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1.
Biosens Bioelectron ; 171: 112679, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33069957

RESUMO

The 2019 SARS CoV-2 (COVID-19) pandemic has illustrated the need for rapid and accurate diagnostic tests. In this work, a multiplexed grating-coupled fluorescent plasmonics (GC-FP) biosensor platform was used to rapidly and accurately measure antibodies against COVID-19 in human blood serum and dried blood spot samples. The GC-FP platform measures antibody-antigen binding interactions for multiple targets in a single sample, and has 100% selectivity and sensitivity (n = 23) when measuring serum IgG levels against three COVID-19 antigens (spike S1, spike S1S2, and the nucleocapsid protein). The GC-FP platform yielded a quantitative, linear response for serum samples diluted to as low as 1:1600 dilution. Test results were highly correlated with two commercial COVID-19 antibody tests, including an enzyme linked immunosorbent assay (ELISA) and a Luminex-based microsphere immunoassay. To demonstrate test efficacy with other sample matrices, dried blood spot samples (n = 63) were obtained and evaluated with GC-FP, yielding 100% selectivity and 86.7% sensitivity for diagnosing prior COVID-19 infection. The test was also evaluated for detection of multiple immunoglobulin isotypes, with successful detection of IgM, IgG and IgA antibody-antigen interactions. Last, a machine learning approach was developed to accurately score patient samples for prior COVID-19 infection, using antibody binding data for all three COVID-19 antigens used in the test.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas Biossensoriais/instrumentação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/sangue , Pneumonia Viral/sangue , Anticorpos Antivirais/imunologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/imunologia , Teste em Amostras de Sangue Seco , Desenho de Equipamento , Fluorescência , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Dispositivos Lab-On-A-Chip , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/imunologia , Sensibilidade e Especificidade
2.
Biosens Bioelectron ; 171: 112709, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33075724

RESUMO

Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was classified as a pandemic by the World Health Organization and has caused over 550,000 deaths worldwide as of July 2020. Accurate and scalable point-of-care devices would increase screening, diagnosis, and monitoring of COVID-19 patients. Here, we demonstrate rapid label-free electrochemical detection of SARS-CoV-2 antibodies using a commercially available impedance sensing platform. A 16-well plate containing sensing electrodes was pre-coated with receptor binding domain (RBD) of SARS-CoV-2 spike protein, and subsequently tested with samples of anti-SARS-CoV-2 monoclonal antibody CR3022 (0.1 µg/ml, 1.0 µg/ml, 10 µg/ml). Subsequent blinded testing was performed on six serum specimens taken from COVID-19 and non-COVID-19 patients (1:100 dilution factor). The platform was able to differentiate spikes in impedance measurements from a negative control (1% milk solution) for all CR3022 samples. Further, successful differentiation and detection of all positive clinical samples from negative control was achieved. Measured impedance values were consistent when compared to standard ELISA test results showing a strong correlation between them (R2=0.9). Detection occurs in less than five minutes and the well-based platform provides a simplified and familiar testing interface that can be readily adaptable for use in clinical settings.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas Biossensoriais/instrumentação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/sangue , Espectroscopia Dielétrica/instrumentação , Pneumonia Viral/sangue , Anticorpos Antivirais/imunologia , Técnicas Biossensoriais/economia , Técnicas de Laboratório Clínico/economia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/economia , Infecções por Coronavirus/imunologia , Espectroscopia Dielétrica/economia , Impedância Elétrica , Desenho de Equipamento , Humanos , Proteínas Imobilizadas/imunologia , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/imunologia , Sensibilidade e Especificidade , Glicoproteína da Espícula de Coronavírus/imunologia , Fatores de Tempo
3.
Gene ; 766: 145145, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-32941953

