Papel de las pruebas rápidas (POCT) en el diagnóstico del SARS-COV-2, agente causal de COVID-19 / Role of Rapid Tests (POCT) in the Diagnosis of SARS-VOC-2, Causal Agent of COVID-19

Resumen El estándar de oro actual para la detección de SARS-CoV-2, agente causal de la pandemia de neumonía atípica (COVID-19) que apareció por primera vez en la ciudad de Wuhan (provincia de Hubei, China) en diciembre de 2019 (1), es la RT-qPCR. El protocolo estándar implica la transcripción inversa de ARN de SARS-CoV-2 en cadenas de ADN complementarias (ADNc), seguida de la amplificación de regiones específicas del ADNc. Este procedimiento demanda varias horas para ser completado y deriva en que la información final del estado de la infección pueda demorar hasta 24 horas. Ante la necesidad de disminuir el riesgo de una posible propagación viral dentro de la población originada por la rápida transmisión del SARS-CoV-2, se ha buscado prevenir el contagio, la propagación nosocomial y la transmisión comunitaria posterior, a través de la identificación rápida de casos sospechosos, y predecir las posteriores ondas infecciosas de recurrencia viral. Para esto, se vienen desarrollando métodos de laboratorio rápidos o point of care testing (POCT), que disminuyen el tiempo de diagnóstico y minimizan el riesgo de contagio por parte de los operadores.

Abstract The gold test to detect SARS-CoV-2, the etiologic agent that leads to the pandemic of atypical pneumonia (COVID 2019) that first appeared in Wuhan City, Hubei Province of China in December 2019 (1), is the RT-qPCR. The standard protocol involves reverse transcription of SARS-CoV-2 RNA into complementary DNA strands (cDNA), followed by the amplification of cDNA specific regions, a procedure that takes several hours to complete and which results in the final information from the infection status can take up to 24 hours. For this reason, and due to the need to reduce the risk of possible viral spread within the population caused by the fast transmission of SARS-CoV-2, in order to prevent nosocomial spread and subsequent community transmission through the quick identification of suspected cases, and to predict the further infectious waves of viral recurrence, rapid laboratory methods or Point of Care Testing (POCT) are being developed to reduce the diagnosis time and minimize the risk of contagion by the operators. These tests are discussed below.

Valor pronóstico de los marcadores bioquímicos en pacientes con COVID-19 / Prognostic value of biochemical markers in patients with COVID-19

Resumen El SARS-CoV-2 es un virus de la familia Coronaviridae, subfamilia coronavirus (CoV) y género β. Este se ha convertido en una amenaza inminente para toda la humanidad por ser el agente causal de la pandemia COVID-19, la cual llevó, por un lado, a la declaratoria de emergencia sanitaria a nivel mundial por parte de la Organización Mundial de la Salud (OMS) y, por otro, a instituir estrictas medidas de control para prevenir su contagio por parte de muchos gobiernos. En cuanto a la fisiopatología presentada en esta entidad, aunque las lesiones pulmonares han sido consideradas como las principales consecuencias de esta infección, a medida que avanza el conocimiento sobre el virus se han identificado también lesiones a nivel cardiaco, hepático y renal, que potencian la severidad de la infección y generan un mayor deterioro de los pacientes, su ingreso a las Unidades de Cuidados Intensivos y un mayor riesgo de mortalidad. Con base en esto, diversas investigaciones se han encaminado a determinar aquellos hallazgos clínicos y paraclínicos que puedan ser relevantes frente al pronóstico de los pacientes. Por lo anterior, la presente revisión aborda literatura disponible sobre los principales biomarcadores bioquímicos reportados por su asociación a daños cardiaco, hepático y renal, los cuales presentan mayor significancia para evaluar el curso, severidad, manejo y pronóstico de la infección, y cuya alteración conlleva finalmente a un mayor riesgo de mortalidad en pacientes hospitalizados que presentan COVID-19.

Abstract SARS-CoV-2 is a virus from the coronaviridae family, coronavirus (CoV) subfamily and genus β, it has become an imminent threat to all humanity as it is the causal agent of the COVID-19 pandemic, which led to On the one hand, the World Health Organization (WHO) declares a worldwide health emergency, and on the other, to institute strict control measures to prevent its spread by many governments. Regarding the pathophysiology presented in this entity, although lung lesions have been considered the main consequences of this infection, as knowledge about the virus progresses, cardiac, hepatic, and renal lesions have also been identified that enhance severity of the infection generating greater deterioration of the patients, their admission to the Intensive Care Units and a higher risk of mortality; Based on this, various investigations have aimed to determine those clinical and paraclinical findings that may be relevant to the prognosis of the patients. Therefore, this review addresses available literature on the main biochemical biomarkers reported for their association with cardiac, liver and kidney damage, which are more significant in evaluating the course, severity, management and prognosis of the infection and whose alteration ultimately leads to an increased risk of mortality in hospitalized patients presenting with COVID-19.

