Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 100.022
Filtrar
1.
Washington, D.C.; PAHO; 2022-01-11.
em Inglês, Espanhol | PAHO-IRIS | ID: phr-55594

RESUMO

[WEEKLY SUMMARY]. North America: Overall, influenza activity remained low but increasing. In Canada, influenza A and B virus co-circulated with influenza A(H3N2) and A(H1N1)pdm09 among samples where subtyping was performed; SARS-CoV-2 activity slightly increased. In Mexico, influenza A(H3N2) prevailed, with B co-circulating and SARS-CoV-2 activity increased. In the United States, influenza A(H3N2) predominated, with SARS-CoV-2 activity increasing, hospitalizations and deaths remained elevated. Respiratory syncytial virus activity remained high in Canada. Caribbean: Influenza remained at low activity levels. Haiti reported a few detections in recent weeks with the predominance of influenza B/Victoria and A(H1N1)pdm09. In Suriname, SARS-CoV-2 and SARI activity decreased to low levels. Central America: Influenza activity continued low and SARS-CoV-2 activity decreased to low levels overall. In Guatemala, influenza activity decreased with the predominance of influenza A(H3N2) in the previous week, while influenza A(H3N2) circulation increased in Honduras with low SARI and ILI activity. Andean: Overall, influenza activity remained low; however, Bolivia, Ecuador, and Peru reported increased influenza activity associated with A(H3N2) detections. SARS-CoV-2 activity stands elevated in Bolivia and Ecuador; and in Bolivia, SARI activity continued at extraordinary levels. Brazil and Southern Cone: Influenza activity increased to pre-pandemic levels, and SARS-CoV-2 activity continues at low levels, except in Argentina. Influenza A(H3N2) detections continue to rise in Brazil, Chile, Paraguay, and Uruguay. Most activity and increasing A(H3N2) detections are recorded in Brazil and Uruguay. Global: In the temperate zones of the northern hemisphere, influenza activity, although still low, appeared to increase in some countries with detections of mainly influenza A(H3N2) and B Victoria lineage (mainly in China). In Europe, influenza activity continued to increase. Influenza A(H3N2) predominated. In East Asia, influenza activity continued rising in China, while influenza illness indicators and activity remained low in the rest of the subregion. Influenza B/Victoria viruses predominated. In tropical Africa, overall influenza activity continued decreasing, with both influenza A and B detected. In Southern Asia, influenza virus detections of predominately influenza A(H3N2) increased overall, although reducing in a few countries. In South-East Asia, sporadic influenza detections were reported in the Philippines. However, in the temperate zones of the southern hemisphere, influenza activity remained low overall. SARS-CoV-2 percent positivity from sentinel surveillance increased to approximately 30%. Activity remained under 10% positivity in the Eastern Mediterranean, South-East Asian and Western Pacific Regions of WHO. In the other WHO Regions, an increasing trend in positivity was observed in recent weeks. Overall positivity from non-sentinel sites also increased and was at 25%.


[RESUMEN SEMANAL] América del Norte: en general, la actividad de la influenza se mantuvo baja pero en aumento. En Canadá, el virus de la influenza A y B circularon concurrentemente con los virus influenza A(H3N2) y A(H1N1)pdm09 en las muestras a las que se les determinó el subtipo; la actividad del SARS-CoV-2 aumentó ligeramente. En México, predominó el virus influenza A(H3N2), con la circulación concurrente de B, y la actividad del SARS-CoV-2 aumentó. En los Estados Unidos, predominó la influenza A(H3N2), con un aumento de la actividad del SARS-CoV-2, las hospitalizaciones y muertes se mantuvieron elevadas. La actividad del virus respiratorio sincitial se mantuvo alta en Canadá. Caribe: la influenza se mantuvo en niveles bajos de actividad. Haití reportó algunas detecciones en las últimas semanas con predominio de influenza B/Victoria y A(H1N1)pdm09. En Surinam, la actividad del SARS-CoV-2 e IRAG disminuyó a niveles bajos. América Central: la actividad de la influenza continuó baja y la actividad del SARS-CoV-2 disminuyó a niveles bajos en general. En Guatemala, la actividad de la influenza disminuyó con el predominio de la influenza A(H3N2) en semanas previa, mientras que la circulación de la influenza A(H3N2) aumentó en Honduras con baja actividad de IRAG y ETI. Andina: en general, la actividad de la influenza se mantuvo baja; sin embargo, Bolivia, Ecuador y Perú informaron un aumento de la actividad de la influenza asociada con las detecciones de A(H3N2). La actividad de SARS-CoV-2 se mantiene elevada en Bolivia y Ecuador; y en Bolivia, la actividad de la IRAG continuó en niveles extraordinarios. Brasil y Cono Sur: la actividad de la influenza aumentó a niveles prepandémicos y la actividad del SARS-CoV-2 continúa en niveles bajos, excepto en Argentina. Las detecciones de influenza A(H3N2) continúan aumentando en Brasil, Chile, Paraguay y Uruguay. La mayor parte de la actividad y las detecciones crecientes de A(H3N2) se registran en Brasil y en Uruguay. Global: en las zonas templadas del hemisferio norte, la actividad de la influenza, aunque todavía baja, pareció aumentar en algunos países con detecciones de influenza principalmente A(H3N2) y B linaje Victoria (principalmente en China). En Europa, la actividad gripal siguió aumentando. Predominó influenza A(H3N2). En el este de Asia, la actividad de la influenza siguió aumentando en China, mientras que los indicadores y la actividad de la enfermedad por influenza se mantuvieron bajos en el resto de la subregión. Predominaron los virus influenza B linaje Victoria. En África tropical, la actividad general de la influenza continuó disminuyendo y se detectaron tanto la influenza A como la B. En el sur de Asia, en general, las detecciones de los virus de la influenza predominantemente A(H3N2) aumentaron, aunque disminuyeron en algunos países. En el sudeste asiático, en Filipinas se informaron detecciones esporádicas de influenza. Sin embargo, en las zonas templadas del hemisferio sur, la actividad de influenza se mantuvo baja en general. El porcentaje de positividad de SARS-CoV-2 de la vigilancia centinela aumentó a aproximadamente el 30%. La actividad se mantuvo por debajo del 10 % de positividad en las Regiones del Mediterráneo Oriental, Asia Sudoriental y el Pacífico Occidental. En las otras Regiones, se observó una tendencia creciente en la positividad en las últimas semanas. La positividad general de los sitios no centinela también aumentó y fue del 25%.


