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Microbiol Spectr ; : e0204723, 2023 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-37695063


Bats are reservoirs of various coronaviruses that can jump between bat species or other mammalian hosts, including humans. This article explores coronavirus infection in three bat species (Tadarida brasiliensis, Eumops bonariensis, and Molossus molossus) of the family Molossidae from Argentina using whole viral metagenome analysis. Fecal samples of 47 bats from three semiurban or highly urbanized areas of the province of Santa Fe were investigated. After viral particle enrichment, total RNA was sequenced using the Illumina NextSeq 550 instrument; the reads were assembled into contigs and taxonomically and phylogenetically analyzed. Three novel complete Alphacoronavirus (AlphaCoV) genomes (Tb1-3) and two partial sequences were identified in T. brasiliensis (Tb4-5), and an additional four partial sequences were identified in M. molossus (Mm1-4). Phylogenomic analysis showed that the novel AlphaCoV clustered in two different lineages distinct from the 15 officially recognized AlphaCoV subgenera. Tb2 and Tb3 isolates appeared to be variants of the same virus, probably involved in a persistent infectious cycle within the T. brasiliensis colony. Using recombination analysis, we detected a statistically significant event in Spike gene, which was reinforced by phylogenetic tree incongruence analysis, involving novel Tb1 and AlphaCoVs identified in Eptesicus fuscus (family Vespertilionidae) from the U.S. The putative recombinant region is in the S1 subdomain of the Spike gene, encompassing the potential receptor-binding domain of AlphaCoVs. This study reports the first AlphaCoV genomes in molossids from the Americas and provides new insights into recombination as an important mode of evolution of coronaviruses involved in cross-species transmission. IMPORTANCE This study generated three novel complete AlphaCoV genomes (Tb1, Tb2, and Tb3 isolates) identified in individuals of Tadarida brasiliensis from Argentina, which showed two different evolutionary patterns and are the first to be reported in the family Molossidae in the Americas. The novel Tb1 isolate was found to be involved in a putative recombination event with alphacoronaviruses identified in bats of the genus Eptesicus from the U.S., whereas isolates Tb2 and Tb3 were found in different collection seasons and might be involved in persistent viral infections in the bat colony. These findings contribute to our knowledge of the global diversity of bat coronaviruses in poorly studied species and highlight the different evolutionary aspects of AlphaCoVs circulating in bat populations in Argentina.

Arch Virol ; 168(10): 251, 2023 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-37702836


One of the challenges associated with introducing a vaccine is monitoring its impact through clinical and molecular surveillance. The aims of this study were to analyze the genetic diversity of rotavirus A in Argentina between 2019 and 2022 and to assess the phylogenetic and phylodynamic features of the unusual G6 strains detected. A significant decline in the Wa-like genogroup strains was observed, and G6 strains were detected for the first time in Argentina, in association with P[8] and P[9]. Spatiotemporal analysis showed that the G6-lineage I strains detected recently in Argentina and Brazil might have emerged from European strains. This study provides recent evidence of the genetic diversity of rotaviruses in isolated cases. It is considered important to support continuous surveillance of rotavirus in the post-vaccine scenario, mainly to evaluate potential changes that may occur after the COVID-19 pandemic.

COVID-19 , Rotavirus , Humanos , Rotavirus/genética , Argentina/epidemiología , Pandemias , Filogenia , COVID-19/epidemiología , Variación Genética
Int J Qual Health Care ; 35(3)2023 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-37572096


Heart failure (HF) is a major clinical and public health problem associated with significant mortality, morbidity, and health-care costs. Despite the existence of evidence-based guidelines for the optimal treatment of HF, the quality of care remains suboptimal. Our aim was to increase the use a care bundle in 50% of enrolled subjects during their hospitalization and discharge and to reduce their readmission for HF causes by 10%. We conducted an uncontrolled before-after study in eight hospitals in Argentina to evaluate the effect of a quality improvement intervention on the use of an HF care bundle in patients with HF New York Heart Association (NYHA) Class II-III. The HF bundle of care included medication, continuum of care, lifestyle habits, and predischarge examinations. Training and follow-up of multidisciplinary teams in each center were performed through learning sessions and plan-do-study-act improvement cycles. Data collectors reviewed bundle compliance in the health records of recruited patients after their hospital discharge and verified readmissions through phone calls to patients within 30-40 days after discharge. We recruited 200 patients (83 before and 127 during the intervention phase), and bundle compliance increased from 9.6% to 28.3% [odds ratio 3.71, 95% confidence interval (8.46; 1.63); P = .002]. Despite a slow improvement during the first months, bundle compliance gained momentum near the end of the intervention surpassing 80%. We observed a non-significant decreased readmission rate within 30 days of discharge due to HF in the postintervention period [8.4% vs. 5.5%, odds ratio 0.63, 95% CI (1.88; 0.21); P = .410]. Qualitative analysis showed that members of the intervention teams acknowledged the improvement of work organization and standardization of care, teamwork, shared mental model, and health record completeness as well as the utility of training fellows. Despite the challenges related to the pandemic, better care of patients with HF NYHA Class II-III was possible through simple interventions and collaborative work. Graphical abstract.

