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1.
Biosens Bioelectron ; 169: 112643, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33007615

RESUMO

Detection of antibodies to upper respiratory pathogens is critical to surveillance, assessment of the immune status of individuals, vaccine development, and basic biology. The urgent need for antibody detection tools has proven particularly acute in the COVID-19 era. We report a multiplex label-free antigen microarray on the Arrayed Imaging Reflectometry (AIR) platform for detection of antibodies to SARS-CoV-2, SARS-CoV-1, MERS, three circulating coronavirus strains (HKU1, 229E, OC43) and three strains of influenza. We find that the array is readily able to distinguish uninfected from convalescent COVID-19 subjects, and provides quantitative information about total Ig, as well as IgG- and IgM-specific responses.


Assuntos
Anticorpos Antivirais/sangue , Infecções por Coronavirus/sangue , Coronavirus/isolamento & purificação , Vírus da Influenza A/isolamento & purificação , Influenza Humana/sangue , Pneumonia Viral/sangue , Betacoronavirus/isolamento & purificação , Técnicas Biossensoriais/instrumentação , Técnicas Biossensoriais/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Desenho de Equipamento , Células HEK293 , Humanos , Influenza Humana/diagnóstico , Influenza Humana/virologia , Coronavírus da Síndrome Respiratória do Oriente Médio/isolamento & purificação , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Análise Serial de Proteínas/instrumentação , Análise Serial de Proteínas/métodos , Vírus da SARS/isolamento & purificação , Sensibilidade e Especificidade
2.
Rev Bras Enferm ; 73(suppl 2): e20200913, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33111784

RESUMO

OBJECTIVE: To evaluate the presence of flu-like syndrome suggestive of COVID-19 in men who have sex with men (MSM) and engaged in casual sex during a period of social isolation. METHOD: National epidemiological survey, applied in April and May 2020, by adaptation of Respondent Drive Sampling. RESULTS: 1,337 MSM participated in the survey, of which 514 (38.4%) had fever associated with another sign or symptom of flu-like syndrome. Social, demographic characteristics, sexual practices and activities during the period of social isolation were statistically associated with the presence of flu-like syndrome. There was a statistical difference (p < 0.001) in the average of partners between those who had signs and symptoms of flu-like syndrome (3.5) and those who did not (1.7). CONCLUSION: Evidence of signs and symptoms indicative of flu-like syndrome suggestive of COVID 19 in Brazilian MSM who were involved in casual sex during the period of social isolation.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Homossexualidade Masculina , Pneumonia Viral/diagnóstico , Minorias Sexuais e de Gênero , Avaliação de Sintomas , Adulto , Brasil , Inquéritos Epidemiológicos , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Influenza Humana/diagnóstico , Masculino , Pessoa de Meia-Idade , Redes Sociais Online , Pandemias , Quarentena , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-33121070

RESUMO

We reviewed the association between seasonal influenza vaccination and the risk of SARS-CoV-2 infection or complicated illness or poor outcome (e.g., severe disease, need for hospitalization or ventilatory support, or death) among COVID-19 patients. None of the studies that were reviewed (n = 12) found a significant increase in the risk of infection or in the illness severity or lethality, and some reported significantly inverse associations. Our findings support measures aimed at raising influenza vaccination coverage in the coming months.


Assuntos
Coinfecção/prevenção & controle , Infecções por Coronavirus , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral , Vacinação/efeitos adversos , Betacoronavirus , Coinfecção/diagnóstico , Coinfecção/epidemiologia , Controle de Doenças Transmissíveis , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Epidemias/prevenção & controle , Humanos , Vacinas contra Influenza/efeitos adversos , Influenza Humana/diagnóstico , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Vacinação/estatística & dados numéricos
4.
J Breath Res ; 15(1): 011001, 2020 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-33089824

