ABSTRACT
La ECP 2023-2028 ha sido desarrollada en estrecha colaboración con el Ministerio de Salud (MINSAL), las instituciones claves del Sistema Nacional de Salud y otros socios internacionales de cooperación en el país. El proceso de trabajo dinámico que ha seguido esta estrategia ha permitido evaluar la ECP anterior, así como realizar un análisis integral de la situación de salud del país y el alineamiento con las prioridades sanitarias del país. Por tanto, el presente documento establece las principales prioridades estratégicas en las que la OPS/OMS brindará su cooperación técnica para apoyar al país en el desarrollo de un sistema nacional de salud resiliente por estar basado en la estrategia de la Atención Primaria de la Salud renovada La ECP 2024-2028 es un instrumento de planificación estratégica para los próximos cinco años. Este documento, que se presenta con satisfacción, ha requerido un análisis cuidadoso y una consulta amplia para asegurar que responde a las necesidades y prioridades de Chile. Dentro de las seis prioridades estratégicas identificadas y sus respectivas áreas de enfoque, se contemplan acciones orientadas a apoyar al país en su determinación de superar los desafíos de la pandemia de COVID-19 además de fortalecer la preparación y respuesta ante las múltiples amenazas a la salud pública.
Subject(s)
International Cooperation , Technical Cooperation , Public Health , Health Systems , Sustainable Development , ChileABSTRACT
The unprecedented worldwide pandemic caused by COVID-19 has motivated several research groups to develop machine-learning based approaches that aim to automate the diagnosis or screening of COVID-19, in large-scale. The gold standard for COVID-19 detection, quantitative-Real-Time-Polymerase-Chain-Reaction (qRT-PCR), is expensive and time-consuming. Alternatively, haematology-based detections were fast and near-accurate, although those were less explored. The external-validity of the haematology-based COVID-19-predictions on diverse populations are yet to be fully investigated. Here we report external-validity of machine learning-based prediction scores from haematological parameters recorded in different hospitals of Brazil, Italy, and Western Europe (raw sample size, 195554). The XGBoost classifier performed consistently better (out of seven ML classifiers) on all the datasets. The working models include a set of either four or fourteen haematological parameters. The internal performances of the XGBoost models (AUC scores range from 84% to 97%) were superior to ML models reported in the literature for some of these datasets (AUC scores range from 84% to 87%). The meta-validation on the external performances revealed the reliability of the performance (AUC score 86%) along with good accuracy of the probabilistic prediction (Brier score 14%), particularly when the model was trained and tested on fourteen haematological parameters from the same country (Brazil). The external performance was reduced when the model was trained on datasets from Italy and tested on Brazil (AUC score 69%) and Western Europe (AUC score 65%); presumably affected by factors, like, ethnicity, phenotype, immunity, reference ranges, across the populations. The state-of-the-art in the present study is the development of a COVID-19 prediction tool that is reliable and parsimonious, using a fewer number of hematological features, in comparison to the earlier study with meta-validation, based on sufficient sample size (n = 195554). Thus, current models can be applied at other demographic locations, preferably, with prior training of the model on the same population. Availability: https://covipred.bits-hyderabad.ac.in/home; https://github.com/debashreebanerjee/CoviPred.
Subject(s)
COVID-19 , Machine Learning , SARS-CoV-2 , Humans , COVID-19/epidemiology , COVID-19/blood , COVID-19/diagnosis , Italy/epidemiology , Brazil/epidemiology , Europe/epidemiology , SARS-CoV-2/isolation & purification , Female , Male , Adult , Middle Aged , Aged , Reproducibility of ResultsABSTRACT
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused an unprecedented pandemic in human history. To date, more than 6.5 million lives have been lost to COVID-19 (coronavirus disease 2019). Following widespread efforts for COVID-19 vaccination in Brazil, there has been a drastic reduction in COVID-19 deaths, which was particularly evident in the city of Botucatu, SP, Brazil, after a campaign to a mass vaccination. Our objective was to assess the temporal and epidemiological spread of variants of concern (VOC) of SARS-CoV-2 in the four weeks preceding the massive vaccination campaign in the municipality. After randomizing 400 samples, Next-Generation Sequencing was used to produce sequences and determine the variants. Among high-quality sequences, 98.4% belonged to the VOC Gamma, with P.1 and P.1.14 being the most prevalent lineages. P.1 was more frequent in both men and women, and in younger individuals and adults (0-59 years) compared to P.1.14. There was no correlation between the variants and the presence of comorbidities or between them and moderate to severe clinical cases of COVID-19 or death. However, P.1 was more frequent than P.1.14 in people with mild forms of the disease and in those who exhibited symptoms. In the phylogenetic analyses, a small cluster of 9 P.1.14 samples containing mutations in ORF1a: M584V and A3620V was observed, which had not been found in any Gamma sequences to date. The importance of genomic surveillance of SARS-CoV-2 is evident in assisting public health decision-making and the management of COVID-19 and other diseases.
