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1.
J Infect Dis ; 228(12): 1680-1689, 2023 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-37571849

RESUMO

This was a household-based prospective cohort study conducted in Rio de Janeiro, in which people with laboratory-confirmed coronavirus disease 2019 (COVID-19) and their household contacts were followed from April 2020 through June 2022. Ninety-eight reinfections were identified, with 71 (72.5%) confirmed by genomic analyses and lineage definition in both infections. During the pre-Omicron period, 1 dose of any COVID-19 vaccine was associated with a reduced risk of reinfection, but during the Omicron period not even booster vaccines had this effect. Most reinfections were asymptomatic or milder in comparison with primary infections, a justification for continuing active surveillance to detect infections in vaccinated individuals. Our findings demonstrated that vaccination may not prevent infection or reinfection with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Therefore we highlight the need to continuously update the antigenic target of SARS CoV-2 vaccines and administer booster doses to the population regularly, a strategy well established in the development of vaccines for influenza immunization programs.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Prospectivos , Reinfecção/epidemiologia , Vacinas contra COVID-19 , Brasil/epidemiologia
2.
Int J Infect Dis ; 114: 58-61, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34757006

RESUMO

We describe a case of prolonged COVID-19 caused by the SARS-CoV-2 Gamma variant in a fully vaccinated healthcare worker, 387 days after an infection caused by lineage B.1.1.33. Infections were confirmed by whole-genome sequencing and corroborated by the detection of neutralizing antibodies in convalescent serum samples. Considering the permanent exposure of this healthcare worker to SARS-CoV-2, the waning immunity after the first infection, the low efficacy of the inactivated vaccine at preventing COVID-19, the immune escape of the Gamma variant (VOC), and the burden of post-COVID syndrome, this individual would have benefited from an additional dose of a heterologous vaccine.


Assuntos
COVID-19 , SARS-CoV-2 , Brasil , COVID-19/complicações , COVID-19/terapia , Humanos , Imunização Passiva , Reinfecção , Vacinas de Produtos Inativados , Soroterapia para COVID-19 , Síndrome Pós-COVID-19 Aguda
3.
PLoS One ; 15(12): e0242367, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33320867

RESUMO

BACKGROUND: The signs and symptoms of Zika virus infection are usually mild and self-limited. However, the disease has been linked to neurological complications such as Guillain-Barré syndrome and peripheral nerve involvement, and also to abortion and fetal deaths due to vertical transmission, resulting in various congenital malformations in newborns, including microcephaly. This review aimed to describe the o signs and symptoms that characterize the congenital Zika syndrome. METHODS AND FINDINGS: A systematic review was performed with a protocol and described according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The search strategy yielded 2,048 studies. After the exclusion of duplicates and application of inclusion criteria, 46 studies were included. The main signs and symptoms associated with the congenital Zika syndrome were microcephaly, parenchymal or cerebellar calcifications, ventriculomegaly, central nervous system hypoplasia or atrophy, arthrogryposis, ocular findings in the posterior and anterior segments, abnormal visual function and low birthweight for gestational age. CONCLUSIONS: Zika virus infection during pregnancy can cause a series of changes in the growth and development of children, while impacting the healthcare system due to the severity of cases. Our findings outline the disease profile in newborns and infants and may contribute to the development and updating of more specific clinical protocols.


Assuntos
Síndrome de Guillain-Barré/diagnóstico , Transmissão Vertical de Doenças Infecciosas , Malformações do Sistema Nervoso/diagnóstico , Complicações Infecciosas na Gravidez/virologia , Infecção por Zika virus/transmissão , Desenvolvimento Infantil/fisiologia , Feminino , Síndrome de Guillain-Barré/virologia , Humanos , Lactente , Recém-Nascido , Malformações do Sistema Nervoso/fisiopatologia , Malformações do Sistema Nervoso/virologia , Gravidez , Síndrome , Zika virus/patogenicidade , Infecção por Zika virus/complicações , Infecção por Zika virus/congênito , Infecção por Zika virus/virologia
4.
Braz J Infect Dis ; 24(2): 180-187, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32330437