RESUMO

Infectious pathogens are a global issue. Global air travel offers an easy and fast opportunity not only for people but also for infectious diseases to spread around the world within a few days. Also, large public events facilitate increasing infection numbers. Therefore, rapid on-site screening for infected people is urgently needed. Due to the small size and easy handling, ion mobility spectrometry coupled with a multicapillary column (MCC-IMS) is a very promising, sensitive method for the on-site identification of infectious pathogens based on scents, representing volatile organic compounds (VOCs). The purpose of this study was to prospectively assess whether identification of Influenza-A-infection based on VOCs by MCC-IMS is possible in breath. Nasal breath was investigated in 24 consecutive persons with and without Influenza-A-infection by MCC-IMS. In 14 Influenza-A-infected patients, infection was proven by PCR of nasopharyngeal swabs. Four healthy staff members and six patients with negative PCR result served as controls. For picking up relevant VOCs in MCC-IMS spectra, software based on cluster analysis followed by multivariate statistical analysis was applied. With only four VOCs canonical discriminant analysis was able to distinguish Influenza-A-infected patients from those not infected with 100% sensitivity and 100% specificity. This present proof-of-concept-study yields encouraging results showing a rapid diagnosis of viral infections in nasal breath within 5 min by MCC-IMS. The next step is to validate the results with a greater number of patients with Influenza-A-infection as well as other viral diseases, especially COVID-19. Registration number at ClinicalTrials.gov NCT04282135.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Vírus da Influenza A/isolamento & purificação , Influenza Humana/diagnóstico , Pneumonia Viral/diagnóstico , Idoso , Testes Respiratórios , Infecções por Coronavirus/complicações , Análise Discriminante , Feminino , Humanos , Influenza Humana/complicações , Espectrometria de Mobilidade Iônica , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Estudos Prospectivos , Sensibilidade e Especificidade
5.
Structure ; 28(10): 1083-1084, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33027689

RESUMO

Monoclonal antibodies are attractive but, in certain applications, limited therapeutic modalities due to their large size and high specificity. In this issue of Structure, Sevy at al. describe a computationally designed cyclic peptide mimicking the CDRH3 loop of the C05 antibody against influenza showing the potential utility of designer biologics.


Assuntos
Influenza Humana , Anticorpos Monoclonais , Fenômenos Biofísicos , Humanos , Influenza Humana/diagnóstico , Peptídeos Cíclicos
6.
JMIR Public Health Surveill ; 6(3): e17242, 2020 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-32909955

RESUMO

BACKGROUND: A better understanding of the influenza epidemiology among primary care workers could guide future recommendations to prevent transmission in primary care practices. Therefore, we designed a pilot study to assess the feasibility of using a work-based online influenza surveillance system among primary care workers. Such an approach is of particular relevance in the context of the coronavirus disease (COVID-19) pandemic, as its findings could apply to other infectious diseases with similar mechanisms of transmission. OBJECTIVE: This study aims to determine the feasibility of using a work-based online influenza surveillance system for primary care workers in Switzerland. METHODS: Physicians and staff of one walk-in clinic and two selected primary care practices were enrolled in this observational prospective pilot study during the 2017-2018 influenza season. They were invited to record symptoms of influenza-like illness in a weekly online survey sent by email and to self-collect a nasopharyngeal swab in case any symptoms were recorded. Samples were tested by real-time polymerase chain reaction for influenza A, influenza B, and a panel of respiratory pathogens. RESULTS: Among 67 eligible staff members, 58% (n=39) consented to the study and 53% (n=36) provided data. From the time all participants were included, the weekly survey response rate stayed close to 100% until the end of the study. Of 79 symptomatic episodes (mean 2.2 episodes per participant), 10 episodes in 7 participants fitted the definition of an influenza-like illness case (attack rate: 7/36, 19%). One swab tested positive for influenza A H1N1 (attack rate: 3%, 95% CI 0%-18%). Swabbing was considered relatively easy. CONCLUSIONS: A work-based online influenza surveillance system is feasible for use among primary care workers. This promising methodology could be broadly used in future studies to improve the understanding of influenza epidemiology and other diseases such as COVID-19. This could prove to be highly useful in primary care settings and guide future recommendations to prevent transmission. A larger study will also help to assess asymptomatic infections.