ABSTRACT
Vaccinating healthcare personnel (HCP) is a top priority for public health globally. This strategy aims not only to protect HCP but also patients, reducing transmission of infections in healthcare services. However, improving vaccine coverage in HCP is still a challenge, especially because they are a risk group for acquiring influenza. Multicomponent influenza vaccination programs targeting behavioral, organizational, and administrative barriers are critical to ensure this priority population is vaccinated. Here, we describe a healthcare worker cohort study that was implemented in Peru, a middle-income country, in 2016, prior to the coronavirus disease 2019 pandemic. This cohort, which is still ongoing, has collected valuable information on influenza vaccine effectiveness, vaccine coverage, risk factors, absenteeism, and use of personal protective equipment, as well as risk of influenza disease, among others. These data can help improve knowledge not only about influenza diseases but also regarding vaccination on this specific influenza risk group in order to improve vaccine uptake.
Subject(s)
Health Personnel , Influenza Vaccines , Influenza, Human , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Peru/epidemiology , Influenza Vaccines/administration & dosage , Vaccination Coverage/statistics & numerical data , Male , Vaccination/statistics & numerical data , Female , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Cohort Studies , Adult , Risk Factors , Middle AgedABSTRACT
Guanidinic compounds are a class of compounds distributed in nature but also synthesized in vitro with a wide variety of applicability. One of the potentials of those molecules is antimicrobial activity. In that sense, although mainly limited to immunocompromised people, fungi pathogens are a cause of concern, even more so after the COVID-19 pandemic. Susceptible groups and increased geographical distribution, besides drug toxicity, resistance, and high costs, made the World Health Organization (WHO) establish a guideline for research and public health politics against different fungi opportunist agents. Our present work evaluated the antifungal activity of 11 guanidine compounds (one of them synthesized for the first time) against six fungi species in the WHO Fungi Priority Pathogens List and their potential for antimicrobial selectivity. The newly synthesized compound, named LQOF-G2-S, was successfully obtained and chemically characterized as spermidine tri-substituted by guanidine moieties in benzylamine-4-bromoaniline groups, and it presented the best antifungal activity and selectivity among the others. It was the only compound active against Candida spp.; however, its activity was more promising against Cryptococcus neoformans, Cryptococcus gattii, and even more against Paracoccidioides brasiliensis and Paracoccidioides lutzii, with a selective index higher than 10. The LQOF-G2-S potential opened up the opportunity to design and evaluate other similar compounds, contributing to finding new effective, less toxic, and more affordable compounds for fungi treatment.