COVID-19 , Insuficiencia Cardíaca , Humanos , Pandemias , Mejoramiento de la Calidad , Argentina/epidemiología , COVID-19/epidemiología , COVID-19/terapia , Insuficiencia Cardíaca/terapia , Readmisión del Paciente
Hist Cienc Saude Manguinhos ; 30(suppl 1): e2023030, 2023.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37585975


This article analyzes feelings, experiences, practices, and actions that underlie the meanings attributed to the covid-19 pandemic. Based on a case study located in the province of Tucumán (Argentina), a mixed-methods investigation was developed, interested in capturing life experiences. Discourse analysis show the resignification of life itself, the valorization of close ties, community social capital, the State and politics. From the personal to the political, the interpretive frames people use to signify life experiences during the covid-19 pandemic exhibit differentiated feelings, experiences, practices, and actions.

Este artículo analiza sentimientos, experiencias, prácticas y acciones que subyacen a los significados atribuidos a la pandemia por covid-19. A partir de un estudio de caso situado en la provincia de Tucumán (Argentina), se desarrolló una investigación mixta, interesada en captar experiencias de vida. Los discursos evidencian la resignificación de la propia vida, la valorización de los vínculos, el capital social comunitario, el Estado y la política. Desde lo personal o desde lo político, el marco interpretativo con el que las personas significan las experiencias de vida durante la pandemia por covid-19 configura sentimientos, experiencias, prácticas y acciones diferenciadas.

COVID-19 , Pandemias , Humanos , Argentina/epidemiología , Acontecimientos que Cambian la Vida , COVID-19/epidemiología , Política
Artículo en Inglés | MEDLINE | ID: mdl-37569050


The COVID-19 pandemic negatively affected mental health worldwide and college students were particularly vulnerable to its adverse effects. This longitudinal study was designed to highlight and compare the COVID experiences of college students in Argentina and the USA (N = 361). Specifically, we examined individual factors (gender, emotional regulation, and social support) assessed prior to the pandemic for their role as predictors or moderators of COVID-fear and psychological stress during the first months of the pandemic. The results supported measurement invariance for brief measures of COVID-fear and indicated that, overall, COVID-fear was highest during the second wave of the study (March-April 2020), lowest during the third wave (June 2020), and then rose again during the fourth wave (September 2020). Several interaction effects emerged, revealing important country-level differences in COVID-fear effects for the emotion regulation and social support factors. More so in the Argentina sample than in the USA sample, higher levels of social support at Time 1 were associated with increases in the effect of COVID-fear on stress among students. We discussed the implications of these and other findings for future cross-cultural pandemic-related stress studies.

COVID-19 , Humanos , Argentina/epidemiología , COVID-19/epidemiología , Estudios Longitudinales , Pandemias , Estudiantes , Miedo
Interdisciplinaria ; 40(2): 445-460, ago. 2023. tab
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1448504


Resumen La pandemia ha generado un nuevo entorno que establece determinadas exigencias o demandas de actuación a las personas, potenciales estresores que pueden desencadenar el proceso de estrés, al que se le podría denominar Estrés de Pandemia (EDP). A este contexto, se sumaron los cambios en la jornada laboral que derivaron en mayor interferencia entre la familia y el trabajo. De esta manera, se volvió relevante generar conocimiento sobre la temática durante este contexto particular. El objetivo del presente estudio fue determinar la asociación entre el (EDP) y el Conflicto Trabajo-Familia (CTF) y Familia-Trabajo (CFT). Además, se indagaron diferencias de grupos según factores laborales como la modalidad de trabajo y la tenencia o no de niños a cargo, entre otros. Se utilizó el Inventario SISCO de EDP (Macías, 2020), la escala de CTF y CFT (Netemeyer et al., 1996) y un cuestionario ad-hoc. Los participantes fueron 637 adultos (M.edad = 38.14, DS = 13.05, femenino = 487). Se encontraron asociaciones positivas entre las variables CFT y CTF y ambas se asociaron de manera positiva con el EDP. Quienes trabajaron de manera virtual evidenciaron mayor CFT y quienes lo hicieron, tanto virtual como presencialmente fueron los que más puntuaron en CTF. Finalmente, quienes tenían niños a cargo tuvieron mayor CFT y CTF. En conclusión, el estrés en torno al COVID-19 se vincula con mayor interferencia y conflictos entre el ámbito laboral y el familiar.