Assuntos
Pessoal de Saúde , Influenza Humana/epidemiologia , Programas de Rastreamento/métodos , Sistemas On-Line , Vigilância da População/métodos , Atenção Primária à Saúde , Adulto , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Estudos de Viabilidade , Feminino , Inquéritos Epidemiológicos , Humanos , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/diagnóstico , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Pandemias , Projetos Piloto , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Prevalência , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Suíça
7.
BMC Infect Dis ; 20(1): 679, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32948121

RESUMO

BACKGROUND: Since December 2019, the coronavirus disease 2019 (COVID-19) has infected more than 12,322,000 people and killed over 556,000 people worldwide. However, Differential diagnosis remains difficult for suspected cases of COVID-19 and need to be improved to reduce misdiagnosis. METHODS: Sixty-eight cases of suspected COVID-19 treated in Wenzhou Central Hospital from January 21 to February 20, 2020 were divided into confirmed and COVID-19-negative groups based on the results of real-time reverse transcriptase polymerase chain reaction (RT-PCR) nucleic acid testing of the novel coronavirus in throat swab specimens to compare the clinical symptoms and laboratory and imaging results between the groups. RESULTS: Among suspected patients, 17 were confirmed to COVID-19-positive group and 51 were distinguished to COVID-19-negative group. Patients with reduced white blood cell (WBC) count were more common in the COVID-19-positive group than in the COVID-19-negative group (29.4% vs 3.9%, P = 0.003). Subsequently, correlation analysis indicated that there was a significant inverse correlation existed between WBC count and temperature in the COVID-19-positive patients (r = - 0.587, P = 0.003), instead of the COVID-19-negative group. But reduced lymphocyte count was no different between the two groups (47.1% vs 25.5%, P = 0.096). More common chest imaging characteristics of the confirmed COVID-19 cases by high-resolution computed tomography (HRCT) included ground-glass opacities (GGOs), multiple patchy shadows, and consolidation with bilateral involvement than COVID-19-negative group (82.4% vs 31.4%, P = 0.0002; 41.2% vs 17.6% vs P = 0.048; 76.5% vs 43.1%, P = 0.017; respectively). The rate of clustered infection was higher in COVID-19-positive group than COVID-19-negative group (64.7% vs 7.8%, P = 0.001). Through multiplex PCR nucleic acid testing, 2 cases of influenza A, 3 cases of influenza B, 2 cases of adenovirus, 2 cases of Chlamydia pneumonia, and 7 cases of Mycoplasma pneumoniae were diagnosed in the COVID-19-negative group. CONCLUSIONS: WBC count inversely correlated with the severity of fever, GGOs, multiple patchy shadows, and consolidation in chest HRCT and clustered infection are common but not specific features in the confirmed COVID-19 group. Multiplex PCR nucleic acid testing helped differential diagnosis for suspected COVID-19 cases.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Adulto , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Diagnóstico Diferencial , Feminino , Febre/diagnóstico , Humanos , Influenza Humana/diagnóstico , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia , Pneumonia Viral/virologia , Radiografia Torácica , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
8.
BMC Med Inform Decis Mak ; 20(1): 247, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993652

RESUMO

BACKGROUND: The recent Coronavirus Disease 2019 (COVID-19) pandemic has placed severe stress on healthcare systems worldwide, which is amplified by the critical shortage of COVID-19 tests. METHODS: In this study, we propose to generate a more accurate diagnosis model of COVID-19 based on patient symptoms and routine test results by applying machine learning to reanalyzing COVID-19 data from 151 published studies. We aim to investigate correlations between clinical variables, cluster COVID-19 patients into subtypes, and generate a computational classification model for discriminating between COVID-19 patients and influenza patients based on clinical variables alone. RESULTS: We discovered several novel associations between clinical variables, including correlations between being male and having higher levels of serum lymphocytes and neutrophils. We found that COVID-19 patients could be clustered into subtypes based on serum levels of immune cells, gender, and reported symptoms. Finally, we trained an XGBoost model to achieve a sensitivity of 92.5% and a specificity of 97.9% in discriminating COVID-19 patients from influenza patients. CONCLUSIONS: We demonstrated that computational methods trained on large clinical datasets could yield ever more accurate COVID-19 diagnostic models to mitigate the impact of lack of testing. We also presented previously unknown COVID-19 clinical variable correlations and clinical subgroups.