ABSTRACT
Dysregulated renin-angiotensin system (RAS) signaling contributes to elevated blood pressure (BP), inflammation, and organ damage in systemic arterial hypertension (HTN). We have demonstrated that hypertensive humans and rats exhibit higher expression of classic RAS components and lower expression of counterregulatory RAS components in the lungs compared with normotensive counterparts. Here, we investigated whether BP control could restore the balance between classic [angiotensin I-converting enzyme 2 (ACE)/angiotensin II (Ang II)] and counterregulatory [angiotensin I-converting enzyme 2 (ACE2)/Ang (1-7)] RAS, thereby mitigating lung inflammation. Male spontaneously hypertensive rats (SHRs) were treated with either losartan or amlodipine, both of which effectively reduced BP. These interventions up-regulated lung Ace2 and down-regulated Ace gene expression. Pulmonary membrane ACE2 abundance and activity were higher in losartan- and amlodipine-treated SHRs than in vehicle-treated SHRs, whereas ACE protein and function remained unchanged. Drug-treated SHRs exhibited lower levels of lung Ang II and higher levels of Ang (1-7) than vehicle-treated SHRs. Rebalancing the pulmonary RAS remarkably reduced macrophage number and down-regulated pro-inflammatory genes in SHR lungs, with lower expression of lung pro-inflammatory genes correlating with lower circulating levels of ACE2. Serum analysis in healthy and hypertensive individuals supported these findings, showing higher ACE2 levels in uncontrolled compared with controlled hypertension and normotension. Collectively, these findings suggest that high blood pressure may induce lung inflammation via an ACE/ACE2 imbalance. BP control with either an RAS inhibitor or a calcium channel blocker rebalances RAS in SHR lungs and alleviates inflammation. Furthermore, this study provides a mechanistic link between inflammatory lung diseases (such as COVID-19) and hypertension as a major risk factor.
Subject(s)
Angiotensin-Converting Enzyme 2 , Antihypertensive Agents , Blood Pressure , Hypertension , Losartan , Lung , Rats, Inbred SHR , Renin-Angiotensin System , Animals , Renin-Angiotensin System/drug effects , Male , Blood Pressure/drug effects , Lung/metabolism , Lung/drug effects , Lung/physiopathology , Angiotensin-Converting Enzyme 2/metabolism , Angiotensin-Converting Enzyme 2/genetics , Rats , Hypertension/physiopathology , Hypertension/drug therapy , Hypertension/metabolism , Losartan/pharmacology , Antihypertensive Agents/pharmacology , Antihypertensive Agents/therapeutic use , Amlodipine/pharmacology , Amlodipine/therapeutic use , Angiotensin I/metabolism , Angiotensin II/metabolism , Humans , Peptide Fragments/metabolism , COVID-19/complications , COVID-19/metabolism , Peptidyl-Dipeptidase A/metabolism , Peptidyl-Dipeptidase A/genetics , SARS-CoV-2ABSTRACT
The COVID-19 pandemic has accelerated efforts to enhance pathogen detection using molecular biology techniques. This study examines the expansion of molecular testing capacity in Colombia, identifying strengths and areas for improvement in the existing infrastructure. The study began with the creation of a database inventorying laboratories based on publicly available data from government entities and active web searches. Ten laboratories were selected for detailed characterization. Structured surveys assessed their testing capacity and progress in implementing molecular-based diagnostic tests for various infectious diseases. The strategy for identifying laboratories showed a total of 311 laboratories. Of these, 65 % (n = 202) are private and 21 % (n = 65) are state-owned, mainly public health laboratories, and the remaining 14 % (n = 44) are affiliated with academic institutions. The highest concentration of these labs is in Bogotá, Antioquia, and Valle del Cauca, primarily in urban areas. Key limitations affecting testing laboratories in Colombia include: i) infrastructure (26.2 %), highlighting the need for standardized facility guidelines; ii) quality and documentation (16.7 %), requiring stronger quality management systems; iii) biosafety (14.3 %), emphasizing the need for continuous waste management, especially in public labs; and iv) human talent (10.7 %), needing better policies for staff retention, particularly in government institutions. Strengthening laboratories can establish a comprehensive national molecular testing system. Integrating molecular tests into health system diagnostic algorithms and implementing sustainable laboratory strategies will address human health challenges and support the "One Health" approach for animal and environmental health.
