SARS-CoV-2 in a tropical area of Colombia, a remarkable conversion of presymptomatic to symptomatic people impacts public health.

BACKGROUND: The ability of SARS-CoV-2 to remain in asymptomatic individuals facilitates its dissemination and makes its control difficult. OBJECTIVE: To establish a cohort of asymptomatic individuals, change to the symptomatic status, and determine the most frequent clinical manifestations.  METHODS: Between April 9 and August 9, 2020, molecular diagnosis of SARS-CoV-2 infection was confirmed in 154 asymptomatic people in contact with subjects diagnosed with COVID-19. Nasopharyngeal swabs were performed on these people in different hospitals in Córdoba, the Caribbean area of Colombia. The genes E, RdRp, and N were amplified with RT-qPCR. Based on the molecular results and the Cq values, the patients were subsequently followed up through telephone calls to verify their health conditions. RESULTS: Overall, of 154 asymptomatic individuals, 103 (66.9%) remained asymptomatic, and 51 (33.1%) changed to symptomatic. The most frequent clinical manifestations in young people were anosmia and arthralgia. Adults showed cough, ageusia, and odynophagia; in the elderly were epigastralgia, dyspnea, and headache. Mortality was 8%. CONCLUSIONS: A proportion of 33% of presymptomatic individuals was found, of which four of them died. This high rate could indicate a silent transmission, contributing significantly to the epidemic associated with SARS-CoV-2.

Clinical outcomes of patients hospitalized for COVID-19 and evidence-based on the pharmacological management reduce mortality in a region of the Colombian Caribbean.

INTRODUCTION: Despite the high volume of infections, some clinical aspects of this disease are still unknown. There are currently no studies in Colombia that describe the disease's clinical and treatment aspects in detail. OBJECTIVE: Describe the characteristics and clinical management of a group of admitted patients with SARS-CoV-2 infection in a private clinic in Montería, Córdoba-Colombia. PATIENTS AND METHODS: A descriptive observational study was carried out between May and August 2020 in 209 hospitalized patients with a confirmed diagnosis of COVID-19. Upon admittance, clinical, sociodemographic characteristics, comorbidities, and complications were analyzed. Additionally, the effect of the following medications was described: 1-antibiotics (cefepime, piperacillin, tazobactam, meropenem, vancomycin) + low molecular weight heparin (LMWH) + corticosteroids (dexamethasone-methylprednisolone) + colchicine. 2- Antibiotic + LMWH + corticosteroids. 3-LMWH + corticosteroids. 4-LMWH + corticosteroids + colchicine. 5-Other treatments (Tocilizumab). RESULTS: 107 (51%) of the 209 patients with a confirmed diagnosis of COVID-19 passed away. The main comorbidities related to mortality of these hospitalized patients with COVID-19 were obesity and kidney disease (P < 0.05). The main complications associated with fatal outcomes in this group of patients were Acute Respiratory Distress Syndrome (ARDS) and sepsis (P < 0.05). Furthermore, it was evidenced that the colchicine combination showed a significant difference in reducing mortality in hospitalized patients compared to the other therapeutic regimens (P < 0.05). CONCLUSION: A mortality rate of 51% was found attributable to several factors such as advanced age, obesity, kidney disease, and an average time in days of late consultation. The implementation of the colchicine combination could reduce the mortality rate in this disease.

Predicción de la concentración de linfocitos T CD4 en sangre periférica con base en la teoría de la probabilidad: Aplicación clínica en poblaciones de leucocitos, linfocitos y CD4 de pacientes con VIH T / CD4 Lymphocytes Prediction Based on the Theory of Probability: Clinical application on leukocytes, lymphocytes and CD4 populations of HIV patients

Introducción. Se han desarrollado modelos para la predicción de la tasa de disminución de células CD4 en pacientes con VIH/sida con base en redes neurales y, también, en la variabilidad de la disminución de los recuentos de CD4 en pacientes seropositivos y seronegativos, con el recurso de métodos epidemiológicos. Objetivo. Predecir la población de linfocitos T CD4, a partir de la información del cuadro hemático sobre leucocitos y linfocitos, mediante la teoría de la probabilidad. Métodos. Se evaluaron los cuadros hemáticos de siete casos particulares, determinando la cantidad total de leucocitos y linfocitos, y la cantidad de linfocitos CD4 por medio de citometría de flujo. A partir de un trabajo previo, se desarrolló una inducción con la que se determinaron los conjuntos A, B, C y D, con base en los cuales se calculó la probabilidad de aparición de combinaciones específicas de valores de leucocitos, linfocitos y CD4, en rangos de 1.000 leucocitos para 128 casos. Resultado. Se predice que los rangos de leucocitos inferiores a 5.000 y 4.000 por mm3 de sangre periférica se asocian a menos de 570 linfocitos CD4 por µl con una probabilidad de 0,92 y 1, respectivamente. A medida que disminuye la cantidad de las poblaciones de leucocitos, el porcentaje de aciertos entre las tres medidas es más efectivo. Conclusión. La teoría de la probabilidad reveló una autoorganización matemática de las poblaciones celulares estudiadas, que permitió desarrollar predicciones clínicas para el número de células CD4 a partir del cuadro hemático, disminuyendo los costos y deduciendo los resultados de la citometría de flujo.