RESUMO

The accuracy of commercially available tests for COVID-19 in Brazil remains unclear. We aimed to perform a meta-analysis to describe the accuracy of available tests to detect COVID-19 in Brazil. We searched at the Brazilian Health Regulatory Agency (ANVISA) online platform to describe the pooled sensitivity (Se), specificity (Sp), diagnostic odds ratio (DOR) and summary receiver operating characteristic curves (SROC) for detection of IgM/IgG antibodies and for tests using naso/oropharyngeal swabs in the random-effects models. We identified 16 tests registered, mostly rapid-tests. Pooled diagnostic accuracy measures [95%CI] were: (i) for IgM antibodies Se=82% [76-87]; Sp=97% [96-98]; DOR=168 [92-305] and SROC=0.98 [0.96-0.99]; (ii) for IgG antibodies Se=97% [90-99]; Sp=98% [97-99]; DOR=1994 [385-10334] and SROC=0.99 [0.98-1.00]; and (iii) for detection of SARS-CoV-2 by antigen or molecular assays in naso/oropharyngeal swabs Se=97% [85-99]; Sp=99% [77-100]; DOR=2649 [30-233056] and SROC=0.99 [0.98-1.00]. These tests can be helpful for emergency testing during the COVID-19 pandemic in Brazil. However, it is important to highlight the high rate of false negative results from tests which detect SARS-CoV-2 IgM antibodies in the initial course of the disease and the scarce evidence-based validation results published in Brazil. Future studies addressing the diagnostic performance of tests for COVID-19 in the Brazilian population are urgently needed.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico/normas , Infecções por Coronavirus/diagnóstico , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Pneumonia Viral/diagnóstico , Betacoronavirus/isolamento & purificação , Brasil/epidemiologia , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Humanos , Modelos Logísticos , Nasofaringe/virologia , Razão de Chances , Orofaringe/virologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Curva ROC , SARS-CoV-2 , Sensibilidade e Especificidade
5.
Braz. j. infect. dis ; 24(2): 180-187, Mar.-Apr. 2020. tab, graf
Artigo em Inglês | LILACS, Coleciona SUS | ID: biblio-1132429

RESUMO

ABSTRACT The accuracy of commercially available tests for COVID-19 in Brazil remains unclear. We aimed to perform a meta-analysis to describe the accuracy of available tests to detect COVID-19 in Brazil. We searched at the Brazilian Health Regulatory Agency (ANVISA) online platform to describe the pooled sensitivity (Se), specificity (Sp), diagnostic odds ratio (DOR) and summary receiver operating characteristic curves (SROC) for detection of IgM/IgG antibodies and for tests using naso/oropharyngeal swabs in the random-effects models. We identified 16 tests registered, mostly rapid-tests. Pooled diagnostic accuracy measures [95%CI] were: (i) for IgM antibodies Se = 82% [76-87]; Sp = 97% [96-98]; DOR = 168 [92-305] and SROC = 0.98 [0.96-0.99]; (ii) for IgG antibodies Se = 97% [90-99]; Sp = 98% [97-99]; DOR = 1994 [385-10334] and SROC = 0.99 [0.98-1.00]; and (iii) for detection of SARS-CoV-2 by antigen or molecular assays in naso/oropharyngeal swabs Se = 97% [85-99]; Sp = 99% [77-100]; DOR = 2649 [30-233056] and SROC = 0.99 [0.98-1.00]. These tests can be helpful for emergency testing during the COVID-19 pandemic in Brazil. However, it is important to highlight the high rate of false negative results from tests which detect SARS-CoV-2 IgM antibodies in the initial course of the disease and the scarce evidence-based validation results published in Brazil. Future studies addressing the diagnostic performance of tests for COVID-19 in the Brazilian population are urgently needed.


Assuntos
Humanos , Pneumonia Viral/diagnóstico , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Infecções por Coronavirus/diagnóstico , Técnicas de Laboratório Clínico/normas , Betacoronavirus/imunologia , Anticorpos Antivirais/sangue , Orofaringe/virologia , Pneumonia Viral/imunologia , Pneumonia Viral/epidemiologia , Brasil/epidemiologia , Modelos Logísticos , Razão de Chances , Nasofaringe/virologia , Curva ROC , Sensibilidade e Especificidade , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/epidemiologia , Técnicas de Laboratório Clínico/métodos , Pandemias , Betacoronavirus/isolamento & purificação , Teste para COVID-19 , SARS-CoV-2 , COVID-19
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