Assuntos
Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Influenza Humana/diagnóstico , Aprendizado de Máquina , Pneumonia Viral/diagnóstico , Betacoronavirus , Simulação por Computador , Infecções por Coronavirus/classificação , Conjuntos de Dados como Assunto , Diagnóstico Diferencial , Feminino , Humanos , Vírus da Influenza A , Masculino , Pandemias/classificação , Pneumonia Viral/classificação , Sensibilidade e Especificidade
9.
Eur J Immunol ; 50(10): 1447-1453, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32886952

RESUMO

The COVID-19 pandemic caused by the zoonotic coronavirus, SARS-CoV-2 has swept the world in 5 months. A proportion of cases develop severe respiratory tract infections progressing to acute respiratory distress syndrome and a diverse set of complications involving different organ systems. Faced with a lack of coronavirus-specific antiviral drugs and vaccines, hundreds of clinical trials have been undertaken to evaluate repurposed drugs. Convalescent plasma from recovered patients is an attractive option because antibodies can have direct or indirect antiviral activity and immunotherapy works well in principle, in animal models, and in anecdotal reports. However, the benefits of convalescent plasma treatment can only be clearly established through carefully designed randomized clinical trials. The experience from investigations of convalescent plasma products for severe influenza offers a cautionary tale. Despite promising pilot studies, large multicenter randomized controlled trials failed to show a benefit of convalescent plasma or hyperimmune intravenous globulin for the treatment of severe influenza A virus infection. These studies provide important lessons that should inform the planning of adequately powered randomized controlled trials to evaluate the promise of convalescent plasma therapy in COVID-19 patients.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/terapia , Vírus da Influenza A/patogenicidade , Influenza Humana/terapia , Pandemias , Pneumonia Viral/terapia , Betacoronavirus/imunologia , Biomarcadores/análise , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Progressão da Doença , Humanos , Imunização Passiva/métodos , Vírus da Influenza A/imunologia , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Influenza Humana/imunologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Índice de Gravidade de Doença , Resultado do Tratamento
10.
PLoS One ; 15(9): e0239258, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32961548

RESUMO

BACKGROUND: Viral infections in children and adolescents with malignancy are commonly encountered and have a significant impact on morbidity and mortality. Studies and epidemiological data regarding viral infections in children with cancer in developing countries are lacking. This retrospective cohort study aims to assess the burden of viral infections in children and adolescents with cancer, by assessing prevalence, risk factors, as well as morbidity and mortality of common viruses over a period of 8 years. METHODS AND FINDINGS: Medical records of cancer patients treated at the Children Cancer Center of Lebanon were reviewed and 155 participants under the age of 21 were identified with at least one documented viral infection during the period from July 2009 to November 2017. This subset included 136 participants with active malignancy and 19 participants with a history of cancer who underwent hematopoietic stem cell transplantation [HSCT] and were in remission; the latter group was analyzed separately. Information regarding participant characteristics, hospital course, and complications were obtained. Associations between viral infections and certain factors were assessed. In the cohort, 64% were male, 81% were Lebanese. In participants with active malignancy, 90% received chemotherapy in the 6 months preceding the viral infection episode, 11% received radiotherapy. 51% of participants were neutropenic at the time of viral detection, and 77% were lymphopenic. 17% experienced a bacterial co-infection, and 3 experienced a viral co-infection. Among 162 viral infection episodes, clinically diagnosed skin infections, mainly herpes simplex virus type 1 and varicella-zoster virus, were the most common [44% of cases]. These were followed by laboratory-proven systemic herpes infections: cytomegalovirus [14%] and Epstein-Barr virus [6%]. Respiratory viruses: influenza and respiratory syncytial virus, accounted for 9% and 4%, respectively, whereas rotavirus represented 11% and BK virus represented 3% of cases. Acute lymphocytic leukemia was the most prevalent neoplasia [57%]. Fever was the most common presenting symptom [55%] and febrile neutropenia was the reason for admission in 24% of cases. The mean length of stay was significantly longer in participants with cytomegalovirus infections and significantly lower in rotavirus infection. Admission to the ICU occurred in 9%, complications in 8%, and mortality in 5%. Participants with viral infections post-HSCT were noted to have a significantly longer length of hospital stay compared to non-HSCT participants, with no other significant differences in clinical course and outcome. The study was limited by its retrospective nature and by the late introduction and underuse of multiplex PCR panels, which may have led to underdiagnosis of viral infections. CONCLUSIONS: Viral infections were prevalent in our sample of cancer patients and may have contributed to morbidity and mortality. Newly available viral diagnostics are likely to vastly increase the number and scope of detectable viral infections in this population. Prospective studies using multiplex PCR technology with systematic testing of patients will be more helpful in defining the burden of viral infections. Furthermore, efforts at antimicrobial stewardship would benefit from the identification of viral causes of infection and limit the unnecessary use of antibiotics in the pediatric cancer population.


