 13,6%. Los signos y síntomas más frecuentes: fiebre 68,6% y tos 51,7%. Según la severidad inicial: 33,9% neumonía moderada y 27,1% grave. El 75% de las tomografías de tórax reveló vidrio esmerilado; linfopenia presentó el 30%. No se detectó coinfección viral. La mortalidad por todas las causas fue del 20%, y del 57% en UTI con ventilación mecánica. Conclusiones: Nuestro trabajo describe las características y mortalidad de pacientes internados con COVID-19. Es necesario aumentar la evidencia para desarrollar modelos de predicción clínica relacionados con COVID-19.Palabras clave: infecciones por coronavirus, pandemias, epidemiología, COVID-19.

ntroduction: The COVID-19 pandemic represents a global health challenge and continues to be investigated.Objective: To describe the epidemiological, demographic, clinical characteristics and all-cause mortality of patients hospitalized with COVID-19, in a private health care facility in Buenos Aires city.Materials and methods: A retrospective, cross-sectional, and descriptive study was conducted between March 3 and July 8, 2020. Adult patients with a confirmed diagnosis of COVID-19 by nasopharyngeal swab RT-PCR, admitted to the general ward and intensive care unit (ICU) at the San José Sanatorium were included. Epidemiological, demographic (age, sex, occupation, origin, residence), clinical characteristics, and all-cause mortality were analyzed. Continuous variables were described with median and interquartile range (IQR) and categorical variables with number and percentage. The STATA v 13.0 program was used. Results: 118 patients were included. The median age was 50 years, 51% were men. The most prevalent comorbidities: arterial hypertension 31.4%, chronic neurological disease 27.1%, cardiovascular disease 14.4% and diabetes 13.6%. The most frequent signs and symptoms: fever 68.6% and cough 51.7%. According to the initial severity: 33.9% moderate pneumonia and 27.1% severe. Ground glass was reported in 75% of chest scans; lymphopenia presented 30%. Viral coinfection was not detected. Mortality from all causes was 20%, and 57% in ICU with mechanical ventilation.Conclusions: Our work describes the characteristics and mortality of hospitalized patients with COVID-19. Increased evidence is needed to develop clinical predictive models related to COVID-19

Molecular identification of Trypanosoma cruzi I tropism for central nervous system in Chagas reactivation due to AIDS.

Trypanosoma cruzi lineages, microsatellite allelic polymorphism, and mithocondrial gene haplotypes were directly typified from peripheral blood and cerebrospinal fluid specimens of a Bolivian patient with Chagas disease with accompanying AIDS and central nervous system severe involvement. Of note, the patient's blood was infected by a mixture of T. cruzi I and T. cruzi IId/e polyclonal populations while the cerebrospinal fluid showed only a monoclonal T. cruzi I population. Our findings do not corroborate the original assumption of innocuity for T. cruzi I in the southern cone of the Americas and highlight lineage I tropism for central nervous system causing lethal Chagas reactivation.

Molecular diagnosis and typing of Trypanosoma cruzi populations and lineages in cerebral Chagas disease in a patient with AIDS.

Trypanosoma cruzi DNA was amplified from an intracranial biopsy and peripheral blood of an HIV patient with encephalitis; this episode was indicative of AIDS and congenital Chagas disease. The analysis of a micro-satellite locus revealed a multiclonal parasite population at the brain lesion with a more complex minicircle signature than that profiled in blood using restriction fragment length polymorphism (RFLP)-PCR and low stringency single primer (LSSP) PCR. Interestingly, different sublineages of T. cruzi II were detected in blood and brain by means of spliced-leader and 24salpha ribosomal-DNA amplifications. Quantitative-competitive PCR monitored the decrease of parasitic load during treatment and secondary prophylaxis with benznidazole. The synergy between parasiticidal plus anti-retroviral treatments probably allowed the patient a longer survival than usually achieved in similar episodes. This is the first case report demonstrating a differential distribution of natural parasite populations and sublineages in Chagas disease reactivation, showing the proliferation of cerebral variants not detectable in peripheral blood.