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1.
J Med Virol ; 94(7): 3147-3154, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35261064

RESUMO

Vaccines against COVID-19 provide immunity to deter severe morbidities associated with the infection. However, it does not prevent infection altogether in all exposed individuals. Furthermore, emerging variants of SARS-CoV-2 impose a threat concerning the competency of the vaccines in combating the infection. This study aims to determine the variability in adverse events and the extent of breakthrough infections in the Indian population. A retrospective study was conducted using a pre-validated questionnaire encompassing social, demographic, general health, the status of SARS-CoV-2 infection, vaccination, associated adverse events, and breakthrough infections in the Indian population. Informed consent and ethical approval were obtained as per Indian Council of Medical Research (ICMR) guidelines. Participants, who provided the complete information, were Indian citizens, above 18 years, and if vaccinated, administered with either Covishield or Covaxin, were considered for the study. Data have been compiled in Microsoft Excel and analyzed for statistical differences using STATA 11. The responses from 2051 individuals fulfilling the inclusion criteria were analyzed. Among 2051, 1119 respondents were vaccinated and 932 respondents were non-vaccinated. Among 1119 vaccinated respondents, 7 were excluded because of missing data. Therefore, out of 1112 vaccinated, 413 experienced adverse events with a major fraction of younger individuals, age 18-40 years, getting affected (74.82%; 309/413). Furthermore, considerably more females than males encountered adverse consequences to vaccination (p < 0.05). Among vaccinated participants, breakthrough infections were observed in 7.91% (88/1112; 57.96% males and 42.04% females) with the older age group, 61 years and above (odds ratio, 3.25 [1.32-8.03]; p = 0.011), and males were found to be at higher risk. Further research is needed to find the age and sex-related factors in determining vaccine effectiveness and adverse events.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Vacinas , Adolescente , Adulto , COVID-19/epidemiologia , COVID-19/etiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Vacinas contra COVID-19/uso terapêutico , ChAdOx1 nCoV-19/efeitos adversos , ChAdOx1 nCoV-19/uso terapêutico , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , SARS-CoV-2 , Vacinação/efeitos adversos , Vacinas/efeitos adversos , Vacinas/uso terapêutico , Adulto Jovem
2.
PLoS One ; 17(3): e0264805, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35239712

RESUMO

INTRODUCTION: Unlike previous pandemics, COVID-19 has sustained over a relatively longer period with cyclical infection waves and numerous variants. Public transport ridership has been hit particularly hard. To restore travellers' confidence it is critical to assess their risk determinants and trade-offs. METHODS: To this end, we survey train travellers in the Netherlands in order to: (i) quantify the impact of trip-specific, policy-based, and pandemic-related attributes on travellers' COVID-19 risk perceptions; and (ii) evaluate the trade-off between this risk perception and other travel attributes. Adopting the hierarchical information integration approach, in a two-stage stated preference experiment, respondents are asked to first rate how risky they perceive different travel situations to be, and then to choose between different travel options that include their own perceived risk rating as an attribute. Perceived risk ratings and choices between travel options are modelled using a linear regression and a mixed multinomial logit model, respectively. RESULTS: We find that on-board crowding and infection rates are the most important factors for risk perception. Amongst personal characteristics, the vulnerability of family and friends has the largest impact-nearly twice that of personal health risk. The bridging choice experiment reveals that while values of time have remained similar to pre-pandemic estimates, travellers are significantly more likely to choose routes with less COVID-19 risk (e.g., due to lower crowding). Respondents making longer trips by train value risk four times as much as their shorter trip counterparts. By combining the two models, we also report willingness to pay for mitigating factors: reduced crowding, mask mandates, and increased sanitization. CONCLUSION: Since we evaluate the impact of a large number of variables on route choice behaviour, we can use the estimated models to predict behaviour under detailed pandemic scenarios. Moreover, in addition to highlighting the importance of COVID-19 risk perceptions in public transport route choices, the results from this study provide valuable information regarding the mitigating impacts of various policies on perceived risk.