RESUMO

COVID-19, a novel coronavirus-related illness, has spread worldwide. Patients with apparently mild/moderate symptoms can suddenly develop severe pneumonia. Therefore, almost all COVID-19 patients require hospitalization, which can reduce limited medical resources in addition to overwhelming medical facilities. To identify predictive markers for the development of severe pneumonia, a comprehensive analysis of serum chemokines and cytokines was conducted using serial serum samples from COVID-19 patients. The expression profiles were analyzed along the time axis. Serum samples of common diseases were enrolled from a BioBank to confirm the usefulness of predictive markers. Five factors, IFN-λ3, IL-6, IP-10, CXCL9, and CCL17, were identified as predicting the onset of severe/critical symptoms. The factors were classified into two categories. Category A included IFN-λ3, IL-6, IP-10, and CXCL9, and their values surged and decreased rapidly before the onset of severe pneumonia. Category B included CCL17, which provided complete separation between the mild/moderate and the severe/critical groups at an early phase of SARS-CoV-2 infection. The five markers provided a high predictive value (area under the receiver operating characteristic curve (AUROC): 0.9-1.0, p < 0.001). Low expression of CCL17 was specifically observed in pre-severe COVID-19 patients compared with other common diseases, and the predictive ability of CCL17 was confirmed in validation samples of COVID-19. The factors identified could be promising prognostic markers to distinguish between mild/moderate and severe/critical patients, enabling triage at an early phase of infection, thus avoiding overwhelming medical facilities.


Assuntos
Biomarcadores/sangue , Quimiocina CCL17/sangue , Infecções por Coronavirus/sangue , Infecções por Coronavirus/fisiopatologia , Pneumonia Viral/sangue , Pneumonia Viral/fisiopatologia , Betacoronavirus/fisiologia , Citocinas/sangue , Hospitalização , Humanos , Pandemias , Índice de Gravidade de Doença
4.
Ann Med ; 53(1): 103-116, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33063540

RESUMO

BACKGROUND: Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19. METHODS: This is a retrospective multi-centre study involving patients hospitalized in Spain. Patients were categorized into three groups according to admission BG levels: <140 mg/dL, 140-180 mg/dL and >180 mg/dL. The primary endpoint was all-cause in-hospital mortality. RESULTS: Of the 11,312 patients, only 2128 (18.9%) had diabetes and 2289 (20.4%) died during hospitalization. The in-hospital mortality rates were 15.7% (<140 mg/dL), 33.7% (140-180 mg) and 41.1% (>180 mg/dL), p<.001. The cumulative probability of mortality was significantly higher in patients with hyperglycaemia compared to patients with normoglycaemia (log rank, p<.001), independently of pre-existing diabetes. Hyperglycaemia (after adjusting for age, diabetes, hypertension and other confounding factors) was an independent risk factor of mortality (BG >180 mg/dL: HR 1.50; 95% confidence interval (CI): 1.31-1.73) (BG 140-180 mg/dL; HR 1.48; 95%CI: 1.29-1.70). Hyperglycaemia was also associated with requirement for mechanical ventilation, intensive care unit (ICU) admission and mortality. CONCLUSIONS: Admission hyperglycaemia is a strong predictor of all-cause mortality in non-critically hospitalized COVID-19 patients regardless of prior history of diabetes. KEY MESSAGE Admission hyperglycaemia is a stronger and independent risk factor for mortality in COVID-19. Screening for hyperglycaemia, in patients without diabetes, and early treatment of hyperglycaemia should be mandatory in the management of patients hospitalized with COVID-19. Admission hyperglycaemia should not be overlooked in all patients regardless prior history of diabetes.


Assuntos
Infecções por Coronavirus/mortalidade , Hiperglicemia/complicações , Pneumonia Viral/mortalidade , Sistema de Registros , Idoso , Idoso de 80 Anos ou mais , Glicemia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Cuidados Críticos/estatística & dados numéricos , Feminino , Humanos , Hiperglicemia/mortalidade , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Respiração Artificial/estatística & dados numéricos , Espanha/epidemiologia
6.
Biomedica ; 40(Supl. 2): 50-67, 2020 10 30.
Artigo em Espanhol | MEDLINE | ID: mdl-33152188

