Diagnosis of type 2 diabetes in a patient with acute sinusitis and COVID-19 in Colombia.

During the COVID-19 pandemic, cases of acute sinusitis due to COVID-19 and even co-infections have been reported [1]. We want to discuss a case in Colombia where a patient with detected type 2 diabetes presented sinusitis and COVID-19. A 51-year-old man from Sincelejo, Sucre, consulted on May 23, 2020, with one day presenting general malaise and fever (38 °C), lumbar pain, frequent urination, polydipsia and hyperglycemia (366 mg/dl). He denied cough, travel during the last two weeksan Physical examination revealed a blood pressure of 170/110 mmHg, heart rate of 115 beats/minute, respiratory rate of 16 breaths/minute, and temperature of 36.6 °C. Neither lymphadenopathies nor cardiopulmonary disturbances were noted. A working diagnosis of febrile syndrome, ketoacidosis, and recent-onset type 2 diabetes, with uncontrolled hypertension, was contemplated at admission RT-PCR for SARS-CoV-2 was positive. A head CT Scan revealed left maxillary sinusitis with mucosal thickening of the maxillary Despite the sizeable SARS-CoV-2 pandemic, the number of reports of sinusitis in association with COVID-19 has been limited [2,3]. Sinusitis is more often diagnosed among immunocompromised patients, including diabetes of our patient. COVID-19, as a multisystemic condition. It may affect different anatomical areas, including the paranasal sinuses and the upper and lower respiratory mucosa. Although it is uncertain whether SARS-CoV-2 was the sole cause of the sinusitis in our patient or just a contributing factor, other reports suggest a significant involvement of the virus in the development of this condition, in addition to its role in worsening the clinical course of patients with chronic rhinosinusitis.

Brote de enfermedad aguda de Chagas adquirida oralmente en Sucre, 2019-2020 / Outbreak of orally acquired acute Chagas disease in Sucre, 2019-2020

Introducción: En las dos últimas décadas, varios países de América Latina han experimentado múltiples brotes de la enfermedad de Chagas oral. El estudio: Estudio retrospectivo que analiza un brote de enfermedad de Chagas oral aguda en Sucre, Colombia durante diciembre-enero de 2020. Los casos fueron confirmados por diferentes métodos diagnósticos. Hallazgos: Durante dos semanas se confirmaron 16 casos, donde la edad media fue de 14 años. Del total, 14 pacientes fueron hospitalizados y 2 fallecieron. Las manifestaciones clínicas incluyeron: fiebre, edema facial, hepatoesplenomegalia. En 13 de los pacientes se observaron tripomastigotes de Trypanosoma cruzi en los frotis fino y grueso. La transmisión oral se estableció como la vía más probable. Conclusiones: La enfermedad de Chagas aguda transmitida por vía oral puede poner en peligro la vida o incluso ser mortal, por tanto, es urgente mejorar las medidas de control epidemiológico a nivel nacional y en otros países de América Latina.

Background:In the last two decades, several Latin Americancountrieshaveexperiencedmultiple outbreaksoforalChagasdisease.Thestudy: Retrospective study analyzing an outbreak of acute oralChagasdiseaseinSucre,Colombiaduring December-January 2020. The cases were confirmed by different diagnostic methods. During two Finding:weeks, 16 cases were confirmed, where the mean age was 14 years and 12 were male. Of the total, 14 patientswerehospitalizedand2died.Clinical manifestationsinclude:fever,facialedema, hepatosplenomegaly,In13ofthepatients Trypanosoma cruzi trypomastigotes were observed in thethinandthicksmears.Oraltransmissionis established as the most likely route in 14 of the patients. Acute orally transmitted Conclusions: Chagas disease can be life-threatening or even fatal, therefore, it is urgent to improve epidemiological control measures at the national level and in other Latin American countries.

Should we concern about reinfection in COVID-19?: [Editorial] / ¿Deberíamos preocuparnos por la reinfección en COVID-19?: [Editorial]

After more than half year with the ongoing pandemic of the Coronavirus Disease 2019 (COVID-19) in all the continents, there are still many concerns regarding this emerging disease. The World Health Organization (WHO) declared COVID-19 as a pandemic in March 11, 2020, but it was on December 31, 2019, when a pneumonia of unknown cause was reported to WHO China Office. One of the most recent concerns about COVID-19 is the possibility of reinfection. Although experimental studies with animals suggested early in August 2020, that primary SARSCoV-2 exposure protects against subsequent reinfection in rhesus macaques, recent clinical case reports are showing that reinfection is possible.

Después de más de medio año con la pandemia en curso de la Enfermedad por Coronavirus 2019 (COVID-19) en todos los continentes, todavía hay muchas preocupaciones con respecto a esta enfermedad emergente. La Organización Mundial de la Salud (OMS) declaró la COVID-19 como pandemia el 11 de marzo de 2020, pero fue el 31 de diciembre de 2019, cuando una neumonía de causa desconocida fue notificada a la Oficina de la OMS en China. Una de las preocupaciones más recientes sobre COVID-19 es la posibilidad de reinfección. Aunque los estudios experimentales con animales sugirieron a principios de agosto de 2020, que la exposición primaria al SARSCoV-2 protege contra la reinfección posterior en macacos rhesus, los informes de casos clínicos recientes están mostrando que la reinfección es posible.