Assuntos
Influenza Humana , COVID-19 , SARS-CoV-2 , Betacoronavirus , Regulamento Sanitário Internacional , Emergências , América , Região do Caribe , Influenza Humana , Regulamento Sanitário Internacional , Emergências , América , Região do Caribe
2.
Artigo em Espanhol | PAHO-IRIS | ID: phr-55571

RESUMO

[RESUMEN]. Objetivo. Estimar el impacto presupuestal de la vacunación contra COVID-19 en seis países de América Latina: Argentina, Brasil, Chile, Colombia, México y Perú, durante el periodo 2021-2022. Métodos. Se evaluaron las vacunas de Sinopharm (BBIBP-CorV), Janssen (JNJ-78436735), Instituto de Gamaleya (Gam-COVID-Vac), Sinovac (CoronaVac), CanSino (Convidecia), AstraZeneca (Vaxzevria), Moderna (mRNA-1273) y Pfizer (BNT162b2), según disponibilidad para cada país. Se adoptó la perspectiva del sistema de salud, de manera que solo se incluyeron costos médicos directos. El horizonte temporal se adoptó teniendo en cuenta los tiempos de implementación de cada plan de vacunación, excluyendo menores de 16 años y gestantes. Se incluyeron los siguientes costos: costo de la vacunación y aplicación, costos de la hospitalización general aislamiento, cuidado intermedio e intensivo. Se compararon dos escenarios de vacunación: 1) Población que desea vacunarse (según las encuestas nacionales) y 2) Población que debería vacunarse (total susceptible de vacunación). Los costos agregados para cada escenario de vacunación se compararon con el escenario de no vacunación. Adicionalmente, se realizaron análisis de sensibilidad determinísticos y probabilísticos. Resultados. Los diferentes esquemas de vacunación contra COVID-19 disponibles en América Latina generan ahorros potenciales que oscilan entre USD 100 y USD 1 500 millones de dólares por país para el período 2021-2022, asumiendo que se logra implementar en su totalidad el plan de vacunación previsto en cada país. Conclusiones. La vacunación contra COVID-19 es una estrategia que además de reducir la morbilidad y mortalidad para Latinoamérica, genera ahorros potenciales para los sistemas de salud en la región.


[ABSTRACT]. Objective. To estimate the budgetary impact of COVID-19 vaccination in six Latin American countries: Argentina, Brazil, Chile, Colombia, Mexico, and Peru, during the 2021-2022 biennium. Methods. Vaccines from Sinopharm (BBIBP-CorV), Janssen (JNJ-78436735), Gamaleya Institute (Gam-COVID-Vac), Sinovac (CoronaVac), CanSino (Convidecia), AstraZeneca (Vaxzevria), Moderna (mRNA-1273), and Pfizer (BNT162b2) were evaluated, according to their availability in each country. The health system perspective was adopted, so that only direct health care costs were included. The time horizon adopted took into account the implementation times of each vaccination plan, excluding children under 16 years of age and pregnant persons. The following costs were included: cost of vaccination/vaccine administration and costs of hospitalization (general isolation, stepdown care, and intensive care). Two vaccination scenarios were compared: 1) population wanting to be vaccinated (according to national surveys); and 2) population that should be vaccinated (total population susceptible to vaccination). The aggregate costs for each vaccination scenario were compared with the no-vaccination scenario. Deterministic and probabilistic sensitivity analyses were also performed. Results. The different COVID-19 vaccination regimens available in Latin America generate potential savings ranging from USD 100 million to USD 1.5 billion per country for the 2021-2022 biennium, assuming that the vaccination plan proposed for each country is fully implemented. Conclusions. COVID-19 vaccination is a strategy that not only reduces morbidity and mortality in Latin America, but also generates potential savings for health systems in the region.