RESUMO

At the end of 2019, in Wuhan, China, the outbreak of a new coronavirus began and quickly spread throughout the world infecting and claiming thousands of lives. To date, certain comorbidities are known to be risk factors for unsatisfactory disease outcomes, but little has been reported regarding hemodialysis patients despite being a population at high risk of infection, complications, and death. Here we describe the clinical course, clinical manifestations and complications of COVID-19 in seven patients on permanent hemodialysis. We also make recommendations for the management of patients with chronic kidney disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Falência Renal Crônica/complicações , Pneumonia Viral/complicações , Diálise Renal , Adulto , Bacteriemia/complicações , Técnicas de Laboratório Clínico , Colômbia/epidemiologia , Terapia Combinada , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/terapia , Diabetes Mellitus Tipo 2/complicações , Suscetibilidade a Doenças , Feminino , Humanos , Hipertensão/complicações , Falência Renal Crônica/sangue , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Diálise Renal/métodos , Fatores Socioeconômicos , Infecções Estafilocócicas/complicações
7.
Mol Med Rep ; 22(6): 4485-4491, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33173966

RESUMO

In December 2019, an emergence of pneumonia was detected in patients infected with a novel coronavirus (CoV) in Wuhan (Hubei, China). The International Committee on Taxonomy of Viruses named the virus severe acute respiratory syndrome­CoV­2 and the disease CoV disease­19 (COVID­19). Patients with COVID­19 present with symptoms associated with respiratory system dysfunction and hematological changes, including lymphopenia, thrombocytopenia and coagulation disorders. However, to the best of our knowledge, the pathogenesis of COVID­19 remains unclear. Therefore, understanding the mechanisms underlying the hematological changes that manifest during COVID­19 may aid in the development of treatments and may improve patient prognosis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/sangue , Pneumonia Viral/sangue , Anticorpos Antivirais/imunologia , Complexo Antígeno-Anticorpo/imunologia , Antivirais/farmacologia , Antivirais/uso terapêutico , Betacoronavirus/imunologia , Microambiente Celular , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/terapia , Síndrome da Liberação de Citocina/sangue , Síndrome da Liberação de Citocina/etiologia , Síndrome da Liberação de Citocina/prevenção & controle , Citocinas/sangue , Testes Diagnósticos de Rotina , Endotélio Vascular/patologia , Testes Hematológicos , Hematopoese/efeitos dos fármacos , Células-Tronco Hematopoéticas/patologia , Humanos , Hipoalbuminemia/etiologia , Fígado/fisiopatologia , Pulmão/fisiopatologia , Linfopenia/etiologia , Linfopenia/fisiopatologia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/terapia , Traumatismo por Reperfusão/etiologia , Trombocitopenia/etiologia , Trombocitopenia/fisiopatologia , Trombofilia/etiologia
8.
Euro Surveill ; 25(45)2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33183404

RESUMO

We analysed factors associated with neutralising antibody levels in 330 convalescent plasma donors. Women and younger donors were more likely not to have measurable neutralising antibodies, while higher antibody levels were observed in men, in older donors and in those who had been hospitalised. These data will be of value in the timely recruitment of convalescent plasma donors most likely to have high levels of neutralising antibodies for ongoing studies investigating its effectiveness.


Assuntos
Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Doadores de Sangue , Infecções por Coronavirus/sangue , Infecções por Coronavirus/terapia , Hospitalização , Pneumonia Viral/sangue , Pneumonia Viral/terapia , Fatores Etários , Idoso , Anticorpos Neutralizantes/uso terapêutico , Doadores de Sangue/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/imunologia , Inglaterra , Ensaio de Imunoadsorção Enzimática , Humanos , Imunização Passiva , Masculino , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/imunologia , Fatores Sexuais
9.
Clin Nutr ESPEN ; 40: 101-102, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33183520