Assuntos
COVID-19 , Comportamento de Escolha/fisiologia , Percepção/fisiologia , Meios de Transporte/métodos , Viagem/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/etiologia , COVID-19/transmissão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Medição de Risco , Fatores de Risco , Assunção de Riscos , SARS-CoV-2 , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
3.
PLoS One ; 17(3): e0264752, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35239718

RESUMO

INTRODUCTION: This highly contagious zoonotic corona virus (SARS-CoV-2) spread to most parts of the world (200 countries) and created a public health emergency. Due to its novel nature and indistinctness, different sources of information and suggestions were developed to guide the individuals about its transmission and prevent its infection. Responses to the active intervention efforts have posed some relevant questions on population understanding and attitudes toward COVID-19. The present study is aims to assess the COVID-19 related knowledge, attitude, and practices (KAP) in a heterogeneous Indian population. MATERIAL AND METHODS: 501 respondents across India participated in a questionnaire-based online survey from April 2020 to May 2020. The questionnaire incorporated 56 questions about demographic characteristics and KAP dimensions. The mixed (quantitative and qualitative) methods were employed to evaluate KAP dimensions. Descriptive analysis was estimated as means, SD, and proportion. The bivariate (χ2), correlation, and regression analysis were utilized for the response analysis. In addition, qualitative analysis, including content and thematic analysis were done for open-ended questions. RESULT: High knowledge and positive attitude were reported in more than half of the study population, with a proportion of 58.6% and 62.1%, respectively. Education shows a significant difference in the knowledge and attitude dimensions. The good practice (50.5% of the total population) reported a significant difference in age and gender categories with the test of independence (χ2). Prevention (56.89%) in knowledge domain and risk (17.56%), information-seeking (45.51%), prevention (51.50%), and treatment-seeking (54.29%) in attitude domains recorded low proportion. KAP variables were found in association in Pearson correlation analysis. In logistic regression analysis, knowledge was the strongest predictor for the positive attitude, whereas attitude was reported as the best predictor for good practice outcome. CONCLUSION: The study presents a moderate level of covid related knowledge, Attitudes, and Practices in Indian population.


Assuntos
COVID-19 , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/etiologia , COVID-19/terapia , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Internet , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
4.
Elife ; 112022 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-35318939

RESUMO

The SARS-CoV-2 pandemic continues to rage around the world. At the same time, despite strong public health measures and high vaccination rates in some countries, a post-COVID-19 syndrome has emerged which lacks a clear definition, prevalence, or etiology. However, fatigue, dyspnea, brain fog, and lack of smell and/or taste are often characteristic of patients with this syndrome. These are evident more than a month after infection, and are labeled as Post-Acute Sequelae of CoV-2 (PASC) or commonly referred to as long-COVID. Metabolic dysfunction (i.e., obesity, insulin resistance, and diabetes mellitus) is a predisposing risk factor for severe acute COVID-19, and there is emerging evidence that this factor plus a chronic inflammatory state may predispose to PASC. In this article, we explore the potential pathogenic metabolic mechanisms that could underly both severe acute COVID-19 and PASC, and then consider how these might be targeted for future therapeutic approaches.


Assuntos
COVID-19/complicações , Suscetibilidade a Doenças , Metabolismo Energético , COVID-19/epidemiologia , COVID-19/etiologia , COVID-19/metabolismo , COVID-19/terapia , Diabetes Mellitus Tipo 2 , Gerenciamento Clínico , Glucose/metabolismo , Intolerância à Glucose , Humanos , Resistência à Insulina , Ilhotas Pancreáticas/metabolismo , Fígado/metabolismo , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Síndrome Metabólica/metabolismo , Síndrome Metabólica/terapia , Medição de Risco , Fatores de Risco , Linfócitos T/imunologia , Linfócitos T/metabolismo
5.
Rev Assoc Med Bras (1992) ; 68(2): 206-211, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35239883

RESUMO

OBJECTIVE: A multicentric, cross-sectional study was carried out to determine the prevalence and risk factors for Coronavirus disease 2019 in medical students and residents from four universities and affiliated hospitals in Brazil. METHODS: A survey about contamination risk and symptoms was sent to all participants through email and WhatsApp. Prevalence was measured by the self-report of positive polymerase chain reaction or serological test. Univariate and multivariate analyses were performed, and odds ratio and 95% confidence interval were calculated. RESULTS: Prevalence of infection by Sars-CoV-2 was 14.9% (151/1011). The disease was more prevalent in residents and interns than in undergraduate students. Contact with an infected relative outside the hospital or with colleagues without using personal protective equipment was associated with higher contamination. Contact with patients without wearing goggles and higher weekly frequency of contact were the two factors independently associated with the infection by Coronavirus disease 2019 in the multivariate analysis. CONCLUSIONS: Medical students, interns, and residents have a higher prevalence of Coronavirus disease 2019 than the general population, in which the last two groups are significantly at higher risk. Contacting patients at a higher weekly frequency increases the risk for infection. The use of goggles should be reinforced when contacting patients.