Subject(s)
COVID-19 , Molecular Diagnostic Techniques , SARS-CoV-2 , Colombia , Humans , COVID-19/diagnosis , COVID-19/epidemiology , Molecular Diagnostic Techniques/methods , Molecular Diagnostic Techniques/standards , SARS-CoV-2/genetics , COVID-19 Testing/methods , Laboratories, Clinical , PandemicsABSTRACT
The advent of the COVID-19 pandemic has profoundly transformed grief around the world. What are the impacts of context factors regarding the COVID-19 pandemic on dysfunctional symptoms of grief? This is a study with a qualitative approach, integrative review, whose article data collection was carried out in the following databases: Biblioteca Virtual de Saúde (BVS), Portal Brasileiro de Publicações e Dados Científicos em Acesso Aberto (Oasisbr), United States National Library of Medicine (PubMed), Scientific Electronic Library (SciELO) and Web of Science. Thirty-three articles were selected for the analysis. The studies showed different results when the risk factors were detailed individually. However, the pandemic context proved to be a complex element that created vulnerability associated with grieving. Bioethics presents itself as a locus of interdisciplinary discussion for a more profound understanding of the complex specificities and, based on the social and political responsibility of Protection Bioethics to protect vulnerable populations, it is recommended to mental health professionals who intentionally explore the impacts of the pandemic on the grieving process. The suffering of people bereaved during the pandemic must be publicly recognized, offering safe spaces for reception and sharing.
ABSTRACT
Background The 4C (Coronavirus Clinical Characterization Consortium) Mortality Score has demonstrated good discrimination in COVID-19 but has not been widely validated in Brazil. The 4C Mortality Score is a clinical tool developed during the COVID-19 pandemic to predict in-hospital mortality for patients admitted with COVID-19. It was derived from a large dataset of hospitalized patients in the United Kingdom and provides a simple yet effective way to stratify patients based on their risk of death. Objective This study aimed to determine the accuracy of the 4C Mortality Score in patients admitted with COVID-19 in a university teaching hospital. Methods The study was observational, longitudinal, and retrospective, conducted in a 180-bed university teaching hospital in Rio de Janeiro, Brazil. We included all patients admitted with COVID-19 and followed them until discharge. The 4C Mortality Score was calculated based on age, sex, Charlson index, respiratory rate, peripheral oxygen saturation (room air), Glasgow Coma Scale, serum urea, and C-reactive protein (CRP) level. The primary outcome was mortality. Results We included 208 participants, with a median age of 63 years. Among them, 111 (53%) were male; 52 (25%) had cardiovascular disease, and 83 (39%) had cancer. Mortality was 39.9%. Independent predictors of mortality were age, hemoglobin, CRP, mechanical ventilation, and the need for vasopressors. The 4C Mortality Score's area under the receiver operating characteristic curve (AUC-ROC) was 89.9%. Conclusion The 4C Mortality Score demonstrated excellent discrimination in a teaching hospital population.
ABSTRACT
The World Health Organization (WHO) has determined a series of guidelines to contain the advance and spread of COVID-19 and other influenza viruses. Among them, frequent hand hygiene has been widely recommended, resulting in an increased consumption of alcohol-based antiseptic products or synthetic molecules. However, when used in excess, these products might cause adverse consequences for human health, such as dermatitis, and for the environment, i.e., the selection of resistant bacterial genotypes. One of the alternatives to overcome this problem is the replacement of common antiseptics by formulations based on natural bioactive compounds with antimicrobial/antiviral activity. In addition, by nanostructuring formulations, it is possible to increase the bioavailability, stability, solubility, and absorption of bioactives in biological systems. In this sense, this study aimed to develop an antiseptic nanoemulsion based on natural bioactive compounds with virucidal activity against SARS-CoV-2. For that, oil-in-water (O/W) nanoemulsions were prepared, being the oil phase composed by Melaleuca alternifolia essential oil, quercetin, PEG400, and surfactants, while the aqueous phase presented carrageenan and purified water. Physicochemical characterization and stability studies were developed to evaluate the viability of the formulations over time. In addition, bactericidal activities against Staphylococcus aureus and antiviral activity against SARS-CoV-2 were determined by in vitro assays. As a result, the average size of the nanoparticles was recorded at 150 nm, with a Polydispersity Index (PdI) of 0.2 and a zeta potential around -10.0 mV. The stability of nanoformulations indicated the occurrence of quercetin-dependent creaming and sedimentation. In addition, the products presented a minimum shelf-life of 3 months. Regarding the bactericidal activity, a minimum inhibition concentration of 1.25 % for S. aureus was found. The cytotoxicity and antiviral assays revealed that the nano-based products showed 100 % of viral replication inhibition and proved to be safe for epithelial cells. In conclusion, two antiseptic nanoformulations with high anti-SARS-CoV-2 activity and great industrial and pharmacological potential were developed.