RESUMO

Systemic inflammation has been reported as a new predictor for COVID-19 outcomes. Thus, we highlight in this viewpoint the importance of the neutrophil to lymphocyte ratio in COVID-19 pandemic-infected patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Linfócitos/citologia , Neutrófilos/citologia , Pneumonia Viral/mortalidade , Biomarcadores , Infecções por Coronavirus/sangue , Estado Terminal , Humanos , Pandemias , Pneumonia Viral/sangue , Prognóstico
10.
Medicine (Baltimore) ; 99(46): e23186, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181697

RESUMO

Coronavirus disease 2019 (COVID-19) has been associated with increased incidence of venous thromboembolic events (VTE) as well as mortality. D-dimer is a marker of fibrinolysis and has been used as a diagnostic and prognostic marker in VTE among other diseases. The purpose of our study is to describe outcomes from out center and to examine trends in D-dimer levels as it relates to VTE and mortality.Patients admitted with confirmed COVID-19 cases to Emory Healthcare from March 12, 2020 through April 6, 2020 with measured plasma D-dimer levels were included in our retrospective analysis. Relevant data about comorbidities, hospitalization course, laboratory results, and outcomes were analyzed.One hundred fifteen patients were included in our study. Mean age was 64 ±â€Š15 years, 47 (41%) females and 84 (73%) African-American. Hypertension was present in 83 (72%) and diabetes in 60 (52%). Mean duration of hospitalization was 19 ±â€Š11 days with 62 (54%) patients intubated (mean duration of 13 ±â€Š8 days). VTE was diagnosed in 27 (23%) patients (mean time to diagnosis 14 ±â€Š9 days). Median D-dimer within the first 7 days of hospitalization was higher (6450 vs. 1596 ng/mL, p < 0.001) in VTE cases compared to non-VTE cases, and was predictive of VTE (area under the curve [AUC] = 0.72, optimal threshold 2500 ng/mL) although not of mortality (AUC 0.55, P = .34). Change in D-dimer level (AUC = 0.72 P = .004) and rate of D-dimer rise (AUC = 0.75 P = .001) were also predictive of VTE, though neither predicted death (P > .05 for all). Within the first 7 days of hospitalization, peak D-dimer level of >2500 ng/mL and a rate of change exceeding 150 ng/mL/d were predictive of future diagnosis of VTE. Rise in D-dimer >2000 ng/mL within any 24 hour period through hospital day 10 had 75% sensitivity and 74% specificity for diagnosis of VTE.We found that both magnitude and rate of rise in d-dimer within the first 10 days of hospitalization are predictive of diagnosis of VTE but not mortality. These parameters may aid in identifying individuals with possible underlying VTE or at high risk for VTE, thereby guiding risk stratification and anticoagulation policies in COVID-19 patients.


Assuntos
Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Tromboembolia Venosa/etiologia , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Biomarcadores , Comorbidade , Feminino , Humanos , Intubação Intratraqueal , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Sensibilidade e Especificidade
11.
Medicine (Baltimore) ; 99(47): e23315, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33217868

RESUMO

Our study aimed to assess the existing evidence on whether severe coronavirus disease 2019 (COVID-19) is associated with elevated inflammatory markers.The PubMed, Embase, Web of Science, Scopus, Chinese National Knowledge Infrastructure, WanFang, and China Science and Technology Journal databases were searched to identify studies published between January 1 and April 21, 2020 that assayed inflammatory markers in COVID-19 patients. Three reviewers independently examined the literature, extracted relevant data, and assessed the risk of publication bias before including the meta-analysis studies.Fifty-six studies involving 8719 COVID-19 patients were identified. Meta-analysis showed that patients with severe disease showed elevated levels of white blood cell count (WMD: 1.15, 95% CI: 0.78-1.52), C-reactive protein (WMD: 38.85, 95% CI: 31.19-46.52), procalcitonin (WMD: 0.08, 95% CI: 0.06-0.11), erythrocyte sedimentation rate (WMD: 10.15, 95% CI: 5.03-15.46), interleukin-6 (WMD: 23.87, 95% CI: 15.95-31.78), and interleukin-10 (WMD: 2.12, 95% CI: 1.97-2.28). Similarly, COVID-19 patients who died during follow-up showed significantly higher levels of white blood cell count (WMD: 4.11, 95% CI: 3.25-4.97), C-reactive protein (WMD: 74.18, 95% CI: 56.63-91.73), procalcitonin (WMD: 0.26, 95% CI: 0.11-0.42), erythrocyte sedimentation rate (WMD: 10.94, 95% CI: 4.79-17.09), and interleukin-6 (WMD: 59.88, 95% CI: 19.46-100.30) than survivors.Severe COVID-19 is associated with higher levels of inflammatory markers than a mild disease, so tracking these markers may allow early identification or even prediction of disease progression.