[RESUMO]. Objetivo. Estimar o impacto orçamentário da vacinação contra a COVID-19 em seis países da América Latina: Argentina, Brasil, Chile, Colômbia, México e Peru, no período 2021-2022. Métodos. Foram avaliadas as vacinas da Sinopharm (BBIBP-CorV), Janssen (JNJ-78436735), Instituto Gamaleya (Gam-COVID-Vac), Sinovac (CoronaVac), CanSino (Convidecia), AstraZeneca (Vaxzevria), Moderna (mRNA-1273) e Pfizer (BNT162b2), conforme a disponibilidade para cada país. Adotou-se a perspectiva do sistema de saúde, de forma que só foram incluídos custos médicos diretos. O horizonte temporal foi adotado levando em consideração os tempos de implementação de cada plano de vacinação, excluindo crianças menores de 16 anos e gestantes. Foram incluídos os seguintes custos: custos de vacinação e aplicação, custos gerais de hospitalização, isolamento, e cuidados intermediários e intensivos. Compararam-se dois cenários de vacinação: 1) população disposta a se vacinar (com base em pesquisas nacionais) e 2) população que deveria ser vacinada (total elegível de vacinação). Os custos agregados para cada cenário de vacinação foram comparados com o cenário de não vacinação. Além disso, foram realizadas análises de sensibilidade determinísticas e probabilísticas. Resultados. Os diferentes esquemas de vacinação contra a COVID-19 disponíveis na América Latina geram economias potenciais entre 100 milhões e 1,5 bilhão de dólares por país para o período 2021-2022, considerando a implementação completa do plano de vacinação previsto em cada país. Conclusões. A vacinação contra a COVID-19 é uma estratégia que, além de reduzir a morbidade e a mortalidade na América Latina, gera economias potenciais para os sistemas de saúde da região.


Assuntos
Vacinação , Coronavirus , COVID-19 , SARS-CoV-2 , Custos de Cuidados de Saúde , Vacinas contra COVID-19 , América Latina , Vacinação , Vacinas contra COVID-19 , Custos de Cuidados de Saúde , América Latina , Vacinação , Vacinas contra COVID-19 , Custos de Cuidados de Saúde
3.
Washington, D.C.; PAHO; 2022-01-04.
em Inglês, Espanhol | PAHO-IRIS | ID: phr-55549

RESUMO

North America: Influenza activity remained low. In Mexico and the United States, SARS-CoV-2 activity continued elevated and increasing. Caribbean: Influenza activity remained low. In Belize, SARS-CoV-2 activity continued at moderate levels and increasing; RSV detections continue to increase in the country. In Puerto Rico and Saint Lucia, SARS-CoV-2 activity continued to increase. Central America: Influenza activity remained low. Overall, SARS-CoV-2 activity continued at moderate levels in the subregion. In Nicaragua, SARS-CoV-2 activity continued elevated and increasing. Andean: Influenza activity remained low. Overall, SARS-CoV-2 activity continued at moderate levels but decreasing. Brazil and Southern Cone: Influenza activity remained low. Overall, SARS-CoV-2 activity continued at moderate levels but decreasing. In Argentina and Uruguay RSV activity remained elevated and increasing. Global: Despite continued or even increased testing for influenza in some countries, influenza activity remained at lower levels than expected for this time of the year. In the temperate zones of the southern and northern hemispheres, influenza activity remained at inter-seasonal levels. In tropical Africa, influenza detections were reported in some countries in Western and Eastern Africa. In Southern Asia, influenza detections were reported from Bangladesh, India, and Nepal. In South East Asia, one detection of Influenza A(H3N2) was reported from the Philippines. Worldwide, influenza B detections accounted for most of the low number of detections reported.


América del Norte: la actividad de la influenza se mantuvo baja. En México y los Estados Unidos, la actividad de SARS-CoV-2 continuó elevada y en aumento. Caribe: la actividad de la influenza se mantuvo baja. En Belice la actividad del SARS-CoV-2 continuó en niveles moderados y en aumento; las detecciones de VRS continúan aumentando en el país. En Puerto Rico y Santa Lucía, la actividad de SARS-CoV-2 continuó en aumento. América Central: la actividad de la influenza se mantuvo baja. En general, la actividad del SARS-CoV-2 continuó en niveles moderados en la subregión. En Nicaragua, la actividad del SARS-CoV-2 continuó elevada y en aumento. Andina: la actividad de la influenza se mantuvo baja. En general, la actividad del SARS-CoV-2 continuó en niveles moderados, pero en disminución. Brasil y Cono Sur: la actividad de la influenza se mantuvo baja. En general, la actividad del SARS-CoV-2 continuó en niveles moderados, pero disminuyó. En Argentina y Uruguay, la actividad del VRS se mantuvo elevada y en aumento. Global: a pesar de que la realización de pruebas para la detección de influenza continuó o incluso aumentó en algunos países, la actividad del virus de la influenza se mantuvo en niveles más bajos de lo esperado para esta época del año. En las zonas templadas de los hemisferios sur y norte, la actividad de la influenza se mantuvo en niveles entre estaciones. En África tropical, se notificaron detecciones de influenza en algunos países de África occidental y oriental. En el sur de Asia, se informaron detecciones de influenza en Bangladesh, India y Nepal. En el sudeste asiático, se informó de una detección de influenza A(H3N2) en Filipinas. A nivel mundial, las detecciones de influenza B representaron la mayor parte del bajo número de detecciones notificadas.