Background: Models for the prediction of the CD4 decrease rate in VIH/AIDS patients have been developed with neural networks, and also for the prediction of the variability in CD4 counts decrease in seropositive and seronegative patients with epidemiological models. Objective: to predict the TCD4 lymphocyte population, beginning with the Complete Blood Count (CBC) information of leucocytes and lymphocytes, through probabilistic theories. Methods: Seven CBC of particular cases were evaluated, by determining the total count of leucocytes and lymphocytes, and the proportion of CD4 Lymphocytes by flow cytometry. Based on a previous work an induction was developed; with that induction the sets A, B, C and D were determined. Based on that sets we established the probability of aparition of specific combinations of leucocytes, Lymphocytes ans CD4 values, in ranges of 1.000 leucocytes, in 128 cases. Results: it is predicted that the leucocytes ranges lower than 5,000 and 4,000 per cubic milimeter of peripheral blood are associated with less than 570 CD4 per microliter with a probability of 0.92 and 1 respectively. As the quantity of populations diminishes, the success percentage between the three measures is more effective. Conclusion: The probability theory revealed a mathematical self-organization of the studied cellular populations, allowing the development of predictions in a clinical level for the CD4 number from the CBC, diminishing costs and deducting the results of the flow cytometry.

Caracterización microbiológica de Salmonella en alimentos de venta callejera en un sector universitario de Bogotá, Colombia. Julio a octubre de 2010 / Microbiological characterization of Salmonella in Street-vended foods an university sector in Bogotá, Colombia. july-october 2010

Introducción. Salmonella spp. perteneciente a la familia Enterobacteriaceae, es uno de los principales microorganismos implicados en las enfermedades transmitidas por alimentos. La infección conocida como salmonelosis se puede manifestar como dos procesos patológicos diferentes, la fiebre tifoidea o la gastroenteritis. El objetivo de esta investigación fue demostrar la presencia de Salmonella spp. en alimentos de venta callejera en un sector universitario delimitado de la ciudad de Bogotá y su posterior caracterización por medio de técnicas de microbiología clínica. Materiales y Métodos. Estudio observacional descriptivo de corte transversal. Se recolectaron 42 muestras de alimentos en ventas callejeras a través de un muestreo no probabilístico. Para el aislamiento y caracterización de Salmonella spp. se realizó el método propuesto por la Food and Drug Administration, empleando pruebas bioquímicas, de serotipificación para Salmonella spp. y realizando la prueba de susceptibilidad antimicrobiana. Resultados. Se detectó crecimiento microbiano en un total de 18 muestras (42,9%), de las cuales solo dos fueron positivas por serotipificación para Salmonella entérica con un 11,1%, 11 de estas 18 muestras fueron positivas para otras bacterias pertenecientes a la familia Enterobacteriaceae (61,1%) y cinco muestras no pudieron ser identificadas (27,8%). Las cepas sometidas a antibiograma fueron susceptibles a Ciprofloxacina, y resistentes al Trimetoprim-Sulfametoxazol, Cloramfenicol y Ampicilina. Conclusiones. Esta investigación permitió identificar la presencia de Salmonella enterica y otras enterobacterias en alimentos de venta callejera, lo cual puede representar un alto riesgo para la salud de los habitantes y la población estudiantil de un sector universitario en Bogotá, Colombia...

Introduction. Salmonella belongs to the Enterobacteriaceae family, and is one of the main microorganisms involved in foodborne disease. It produces a clinical entity known as salmonelosis can manifest as two different pathological processes, typhoid fever or gastroenteritis. The objective of this research was to demonstrate the presence of Salmonella spp. in street-vended foods in an area bounded by Universities in the city of Bogotá and its subsequent characterization by means of clinical microbiology techniques. Materials and Methods. Observational cross sectional study. Was analyze 42 samples of street-vended foods obtained through a non-probability sampling, the isolation of Salmonella spp. was performed following the method proposed by the Food and Drug Administration, performing biochemical identification and serological tests for Salmonella spp. and antimicrobial susceptibility testing. Results. Growth was detected in a total of 18 samples (42.9%), of which only 2 were positive for Salmonella enterica with a 11.1%, 11 out of 18 samples were positive for other bacteria belonging to the family Enterobacteriaceae (61.1%) and 5 samples without profile identified (27.8%). The samples tested were susceptible to ciprofloxacin susceptibility, showing resistance to Trimethoprim-Sulfamethoxazole, Chloramphenicol and Ampicillin. Conclusions. This investigation established the presence of Salmonella enterica and other Enterobacteriaceae in street-vended foods, showing a high risk to the health of residents and student population of a university sector in the city of Bogotá, Colombia...