Abstract Pandemic Stress can be defined as a psychological state produced by an adaptation process where the individual values ​​the environment demands, determined by the pandemic, as overflowing with their resources to carry them out effectively (Macías, 2020). The change in routine carries the possibility of an increase in relation to work-family conflict. Family conflict involves two directions: work can interfere with the family (family work conflict or FWC) and the family can interfere with work (work family conflict, or WFC) (Bellavia y Frone, 2005) because of the incompatibility of responsibilities in the workplace and family (Greenhaus y Beutell, 1985). Added to this context are changes in the working day and, since there are no studies that analyze the relationships between SP and family and work conflict, it becomes relevant to generate knowledge on this issue during this context that humanity is going through. In this way, the aim was to establish the association between Pandemic Stress (PS), Work-Family Conflict (WFC) and Family-Work Conflict (FWC). In addition, the possible existence of group differences was analyzed according to work factors such as work modality, and the possession or not of dependent children. SISCO Pandemic Stress Inventory (Macías, 2020), the Work-Family Conflict and Family-Work Conflict scale (Netemeyer et al., 1996) and an ad-hoc questionnaire were used. The participants were 637 adults (M.age = 38.14, SD = 13.05, female = 487). Positive associations were found between the variables WFC and FWC, and both were positively associated with PS. Those who worked virtually showed higher FWC and those who did it both virtually and in person, were the ones who scored the most in WFC, realizing the difficulty in balancing family and work demands. This could be due to the difficulty for parents who worked outside the home, since they had to organize alternative solutions to take care of their children, which is hampered by the closure of establishments, difficulty in mobilizing and preventive and mandatory isolation of social networks that, in another context, contribute to the care of children. It is of great relevance to consider that the majority of those surveyed have been women, being the most likely to report that the excessive amount of housework made it difficult for them to combine work and family (Blasko, 2020). Finally, those who had children had higher WFC and FWC. In this sense, Gutierrez et al. (2020) explain that in households the unpaid workload and care has increased, which falls unequally on women, a fact that further limits their availability of time to develop productive and / or work activities. Following Park et al. (2020), being young, being female, and being a caregiver increase the risk of exposure to stressors and a greater level of stress. In conclusion, the lawsuits surrounding COVID-19 interfere in conflicts between the workplace and the family. This shows the importance of carrying out evidence-based interventions aimed at mitigating the effects of SP due to COVID-19 and reducing WFC and FWC. In this sense, the present research provides an advance in the understanding of interference between home and work, as well as the impact of the pandemic in both spheres of daily life.

Interdisciplinaria ; 40(2): 461-477, ago. 2023. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1448505


Resumen El objetivo de este estudio fue conocer si la temporalidad subjetiva -perspectiva y foco temporales- y la capacidad de autocontrol e impulsividad repercuten en el malestar psicológico, en particular durante la pandemia por COVID-19. La conjetura teórica es que el tiempo psicológico está estrechamente vinculado a la autorregulación, que influye en el desarrollo de la impulsividad y el autocontrol e impacta en el malestar psicológico. Se diseñó un modelo y se realizó un estudio empírico cuantitativo, no experimental y transversal (. = 279; 78 % mujeres; ME = 30.14 años; DE = 11.21). Los resultados del análisis de correlación mostraron relaciones significativas entre las variables de interés. Para determinar las variables predictoras del malestar psicológico se realizó un análisis de regresión lineal múltiple. El 48 % de la varianza del malestar psicológico fue explicado por el pasado negativo, autocontrol e impulsividad, y focos temporales futuro y presente. Finalmente, se probó el modelo teórico diseñado para analizar los efectos directos e indirectos del malestar psicológico a través de un análisis de senderos que presentó un buen ajuste a los datos, ya que explicó el 50 % de la varianza de aquel. La perspectiva y el foco temporal explicaron el 53 % de la variabilidad del autocontrol, y presentaron efectos indirectos sobre el malestar psicológico a través del autocontrol. El autocontrol influyó de manera inversa en el malestar. Los hallazgos indican que el tiempo subjetivo y el autocontrol sirven para explicar estados psicológicos, incluso en pandemia, lo cual confirma estudios previos que muestran la importancia de las variables de personalidad -además de las biológicas y contextuales- en la aparición de malestar psicológico.