Assuntos
Betacoronavirus , Biomarcadores/sangue , Infecções por Coronavirus/sangue , Mediadores da Inflamação/sangue , Pneumonia Viral/sangue , Índice de Gravidade de Doença , Adulto , Idoso , Sedimentação Sanguínea , Proteína C-Reativa/análise , Infecções por Coronavirus/mortalidade , Progressão da Doença , Feminino , Humanos , Inflamação , Interleucina-10/sangue , Interleucina-6/sangue , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/mortalidade , Pró-Calcitonina/sangue
12.
Medicine (Baltimore) ; 99(47): e23365, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33217881

RESUMO

Hypercoagulability and thrombosis remain a challenge in severe coronavirus disease 2019 (COVID-19) infections. Our aim is to investigate the hemostatic profile of critically ill COVID-19 patients on therapeutic anticoagulant treatment.Forty one patients were enrolled into the study. We recruited 11 consecutive, COVID-19, patients who received therapeutic anticoagulant treatment on intensive care unit (ICU) admission. Disease severity indexes, biochemical, hematological and haemostatic parameters, endogenous thrombin potential (ETP), plasminogen activator inhibitor-1 (PAI-1) activity and extrinsically activated rotational thromboelastometry assay (EXTEM) were recorded on days 1, 3, 7. We also enrolled 9 ICU non-COVID-19, 21 non-ICU COVID-19 patients and 20 healthy blood donors as control populations.Critically ill COVID-19 patients demonstrated a more hypercoagulable and hypofibrinolytic profile related to those with COVID-19 mild illness, based on EXTEM amplitude at 10 min (A10), maximum clot firmness (MCF) and lysis index at 60 min (LI60) variables (p = 0.020, 0.046 and 0.001, respectively). Similarly, a more hypercoagulable state was detected in COVID-19 ICU patients related to non-COVID-19 ICU patients based on A10 and MCF parameters (p = 0.03 and 0.04, respectively). On the contrary, ETP and EXTEM (clotting time) CT values were similar between patients with severe and mild form of the COVID-19 infection, probably due to anticoagulant treatment given.Critically ill COVID-19 patients showed a hypercoagulable profile despite the therapeutic anticoagulant doses given. Due to the small sample size and the study design, the prognostic role of the hypercoagulability in this clinical setting remains unknown and further research is required in order to be assessed.


Assuntos
Anticoagulantes/farmacologia , Infecções por Coronavirus/sangue , Hemostasia/efeitos dos fármacos , Pneumonia Viral/sangue , Trombofilia/tratamento farmacológico , Trombose/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Testes de Coagulação Sanguínea , Estudos de Casos e Controles , Infecções por Coronavirus/complicações , Infecções por Coronavirus/fisiopatologia , Estado Terminal , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/fisiopatologia , Prognóstico , Índice de Gravidade de Doença , Tromboelastografia , Trombofilia/sangue , Trombofilia/virologia , Trombose/sangue , Trombose/virologia , Resultado do Tratamento
13.
Medicine (Baltimore) ; 99(47): e23392, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33217883

