Retrospective Analysis of the SARS-CoV-2 Infection Profile in COVID-19 Positive Patients in Vitoria da Conquista, Northeast Brazil.

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is responsible for causing Coronavirus Disease-2019 (COVID-19), a heterogeneous clinical condition that manifests varying symptom severity according to the demographic profile of the studied population. While many studies have focused on the spread of COVID-19 in large urban centers in Brazil, few have evaluated medium or small cities in the Northeast region. The aims of this study were: (i) to identify risk factors for mortality from SARS-CoV-2 infection, (ii) to evaluate the gene expression patterns of key immune response pathways using nasopharyngeal swabs of COVID-19 patients, and (iii) to identify the circulating SARS-CoV-2 variants in the residents of a medium-sized city in Northeast Brazil. A total of 783 patients infected with SARS-CoV-2 between May 2020 and August 2021 were included in this study. Clinical-epidemiological data from patients who died and those who survived were compared. Patients were also retrospectively divided into three groups based on disease severity: asymptomatic, mild, and moderate/severe. Samples were added to a qPCR array for analyses of 84 genes involved with immune response pathways and sequenced using the Oxford Nanopore MinION technology. Having pre-existing comorbidity; being male; having cardiovascular disease, diabetes, and/or chronic obstructive pulmonary disease; and PCR cycle threshold (Ct) values under 22 were identified as risk factors for mortality. Analysis of the expression profiles of inflammatory pathway genes showed that the greater the infection severity, the greater the activation of inflammatory pathways, triggering the cytokine storm and downregulating anti-inflammatory pathways. Viral genome analysis revealed the circulation of multiple lineages, such as B.1, B.1.1.28, Alpha, and Gamma, suggesting that multiple introduction events had occurred over time. This study's findings help identify the specific strains and increase our understanding of the true state of local health. In addition, our data demonstrate that epidemiological and genomic surveillance together can help formulate public health strategies to guide governmental actions.

Toxocariasis of the central nervous system: with report of two cases.

Clinical involvement of the nervous system in visceral larva migrans due to Toxocara is rare, although in experimental animals the larvae frequently migrate to the brain. A review of the literature from the early 50's to date found 29 cases of brain involvement in toxocariasis. In 20 cases, various clinical and laboratory manifestations of eosinophilic meningitis, encephalitis, myelitis or radiculopathy were reported. We report two children with neurological manifestations, in which there was cerebrospinal fluid pleocytosis with marked eosinophilia and a positive serology for Toxocara both in serum and CSF. Serology for Schistosoma mansoni, Cysticercus cellulosae, Toxoplasma and cytomegalovirus were negative in CSF, that was sterile in both cases. Improvement of signs and symptoms after specific treatment (albendazole or thiabendazole) was observed in the two cases. A summary of data described in the 25 cases previously reported is presented and we conclude that in cases of encephalitis and myelitis with cerebrospinal fluid pleocytosis and eosinophilia, parasitic infection of the central nervous system should be suspected and serology should be performed to establish the correct diagnosis and treatment.

Toxocariasis of the central nervous system: with report of two cases

Envolvimento do sistema nervoso, com manifestações clínicas, na infecção pelo Toxocara é raro, embora, nos modelos experimentais a larva freqüentemente se localize no sistema nervoso central. Uma revisão da literatura a partir de 1956, quando a síndrome foi descrita, até 2002, mostrou a publicação de 29 casos de neurotoxocaríase, dos quais em 20 havia relato de alterações clínicas e laboratoriais indicativas de meningite, ou encefalite, ou mielite ou radiculite eosinofílicas. Nessa comunicação estamos relatando observações em duas crianças que apresentaram sinais e sintomas neurológicos, com pleocitose e eosinofilia acentuada no líquor e com sorologia positiva para Toxocara no soro e no liquor. Sorologia para Schistosoma mansoni, Cysticercus cellulosae, Toxoplasma e citomegalovirus foram negativas no liquor, que era estéril nos dois casos. Houve melhora dos sinais e sintomas após o tratamento específico (albendazol e tiabendazol) nos dois casos. É apresentado um sumário dos principais achados nos casos relatados na literatura e se conclue que em casos de meningite, encefalite ou mielite com líquor apresentando pleocitose com eosinofilia acentuada, a suspeita de infecção parasitária deve ser levantada, sendo necessário sorologia especifica para diagnóstico e tratamento adequados.