Assuntos
Influenza Humana , COVID-19 , SARS-CoV-2 , Betacoronavirus , Infecções por Coronavirus , Emergências , Regulamento Sanitário Internacional , Infecções por Coronavirus , Influenza Humana , Emergências , Regulamento Sanitário Internacional
4.
Washington, D.C.; OPS; 2022-01-04.
em Inglês, Espanhol | PAHO-IRIS | ID: phr-55548

RESUMO

North America: Influenza activity remained low overall. In Mexico, SARI activity continued to rise and was associated with high SARS-CoV-2 activity. In the United States, SARS-CoV-2 detections continued to increase, and COVID-19 mortality remained elevated and above the epidemic threshold. Caribbean: Influenza activity remained low overall. In Jamaica, SARS-CoV-2 activity continues to increase, and pneumonia activity continued above moderate levels and rising. In Puerto Rico, SARS-CoV-2 activity continued elevated and increasing. In Saint Lucia, ILI activity in the population five years of age and older continues above the alert threshold and was associated with SARS-CoV-2 activity. Central America: Influenza activity remained low and SARS-CoV-2 activity continued at moderate levels overall. In Nicaragua, SARS-CoV-2 activity continued high and increasing. Andean: Influenza activity remained low and SARS-CoV-2 activity continued at moderate levels overall. In Peru, RSV activity continues to increase. Brazil and Southern Cone: Influenza activity remained low and SARS-CoV-2 activity continued at moderate levels overall. In Argentina, RSV activity remained high and increasing. In Uruguay, SARI activity continued above epidemic levels and rising.


América del Norte: la actividad de la influenza se mantuvo baja en general. En México, la actividad de la IRAG continuó aumentando y se asoció con una alta actividad de SARS-CoV-2. En los Estados Unidos, las detecciones de SARS-CoV-2 continuaron aumentando y la mortalidad por COVID-19 se mantuvo elevada y por encima del umbral epidémico. Caribe: la actividad de la influenza se mantuvo baja en general. En Jamaica, la actividad del SARS-CoV-2 continúa aumentando y la actividad de la neumonía continuó por encima de niveles moderados y en aumento. En Puerto Rico, la actividad del SARS-CoV-2 continuó elevada y en aumento. En Santa Lucía, la actividad de la ETI en la población de cinco años o más continúa por encima del umbral de alerta y se asoció con la actividad del SARS-CoV-2. América Central: la actividad de la influenza se mantuvo baja y la actividad del SARS-CoV-2 continuó a niveles moderados en general. En Nicaragua, la actividad del SARS-CoV-2 continuó elevada y en aumento. Andina: la actividad de la influenza se mantuvo baja y la actividad del SARS-CoV-2 continuó en niveles moderados en general. En Perú, la actividad del VRS sigue en aumento. Brasil y Cono Sur: la actividad de la influenza se mantuvo baja y la actividad del SARS-CoV-2 continuó en niveles moderados en general. En Argentina, la actividad del VRS se mantuvo alta y en aumento. En Uruguay, la actividad de la IRAG continuó por encima de los niveles epidémicos y en aumento.


Assuntos
Influenza Humana , SARS-CoV-2 , COVID-19 , Infecções por Coronavirus , Betacoronavirus , Emergências , Regulamento Sanitário Internacional , Influenza Humana , Infecções por Coronavirus , Emergências , Regulamento Sanitário Internacional
8.
Curr Opin Pediatr ; 34(1): 2-7, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34980871

RESUMO

PURPOSE OF REVIEW: This article describes the impacts of food insecurity (FI) on child health, outlines clinical and public policy interventions to mitigate FI in children, and defines new paradigms in population health to ameliorate the harmful effects of FI in children. RECENT FINDINGS: Rates of FI among children have dramatically increased with the onset of the COVID-19 pandemic, with particular adverse impact on low-income children. Population health innovations in screening, referral, and social service integration offer new opportunities to address FI. SUMMARY: Despite advances in clinical practice and public policy, FI remains a persistent issue for many US children. Clinicians and policymakers have opportunities to leverage clinical and community-based integration to improve service delivery opportunities to ameliorate childhood hunger and racial and socioeconomic inequity in the United States.