Assuntos
COVID-19 , Internato e Residência , Estudantes de Medicina , Centros Médicos Acadêmicos/estatística & dados numéricos , Brasil/epidemiologia , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/etiologia , COVID-19/prevenção & controle , Estudos Transversais , Humanos , Internato e Residência/estatística & dados numéricos , Equipamento de Proteção Individual , Prevalência , Fatores de Risco , SARS-CoV-2 , Faculdades de Medicina/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários
7.
Dan Med J ; 69(4)2022 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-35319451

RESUMO

INTRODUCTION: We aimed to evaluate post-COVID-19 fatigue, change in functional capacity and health-related quality of life (HRQoL) eight months after discharge from hospital due to COVID-19. METHODS: A total of 83 patients (35 women) admitted to the Copenhagen University Hospital - North Zealand Hospital, Denmark, for COVID-19 during the period from March to June 2020 were evaluated eight months after discharge using validated questionnaires quantifying fatigue, HRQoL and post-COVID-19 functional status. Follow-up data were correlated with measures of pre-COVID-19 status (anthropometrics, comorbidities) and measures of severity of the acute infection. RESULTS: A total of 22 (65%) women and 12 (26%) men reported excessive fatigue. In all, 20 women (67%) and 17 men (37%) reported decreased physical function. Female sex was associated with fatigue. Loss of physical function was associated with pre-COVID-19 presence of heart disease and absence of lung disease. Severity of the acute COVID-19 infection was not associated with fatigue or change in functional status. Fatigue and functional status were correlated with both generic HRQoL and lung disease-specific HRQoL. CONCLUSIONS: Female sex was associated with a higher risk of fatigue eight months after hospitalisation with COVID-19 infection. Regarding loss of functional capacity after COVID-19, we found an apparently protective effect of pre-COVID-19 lung disease. Our findings underscore the urgent need for further research and the importance of evaluating those recovering from COVID-19 for symptoms of excessive fatigue and change in functional capacity irrespective of the severity of the initial infection. FUNDING: none. TRIAL REGISTRATION: not relevant.


Assuntos
COVID-19/complicações , Fadiga , Qualidade de Vida , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/etiologia , Comorbidade , Fadiga/diagnóstico , Fadiga/epidemiologia , Fadiga/etiologia , Feminino , Hospitalização , Humanos , Masculino , Desempenho Físico Funcional , Recuperação de Função Fisiológica , Fatores de Risco , SARS-CoV-2 , Perfil de Impacto da Doença
9.
PLoS One ; 17(3): e0264964, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35298500

RESUMO

INTRODUCTION: We performed a longitudinal SARS-CoV-2 seroepidemiological study in healthcare personnel of the two largest tertiary COVID-19 referral hospitals in Mexico City. METHODS: All healthcare personnel, including staff physicians, physicians in training, nurses, laboratory technicians, researchers, students, housekeeping, maintenance, security, and administrative staff were invited to voluntarily participate, after written informed consent. Participants answered a computer-assisted self-administered interview and donated blood samples for antibody testing every three weeks from October 2020 to June 2021. RESULTS: A total of 883 participants (out of 3639 registered employees) contributed with at least one blood sample. The median age was 36 years (interquartile range: 28-46) and 70% were women. The most common occupations were nurse (28%), physician (24%), and administrative staff (22%). Two hundred and ninety participants (32.8%) had a positive-test result in any of the visits, yielding an overall adjusted prevalence of 33.5% for the whole study-period. Two hundred and thirty-five positive tests were identified at the baseline visit (prevalent cases), the remaining 55 positive tests were incident cases. Prevalent cases showed associations with both occupational (institution 2 vs. 1: adjusted odds ratio [aOR] = 2.24, 95% confidence interval [CI]: 1.54-3.25; laboratory technician vs. physician: aOR = 4.38, 95% CI: 1.75-10.93) and community (municipality of residence Xochimilco vs. Tlalpan: aOR = 2.03, 95% CI: 1.09-3.79) risk-factors. The incidence rate was 3.0 cases per 100 person-months. Incident cases were associated with community-acquired risk, due to contact with suspect/confirmed COVID-19 cases (HR = 2.45, 95% CI: 1.21-5.00). CONCLUSIONS: We observed that between October 2020 and June 2021, healthcare workers of the two largest tertiary COVID-19 referral centers in Mexico City had similar level of exposure to SARS-CoV-2 than the general population. Most variables associated with exposure in this setting pointed toward community rather than occupational risk. Our observations are consistent with successful occupational medicine programs for SARS-CoV-2 infection control in the participating institutions but suggest the need to strengthen mitigation strategies in the community.