Abstract Psychological time is an essential aspect of humans. Two of the most important notions of subjective temporality are time perspective and temporal focus. Time perspective is a process by which the flow of personal and social experiences are framed in five different temporal categories: past negative, past positive, present hedonistic, present fatalistic and future. Temporal focus refers to the attention people devote to thinking about the past, present, and future. Previous research shows there is a strong relation between psychological time and self-regulatory processes, specifically self-control and impulsivity. Self-control is the ability to inhibit impulsive behaviors or reactions that can keep the person from pursuing the proposed goals. On the other hand, impulsivity refers to a short attention span and a tendency to engage in risky behaviors, and to prefer immediate rewards. Both subjective temporality and self-regulatory processes influence behaviors and psychological states such as psychological distress. In particular, the objective of this study was to find out if subjective temporality -time perspective and temporal focus-- and self-control and impulsivity have repercussions on psychological distress, particularly during the COVID-19 pandemic, in an Argentinian sample. The theoretical conjecture is that subjective temporality is closely linked to self-regulation, which influences the development of impulsivity and self-control, and impacts psychological distress. A quantitative, non-experimental, and cross-sectional empirical study was carried out (. = 279; 78 % women; ME = 30.14 years old; SD = 11.21). Firstly, the results of the correlational analysis showed significant relations between the variables. Then, to facilitate further analyses, an index variable of self-control was created, which included the scores of self-control and three dimensions of impulsivity. An optimal parallel analysis was performed. It indicated the existence of a single dimension. Then a semi-confirmatory factor analysis was ran, which showed acceptable results (KMO = .68; X. (6) = 198.8, . < .001; GFI = .99; RMSR = 0.03). Thirdly, to determine the predictive variables of psychological distress, a multiple linear regression analysis was performed. It was found that 48 % of the variance of psychological distress was explained by negative past, self-control index, and future and present temporal focuses (. (4, 266) = 64.66, . < .001, R. = .49, R. adjusted = .48). The best predictor variable was past negative. Afterwards, a theoretical model was tested to explain the direct and indirect causes of psychological distress. It presented a good fit (X./gl = 1.63; GFI = .99; RMSEA = .04). Time perspective and temporal focus explained 53 % of the variability of self-control and presented indirect effects on psychological distress through self-control. Self-control inversely influenced psychological distress; more self-control generates less psychological distress. The model explained half of the variance of psychological distress (R. = .50). The findings indicate that subjective temporality and self-control explain psychological states, even during a pandemic, which confirms previous studies that show the importance of personality variables -in addition to biological and contextual variables- in the manifestation of psychological distress. The results support the theory that psychological time can be considered as a personality trait underlying self-control and psychological distress. A theoretical and practical discussion of the results is presented.

Int J Transgend Health ; 24(3): 320-333, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37519918


Background: Lockdown measures are effective to control COVID-19 spread; however, concerns have increased regarding its impact on transgender and non-binary people. Aims: This study describes self-reported changes in mental health, substance use, experiences of violence, and access to health care and basic services among transgender and non-binary population from Argentina after two months of implementation of the lockdown. Methods: An online national survey was responded by 182 participants (72 transfeminine [TF], 66 transmasculine [TM], 44 non-binary [NB] people) between May and June 2020. The questionnaire was informed by the results of focus groups, reviewed by activists, and disseminated through social media. Descriptive statistics were used to summarize data. Results: The COVID-19 pandemic and the lockdown have had a general negative impact on the participants. TF participants reported a greater proportion of negative changes in the socioeconomic aspect, such as reduction in income and barriers to access basic services (housing, food, hygiene products and financial assistance). TM and NB participants reported higher proportions of adverse psychological impact, with high frequencies of intense negative emotions and suicidal ideation. A general reduction in substance use was observed in the three groups. The most frequent source of violence in the three groups was from a family member, especially among NB participants. Half of the TF and TM individuals reported difficulties to access or continue their hormone therapy. TM and NB participants reported considerable barriers to access mental health care. Conclusion: The COVID-19 pandemic and the prolonged lockdown have had a negative impact on the transgender and NB population, aggravating their preexisting situation of vulnerability and exclusion. Furthermore, this impact affected each subgroup differently in a particular and specific way.