Assuntos
COVID-19 , Pandemias , Criança , Insegurança Alimentar , Humanos , Política Pública , SARS-CoV-2 , Fatores Socioeconômicos , Estados Unidos/epidemiologia
9.
J Korean Med Sci ; 37(1): e12, 2022 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-34981682

RESUMO

BACKGROUND: Despite the extraordinary speed of mass vaccination efforts, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant in a vaccinee with coronavirus disease 2019 (COVID-19) mRNA vaccine was identified in an adult day service center (ADSC) of Jeju, South Korea. The primary objective of this study was to investigate the epidemiologic features in infection-vulnerable facilities with a high vaccination rate of BNT162b2 mRNA COVID-19 vaccine. The second was to estimate the secondary transmission prevention effect of the vaccine in the household members by vaccination status. METHODS: We included all ADSC participants, staff and their household members. All COVID-19 infected cases were confirmed by reverse transcriptase polymerase chain reaction. We calculated attack rate in ADSC and the secondary attack rate (SAR) in household members by vaccination status. RESULTS: Among a total of 42 participants and 16 staff, of which 96.6% were fully vaccinated with BNT162b2 mRNA COVID-19 vaccine, 12 symptomatic cases and 13 asymptomatic confirmed cases of COVID-19 were found. The attack rate was 43.1%, with 13 isolates identified as SARS-CoV-2 virus, delta variant. The SAR in unvaccinated and partially vaccinated household members were 27.8% (5/18) and 25.0% (5/20), respectively, while the SAR in fully vaccinated household members was 12.5% (1/8). CONCLUSION: We describe a SARS-CoV-2 delta variant outbreak in ADSC with high vaccine coverage rate, characterized by high infection rate, high transmissibility, and low clinical severity. The outbreak proceeded to unvaccinated or partially vaccinated household members, emphasizing the need for immunizing close contacts of high-risk groups.


Assuntos
COVID-19/epidemiologia , SARS-CoV-2 , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/prevenção & controle , COVID-19/transmissão , Vacinas contra COVID-19 , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Vacinação
10.
J Korean Med Sci ; 37(1): e13, 2022 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-34981683

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is generally asymptomatic or mild in otherwise healthy children, however, severe cases may occur. In this study, we report the clinical characteristics of children classified as critical COVID-19 in Korea to provide further insights into risk factors and management in children. METHODS: This study was a retrospective case series of children < 18 years of age classified as critical COVID-19. Cases were identified by the Korea Disease Control and Prevention Agency surveillance system and medical records were reviewed. Critical COVID-19 was defined as cases with severe illness requiring noninvasive (high flow nasal cannula, continuous positive airway pressure, or bilevel positive airway pressure) or invasive mechanical ventilation, extracorporeal membrane oxygenation (ECMO) or continuous renal replacement therapy (CRRT), between January 20, 2020 and October 7, 2021. RESULTS: Among 39,146 cases diagnosed with COVID-19 in subjects < 18 years of age, eight cases (0.02%) were identified as critical COVID-19. The median age was 13 years (range 10 month-17 years) and male-to-female ratio was 1:1. Three children had underlying diseases; one child has asthma and major depressive disorder, one child had Lennox-Gastaut syndrome and one child had mental retardation and was newly diagnosed with type 2 diabetes mellitus with the diagnosis of COVID-19. Among the eight children, seven were obese (body mass index range [BMI] median 29.3, range 25.9-38.2, weight-for-length > 97% for infant) and one was overweight (BMI 21.3). All patients had fever, six patients had dyspnea or cough and other accompanied symptoms included sore throat, headache, lethargy and myalgia. Radiologic findings showed pneumonia within 1-8 days after symptom onset. Pneumonia progressed in these children for 2-6 days and was improved within 5-32 days after diagnosis. Among the eight critical cases, remdesivir was administered in six cases. Steroids were provided for all cases. Inotropics were administered in one case. Six cases were treated with noninvasive mechanical ventilator and three required mechanical ventilator. One case required ECMO due to acute respiratory distress syndrome. All cases were admitted to the intensive care unit and admission period ranged from 9-39 days. Among all critical COVID-19 cases < 18 years of age, there were no fatal cases. CONCLUSION: To develop appropriate policies for children in the COVID-19 pandemic, it is important to monitor and assess the clinical burden in this population.


Assuntos
COVID-19/epidemiologia , SARS-CoV-2 , Adolescente , COVID-19/complicações , COVID-19/terapia , Criança , Pré-Escolar , Cuidados Críticos , Feminino , Humanos , Lactente , Masculino , República da Coreia/epidemiologia , Estudos Retrospectivos , Índice de Gravidade de Doença
11.
Curr Microbiol ; 79(2): 48, 2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34982246

RESUMO

This study aimed to characterize the whole genome of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) isolated from an oropharyngeal swab specimen of a Pashtun Pakistani patient using next-generation sequencing. Upon comparing the SARS-CoV2 genome to the reference genome, a total of 10 genetic variants were identified. Among the 10 genetic variants, 1 missense mutation (c.1139A > G, p.Lys292Glu) in the Open Reading Frame 1ab (ORF1ab) positioned at 112 in the non-structural protein 2 (NSP2) was found to be unique. Phylogenetic analysis (n = 84) revealed that the current SARS-CoV2 genome was closely clustered with 8 Pakistani strains belonging to Punjab, Federal Capital, Azad Jammu and Kashmir (AJK), and Khyber Pakhtunkhwa (KP). In addition, the current SARS-CoV2 genome was very similar to the genome of SARS-CoV2 reported from Guam, Taiwan, India, the USA, and France. Overall, this study reports a slight mismatch in the SARS-CoV2 genome, indicating the presence of a single unique missense mutation. However, phylogenetic analysis revealed that the current SARS-CoV2 genome was closely clustered with 8 other Pakistani strains.