ABSTRACT
BACKGROUND: Peptidyl arginine deiminases (PADs) and citrullinated H3 histone (H3Cit) play a crucial role in the inflammatory response. These components determine various clinical situations in COVID-2019 associated pneumonia. Single nucleotide polymorphisms (SNPs) in the genes PADI2 and PADI4 may influence the outcome of poorer patient outcomes. We analyze the association of circulating levels NETs biomarkers (PAD2, PAD4, and H3Cit) and the SNPs on PADI2 (rs1005753 and rs2235926) and PADI4 (rs11203366, rs11203367, and rs874881) in hospitalized patients with severe acute respiratory distress syndrome (ARDs) by SARS-CoV-2 pneumonia. METHODS: A cross-sectional study in 160 hospitalized patients with ARDs by SARS-CoV-2 pneumonia. The plasma levels of PAD2, PAD4, and H3Cit were determined by ELISA method. The SNPs were determined by qPCR using TaqMan probes. Logistic regression models and receiver operating characteristics (ROC) curve were used to assess the association and predictive value of PAD2, PAD4, and H3Cit plasma levels in outcome by ARDs by SARS-CoV-2 pneumonia. RESULTS: PAD2, PAD4, and H3Cit concentrations were predictors of invasive mechanical ventilation (IMV) requirement and non-survival. PAD2 were associated with non-survival, while PAD4 and H3Cit were associated with requirement IMV. In addition, PAD2 and PAD4 concentrations were related with inflammation markers such as NLR, MLR, dNLR, SII, SIRI, AISI, and NHL. In the carriers of TT genotype of rs1005753 of PADI2 were associated with increased of H3Cit, while, the carriers of GTG/GTG haplotype of PADI4 was related to the presence of increased of PAD4 circulating levels. CONCLUSION: SNPs in PADI2 and PADI4 have a significant influence on concentrations of PAD2, PAD4, and H3Cit, which are predictor markers of requirement IMV and non-survival in severe ARDS by SARS-CoV-2 pneumonia.
Subject(s)
COVID-19 , Histones , Polymorphism, Single Nucleotide , SARS-CoV-2 , Humans , COVID-19/genetics , COVID-19/blood , Female , Male , Middle Aged , Histones/blood , Histones/genetics , Cross-Sectional Studies , Aged , Protein-Arginine Deiminase Type 4/genetics , Protein-Arginine Deiminase Type 2/genetics , Protein-Arginine Deiminase Type 2/blood , Citrullination , Biomarkers/blood , Respiratory Distress Syndrome/genetics , Respiratory Distress Syndrome/blood , Adult , Protein-Arginine Deiminases/geneticsABSTRACT
New immunogens against emerging new virus variants are essential for controlling new variants. METHODS: A preclinical study in which a receptor-binding domain (RBD) trimer was designed in silico with information from the Beta (B.1.351), Omicron (BA.5), and Wuhan 1 variant. A three-dimensional model of the RBD-trimer was made, and the synthesis of the trimer was based on the RBD domain of the S protein of Beta and Omicron. For the experimental trials, 63 BALB/c mice were immunized and divided into three groups: control (n = 15), adjuvant (n = 15), and RBD-trimer (n = 33). RESULTS: 81 % (13/16), 90 % (9/10), and 85 % (6/7) of BALB/c mice that received one dose, two doses, and three doses, respectively, seroconverted. Significant statistical differences (p < 0.001) were found between the experimental group vaccinated with the RBD-trimer, the group with adjuvant, and the control group. The booster did not show significant differences (p > 0.05. No inflammatory or cellular changes were observed, highlighting the safety of the RBD vaccine candidate. Kinetics and seroconversion of 75 % were obtained in the mice with two doses of tri-RBD. (P < 0.0001). CONCLUSIONS: Applying two doses of the RBD vaccine candidate in BALB/c mice was safe and immunogenic against SARS-CoV-2. This study provides support for the country's biotechnological sovereignty and its potential contribution to public health in Colombia.