RESUMO

BACKGROUND: The impact of glycosylated hemoglobin on mortality in patients with coronavirus disease 2019 (COVID-19) and type 2 diabetes (T2D) remains uncertain. In this study, we aim to assess the effect of pre-hospital blood glucose regulation on patients with COVID-19 and pre-existing T2D. METHODS: All randomized controlled trials (RCTs) and cohort studies of association of glycosylated hemoglobin and outcomes in patients with COVID-19 and T2D will be included in this review. PubMed, Embase, and CNKI will be searched for relevant literature, up to August 20, 2020 in English and Chinese language. Two reviewers will select trials independently for inclusion and assess trial quality. Two pairs of authors will independently extract information for each included trials. Primary outcomes are death and composite adverse outcomes: the number of participants who died or remained severely disabled. Revman 5.3 will be used for heterogeneity assessment, data synthesis, subgroup analysis, sensitivity analysisa and generating funnel-plots. RESULTS: We will provide practical results about the association of glycosylated hemoglobin and outcomes in patients with COVID-19 and T2D. CONCLUSION: The stronger evidence about the association of glycosylated hemoglobin and outcomes in patients with COVID-19 and T2D will be provided for clinical practice. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020200574. ETHICS AND DISSEMINATION: There is no need for ethical approval, and the review will be reported in a peer-reviewed journal.


Assuntos
Betacoronavirus , Infecções por Coronavirus/sangue , Diabetes Mellitus Tipo 2/sangue , Hemoglobina A Glicada/análise , Pneumonia Viral/sangue , Índice de Gravidade de Doença , Adulto , Idoso , Estudos de Coortes , Infecções por Coronavirus/mortalidade , Diabetes Mellitus Tipo 2/mortalidade , Diabetes Mellitus Tipo 2/virologia , Feminino , Humanos , Masculino , Metanálise como Assunto , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/mortalidade , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
14.
J Immunol ; 205(11): 3130-3140, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33148714

RESUMO

Currently, there is a need for reliable tests that allow identification of individuals that have been infected with SARS-CoV-2 even if the infection was asymptomatic. To date, the vast majority of the serological tests for SARS-CoV-2-specific Abs are based on serum detection of Abs to either the viral spike glycoprotein (the major target for neutralizing Abs) or the viral nucleocapsid protein that is known to be highly immunogenic in other coronaviruses. Conceivably, exposure of Ags released from infected cells could stimulate Ab responses that might correlate with tissue damage and, hence, they may have some value as a prognostic indicator. We addressed whether other nonstructural viral proteins, not incorporated into the infectious viral particle, specifically the viral cysteine-like protease, might also be potent immunogens. Using ELISA tests, coating several SARS-CoV-2 proteins produced in vitro, we describe that COVID-19 patients make high titer IgG, IgM, and IgA Ab responses to the Cys-like protease from SARS-CoV-2, also known as 3CLpro or Mpro, and it can be used to identify individuals with positive serology against the coronavirus. Higher Ab titers in these assays associated with more-severe disease, and no cross-reactive Abs against prior betacoronavirus were found. Remarkably, IgG Abs specific for Mpro and other SARS-CoV-2 Ags can also be detected in saliva. In conclusion, Mpro is a potent Ag in infected patients that can be used in serological tests, and its detection in saliva could be the basis for a rapid, noninvasive test for COVID-19 seropositivity.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/metabolismo , Infecções por Coronavirus/sangue , Cisteína Proteases/metabolismo , Proteínas do Nucleocapsídeo/metabolismo , Pneumonia Viral/sangue , Saliva/metabolismo , Adulto , Idoso , Feminino , Células HEK293 , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias
15.
Biomedica ; 40(Supl. 2): 44-49, 2020 10 30.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33152187