Assuntos
COVID-19 , RNA Viral , Genoma Viral , Genômica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Paquistão , Filogenia , SARS-CoV-2
12.
Artigo em Inglês | MEDLINE | ID: mdl-34982060

RESUMO

BACKGROUND: This study investigated the outcomes of coronavirus disease (COVID-19)-positive patients undergoing hip fracture surgery using a national database. METHODS: This is a retrospective cohort study comparing hip fracture surgery outcomes between COVID-19 positive and negative matched cohorts from 46 sites in the United States. Patients aged 65 and older with hip fracture surgery between March 15 and December 31, 2020, were included. The main outcomes were 30-day all-cause mortality and all-cause mortality. RESULTS: In this national study that included 3303 adults with hip fracture surgery, the 30-day mortality was 14.6% with COVID-19-positive versus 3.8% in COVID-19-negative, a notable difference. The all-cause mortality for hip fracture surgery was 27.0% in the COVID-19-positive group during the study period. DICUSSION: We found higher incidence of all-cause mortality in patients with versus without diagnosis of COVID-19 after undergoing hip fracture surgery. The mortality in hip fracture surgery in this national analysis was lower than other local and regional reports. The medical community can use this information to guide the management of hip fracture patients with a diagnosis of COVID-19.


Assuntos
COVID-19 , Fraturas do Quadril , Adulto , Estudos de Coortes , Fraturas do Quadril/cirurgia , Humanos , Estudos Retrospectivos , SARS-CoV-2 , Estados Unidos/epidemiologia
13.
Bull Math Biol ; 84(2): 28, 2022 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-34982256

RESUMO

The spread of COVID-19 in Wuhan was successfully curbed under the strategy of "Joint Prevention and Control Mechanism." To understand how this measure stopped the epidemics in Wuhan, we establish a compartmental model with time-varying parameters over different stages. In the early stage of the epidemic, due to resource limitations, the number of daily reported cases may lower than the actual number. We employ a dynamic-based approach to calibrate the accumulated clinically diagnosed data with a sudden jump on February 12 and 13. The model simulation shows reasonably good match with the adjusted data which allows the prediction of the cumulative confirmed cases. Numerical results reveal that the "Joint Prevention and Control Mechanism" played a significant role on the containment of COVID-19. The spread of COVID-19 cannot be inhibited if any of the measures was not effectively implemented. Our analysis also illustrates that the Fangcang Shelter Hospitals are very helpful when the beds in the designated hospitals are insufficient. Comprised with Fangcang Shelter Hospitals, the designated hospitals can contain the transmission of COVID-19 more effectively. Our findings suggest that the combined multiple measures are essential to curb an ongoing epidemic if the prevention and control measures can be fully implemented.


Assuntos
COVID-19 , China/epidemiologia , Humanos , Conceitos Matemáticos , Modelos Biológicos , SARS-CoV-2
14.
BMC Anesthesiol ; 22(1): 10, 2022 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-34983402

RESUMO

BACKGROUND: ICU operational conditions may contribute to cognitive overload and negatively impact on clinical decision making. We aimed to develop a quantitative model to investigate the association between the operational conditions and the quantity of medication orders as a measurable indicator of the multidisciplinary care team's cognitive capacity. METHODS: The temporal data of patients at one medical ICU (MICU) of Mayo Clinic in Rochester, MN between February 2016 to March 2018 was used. This dataset includes a total of 4822 unique patients admitted to the MICU and a total of 6240 MICU admissions. Guided by the Systems Engineering Initiative for Patient Safety model, quantifiable measures attainable from electronic medical records were identified and a conceptual framework of distributed cognition in ICU was developed. Univariate piecewise Poisson regression models were built to investigate the relationship between system-level workload indicators, including patient census and patient characteristics (severity of illness, new admission, and mortality risk) and the quantity of medication orders, as the output of the care team's decision making. RESULTS: Comparing the coefficients of different line segments obtained from the regression models using a generalized F-test, we identified that, when the ICU was more than 50% occupied (patient census > 18), the number of medication orders per patient per hour was significantly reduced (average = 0.74; standard deviation (SD) = 0.56 vs. average = 0.65; SD = 0.48; p < 0.001). The reduction was more pronounced (average = 0.81; SD = 0.59 vs. average = 0.63; SD = 0.47; p < 0.001), and the breakpoint shifted to a lower patient census (16 patients) when at a higher presence of severely-ill patients requiring invasive mechanical ventilation during their stay, which might be encountered in an ICU treating patients with COVID-19. CONCLUSIONS: Our model suggests that ICU operational factors, such as admission rates and patient severity of illness may impact the critical care team's cognitive function and result in changes in the production of medication orders. The results of this analysis heighten the importance of increasing situational awareness of the care team to detect and react to changing circumstances in the ICU that may contribute to cognitive overload.


