ABSTRACT
Herein, we report a case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and dengue coinfection, presented as a fatal stroke in our hospital, in São José do Rio Preto, São Paulo State, a Brazilian city hyperendemic for dengue viruses and other arthropod-borne viruses (arboviruses) and currently facing a surge of SARS-CoV-2 cases. This case is the first described in the literature and contributes to the better understanding of clinical presentations of two important diseases in a tropical setting.
Subject(s)
COVID-19/complications , Coinfection/complications , Dengue Virus/pathogenicity , Dengue/complications , SARS-CoV-2/pathogenicity , Stroke/etiology , Stroke/virology , Arboviruses/pathogenicity , Brazil , COVID-19/virology , Coinfection/virology , Dengue/virology , Female , Humans , Middle AgedABSTRACT
ABSTRACT Mutations related to Factor V Leiden (G1691A) and prothrombin (G20210A) are associated with a significantly increased risk of venous thromboembolism. The identification of a patient affected by episodes of venous thromboembolism and carrier of G1691A (heterozygous) and G20210A (homozygous) polymorphisms was determined by molecular tests [real-time polymerase chain reaction (PCR) methodology, Genexpert system] during attendance at the Base Hospital of São José do Rio Preto-SP, Brazil.
RESUMO Mutações relacionadas com o fator V de Leiden (G1691A) e a protrombina (G20210A) estão associadas a um significativo aumento do risco de tromboembolismo venoso. Por meio da realização de exames moleculares [metodologia de reação em cadeia da polimerase (PCR) em tempo real, sistema Genexpert], em pacientes atendidos no Hospital de Base de São José do Rio Preto-SP, Brasil, foi determinada a identificação de uma paciente afetada por episódios de tromboembolismo venoso e portadora dos polimorfismos G1691A (heterozigota) e G20210A (homozigota).
ABSTRACT
Human cytomegalovirus is a ubiquitous infectious agent that affects mainly immunosuppressed, fetuses, and newborns. The virus has several polymorphic regions, in particular in the envelope glycoproteins. The UL55 gene encodes the glycoprotein B that has a variable region, containing a furin cleavage site and according to the variability different genotypes are characterized. Here we investigated variability and existence of selective pressure on the UL55 variable region containing the furin cleavage site in 213 clinical sequences from patients worldwide. We showed the occurrence of positive selective pressure on gB codons 461 and 462, near the furin cleavage site. Cleavage analysis of synthesized peptides demonstrated that most mutations confer better cleavage by furin, suggesting that evolution is acting in order to increase the efficiency cleavage and supporting the hypothesis that gB processing is important in the host. We also demonstrated that peptides containing sequences, that characterize genotypes gB2 and 3, are differentially cleaved by furin. Our data demonstrate for the first time that variability in the cleavage site is related to degree of gB processing by furin.