Assuntos
Infecções por Citomegalovirus/epidemiologia , Influenza Humana/epidemiologia , Neoplasias/epidemiologia , Infecções Respiratórias/epidemiologia , Adolescente , Criança , Criança Hospitalizada , Pré-Escolar , Coinfecção/complicações , Coinfecção/diagnóstico , Coinfecção/virologia , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/virologia , Feminino , Transplante de Células-Tronco Hematopoéticas , Hospitais , Humanos , Lactente , Influenza Humana/complicações , Influenza Humana/diagnóstico , Influenza Humana/virologia , Líbano/epidemiologia , Reação em Cadeia da Polimerase Multiplex/métodos , Neoplasias/complicações , Neoplasias/diagnóstico , Neoplasias/virologia , Pediatria , Vírus Sincicial Respiratório Humano/genética , Vírus Sincicial Respiratório Humano/isolamento & purificação , Vírus Sincicial Respiratório Humano/patogenicidade , Infecções Respiratórias/complicações , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/virologia , Estudos Retrospectivos , Infecções por Rotavirus/complicações , Infecções por Rotavirus/diagnóstico , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/patologia
11.
PLoS One ; 15(9): e0238615, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915821

RESUMO

Influenza, which is an acute respiratory disease caused by the influenza virus, represents a worldwide public health and economic problem owing to the significant morbidity and mortality caused by its seasonal epidemics and pandemics. Sensitive and convenient methodologies for the detection of influenza viruses are important for clinical care and infection control as well as epidemiological investigations. Here, we developed a multiplex reverse transcription loop-mediated isothermal amplification (RT-LAMP) with quencher/fluorescence oligonucleotides connected by a 5' backward loop (LF or LB) primer for the detection of two subtypes of influenza viruses: Influenza A (A/H1 and A/H3) and influenza B. The detection limits of the multiplex RT-LAMP assay were 103 copies and 102 copies of RNA for influenza A and influenza B, respectively. The sensitivities of the multiplex influenza A/B/IC RT-LAMP assay were 94.62% and 97.50% for influenza A and influenza B clinical samples, respectively. The specificities of the multiplex influenza A/B/IC RT-LAMP assay were 100% for influenza A, influenza B, and healthy clinical samples. In addition, the multiplex influenza A/B/IC RT-LAMP assay had no cross-reactivity with other respiratory viruses.


Assuntos
Influenza Humana/diagnóstico , Técnicas de Diagnóstico Molecular , Infecções por Orthomyxoviridae/diagnóstico , Orthomyxoviridae/isolamento & purificação , Animais , Epidemias , Humanos , Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Vírus da Influenza B/genética , Vírus da Influenza B/isolamento & purificação , Influenza Humana/genética , Influenza Humana/virologia , Influenzavirus C/genética , Influenzavirus C/isolamento & purificação , Orthomyxoviridae/genética , Orthomyxoviridae/patogenicidade , Infecções por Orthomyxoviridae/epidemiologia , Infecções por Orthomyxoviridae/virologia , Pandemias
12.
PLoS One ; 15(8): e0236866, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760080

RESUMO

INTRODUCTION: Influenza may precipitate cardiovascular disease, but influenza typically peaks in winter, coinciding with other triggers of myocardial infarction (MI) such as low air temperature, high wind velocity, low atmospheric pressure, and short sunshine duration. OBJECTIVE: We aimed to determine the relationship of week-to-week variation in influenza cases and acute MI, controlling for meteorological factors in a nationwide population. METHODS: Weekly laboratory-confirmed influenza case reports were obtained from the Public Health Agency of Sweden from 2009 to 2016 and merged with the nationwide SWEDEHEART MI registry. Weekly incidence of MI was studied with regard to number of influenza cases stratified into tertiles of 0-16, 17-164, and >164 cases/week. Incidence rate ratios (IRR) were calculated using a count regression model for each category and compared to a non-influenza period as reference, controlling for air temperature, atmospheric pressure, wind velocity, and sunshine duration. RESULTS: A total of 133562 MI events was reported to the registry during the study period. Weeks with influenza cases were associated with higher incidence of MI than those without in unadjusted analysis for overall MI, ST-elevation MI and non ST-elevation MI independently. During the influenza season, weeks with 0-16 reported cases/week were not associated with MI incidence after adjusting for weather parameters, adjusted IRR for MI was 1.03 (95% CI 1.00-1.06, P = 0.09). However, weeks with more cases reported were associated with MI incidence: 17-163 reported cases/week, adjusted IRR = 1.05 (95% CI 1.02-1.08, P = 0.003); and for ≥164 cases/week, the IRR = 1.06 (95% CI 1.02-1.09, P = 0.002). Results were consistent across a large range of subgroups. CONCLUSIONS: In this nationwide observational study, we found an association of incidence of MI with incidence of influenza cases beyond what could be explained by meteorological factors.