Assuntos
Cognição , Unidades de Terapia Intensiva , Equipe de Assistência ao Paciente , Idoso , COVID-19/terapia , Tomada de Decisões Gerenciais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , SARS-CoV-2 , Carga de Trabalho
15.
BMC Med Inform Decis Mak ; 22(1): 2, 2022 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-34983496

RESUMO

BACKGROUND: The coronavirus disease (COVID-19) hospitalized patients are always at risk of death. Machine learning (ML) algorithms can be used as a potential solution for predicting mortality in COVID-19 hospitalized patients. So, our study aimed to compare several ML algorithms to predict the COVID-19 mortality using the patient's data at the first time of admission and choose the best performing algorithm as a predictive tool for decision-making. METHODS: In this study, after feature selection, based on the confirmed predictors, information about 1500 eligible patients (1386 survivors and 144 deaths) obtained from the registry of Ayatollah Taleghani Hospital, Abadan city, Iran, was extracted. Afterwards, several ML algorithms were trained to predict COVID-19 mortality. Finally, to assess the models' performance, the metrics derived from the confusion matrix were calculated. RESULTS: The study participants were 1500 patients; the number of men was found to be higher than that of women (836 vs. 664) and the median age was 57.25 years old (interquartile 18-100). After performing the feature selection, out of 38 features, dyspnea, ICU admission, and oxygen therapy were found as the top three predictors. Smoking, alanine aminotransferase, and platelet count were found to be the three lowest predictors of COVID-19 mortality. Experimental results demonstrated that random forest (RF) had better performance than other ML algorithms with accuracy, sensitivity, precision, specificity, and receiver operating characteristic (ROC) of 95.03%, 90.70%, 94.23%, 95.10%, and 99.02%, respectively. CONCLUSION: It was found that ML enables a reasonable level of accuracy in predicting the COVID-19 mortality. Therefore, ML-based predictive models, particularly the RF algorithm, potentially facilitate identifying the patients who are at high risk of mortality and inform proper interventions by the clinicians.


Assuntos
COVID-19 , Algoritmos , Feminino , Humanos , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , SARS-CoV-2
16.
J Nanobiotechnology ; 20(1): 6, 2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34983543

RESUMO

BACKGROUND: Gold nanoparticles (AuNPs) have been widely used in local surface plasmon resonance (LSPR) immunoassays for biomolecule sensing, which is primarily based on two conventional methods: absorption spectra analysis and colorimetry. The low figure of merit (FoM) of the LSPR and high-concentration AuNP requirement restrict their limit of detection (LOD), which is approximately ng to µg mL-1 in antibody detection if there is no other signal or analyte amplification. Improvements in sensitivity have been slow in recent for a long time, and pushing the boundary of the current LOD is a great challenge of current LSPR immunoassays in biosensing. RESULTS: In this work, we developed spectral image contrast-based flow digital nanoplasmon-metry (Flow DiNM) to push the LOD boundary. Comparing the scattering image brightness of AuNPs in two neighboring wavelength bands near the LSPR peak, the peak shift signal is strongly amplified and quickly detected. Introducing digital analysis, the Flow DiNM provides an ultrahigh signal-to-noise ratio and has a lower sample volume requirement. Compared to the conventional analog LSPR immunoassay, Flow DiNM for anti-BSA detection in pure samples has an LOD as low as 1 pg mL-1 within only a 15-min detection time and 500 µL sample volume. Antibody assays against spike proteins of SARS-CoV-2 in artificial saliva that contained various proteins were also conducted to validate the detection of Flow DiNM in complicated samples. Flow DiNM shows significant discrimination in detection with an LOD of 10 pg mL-1 and a broad dynamic detection range of five orders of magnitude. CONCLUSION: Together with the quick readout time and simple operation, this work clearly demonstrated the high sensitivity and selectivity of the developed Flow DiNM in rapid antibody detection. Spectral image contrast and digital analysis further provide a new generation of LSPR immunoassay with AuNPs.