RESUMO

During the SARS COV-2 pandemic, the vast majority of infected patients are showing symptoms related to lung damage. At pediatric ages, especially newborns, symptoms from other organ systems without respiratory illness could make COVID-19 hard to diagnose. We are reporting three cases of newborns who were attended in the course of the mitigation phase in the emergency service of a maternal hospital in Barranquilla, Colombia, for high temperature and general compromised condition. During their clinical course, they developed gastrointestinal symptoms without showing any respiratory manifestations. They were not epidemiologically linked to a contact suspected to be a COVID-19 case and their mothers had had no respiratory symptoms since the public health emergency in our country was declared 45 days before. The absence of clinical respiratory manifestations in this group of patients with COVID-19 should draw clinicians' attention to the need to suspect SARS CoV-2 infection in febrile newborns.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/transmissão , Febre/etiologia , Transmissão Vertical de Doença Infecciosa , Sepse Neonatal/etiologia , Pneumonia Viral/transmissão , Complicações Infecciosas na Gravidez , Adolescente , Adulto , Doenças Assintomáticas , Técnicas de Laboratório Clínico , Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Diagnóstico Diferencial , Diarreia Infantil/etiologia , Serviço Hospitalar de Emergência , Enterocolite Necrosante/diagnóstico , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Humanos , Recém-Nascido , Masculino , Sepse Neonatal/virologia , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/virologia , Migrantes , Adulto Jovem
16.
Biomedica ; 40(Supl. 2): 116-130, 2020 10 30.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33152195

RESUMO

Introduction: Infection with the new SARS-Cov-2 coronavirus is a worldwide public health emergency; its diagnosis is based on molecular tests, while its prognosis depends on the patient's history and on some paraclinical tests. In Colombia, forecasts are not yet counted. Objective: To assess the factors associated with the development of severe disease in hospitalized patients diagnosed with SARS-CoV-2 infection, as well as the prognostic factors for the outcome of mortality. Materials and methods: We conducted an ambispective cohort study in hospitalized patients at the Fundación Cadioinfantil from March to June, 2020. Results: Of the 104 patients analyzed, 31.7% (n=33) had a severe presentation and 9.6% (n=10) had a mortality outcome. For mortality, the most important prognostic factor was the development of severe disease followed by age over 60 years and malnutrition. For the development of the severe disease, prognostic factors were a history of hemodialysis (HR=135), diabetes (HR=4.4), and an increased level of lactate dehydrogenase (LDH) (HR=1,004), while the lymphocyte count over 1,064 was a protective factor (HR=0.9). In the classification of patients, the National Early Warning Score (NEWS2) score in the high and low-risk categories corresponded to the best performance. There was no difference between the treatments administered. Conclusions: The most important prognostic factors for mortality were being over 60 years of age, hypertension, diabetes, and cirrhosis, while for the development of severe disease they were chronic kidney disease with hemodialysis, NEWS2 with high risk at admission, increased levels of LDH and C reactive protein (CRP), and leukocytosis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Pandemias , Pneumonia Viral/mortalidade , Adulto , Idoso , Antígenos de Grupos Sanguíneos , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Colômbia/epidemiologia , Comorbidade , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/terapia , Diabetes Mellitus/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Pacientes Internados/estatística & dados numéricos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/terapia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Insuficiência Renal Crônica/epidemiologia , /mortalidade , Estudos Retrospectivos , Fatores de Risco , Fumar/epidemiologia
17.
Biomedica ; 40(Supl. 2): 139-147, 2020 10 30.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33152197

RESUMO

Introduction: Rapid IgM-IgG combined antibody tests can play an important role in the COVID-19 surveillance by supporting the diagnosis of infection, assessing the immune response, and verifying the progress towards herd immunity. Objective: To evaluate the performance of rapid IgM-IgG combined antibody tests in COVID-19 occupational surveillance in a group of Colombian enterprises. Materials and methods: We used the occupational surveillance data from companies that had performed periodic serological tests on all personnel from the end of April to the beginning of July, 2020. Workers were organized in small groups ("social bubbles") to prevent outbreaks and optimize surveillance. The sensitivity was estimated as if the sampling had a prospective design. We describe here the changes in serological testing through periodic rounds. Results: Data were obtained from 4,740 workers, of whom only 23 were symptomatic showing changes from IgM(-)/IgG(-) to IgM(+) and then to IgM(+)/IgG(+) and IgG(+). The sensitivity was 40.94% for IgM(+) and 47.95% for IgM(+)/IgG(+). This implies that a little less than half of the cases can be detected. Conclusion: Antibody rapid tests have a role in the diagnostic process of infection and they must be evaluated taking into account the moment of the epidemic, the type of test purchased, and the populations at risk since their results depend on the number of infections and cases. In the context of a health crisis, they can be optimized by organizing workers into "social bubbles"