Assuntos
Influenza Humana/diagnóstico , Infarto do Miocárdio/diagnóstico , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Humanos , Incidência , Influenza Humana/complicações , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/epidemiologia , Sistema de Registros , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Suécia/epidemiologia
13.
PLoS One ; 15(8): e0237214, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764788

RESUMO

INTRODUCTION: Every winter, emergency departments (EDs) face overcrowding with patients presenting influenza-like symptoms, and organisational issues such as single room assignment and droplet precautions to avoid hospital-acquired influenza. Our main objective was to assess the impact of PCR results and patient's severity on single room assignment. METHODS: All patients admitted to Bichat-Claude Bernard Hospital through the ED and tested for influenza by PCR (GenXpert, Cepheid) or (FilmArray, BioMérieux) on a nasopharyngeal swab were retrospectively included during three influenza seasons (2015-2018. RESULTS: Of 1,330 included patients, 278 (20.9%) had a positive PCR for influenza. The median time to obtain a PCR result was 19 hours, and 238 (18.3%) patients were assigned a single room. Among patients with positive and negative influenza PCR, 22.3% and 16.7% were assigned a single room (p = 0.03). The multivariable analysis was performed on the two first epidemic periods, excluding the third epidemic because of the concomitant use of influenza immune-chromatic test. Only level 1 of the Emergency severity index (ESI) (aOR, 1.9; 95% CI, 1.3-2.8; p < 0.01) was associated with single-room assignment. PCR result was not statistically associated with the decision of single room assignment (aOR, 1.4; 95%CI, 1.0-1.4; p = 0.07). CONCLUSION: A PCR positive for influenza was not significantly associated with single-room assignment. Less than one quarter of influenza patients were adequately assigned a single room, likely due to the long turnaround time of PCR result and other conflicting indications for single room-assignment. Accelerating biological diagnosis could improve single-room assignment.


Assuntos
Serviço Hospitalar de Emergência/organização & administração , Vírus da Influenza A/isolamento & purificação , Influenza Humana/diagnóstico , Influenzavirus B/isolamento & purificação , Idoso , Idoso de 80 Anos ou mais , Testes Diagnósticos de Rotina , Feminino , Humanos , Vírus da Influenza A/genética , Influenza Humana/epidemiologia , Influenzavirus B/genética , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Estudos Retrospectivos
14.
BMC Infect Dis ; 20(1): 630, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32842978

RESUMO

BACKGROUND: Avian influenza A (H7N9) virus was first reported in mainland China in 2013, and alarming in 2016-17 due to the surge across a wide geographic area. Our study aimed to identify and explore the spatial and temporal variation across five epidemics to reinforce the epidemic prevention and control. METHODS: We collected spatial and temporal information about all laboratory-confirmed human cases of A (H7N9) virus infection reported in mainland China covering 2013-17 from the open source. The autocorrelation analysis and intensity of cases were used to analyse the spatial cluster while circular distribution method was used to analyse the temporal cluster. RESULTS: Across the five epidemics, a total of 1553 laboratory-confirmed human cases with A (H7N9) virus were reported in mainland China. The global Moran's I index values of five epidemic were 0.610, 0.132, 0.308, 0.306, 0.336 respectively, among which the differences were statistically significant. The highest intensity was present in the Yangtze River Delta region and the Pearl River Delta region, and the range enlarged from the east of China to inner provinces and even the west of China across the five epidemics. The temporal clusters of the five epidemics were statistically significant, and the peak period was from the end of January to April with the first and the fifth epidemic later than the mean peak period. CONCLUSIONS: Spatial and temporal clusters of avian influenza A (H7N9) virus in humans are obvious, moreover the regions existing clusters may enlarge across the five epidemics. Yangtze River Delta region and the Pearl River Delta region have the spatial cluster and the peak period is from January to April. The government should facilitate the tangible improvement for the epidemic preparedness according to the characteristics of spatial and temporal clusters of patients with avian influenza A (H7N9) virus.