ABSTRACT
Nature-based solutions (NBSs) offer environmentally rational, socially acceptable, and economically viable alternatives for solving diverse water issues. Therefore, the involvement of local communities is crucial, as their participation in developing shared knowledgewithin their territories is essential for building and sustaining resilient ecosystems. This study highlights a co-created, nature-based initiative that led to the construction of a vegetated vermifilter for greywater reuse and monitoring in a small community at the Nonguén School Community, located in the Biobío region, central Chile. The project was initiated in 2019, but not completed until 2022 due to the COVID-19 pandemic. The vermifilter was based on green filters and was used to recover white greywater (dishwater and handwash water) for irrigation use. The circular biofilter, built by the community and directly connected to the kitchen, consisted of four distinct layers: rock, sand, topsoil, and sawdust. It also included populations of earthworms and wetland plants, all primarily collected by the community. Water analysis (i.e., pH, temperature, BOD5, TSS, nitrate, phosphate, turbidity, dissolved oxygen, and total and fecal coliforms) demonstrated a moderate effectiveness during a measured period in 2022. We highlight and discuss the fundamental role of the participation of the local community in the whole co-work process and key lessons and barriers to further optimize a vermifilter design.
Subject(s)
Citizen Science , Chile , COVID-19 , Wetlands , Environmental Monitoring/methods , HumansABSTRACT
OBJECTIVE: To analyze the classification of the risk of transmission of vaccine-preventable diseases in Brazilian municipalities before and after the National Movement for Vaccination and Multivaccination proposed by the Ministry of Health. METHODS: This is an epidemiological, ecological study using secondary data on vaccination coverage, dropout rates, and homogeneity of vaccination coverage (HCV) for ten immunobiologicals recommended for children under 2 years of age. The study aims to compare the years 2022 and 2023 in Brazil. The vaccination coverage index (VCI), HCV, and dropout rate (DR) were evaluated in the municipalities of Brazil in the years 2022 and 2023. The municipalities were classified into risk strata for transmission of vaccine-preventable diseases before and after the strategy proposed by the Ministry of Health. RESULTS: The study found an increase in median vaccination coverage (VC) for all vaccines evaluated, except for the varicella vaccine. Regarding HCV, in 2022, 27.99% of Brazilian municipalities were classified as adequate (≥ 70%), and 410 (7.36%) achieved 100% HCV for all vaccines. In 2023, 34.90% of municipalities were classified as adequate (≥ 70%), and among them, 582 (10.46%) achieved 100% HCV for all vaccines. In terms of the risk classification for the transmission of vaccine-preventable diseases, Brazil had 72.01% of municipalities classified as high or very high risk in 2022, which decreased to 65.13% in 2023. As for municipalities classified as low or very low risk, 11.27% fell into this category in 2022, increasing to 18.12% in 2023. CONCLUSION: The study concludes that VC surveillance, in conjunction with the Microplanning for High-Quality Vaccination Activities methodology developed by the Ministry of Health in 2023, played a crucial role in resuming immunization efforts that had been hindered by science denialism and the COVID-19 pandemic.
Subject(s)
Immunization Programs , Vaccine-Preventable Diseases , Humans , Brazil/epidemiology , Immunization Programs/statistics & numerical data , Vaccine-Preventable Diseases/prevention & control , Vaccine-Preventable Diseases/epidemiology , Cities , Vaccination Coverage/statistics & numerical data , Risk Assessment , Infant , Vaccination/statistics & numerical dataABSTRACT
The indigenous peoples of the Amazon have experienced changes in cultural identity due to Western colonisation, contact with other cultures, migration, and pandemics. COVID-19, caused by the SARS-CoV-2 virus, affected all of humanity, including populations with limited contact with Western cultures, such as the Waorani indigenous people of the Amazon. Following the global pandemic, their culture may have undergone modifications. This study presents a comparative analysis of Waorani indigenous culture in the pre- and post-pandemic periods (2017-2022). In 2022, the same instrument designed to measure their culture in 2017 was applied, using the same methodology (participatory action in the territory) and in the same indigenous communities (88 individuals in 2017, 85 individuals in 2022). The results show that the cultural identity of the Waorani indigenous people has remained largely unchanged from the first measurement in 2017 to the second measurement after the pandemic in 2022 across most variables (economic, production, property, and land cultivation; family, reproduction, education, childcare, and medicine; organization, community politics, and justice; social, music, art, food, clothing, and housing). However, in the ideological, religious, beliefs, and spirituality domains, there was a significant decline in scores after COVID-19.