Identification of metabolic indicators for cardiovascular risk in schoolchildren

Objective: CardioVascular Disease (CVD) is one of the most important causes of death worldwide affecting people at younger ages every year. The purpose of this study was to identify the metabolic indicators for cardiovascular risk factors in primary school students from Mexico and Colombia. Methods: A clinical, prospective, cross-sectional and comparative study was conducted in Mexico and Colombia to contrast anthropometric measurements, biochemical and dietetic determinations and physical activity. Results: The Waist-Hip Ratio (WHR) and the Waist-to-Height Ratio (WtHR) showed significant differences (p≤0.001) between Mexico and Colombia (0.8 ± 0.1 versus 0.5 ± 0.1) and (0.4 ± 0.06 vs. 0.78 ± 0.04) respectively. The Automatic Linear Modeling showed that the main predictors for cholesterol levels were WtHR, MonoUnsaturated Fatty Acids (MUFA) and lipids ingestion. For glucose there were four main predictors: WHR, carbohydrates, MUFA and Saturated Fatty Acids (SFA). For triglycerides the pedictors were Products of Animal Origin (PAO), BMI, waist circumference, lipids and cholesterol ingestion and Mean Arterial Pressure (MAP). The Weight Estimation tests weighted per gender showed that for glucose levels the main determinants were carbohydrates, MUFA and oils; for cholesterol these were MUFA, PUFA and oils; and for LDL the significant variables were proteins, SFA, PAO and sugars; and last, for triglycerides the main variables were BMI, cholesterol and vegetables. Conclusions: Mexico has higher values in almost all items of cardiovascular risk in children, but both countries have significant percentages of obesity and the population free of cardiovascular risk is minimal.

Evaluación de factores de riesgo asociados a enfermedad cardiovascular en jóvenes universitarios de la Localidad Santafé en Bogotá, Colombia / Evaluation of risk factors associated with cardiovascular disease in young university students of Santafe Locality from Bogota, Colombia

Objetivo. Identificar factores de riesgo cardiovascular en población joven de la Localidad Santafé de Bogotá, Colombia. Métodos. Estudio descriptivo, transversal desarrollado en estudiantes de tres universidades de la Localidad Santafé en Bogotá, con edades comprendidas entre los 16 a 29 años, a quienes se les realizaron exámenes clínicos y paraclínicos y se les aplicó una encuesta de factores de riesgo. Resultados. Se estudiaron 747 estudiantes, encontrando que la prevalencia más alta de factores de riesgo estuvo dada por el consumo de alcohol (96.1%), que mostró además relación con el aumento de tensión arterial con la prueba Chi cuadrada. Las prevalencias de sedentarismo (63.8%) y tabaquismo (48.1%) no presentaron diferencias marcadas en comparación con otros estudios, pero el segundo fue el único que se asoció con el aumento de la tensión arterial sistólica (P < 0.001) y diastólica (P = 0.04). La prevalencia de obesidad fue similar a la hallada en investigaciones anteriores hechas en Colombia (2.3%); de igual manera se encontró asociación entre aquella, la presencia de hipertrigliceridemia (P = 0.001) y el incremento en los niveles de glucosa (P = 0.01). Los resultados de este estudio indican que los estudiantes universitarios de la Localidad Santafé en Bogotá, tienen como factores de riesgo preponderantes de enfermedad cardiovascular al consumo de alcohol, el tabaquismo y el sedentarismo.

Objective. To identify cardiovascular risk factors in young people of Santafé Locality of Bogotá, Colombia. Method. This was a descriptive cross-sectional study conducted at three universities in the Santafe Locality of Bogota, aged 16-29 years, who underwent clinical and laboratory examinations and they were asked to answer a risk factor questionnaire. Results. 747 students were evaluated, finding that the highest prevalence of cardiovascular risk factor was alcohol (96.1%), also related to an increased blood pressure with the Chi square test. The prevalence of physical inactivity (63.8%) and smoking (48.1%) showed no marked differences compared with other studies, and the second was the only one that was associated with increased systolic (P < 0.001) and diastolic blood pressure (P = 0.04). The prevalence of obesity was similar to that found in previous research (2.3 %); and it was also associated to the presence of high levels of triglycerides (P = 0.001) and increase in blood glucose (P = 0.01). The results of this study indicate that college students in the Santafe Locality of Bogotá, have as main risk factors of cardiovascular disease, alcohol consumption, smoking and physical inactivity.

Comparative study of risk factors related to cardiovascular disease in children from Bogotá, Colombia and Toluca, Mexico.