Assuntos
Análise por Conglomerados , Epidemias , Subtipo H7N9 do Vírus da Influenza A , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , China/epidemiologia , Estudos Epidemiológicos , Humanos , Influenza Humana/virologia , Laboratórios , Medição de Risco , Estações do Ano
15.
BMC Infect Dis ; 20(1): 606, 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-32807104

RESUMO

BACKGROUND: Infections due to Respiratory Syncytial Virus (RSV) and Influenza virus (FLU) are leading causes of hospitalization in young children. Yet, there is little data on factors associated with antibiotic use in these patients. METHODS: We conducted a retrospective, single-center study of all patients below 2 years of age hospitalized between 2014 and 2018. We compared children with RSV infection to children with FLU infection analyzing clinical characteristics and factors contributing to an increased rate of antimicrobial utilization. RESULTS: RSV infection was diagnosed in 476/573 (83.1%), FLU in 95/573 (16.6%), and RSV-FLU-co-infection in 2/573 (0.3%) patients. Median age was lower for RSV compared to FLU (4 vs. 12 months; p < 0.0001). Children with RSV had longer hospitalization (5 vs. 4 days; p = 0.0023) and needed oxygen more frequently (314/476 vs. 23/95; p < 0.0001) than FLU patients. There was no significant difference in the overall antibiotic utilization between RSV and FLU patients (136/476 vs. 21/95; p = 0.2107). Logistic regression analyses revealed that septic appearance on admission (odds ratio [OR] 8.95, 95% confidence interval [CI] 1.5-54.1), acute otitis media (OR 4.5, 95% CI 2.1-9.4), a longer oxygen therapy (OR 1.40; 95% CI 1.13-1.74) and a higher C-reactive protein (CRP) (OR 1.7, 95% CI 1.5-2.0) were significantly associated with antibiotic use in both groups, but not age or pneumonia. CONCLUSIONS: In our cohort, the rate of antibiotic utilization was comparable between RSV and FLU patients, while for both groups distinct clinical presentation and a high CRP value were associated with higher antibiotic use.


Assuntos
Antibacterianos/uso terapêutico , Influenza Humana/diagnóstico , Infecções por Vírus Respiratório Sincicial/diagnóstico , Proteína C-Reativa/análise , Coinfecção/diagnóstico , Feminino , Humanos , Oxigenação Hiperbárica , Lactente , Influenza Humana/tratamento farmacológico , Influenza Humana/virologia , Tempo de Internação , Modelos Logísticos , Masculino , Razão de Chances , Infecções por Vírus Respiratório Sincicial/tratamento farmacológico , Infecções por Vírus Respiratório Sincicial/virologia , Estudos Retrospectivos , Fatores de Risco
16.
Nat Hum Behav ; 4(8): 856-865, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32737472

RESUMO

The first case of COVID-19 was detected in Brazil on 25 February 2020. We report and contextualize epidemiological, demographic and clinical findings for COVID-19 cases during the first 3 months of the epidemic. By 31 May 2020, 514,200 COVID-19 cases, including 29,314 deaths, had been reported in 75.3% (4,196 of 5,570) of municipalities across all five administrative regions of Brazil. The R0 value for Brazil was estimated at 3.1 (95% Bayesian credible interval = 2.4-5.5), with a higher median but overlapping credible intervals compared with some other seriously affected countries. A positive association between higher per-capita income and COVID-19 diagnosis was identified. Furthermore, the severe acute respiratory infection cases with unknown aetiology were associated with lower per-capita income. Co-circulation of six respiratory viruses was detected but at very low levels. These findings provide a comprehensive description of the ongoing COVID-19 epidemic in Brazil and may help to guide subsequent measures to control virus transmission.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Transmissão de Doença Infecciosa , Influenza Humana , Pandemias , Pneumonia Viral , Adulto , Idoso , Brasil/epidemiologia , Criança , Técnicas de Laboratório Clínico/métodos , Técnicas de Laboratório Clínico/estatística & dados numéricos , Coinfecção/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Transmissão de Doença Infecciosa/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Influenza Humana/virologia , Masculino , Mortalidade , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Pneumonia Viral/transmissão , Fatores Socioeconômicos
17.
Am J Disaster Med ; 15(2): 99-111, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804390