ABSTRACT
The development of new strategies to produce nanomaterials that can be used as personal protective equipment with antiviral activity and low toxicity is crucial. Electrospun ultrathin fibers have attracted considerable attention due to their potential for biomedical applications, including antiviral activity. Herein, we electrospun different grades of commercially available polyamide to produce ultrathin fibers and investigate their antiviral activity against SARS-CoV-2 Gamma lineage (P.1). We evaluated the morphology, chemical composition, and mechanical properties of the ultrathin fibers. We also investigated the in vitro cytotoxicity, hemolytic activity, and antiviral activity against SARS-CoV-2 Gamma lineage (P.1) of the developed ultrathin fibers. The ultrathin fibers had the following diameters and elastic moduli: (i) unmodified crude ultrathin polyamide (PAP) 0.59 µm and 3 MPa, (ii) polyamide Biotech (PAAM) 0.74 µm and 2.2 MPa, and (iii) Amni Virus-Bac OFF polyamide (PAVB) 0.69 µm and 1.06 MPa. The ultrathin PAP fibers showed increased antiviral activity compared to the other ultrathin fibers (PAAM and PAVB). None of the electrospun fibers showed cytotoxicity at the lowest concentration (12.5%). Additionally, hemolysis tests demonstrated a nonhemolytic profile for all fiber groups, reinforcing their biocompatibility and suitability for biomedical applications. The antiviral properties of the electrospun ultrathin PAP fibers, combined with their noncytotoxic and nonhemolytic characteristics, highlight their potential to be used as personal protection against SARS-CoV-2.
ABSTRACT
The SARS-CoV-2 2019 pandemic prompted the emergence of collaborative initiatives within South America and the Caribbean, to tackle common challenges. Many initiatives included local government, international entities, military, academia, and research institutions, united to face the challenges brought by the pandemic. Some collaborations were new, but most were built on top of existing networks developed to prevent and control challenges like zoonotic diseases. In the last 40 years, the U.S. Naval Medical Research Unit (NAMRU) SOUTH has helped ensure the readiness and health of U.S. service members, Peruvian partners, and civilian population through research, surveillance, and global health, covering One Health interconnectedness of human, animal, and environmental health to address zoonotic diseases, antimicrobial resistance, and vector-borne diseases. This article puts together the different communications, data sharing, and initiatives developed throughout South America towards One Health surveillance, focusing on zoonotic pathogens, and to describe the best practices for these networks.
Subject(s)
COVID-19 , One Health , Pandemics , Zoonoses , Humans , South America/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Animals , Zoonoses/epidemiology , Zoonoses/prevention & control , Pandemics/prevention & control , SARS-CoV-2 , Central America/epidemiology , Communicable Diseases/epidemiology , Pandemic PreparednessABSTRACT
This review is intended to evaluate the severity of Coronavirus Disease 2019 (COVID-19) in hospitalized pediatric patients with obesity. The increased risk of hospitalization in pediatric patients with obesity highlights the need for a thorough investigation into the impact of COVID-19 in this vulnerable population, given the significant public health challenges obesity presents in this age group. The review followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. A systematic search was conducted in the PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online), LILACS (scientific health information from Latin America and the Caribbean countries), Web of Science, Embase, and Scopus databases for relevant articles published between December 2019 and November 2021. Observational studies (cross-sectional and cohort) involving pediatric patients with obesity who tested positive for COVID-19, were hospitalized, and had outcomes related to disease severity parameters such as intensive care unit (ICU) admission, length of ICU stay, and mechanical ventilation) were included. The quality of evidence from the included studies was assessed using the NewcastleâOttawa Scale. Extracted data included the author, year, country, study design, aim, population, outcomes/severity, and primary results. Eight studies were included in the review. A narrative synthesis was conducted to qualitatively summarize the findings, highlighting that obesity is a potential aggravating factor in the clinical presentation of COVID-19 among hospitalized pediatric patients. The findings revealed a positive association between the pediatric population with obesity and COVID-19 severity, particularly among adolescents, who were at greater risk of developing severe illness. This association was also evident in higher rates of ICU admission and increased use of mechanical ventilation.