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico , Comércio/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Medicina do Trabalho/métodos , Pandemias , Pneumonia Viral/diagnóstico , Adulto , Infecções Assintomáticas/epidemiologia , Colômbia/epidemiologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/imunologia , Feminino , Humanos , Relações Interpessoais , Masculino , Pneumonia Viral/sangue , Pneumonia Viral/imunologia , Estudos Prospectivos , Sensibilidade e Especificidade , Avaliação de Sintomas
18.
Int J Mol Sci ; 21(21)2020 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-33153161

RESUMO

Progressive respiratory failure is seen as a major cause of death in severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2)-induced infection. Relatively little is known about the associated morphologic and molecular changes in the circulation of these patients. In particular, platelet and erythrocyte pathology might result in severe vascular issues, and the manifestations may include thrombotic complications. These thrombotic pathologies may be both extrapulmonary and intrapulmonary and may be central to respiratory failure. Previously, we reported the presence of amyloid microclots in the circulation of patients with coronavirus disease 2019 (COVID-19). Here, we investigate the presence of related circulating biomarkers, including C-reactive protein (CRP), serum ferritin, and P-selectin. These biomarkers are well-known to interact with, and cause pathology to, platelets and erythrocytes. We also study the structure of platelets and erythrocytes using fluorescence microscopy (using the markers PAC-1 and CD62PE) and scanning electron microscopy. Thromboelastography and viscometry were also used to study coagulation parameters and plasma viscosity. We conclude that structural pathologies found in platelets and erythrocytes, together with spontaneously formed amyloid microclots, may be central to vascular changes observed during COVID-19 progression, including thrombotic microangiopathy, diffuse intravascular coagulation, and large-vessel thrombosis, as well as ground-glass opacities in the lungs. Consequently, this clinical snapshot of COVID-19 strongly suggests that it is also a true vascular disease and considering it as such should form an essential part of a clinical treatment regime.


Assuntos
Plaquetas/patologia , Doenças Cardiovasculares/virologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/patologia , Eritrócitos/patologia , Ferritinas/sangue , Selectina-P/sangue , Pneumonia Viral/sangue , Pneumonia Viral/patologia , Betacoronavirus/isolamento & purificação , Coagulação Sanguínea/fisiologia , Plaquetas/virologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/patologia , Infecções por Coronavirus/virologia , Eritrócitos/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Trombose/patologia , Trombose/virologia
19.
Eur Rev Med Pharmacol Sci ; 24(20): 10879-10884, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33155251

RESUMO

OBJECTIVE: Among the illnesses that may develop from COVID-19, the disease caused by the novel coronavirus (SARS-CoV-2), is pneumonia, a severe acute respiratory infectious disease. SARS-CoV-2 continues to spread worldwide and has caused hundreds of thousands of deaths thus far and has disrupted the world economy. PATIENTS AND METHODS: This review summarized the reported distributions of SARS-CoV-2 in 13 biological samples of the human body, including nose, feces, sperm, tears, breast milk, cerebrospinal fluid, urine, organs, sputum, cell lines, bronchial brush, blood, throat, and bronchoalveolar lavage fluid. Moreover, this review briefly describes the detection of SARS-CoV-2 in human body samples of five other coronaviruses. CONCLUSIONS: This review offers several recommendations for controlling the spread of SARS-CoV-2 control, specifically, sample collection from suspected cases from foreign countries and risk assessment of imported special goods (biological materials).


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Mama/virologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/líquido cefalorraquidiano , Infecções por Coronavirus/urina , Diagnóstico Precoce , Fezes/virologia , Feminino , Humanos , Masculino , Nariz/virologia , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/líquido cefalorraquidiano , Pneumonia Viral/urina , Espermatozoides/virologia , Escarro/virologia , Lágrimas/virologia
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