Assuntos
COVID-19/epidemiologia , Recursos Humanos em Hospital/estatística & dados numéricos , SARS-CoV-2 , Centros de Atenção Terciária/estatística & dados numéricos , Adulto , COVID-19/diagnóstico , COVID-19/etiologia , Teste Sorológico para COVID-19/estatística & dados numéricos , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Estudos Soroepidemiológicos
10.
PLoS One ; 17(3): e0264785, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35298502

RESUMO

The variability of clinical course and prognosis of COVID-19 highlights the necessity of patient sub-group risk stratification based on clinical data. In this study, clinical data from a cohort of Indian COVID-19 hospitalized patients is used to develop risk stratification and mortality prediction models. We analyzed a set of 70 clinical parameters including physiological and hematological for developing machine learning models to identify biomarkers. We also compared the Indian and Wuhan cohort, and analyzed the role of steroids. A bootstrap averaged ensemble of Bayesian networks was also learned to construct an explainable model for discovering actionable influences on mortality and days to outcome. We discovered blood parameters, diabetes, co-morbidity and SpO2 levels as important risk stratification features, whereas mortality prediction is dependent only on blood parameters. XGboost and logistic regression model yielded the best performance on risk stratification and mortality prediction, respectively (AUC score 0.83, AUC score 0.92). Blood coagulation parameters (ferritin, D-Dimer and INR), immune and inflammation parameters IL6, LDH and Neutrophil (%) are common features for both risk and mortality prediction. Compared with Wuhan patients, Indian patients with extreme blood parameters indicated higher survival rate. Analyses of medications suggest that a higher proportion of survivors and mild patients who were administered steroids had extreme neutrophil and lymphocyte percentages. The ensemble averaged Bayesian network structure revealed serum ferritin to be the most important predictor for mortality and Vitamin D to influence severity independent of days to outcome. The findings are important for effective triage during strains on healthcare infrastructure.


Assuntos
COVID-19/mortalidade , Hospitalização/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , COVID-19/epidemiologia , COVID-19/etiologia , Criança , China/epidemiologia , Feminino , Humanos , Índia/epidemiologia , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Medição de Risco/métodos , Fatores de Risco , Adulto Jovem
11.
PLoS One ; 17(3): e0265686, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35320821

RESUMO

Olfactory and gustatory disorders are prominent symptoms of acute COVID-19. Although both senses recover in many patients within weeks to months, persistency has been described in up to 60%. However up to now most reports on the course of chemosensitive disorders after COVID-19 are not based on psychophysical testing but only on subjective patients' ratings. In this study we assessed both olfaction and gustation using psychophysical tests eight months after COVID-19. Validated psychophysical testing revealed hyposmia in 18% and hypogeusia in even 32% of 303 included patients. This shows that olfactory and especially gustatory disorders have to be seen as important chronic symptoms post-COVID-19. The high prevalence of gustatory dysfunction indicates that gustatory function does not recover or might even deteriorate in the months following the acute infection.


Assuntos
COVID-19/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos do Olfato/etiologia , Paladar , COVID-19/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/diagnóstico , Inquéritos e Questionários , Limiar Gustativo
12.
Biochem J ; 479(5): 609-628, 2022 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-35244141

RESUMO

Two years after the emergence of SARS-CoV-2, our understanding of COVID-19 disease pathogenesis is still incomplete. Despite unprecedented global collaborative scientific efforts and rapid vaccine development, an uneven vaccine roll-out and the emergence of novel variants of concern such as omicron underscore the critical importance of identifying the mechanisms that contribute to this disease. Overt inflammation and cell death have been proposed to be central drivers of severe pathology in COVID-19 patients and their pathways and molecular components therefore present promising targets for host-directed therapeutics. In our review, we summarize the current knowledge on the role and impact of diverse programmed cell death (PCD) pathways on COVID-19 disease. We dissect the complex connection of cell death and inflammatory signaling at the cellular and molecular level and identify a number of critical questions that remain to be addressed. We provide rationale for targeting of cell death as potential COVID-19 treatment and provide an overview of current therapeutics that could potentially enter clinical trials in the near future.