ABSTRACT
Although most cases of COVID-19 are mild cases, severe cases requiring hospitalization and mechanical ventilation were sufficient to overwhelm healthcare systems worldwide, leading to more than 6 million deaths and the increase in healthcare associated infections (HAIs). The incidence of HAIs in COVID-19 hospitalized patients has been addressed in systematic reviews, but in these there was no description of mortality related to these infections. Therefore, the aim of this review was to evaluate the impact of HAIs on mortality of hospitalized patients with COVID-19, specially by multidrug resistant bacteria as Acinetobacter baumannii. A systematic review was carried out in the PubMed database on July 2022 using the keywords "healthcare-associated infection" OR "nosocomial infection" AND "COVID-19" AND "Acinetobacter baumannii". The incidence of HAIs in COVID-19 patients was 18.85%, with 42.17% of mortality rate and relative risk (RR) 2.08 (95%CI 1.61-2.68). Considering that the risk of death was twice greater in co-infection COVID-19/HAI, it is essential the broad vaccination against COVID-19 and the adoption of measures to reduce HAI incidence in hospitalized patients and mortality by superinfections.
Subject(s)
COVID-19 , Cross Infection , Hospitalization , Humans , COVID-19/mortality , COVID-19/epidemiology , COVID-19/complications , Cross Infection/epidemiology , Cross Infection/mortality , Hospitalization/statistics & numerical data , Incidence , Acinetobacter baumannii , Acinetobacter Infections/mortality , Acinetobacter Infections/epidemiology , Hospital Mortality , Coinfection/mortality , Coinfection/epidemiologyABSTRACT
BACKGROUND: Understanding the dynamics of SARS-CoV-2 viral infection and factors associated with in-hospital transmission rates among healthcare workers (HCW) is crucial for their protection. Brazil experienced high mortality rates due to COVID-19, and limited data are available on transmission of SARS-CoV-2 infection among HCW. This cohort study aimed to assess the dynamic of SARS-CoV-2 infections in HCW from two tertiary hospitals in central Brazil, one of them a Reference Hospital for COVID-19. METHODS: From May 2020 to January 2021, 554 HCW directly involved with COVID-19 care were followed through 12 biweekly visits. During these visits, blood, nasal, and oropharyngeal samples were collected, and participants underwent interviews. SARS-CoV-2 detection was carried out using RT-qPCR, while the assessment of seroprevalence was based on IgG detection. Additionally, 35 positive samples underwent viral whole-genome sequencing. RESULTS: The infection prevalence, as per RT-qPCR, was 28.5% (24.9-32.4), reflecting an overall attack rate ranging from 0.5% to 9.5%, marked by two peaks in August and December 2020. Oligosymptomatic and asymptomatic infections accounted for 14% of prevalent infections. The seroprevalence rate stood at 25.8%. The hospitalization rate was 8.2%, with a fatality rate of 1.3%. Risk factors associated with a positive diagnosis of COVID-19 included being male, working at the referral hospital, having a graduate-education level, and using hydroxychloroquine and zinc for prevention or treatment. One reinfection was identified. Absenteeism was 56.6%. The infection dynamics mirrored the pattern observed in the general population. CONCLUSION: One-third of the professionals in the followed cohort were infected. Being male, working in a COVID-19 referral center, having a low level of education, and using medications for preventive treatment represented risk factors. Healthcare workers at the COVID-19 referral hospital exhibited a higher incidence rate compared to those at the non-referral hospital, increasing the plausibility that some of the infections occur in the hospital environment.