Clin Infect Dis ; 77(Suppl 1): S4-S11, 2023 07 05.
Artículo en Inglés | MEDLINE | ID: mdl-37406043


BACKGROUND: High rates of antibiotic use (AU) among inpatients with coronavirus disease 2019 (COVID-19) despite low rates of bacterial coinfection and secondary infection have been reported. We evaluated the impact of the COVID-19 pandemic on AU in healthcare facilities (HCFs) in South America. METHODS: We conducted an ecologic evaluation of AU in inpatient adult acute care wards in 2 HCFs each in Argentina, Brazil, and Chile. The AU rates for intravenous antibiotics were calculated as the defined daily dose per 1000 patient-days, using pharmacy dispensing records and hospitalization data from March 2018-February 2020 (prepandemic) and March 2020-February 2021 (pandemic). Differences in median AU were compared between the prepandemic and pandemic periods, using the Wilcoxon rank sum test to determine significance. Interrupted time series analysis was used to analyze changes in AU during the COVID-19 pandemic. RESULTS: Compared with the prepandemic period, the median difference in AU rates for all antibiotics combined increased in 4 of 6 HCFs (percentage change, 6.7%-35.1%; P < .05). In the interrupted time series models, 5 of 6 HCFs had significant increases in use of all antibiotics combined immediately at the onset of the pandemic (immediate effect estimate range, 15.4-268), but only 1 of these 5 HCFs experienced a sustained increase over time (change in slope, +8.13; P < .01). The effect of the pandemic onset varied by antibiotic group and HCF. CONCLUSIONS: Substantial increases in AU were observed at the beginning of the COVID-19 pandemic, suggesting the need to maintain or strengthen antibiotic stewardship activities as part of pandemic or emergency HCF responses.

Antibacterianos , COVID-19 , Humanos , Adulto , Antibacterianos/uso terapéutico , COVID-19/epidemiología , Pacientes Internos , Pandemias , Chile/epidemiología , Argentina/epidemiología , Brasil
Arch Argent Pediatr ; 121(4): e202310054, 2023 Aug 01.
Artículo en Español | MEDLINE | ID: mdl-37471382


The frequency of the severity of the different expressions of SARS-COV-2 disease, and its mortality in the pediatric population have been low unlike in the adult population. However, children and adolescents have been very affected by this virus, through the restriction and limitations of their rights. The Subcommittee on the Rights of the Childhood and Adolescence and the Committee of Social Pediatrics of the Sociedad Argentina de Pediatría understood that it was very important to gather their voices to weigh the impact of the transition from COVID pandemic to this "new normalcy" and the effects on argentine children and adolescents' rights, emotions and desires, especially those related to accessibility to education and health. We carried on a qualitative descriptive narrative transversal phenomenological research, through an open anonymous survey, among children and adolescents between 6 and 18 years old, living in Argentina; 1537 surveys were collected. The research findings allowed elaborate recommendations to develop strategies to face, protect and accompany the children and adolescents during the post-pandemic.

La mortalidad y formas graves atribuibles al COVID-19 en población pediátrica han sido bajas en comparación con los adultos. No obstante, los niños, niñas y adolescentes (NNA) constituyen un universo especialmente afectado por la pandemia, en cuanto a restricción y limitación de sus derechos. La Subcomisión de Derechos de la Niñez y Adolescencia y el Comité de Pediatría Social de la Sociedad Argentina de Pediatría entendieron trascendente recolectar sus voces para relevar el impacto que la transición de la situación de pandemia por COVID-19 a la actual "nueva normalidad" ha producido en los sentimientos, emociones y deseos de los NNA en Argentina. Realizamos un estudio cualitativo, descriptivo, basado en encuesta anónima, entre NNA argentinos de 6 a 18 años residentes en Argentina. El análisis incluyó 1537 entrevistas efectivas. Los resultados permitieron sugerir recomendaciones para desarrollar estrategias de afrontamiento, contención y acompañamiento de los NNA en la pospandemia.

Arch. argent. pediatr ; 121(3): e202202767, jun. 2023. tab, graf
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1435635


Introducción. La pubertad se manifiesta inicialmente por la aparición de los caracteres sexuales secundarios, como consecuencia de cambios hormonales que progresivamente conducen a la madurez sexual completa. En Argentina y el mundo, la pandemia ocasionada por el coronavirus SARS-CoV-2 generó un confinamiento que pudo haber interferido en el inicio y tempo del desarrollo puberal. Objetivo. Describir la percepción de los endocrinólogos pediatras del país sobre las consultas por sospecha de pubertad precoz y/o pubertad de rápida progresión durante la pandemia. Materiales y métodos. Estudio descriptivo, observacional, transversal. Encuesta anónima a endocrinólogos pediatras pertenecientes a la Sociedad Argentina de Pediatría y/o a la Asociación de Endocrinología Pediátrica Argentina, en diciembre de 2021. Resultados. Respondieron la encuesta 83 de 144 endocrinólogos pediátricos (tasa de respuesta 58 %). Todos consideraron que aumentó la consulta por desarrollo precoz o temprano, ya sea en sus variantes telarca precoz (84 %), pubarca precoz (26 %) y/o pubertad precoz (95 %). El 99 % acuerda con que se ha dado en mayor medida en niñas. La totalidad de los encuestados también considera que aumentó el diagnóstico de pubertad precoz central. El 96,4 % considera que ha aumentado el número de pacientes tratados con análogos de GnRH. Conclusión. Nuestros resultados sobre la percepción de endocrinólogos pediatras coinciden con datos publicados en otras regiones sobre el aumento del diagnóstico de pubertad precoz durante la pandemia por COVID-19. Se reafirma la necesidad de generar registros nacionales de pubertad precoz central, difundir las evidencias para su detección y abordaje oportuno.