Assuntos
Teste Sorológico para COVID-19/métodos , COVID-19/diagnóstico , SARS-CoV-2/isolamento & purificação , Ressonância de Plasmônio de Superfície/métodos , Anticorpos Antivirais/imunologia , COVID-19/imunologia , Teste Sorológico para COVID-19/instrumentação , Desenho de Equipamento , Ouro/química , Humanos , Imunoensaio/instrumentação , Imunoensaio/métodos , Nanopartículas Metálicas/química , SARS-CoV-2/imunologia , Saliva/virologia , Glicoproteína da Espícula de Coronavírus/imunologia , Ressonância de Plasmônio de Superfície/instrumentação
17.
J Investig Med High Impact Case Rep ; 10: 23247096211063332, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34984948

RESUMO

We present the case of a 56-year-old woman who was diagnosed with severe coronavirus disease 2019 (COVID-19) pneumonia complicated by severe acute respiratory distress syndrome who was intubated for 19 days. She recovered from COVID-19 after a month. A computed tomography (CT) scan of the chest, after a month, showed improved infiltrates with a small residual cavity within the lingula. A CT angiogram showed a more confluent density in the lingular portion on follow-up 2 months later. She developed intermittent hemoptysis after 3 months in December 2020, which persisted for almost 6 months, and CT of the chest showed the lingular nodular with resolution of the cavitation. She underwent bronchoscopy with bronchoalveolar lavage, confirming Aspergillus fumigatus by galactomannan assay and histology showing branching hyphae. Once she started treatment with itraconazole, her hemoptysis resolved. The follow-up CT of the chest after 2 months of treatment did not show a cavity or a nodule in the lingula. Our patient developed invasive pulmonary aspergillosis (IPA) as a sequela of severe COVID-19 infection. COVID-19-associated invasive pulmonary aspergillosis (CAPA) is an underrecognized complication that needs to be investigated on whether prophylactic treatment is required. Our case also demonstrates that the diagnosis of IPA needs to be considered months after COVID-19 infection when a superimposed fungal infection can occur after a viral infection if the patient continues to have persistent symptoms.


Assuntos
COVID-19 , Aspergilose Pulmonar Invasiva , Aspergilose Pulmonar , Aspergillus fumigatus , Feminino , Humanos , Aspergilose Pulmonar Invasiva/complicações , Aspergilose Pulmonar Invasiva/diagnóstico , Aspergilose Pulmonar Invasiva/tratamento farmacológico , Pessoa de Meia-Idade , Aspergilose Pulmonar/complicações , Aspergilose Pulmonar/tratamento farmacológico , SARS-CoV-2
18.
J Evid Based Integr Med ; 27: 2515690X211053641, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34985368

RESUMO

The coronavirus disease-2019 (COVID-19) pandemic started in early 2020 with the outbreak of a highly pathogenic human coronavirus. The world is facing a challenge and there is a pressing need for efficient drugs. Plants and natural compounds are a proven rich resource for new drug discovery. Considering the potential of natural products to manage the pandemic, this article was designed to provide an inclusive map of the stages and pathogenetic mechanisms for effective natural products on COVID-19. New drug discovery for the COVID-19 pandemic can encompass both prevention and disease management strategies. Preventive mechanisms that may be considered include boosting the immune response and hand hygiene in the preexposure phase; and blocking of virus binding and entry in the postexposure phase. Potential therapeutic target mechanisms include virus-directed therapies and host-directed therapies. Several medicinal plants and natural products, such as Withania somnifera (L.) Dunal and propolis for prevention; Tanacetum parthenium (L.) for treatment; and Ammoides verticillata (Desf.) Briq and Nigella sativa L. for both prevention and treatment have been found effective and are good targets for future research. The examples of phytochemical compounds that may be effective include aloin and terpenes as anti-septics; isothymol, dithymoquinone, and glycyrrhizin as inhibitors of virus binding and entry; glycyrrhizin, and berberine as replication suppressants; ginsenoside Rg1 and parthenolide as immunomodulators; and eriocitrin, rhoifolin, hesperidin, naringin, rutin, and veronicastroside as anti-complements. Recognizing different mechanisms of fighting against this virus can lead to a more systematic approach in finding natural products and medicinal plants for COVID-19 prevention and treatment.


Assuntos
COVID-19 , Plantas Medicinais , Humanos , Pandemias , Fitoterapia , SARS-CoV-2
20.
J Int Med Res ; 50(1): 3000605211069279, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34986676

RESUMO

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, antibody screening is a critical tool to assess anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunity. We examined variation in antibody titers associated with age and sex among patients with confirmed COVID-19. METHODS: Blood IgG levels were tested in 1081 patients with positive SARS-CoV-2 quantitative reverse transcription polymerase chain reaction (RT-qPCR) tests between 1 September and 31 December 2020. Patients who did not experience reinfection were identified. Serum IgG levels were measured by immunofluorescence assay. Antibody positivity and antibody titers were analyzed according to time since infection, sex, and age. RESULTS: The mean (standard deviation) age was 41.2 (14.2) years and 41.2% of patients were women. The lowest antibody positivity rate between the first and ninth month post-infection was detected in the sixth month. The lowest antibody titers among patients aged 20 to 80 years occurred in those aged 30 to 39 years. The IgG titer was positively correlated with age in years (r = 0.125) and decades (r = 0.126). CONCLUSIONS: Six months after infection, anti-SARS-CoV-2 antibody titers increased. Anti-SARS-CoV-2 antibody titers also increased with age. Immunity and pathogenicity should be investigated in addition to antibody positivity rates and antibody titers.


Assuntos
COVID-19 , Adulto , Anticorpos Antivirais , Feminino , Imunofluorescência , Humanos , Imunoglobulina G , Pandemias , SARS-CoV-2
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...