Assuntos
COVID-19/etiologia , COVID-19/patologia , Antivirais , Apoptose/efeitos dos fármacos , Apoptose/fisiologia , COVID-19/tratamento farmacológico , Humanos , Inflamassomos/fisiologia , Interferons/metabolismo , Necroptose/fisiologia , Neutrófilos/patologia , Neutrófilos/virologia , Piroptose/fisiologia , SARS-CoV-2/patogenicidade
13.
Indoor Air ; 32(3): e13012, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35347787

RESUMO

In this study, the risk of infection from SARS-CoV-2 Delta variant of passengers sharing a car cabin with an infected subject for a 30-min journey is estimated through an integrated approach combining a recently developed predictive emission-to-risk approach and a validated CFD numerical model numerically solved using the open-source OpenFOAM software. Different scenarios were investigated to evaluate the effect of the infected subject position within the car cabin, the airflow rate of the HVAC system, the HVAC ventilation mode, and the expiratory activity (breathing vs. speaking). The numerical simulations here performed reveal that the risk of infection is strongly influenced by several key parameters: As an example, under the same ventilation mode and emitting scenario, the risk of infection ranges from zero to roughly 50% as a function of the HVAC flow rate. The results obtained also demonstrate that (i) simplified zero-dimensional approaches limit proper evaluation of the risk in such confined spaces, conversely, (ii) CFD approaches are needed to investigate the complex fluid dynamics in similar indoor environments, and, thus, (iii) the risk of infection in indoor environments characterized by fixed seats can be in principle controlled by properly designing the flow patterns of the environment.


Assuntos
COVID-19 , Automóveis , COVID-19/etiologia , Simulação por Computador , Humanos , Hidrodinâmica , SARS-CoV-2
14.
Sci Rep ; 12(1): 1891, 2022 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-35115602

RESUMO

The COVID-19 pandemic has produced broad clinical manifestations, from asymptomatic infection to hospitalization and death. Despite progress from genomic and clinical epidemiology research, risk factors for developing severe COVID-19 are incompletely understood and identification of modifiable risk factors is desperately needed. We conducted linkage disequilibrium score regression (LDSR) analysis to estimate cross-trait genetic correlation between COVID-19 severity and various polygenic phenotypes. To attenuate the genetic contribution of smoking and BMI, we further conducted sensitivity analyses by pruning genomic regions associated with smoking/BMI and repeating LDSR analyses. We identified robust positive associations between the genetic architecture of severe COVID-19 and both BMI and smoking. We observed strong positive genetic correlation (rg) with diabetes (rg = 0.25) and shortness of breath walking on level ground (rg = 0.28) and novel protective associations with vitamin E (rg = - 0.53), calcium (rg = - 0.33), retinol (rg = - 0.59), Apolipoprotein A (rg = - 0.13), and HDL (rg = - 0.17), but no association with vitamin D (rg = - 0.02). Removing genomic regions associated with smoking and BMI generally attenuated the associations, but the associations with nutrient biomarkers persisted. This study provides a comprehensive assessment of the shared genetic architecture of COVID-19 severity and numerous clinical/physiologic parameters. Associations with blood and plasma-derived traits identified biomarkers for Mendelian randomization studies to explore causality and nominates therapeutic targets for clinical evaluation.