Introduction. Puberty is manifested initially by the onset of secondary sexual characteristics as a result of hormonal changes that progressively lead to complete sexual maturity. In Argentina and worldwide, the lockdown resulting from the SARS-CoV-2 pandemic may have interfered in the onset and timing of pubertal development. Objective. To describe the perception of pediatric endocrinologists in Argentina regarding consultations for suspected precocious and/or rapidly progressive puberty during the pandemic. Materials and methods. Descriptive, observational, cross-sectional study. Anonymous survey among pediatric endocrinologists members of the Sociedad Argentina de Pediatría and/or the Asociación de Endocrinología Pediátrica Argentina administered in December 2021. Results. Out of 144 pediatric endocrinologists, 83 completed the survey (rate of response: 58%). All of them considered that consultation for precocious or early puberty increased, either in terms of early thelarche (84%), early pubarche (26%), and/or precocious puberty (95%). Ninety-nine percent agreed that this has occurred to a greater extent in girls. All survey respondents also consider that the diagnosis of central precocious puberty has increased. In total, 96.4% of respondents consider that the number of patients treated with GnRH analogs has increased. Conclusion. Our results about the perception of pediatric endocrinologists are consistent with data published in other regions on the increase in the diagnosis of precocious puberty during the COVID-19 pandemic. We underscore the need to develop national registries of central precocious puberty, and to disseminate the evidence for a timely detection and management

Humanos , Niño , Pubertad Precoz/diagnóstico , Pubertad Precoz/epidemiología , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Estudios Transversales , Pandemias , Endocrinólogos , SARS-CoV-2
Artículo en Inglés | PAHO-IRIS | ID: phr-57667


[ABSTRACT]. Objectives. To implement and evaluate the use of wastewater sampling for detection of severe acute respira- tory syndrome coronavirus 2 (SARS-CoV-2) in two coastal districts of Buenos Aires Province, Argentina. Methods. In General Pueyrredon district, 400 mL of wastewater samples were taken with an automatic sam- pler for 24 hours, while in Pinamar district, 20 L in total (2.2 L at 20-minute intervals) were taken. Samples were collected once a week. The samples were concentrated based on flocculation using polyaluminum chloride. RNA purification and target gene amplification and detection were performed using reverse transcription poly- merase chain reaction for clinical diagnosis of human nasopharyngeal swabs. Results. In both districts, the presence of SARS-CoV-2 was detected in wastewater. In General Pueyrre- don, SARS-CoV-2 was detected in epidemiological week 28, 2020, which was 20 days before the start of an increase in coronavirus virus disease 2019 (COVID-19) cases in the first wave (epidemiological week 31) and 9 weeks before the maximum number of laboratory-confirmed COVID-19 cases was recorded. In Pinamar district, the virus genome was detected in epidemiological week 51, 2020 but it was not possible to carry out the sampling again until epidemiological week 4, 2022, when viral circulation was again detected. Conclusions. It was possible to detect SARS-CoV-2 virus genome in wastewater, demonstrating the useful- ness of the application of wastewater epidemiology for long-term SARS-CoV-2 detection and monitoring.