RESUMO

OBJECTIVE: Identify operational lessons to support hospital and health system preparedness and response for sea-sonal and pandemic influenza based on firsthand experiences from the 2017-2018 influenza season. DESIGN: We conducted semistructured, retrospective interviews with New York City Health+Hospitals (NYCH+H) personnel to gather firsthand experiences from the 2017-2018 influenza season and evaluated stress data across four operational domains reported by NYCH+H hospitals during the 2017-2018 influenza season. SETTING: Frontline hospitals in the NYCH+H health system during and after the 2017-2018 influenza season. PARTICIPANTS: Interviews conducted with personnel from 5 NYCH+H frontline hospitals. Operational stress data re-ported by 11 NYCH+H hospitals during the 2017-2018 influenza season. MAIN OUTCOME MEASURES: Operational challenges and lessons from frontline hospitals responding to severe sea-sonal influenza. RESULTS: Operational stresses during the 2017-2018 influenza season varied over the influenza season, between facilities, and across operational domains. Patient surge and staff absenteeism pushed some facilities to their limits, and supply shortages highlighted shortcomings in existing procurement systems. Resources tied to pandemic influ-enza were unavailable without a pandemic declaration. CONCLUSION: Seasonal influenza poses dynamic operational stresses across health systems and cities, potentially causing major impacts outside of declared pandemics. Lessons from NYCH+H can help other hospitals and health systems anticipate operational challenges, but novel solutions are needed to mitigate effects of patient surge and per-sonnel and supply shortages during severe influenza seasons and pandemics. Improved data collection can help health systems better understand operational stresses and challenges across their facilities.


Assuntos
Assistência à Saúde/organização & administração , Pessoal de Saúde/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Influenza Humana , Pacientes/estatística & dados numéricos , Absenteísmo , Pessoal de Saúde/psicologia , Planejamento em Saúde/organização & administração , Administração Hospitalar , Humanos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Entrevistas como Assunto , Cidade de Nova Iorque/epidemiologia , Pandemias , Estudos Retrospectivos , Estações do Ano
19.
Adv Clin Exp Med ; 29(8): 971-977, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32790248

RESUMO

BACKGROUND: The influenza A virus is the most important human pathogen affecting respiratory tract in children and has been prevalent for more than a century. OBJECTIVES: To describe epidemiological and clinical features in hospitalized children with acute respiratory infection caused by a novel swine-origin influenza virus (S-OIV) and seasonal influenza virus A (IVA). MATERIAL AND METHODS: A total of 1,074 nasopharyngeal aspirate (NPA) samples were collected from children hospitalized with acute respiratory tract infections. The RNAs of S-OIV and seasonal IVA in the samples were examined using real-time polymerase chain reaction (RT-PCR). RESULTS: The presence of IVA was detected in 105 samples (9.8%), including S-OIV in 15 samples (1.4%) and seasonal IVA in the remaining samples (8.4%). The incidence of both viral infections was lower in autumn and winter. The rates of severe pneumonia in patients with S-OIV and seasonal IVA were 6.7% and 15.6%, respectively. In total, 14 out of 90 seasonal IVA-positive cases were categorized as severe pneumonia and 1 out of 15 S-OIV-positive cases as severe bronchiolitis. Five samples were found to have single S-OIV infection among 15 S-OIV-positive cases, while other respiratory viruses were detected in the other 9 samples. Twenty-one samples were found to be single seasonal-IVA-positive among the 90 seasonal-IVA-positive cases. Underlying heart conditions (odds ratio (OR) = 13.60), wheezing (OR = 6.82) and co-infection with adenovirus (OR = 6.21) were risk factors for developing severe pneumonia in seasonal IVA patients. CONCLUSIONS: Children younger than 2 years appeared to be susceptible to both kinds of viral infection. Diagnoses of non-severe respiratory tract infection were mainly made for patients with S-OIV and IVA infection. Underlying heart conditions, wheezing and co-infection with adenovirus increase the risk of developing severe pneumonia in seasonal IVA patients.


Assuntos
Vírus da Influenza A Subtipo H1N1 , Influenza Humana , Infecções Respiratórias , Criança , Humanos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Infecções por Orthomyxoviridae , Fatores de Risco , Estações do Ano
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