Assuntos
COVID-19/genética , Estudo de Associação Genômica Ampla , Desequilíbrio de Ligação/genética , Índice de Massa Corporal , COVID-19/etiologia , Diabetes Mellitus/genética , Dispneia/genética , Feminino , Humanos , Masculino , Análise da Randomização Mendeliana , Herança Multifatorial , Nutrientes , Gravidade do Paciente , Fenótipo , Análise de Regressão , Fatores de Risco , Fumar/genética
15.
Int J Mol Sci ; 23(4)2022 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-35216286

RESUMO

Several diseases (such as diabetes, cancer, and neurodegenerative disorders) affect the morpho-functional aspects of red blood cells, sometimes altering their normal metabolism. In this review, the hematological changes are evaluated, with particular focus on the morphology and metabolic aspects of erythrocytes. Changes in the functionality of such cells may, in fact, help provide important information about disease severity and progression. The viral infection causes significant damage to the blood cells that are altered in size, rigidity, and distribution width. Lower levels of hemoglobin and anemia have been reported in several studies, and an alteration in the concentration of antioxidant enzymes has been shown to promote a dangerous state of oxidative stress in red blood cells. Patients with severe COVID-19 showed an increase in hematological changes, indicating a progressive worsening as COVID-19 severity progressed. Therefore, monitored hematological alterations in patients with COVID-19 may play an important role in the management of the disease and prevent the risk of a severe course of the disease. Finally, monitored changes in erythrocytes and blood, in general, may be one of the causes of the condition known as Long COVID.


Assuntos
COVID-19/sangue , COVID-19/dietoterapia , Eritrócitos/virologia , Anemia/virologia , Antivirais/farmacologia , COVID-19/complicações , COVID-19/etiologia , COVID-19/metabolismo , Eritrócitos/metabolismo , Eritrócitos/patologia , Hemoglobinas/metabolismo , Hemólise , Humanos , Estresse Oxidativo
16.
Int J Mol Sci ; 23(4)2022 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-35216349

RESUMO

Tuberculosis is still an important medical and social problem. In recent years, great strides have been made in the fight against M. tuberculosis, especially in the Russian Federation. However, the emergence of a new coronavirus infection (COVID-19) has led to the long-term isolation of the population on the one hand and to the relevance of using personal protective equipment on the other. Our knowledge regarding SARS-CoV-2-induced inflammation and tissue destruction is rapidly expanding, while our understanding of the pathology of human pulmonary tuberculosis gained through more the 100 years of research is still limited. This paper reviews the main molecular and cellular differences and similarities caused by M. tuberculosis and SARS-CoV-2 infections, as well as their critical immunological and pathomorphological features. Immune suppression caused by the SARS-CoV-2 virus may result in certain difficulties in the diagnosis and treatment of tuberculosis. Furthermore, long-term lymphopenia, hyperinflammation, lung tissue injury and imbalance in CD4+ T cell subsets associated with COVID-19 could propagate M. tuberculosis infection and disease progression.


Assuntos
COVID-19/etiologia , Tuberculose/diagnóstico , Tuberculose/etiologia , COVID-19/imunologia , Coinfecção , Interações Hospedeiro-Patógeno , Humanos , Inflamação/microbiologia , Inflamação/patologia , Inflamação/virologia , Linfopenia/microbiologia , Linfopenia/virologia , Mycobacterium tuberculosis/patogenicidade , SARS-CoV-2/patogenicidade
17.
Viruses ; 14(2)2022 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-35215930

RESUMO

Background: Healthcare workers (HCWs) are particularly exposed to biological risk, including SARS-CoV-2 infection. In order to contrast the current pandemic and alleviate the burden of the disease on the healthcare system, a mass vaccination campaign against COVID-19 has been launched worldwide. Aim To evaluate the impact of COVID-19 vaccination in HCWs exposed to SARS-CoV-2, to describe the clinical presentation of COVID-19 in infected HCWs, and to investigate clinical and occupational risk factors for breakthrough infection. Design: Retrospective cohort study. Methods: The cohort of HCWs of Trieste Hospitals were followed up from 1 March 2020, to 30 November 2021 (21 months). All HCWs were periodically screened for SARS-CoV-2 infection by real-time PCR (RT-PCR) analysis. Clinical data were obtained through routine medical surveillance records. Risk factors for SARS-CoV-2 infection were investigated by univariable as well as multivariable logistic regression analysis. Results: Among 4394 HCWs routinely screened for SARS-CoV-2 by PCR on nasopharyngeal swab, a total of 800 incident cases were identified during the entire study period (1 March 2020 to 30 November 2021). Five hundred and sixty-four cases occurred before, and 236 after the start of the vaccination campaign against COVID-19, of whom 155 received a complete vaccination scheme before SARS-CoV-2 infection. Breakthrough infection was featured by mild or no symptoms and was significantly associated with the male sex, BMI > 25, and diabetes mellitus. Some categories of HCWs (physicians and nurse aids/auxiliary personnel) were at a higher risk of breakthrough infection. Conclusions: Fully vaccinated HCWs were less likely to acquire symptomatic as well as asymptomatic SARS-CoV-2 infection. Risk factors for SARS-CoV-2 infection after a full COVID-19 vaccination scheme included the male gender, diabetes mellitus, and overweight. HCWs with higher exposure to COVID-19 patients were at higher risk of breakthrough infection.