INTRODUCTION: Currently, cardiovascular risk factors have not been studied so extensively in young people. OBJECTIVE: To compare the cardiovascular risk factor between Colombian and Mexican children. PATIENTS AND METHODS: This was a transversal, descriptive, comparative and clinical study. 30 children of primary school aged 6-12 from Bogotá, Colombia were matched by age with a sample of 30 children from Toluca, Mexico. Cardiovascular risk factors measured were Body Mass Index (BMI), serum lipid profile, glucose and homocystein (Hcy). Besides we applied the validated surveys formats for food (dietary history), physical activity (International Physical Activity Questionnaire, IPAQ), alcohol consumption and smoking. RESULTS: BMI was higher in Mexican children than in Colombian (20.43±3.35 vs 16.92±3.46) (p≤0.001). Among Mexican children, 20% (6) of them had blood glucose concentration greater than 100 mg/dl, 6.6% (2) had triglycerides greater than 200 mg/dl, 36.6% (11) had cholesterol levels greater than 170 mg/dl, 16% (53.3) had HDL lower than the recommended limits, and 60% (18) had LDL above the normal limit. For the Colombian population these percentages were of 0, 3.3, 46.6, 13.33 and 53.3 respectively. DISCUSSION: Mexican children had a stronger correlation between BMI and atherogenic indices and less physical activity than Colombian. Of the 30 Mexican children enrolled in the study only 13% had none of the cardiovascular risk factors, while in the Colombian this percentage was of 33. CONCLUSION: Latin American children are not metabolically homogeneous, Mexican children are at high risk of cardiovascular disease.

Comparative study of risk factors related to cardiovascular disease in children from Bogotá, Colombia and Toluca, Mexico. / Comparative study of risk factors related to cardiovascular disease in children from Bogotá, Colombia and Toluca, Mexico.

INTRODUCTION: Currently, cardiovascular risk factors have not been studied so extensively in young people. OBJECTIVE: To compare the cardiovascular risk factor between Colombian and Mexican children. PATIENTS AND METHODS: This was a transversal, descriptive, comparative and clinical study. 30 children of primary school aged 6-12 from Bogotá, Colombia were matched by age with a sample of 30 children from Toluca, Mexico. Cardiovascular risk factors measured were Body Mass Index (BMI), serum lipid profile, glucose and homocystein (Hcy). Besides we applied the validated surveys formats for food (dietary history), physical activity (International Physical Activity Questionnaire, IPAQ), alcohol consumption and smoking. RESULTS: BMI was higher in Mexican children than in Colombian (20.43±3.35 vs 16.92±3.46) (pÔëñ0.001). Among Mexican children, 20

(6) of them had blood glucose concentration greater than 100 mg/dl, 6.6

(2) had triglycerides greater than 200 mg/dl, 36.6

(11) had cholesterol levels greater than 170 mg/dl, 16

(53.3) had HDL lower than the recommended limits, and 60

(18) had LDL above the normal limit. For the Colombian population these percentages were of 0, 3.3, 46.6, 13.33 and 53.3 respectively. DISCUSSION: Mexican children had a stronger correlation between BMI and atherogenic indices and less physical activity than Colombian. Of the 30 Mexican children enrolled in the study only 13

had none of the cardiovascular risk factors, while in the Colombian this percentage was of 33. CONCLUSION: Latin American children are not metabolically homogeneous, Mexican children are at high risk of cardiovascular disease.

Comparative study of risk factors related to cardiovascular disease in children from Bogotá, Colombia and Toluca, Mexico / Comparative study of risk factors related to cardiovascular disease in children from Bogotá, Colombia and Toluca, Mexico.

INTRODUCTION: Currently, cardiovascular risk factors have not been studied so extensively in young people. OBJECTIVE: To compare the cardiovascular risk factor between Colombian and Mexican children. PATIENTS AND METHODS: This was a transversal, descriptive, comparative and clinical study. 30 children of primary school aged 6-12 from Bogotá, Colombia were matched by age with a sample of 30 children from Toluca, Mexico. Cardiovascular risk factors measured were Body Mass Index (BMI), serum lipid profile, glucose and homocystein (Hcy). Besides we applied the validated surveys formats for food (dietary history), physical activity (International Physical Activity Questionnaire, IPAQ), alcohol consumption and smoking. RESULTS: BMI was higher in Mexican children than in Colombian (20.43±3.35 vs 16.92±3.46) (pÔëñ0.001). Among Mexican children, 20

(6) of them had blood glucose concentration greater than 100 mg/dl, 6.6

(53.3) had HDL lower than the recommended limits, and 60

(18) had LDL above the normal limit. For the Colombian population these percentages were of 0, 3.3, 46.6, 13.33 and 53.3 respectively. DISCUSSION: Mexican children had a stronger correlation between BMI and atherogenic indices and less physical activity than Colombian. Of the 30 Mexican children enrolled in the study only 13

had none of the cardiovascular risk factors, while in the Colombian this percentage was of 33. CONCLUSION: Latin American children are not metabolically homogeneous, Mexican children are at high risk of cardiovascular disease.