Dengue and COVID-19, overlapping epidemics? An analysis from Colombia.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout Latin America, a region swept by multiple previous and ongoing epidemics. There are significant concerns that the arrival of COVID-19 is currently overlapping with other viruses, particularly dengue, in various endo-epidemic regions across South America. In this report, we analyzed trends for both viral infections in Colombia during the first 20 epidemiological weeks (EWs) of 2020. From 1st January to 16th May 2020 (EWs, 1-20), a total of 52 679 cases of dengue and 14 943 cases of COVID-19 have been confirmed in Colombia. As both conditions may potentially lead to fatal outcomes, especially in patients with chronic co-morbidities, overlapping infections, and co-occurrence may increase the number of patients requiring intensive care and mechanical ventilation. In regions, such as Valle del Cauca, intensified preparation for such scenarios should be pondered, and further studies should be performed to address this critical issue in a timely matter.

Risk of Chronic Cardiomyopathy Among Patients With the Acute Phase or Indeterminate Form of Chagas Disease: A Systematic Review and Meta-analysis.

Importance: Chagas cardiomyopathy is associated with substantial morbidity and mortality. Precise estimates of the risk of developing cardiomyopathy among patients with the acute or indeterminate chronic forms of Chagas disease are lacking. Objective: To estimate the risk of developing chronic cardiomyopathy in patients with acute and indeterminate chronic forms of Chagas disease. Data Sources: A systematic search in the Cochrane Library, Embase, Latin American and Caribbean Health Sciences Literature (LILACS), Medline, and Web of Science Core Collection databases was conducted from October 8 to October 24, 2018. Studies published between January 1, 1946, and October 24, 2018, that were written in the English, Spanish, and Portuguese languages were included. Search terms included Chagas disease; development of cardiomyopathy; latency duration; and determinants of the Chagas latency period. Study Selection: Longitudinal observational studies of participants diagnosed with the acute phase of Chagas infection or the indeterminate chronic form of Chagas disease who were followed up until the development of cardiomyopathy were included. Studies were excluded if they did not provide sufficient outcome data. Of 10 761 records initially screened, 32 studies met the criteria for analysis. Data Extraction and Synthesis: Critical appraisals of studies were performed using checklists from the Joanna Briggs Institute Reviewer's Manual, and data were collected from published studies. A random-effects meta-analysis was used to obtain pooled estimated annual rates. Data were analyzed from September 11 to December 4, 2019. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline for the registration of the protocol, data collection and integrity, assessment of bias, and sensitivity analyses. Main Outcomes and Measures: Main outcomes were defined as the composite of the development of any new arrhythmias or changes in electrocardiogram results, dilated cardiomyopathy and segmental wall motion abnormalities in echocardiogram results, and mortality associated with Chagas disease. Results: A total of 5005 records were screened for eligibility. Of those, 298 full-text articles were reviewed, and 178 of those articles were considered for inclusion in the quantitative synthesis. After exclusions, 32 studies that included longitudinal observational outcomes were selected for the analysis; 23 of those studies comprised patients with the indeterminate chronic form of Chagas disease, and 9 of those studies comprised patients in the acute phase of Chagas infection. The analysis indicated that the pooled estimated annual rate of cardiomyopathy development was 1.9% (95% CI, 1.3%-3.0%; I2 = 98.0%; τ2 [ln scale] = 0.9992) in patients with indeterminate chronic Chagas disease and 4.6% (95% CI, 2.7%-7.9%; I2 = 86.6%; τ2 [ln scale] = 0.4946) in patients with acute Chagas infection. Conclusions and Relevance: Patients with the indeterminate chronic form of Chagas disease had a significant annual risk of developing cardiomyopathy. The annual risk was more than double among patients in the acute phase of Chagas infection.

Esperando lo inesperado, la pandemia del milenio hasta el momento: COVID-19 / Expecting the unexpected, the pandemic of the millennium till now: COVID-19

Al iniciar el milenio, dos décadas atrás, el mundo experimentó los primeros brotes epidémicos de gran preocupación, como fueron precisamente el Síndrome Respiratorio Agudo Severo (SARS) causado por el SARSCoV, y la influenza aviar H5N1, ambos originados en Asia, siendo el primero declarado como una emergencia sanitaria de preocupación internacional (ESPI) por parte de la Organización Mundial de la Salud (OMS)

Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis.

INTRODUCTION: An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 in China leading to a Public Health Emergency of International Concern (PHEIC). Clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews on COVID-19 have been published to date. METHODS: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases. Observational studies and also case reports, were included, and analyzed separately. We performed a random-effects model meta-analysis to calculate pooled prevalences and 95% confidence intervals (95%CI). RESULTS: 660 articles were retrieved for the time frame (1/1/2020-2/23/2020). After screening, 27 articles were selected for full-text assessment, 19 being finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 95%CI 40.8-74.4%) and dyspnea (45.6%, 95%CI 10.9-80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), 32.8% presented with acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock. Some 13.9% (95%CI 6.2-21.5%) of hospitalized patients had fatal outcomes (case fatality rate, CFR). CONCLUSION: COVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected patients and hospitalization was associated with a CFR of >13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure and facilities to treat severe COVID-19.