Assuntos
/imunologia , COVID-19/epidemiologia , COVID-19/etiologia , Pessoal de Saúde/estatística & dados numéricos , Hospitais de Ensino/estatística & dados numéricos , Adulto , COVID-19/imunologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2/genética , SARS-CoV-2/imunologia , Fatores Sexuais , Vacinação
18.
Säo Paulo med. j ; 140(1): 12-16, Jan.-Feb. 2022. tab
Artigo em Inglês | LILACS | ID: biblio-1357469

RESUMO

ABSTRACT BACKGROUND: Coronavirus disease 2019 (COVID-19) is an ongoing global health threat. However, currently, no standard therapy has been approved for the disease. OBJECTIVES: To evaluate the clinical effectiveness of convalescent plasma (CP) in patients with acute respiratory distress syndrome (ARDS) due to COVID-19. DESIGN AND SETTING: Retrospective study conducted at Kayseri City Education and Research Hospital, Kayseri, Turkey. METHODS: The case group consisted of adult patients (> 18 years) with ARDS due to COVID-19 who received CP in combination with antiviral and supportive treatment. These patients were compared with others who only received antiviral and supportive treatment. RESULTS: During the study period, a total of 30 patients with ARDS due to COVID-19 were included. Eleven patients (36%) received CP in combination with antiviral and supportive treatment, whereas nineteen patients (64%) in the control group only received antiviral and supportive treatment. On admission, the median age, demographic and clinical data and initial laboratory test results were similar between the groups (P > 0.05). On the 14th day of treatment, the laboratory values remained similar between the groups (P > 0.05). The mortality rates were not significantly different between the groups. CONCLUSION: CP treatment did not affect mortality or lead to clinical improvement for COVID-19 patients with ARDS.


Assuntos
Humanos , Adulto , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , COVID-19/etiologia , Estudos Retrospectivos , Imunização Passiva , SARS-CoV-2
20.
J Korean Med Sci ; 37(8): e65, 2022 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-35226423

RESUMO

BACKGROUND: Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2) are key proteins mediating viral entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although gene expressions of ACE2 and TMPRSS2 have been analyzed in various organs and diseases, their soluble forms have been less studied, particularly in asthma. Therefore, we aimed to measure circulating ACE2 and TMPRSS2 in the serum of asthmatics and examine their relationship with clinical characteristics. METHODS: Clinical data and serum samples of 400 participants were obtained from an asthma cohort. The soluble ACE2 (sACE2) and soluble TMPRSS2 (sTMPRSS2) level was measured by enzyme-linked immunosorbent assay, and the values underwent a natural log transformation. Associations between sACE2 and TMPRSS2 levels and various clinical variables were analyzed. RESULTS: The patients younger than 70 years old, those with eosinophilic asthma (eosinophils ≥ 200 cells/µL), and inhaled corticosteroids (ICS) non-users were associated with higher levels of sACE2. Blood eosinophils and fractionated exhaled nitric oxide levels were positively correlated with serum ACE2. In contrast, lower levels of sTMPRSS2 were noted in patients below 70 years and those with eosinophilic asthma, while no association was noted between ICS use and sTMPRSS2. The level of sTMPRSS2 also differed according to sex, smoking history, coexisting hypertension, and forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio. The proportion of sputum neutrophils was positively correlated with sTMPRSS2, while the FEV1/FVC ratio reported a negative correlation with sTMPRSS2. CONCLUSION: The levels of ACE2 and TMPRSS2 were differently expressed according to age, ICS use, and several inflammatory markers. These findings suggest variable susceptibility and prognosis of SARS-CoV-2 infection among asthmatic patients.


Assuntos
Enzima de Conversão de Angiotensina 2/sangue , Asma/complicações , COVID-19/etiologia , SARS-CoV-2 , Serina Endopeptidases/sangue , Corticosteroides/uso terapêutico , Adulto , Fatores Etários , Idoso , Asma/sangue , Asma/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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