[RESUMEN]. Objetivos. Aplicar y evaluar la utilización de muestreos de aguas residuales como método para la detección del coronavirus del síndrome respiratorio agudo severo de tipo 2 (SARS-CoV-2) en dos distritos costeros de la Provincia de Buenos Aires, Argentina. Métodos. Se utilizó un dispositivo de muestreo automático para tomar muestras de 400 mL de las aguas residuales de 24 horas en el distrito de General Pueyrredon, mientras que en el distrito de Pinamar se tomaron muestras de 2,2 L a intervalos de 20 minutos hasta un volumen total de 20 L. Los muestreos se realizaron una vez por semana. Las muestras se concentraron mediante floculación con policloruro de aluminio. La purificación del ARN y la amplificación y detección del gen diana se llevaron a cabo mediante la prueba de reacción en cadena de la polimerasa con retrotranscripción para el diagnóstico clínico a partir de hisopados nasofaríngeos. Resultados. Se observó la presencia de SARS-CoV-2 en las aguas residuales de ambos distritos. En General Pueyrredon, el SARS-CoV-2 se halló en la semana epidemiológica 28 del 2020, es decir, 20 días antes del inicio del aumento de casos de enfermedad por coronavirus 2019 (COVID-19) registrado en la primera ola (semana epidemiológica 31) y nueve semanas antes de que se alcanzara el número máximo de casos de COVID-19 con confirmación de laboratorio. En el distrito de Pinamar se detectó el genoma viral en la semana epidemiológica 51 del 2020, pero solo se pudo volver a realizar el muestreo en la semana epidemiológica 4 del 2022, en la que se volvió a detectar la circulación del virus. Conclusiones. Se pudo detectar el genoma del virus SARS-CoV-2 en aguas residuales, lo que muestra la utilidad de la aplicación de la epidemiología de aguas residuales como método para la detección y el segui- miento del SARS-CoV-2 a largo plazo.

[RESUMO]. Objetivos. Implementar e avaliar o uso de amostragem de águas residuais na detecção do coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2) em dois distritos costeiros da Província de Buenos Aires, Argentina. Métodos. No distrito de General Pueyrredon, amostras de 400 mL de águas residuais foram coletadas ao longo de 24 horas com um amostrador automático; já no distrito de Pinamar, foram coletados 20 L no total (2,2 L a intervalos de 20 minutos). As amostras foram coletadas uma vez por semana e concentradas por flocu- lação com cloreto de polialumínio. A purificação do RNA e a amplificação e detecção de genes-alvo foram realizadas por meio de reação em cadeia da polimerase com transcrição reversa para diagnóstico clínico de esfregaços nasofaríngeos humanos. Resultados. Detectou-se presença de SARS-CoV-2 em águas residuais dos dois distritos. Em General Puey- rredon, o SARS-CoV-2 foi detectado na semana epidemiológica 28 de 2020, ou seja, 20 dias antes do início de um aumento no número de casos da doença provocada pelo coronavírus de 2019 (COVID-19) na primeira onda (semana epidemiológica 31) e 9 semanas antes de se registrar o número máximo de casos de COVID-19 confirmados em laboratório. No distrito de Pinamar, o genoma viral foi detectado na semana epidemiológica 51 de 2020, mas não foi possível realizar a amostragem novamente até a semana epidemiológica 4 de 2022, quando a circulação do vírus foi novamente constatada. Conclusões. Foi possível detectar o genoma do vírus SARS-CoV-2 em águas residuais, demonstrando a uti- lidade da aplicação da epidemiologia baseada em águas residuais para detectar e monitorar o SARS-CoV-2 em longo prazo.

SARS-CoV-2 , Aguas Residuales , Brotes de Enfermedades , Monitoreo del Ambiente , Argentina , Aguas Residuales , Brotes de Enfermedades , Monitoreo del Ambiente , Aguas Residuales , Brotes de Enfermedades , Monitoreo del Ambiente
Nat Commun ; 14(1): 3557, 2023 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-37322028


At over 0.6% of the population, Peru has one of the highest SARS-CoV-2 mortality rate in the world. Much effort to sequence genomes has been done in this country since mid-2020. However, an adequate analysis of the dynamics of the variants of concern and interest (VOCIs) is missing. We investigated the dynamics of the COVID-19 pandemic in Peru with a focus on the second wave, which had the greatest case fatality rate. The second wave in Peru was dominated by Lambda and Gamma. Analysis of the origin of Lambda shows that it most likely emerged in Peru before the second wave (June-November, 2020). After its emergence it reached Argentina and Chile from Peru where it was locally transmitted. During the second wave in Peru, we identify the coexistence of two Lambda and three Gamma sublineages. Lambda sublineages emerged in the center of Peru whereas the Gamma sublineages more likely originated in the north-east and mid-east. Importantly, it is observed that the center of Peru played a prominent role in transmitting SARS-CoV-2 to other regions within Peru.

COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/genética , COVID-19/epidemiología , Pandemias , Perú/epidemiología , Argentina
Medicina (B Aires) ; 83(3): 358-365, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37379532


INTRODUCTION: The objective was to assess the immunogenicity and effectiveness of vaccines against SARSCoV-2 in multiple sclerosis (MS) patients included in the Argentinean MS registry. METHODS: A prospective cohort study between May and December 2021. The primary outcome was immunogenicity and effectiveness of vaccines during a three-month follow-up. Immunogenicity was evaluated based on detection of total antibodies (Ab) against spike protein and neutralizing Ab in serum 4 weeks after the second vaccine dose. A positive COVID-19 case was defined according to Argentinean Ministry of Health. RESULTS: 94 patients were included, mean age: 41.7 ± 12.1 years. Eighty (85.1%) had relapsing remitting multiple sclerosis (RRMS); 30 (31.9%) were under fingolimod treatment. The Sputnik V vaccine was the first dose in 33 (35.1%), and AstraZeneca in 61 (64.9%). In 60 (63.8%), the vaccine elicited a specific humoral response. Immunological response according to the vaccination schemes showed no qualitative differences (p = 0.45). Stratified analysis according to the MS treatment showed that a significantly smaller number of subjects developed antibodies against spike antigen among those that were on ocrelizumab compared to other groups (p = 0.001), while a reduced number of patients under ocrelizumab where evaluated (n = 7). This was also observed for neutralizing antibodies in the ocrelizumab group (p < 0.001). During the three-month follow-up, two individuals were diagnosed with COVID-19. CONCLUSION: We found that MS patients that received Sputnik V or AstraZeneca vaccines for SARS-CoV-2 developed a serological response with no differences between the vaccines used.

Introducción: El objetivo fue evaluar la inmunogenicidad y efectividad de las vacunas contra el SARS-CoV-2 en pacientes con esclerosis múltiple (EM) incluidos en el registro argentino de EM (RelevarEM, NCT03375177). Métodos: Estudio de cohorte prospectivo entre mayo y diciembre 2021. Se evaluó la inmunogenicidad (detección de anticuerpos totales (Ab) contra proteína espiga y anticuerpos neutralizantes en suero) y eficacia (nueva infección por COVID-19) durante seguimiento de tres meses. El momento de detección de anticuerpos fue 4 semanas después de segunda dosis de vacuna. Un caso positivo de COVID-19 se definió de acuerdo con la definición del Ministerio de Salud. Resultados: Se incluyeron 94 pacientes, edad media de 41.7 ± 12.1 años. Ochenta (85.1%) tenían EM remitente-recurrente; 30 (31.9%) en tratamiento con fingolimod. La vacuna Sputnik V fue usada en 33 (35.1%), mientras que AstraZeneca se administró en 61 (64.9%). En 60 pacientes (63.8 %), la vacuna provocó respuesta humoral específica. La respuesta inmunológica según esquemas de vacunación (Sputnik V, Astra Zeneca o esquemas heterólogos) no mostró diferencias cualitativas (p = 0.45). El análisis estratificado según tratamiento recibido para la EM mostró que número significativamente menor de sujetos desarrolló anticuerpos contra el antígeno espiga en los pacientes que recibieron ocrelizumab (p = 0.001), aunque con un número reducido de pacientes evaluados bajo este tratamiento (n = 7). Esto también se observó para anticuerpos neutralizantes en el grupo bajo ocrelizumab (p < 0.001). Durante el seguimiento de tres meses, dos personas fueron diagnosticadas con COVID-19. Conclusión: Encontramos que los pacientes con EM que recibieron vacunas Sputnik V o AstraZeneca para el SARS-CoV-2 desarrollaron respuesta serológica sin diferencias entre las vacunas utilizadas.

COVID-19 , Esclerosis Múltiple , Humanos , Adulto , Persona de Mediana Edad , Vacunas contra la COVID-19 , Argentina/epidemiología , Estudios Prospectivos , COVID-19/prevención & control , SARS-CoV-2 , Anticuerpos Neutralizantes , Vacunación , Anticuerpos Antivirales
Medicina (B Aires) ; 83(3): 442-454, 2023.
Artículo en Español | MEDLINE | ID: mdl-37379541


The Muñiz hospital is an institution with historical, cultural and health heritage. A historical analysis of the different epidemics/pandemics and outbreaks is carried out here, assessing the epidemiological management (surveillance, prevention, control and emergency management) in the institution and the reason for its architecture. To this end, a systematic review of the literature on the history of the Muñiz hospital and its references was carried out, since 1980 to 2023, following the PRISMA format. Thirty-six publications were found that met the required methodological and epidemiological criteria. The review shows the relevant health problems, the events present in an epidemic/ pandemic, the importance of preventive measures and to assess the need for a continuous epidemiological surveillance system, as well as the contribution of historical methodological references that allow obtaining useful information in the health area. We have addressed great historical moments in epidemiology, explaining the management of diseases or epidemics/pandemics at the Muñiz hospital, which were largely related to the society of the time (paradigms). It should be noted that population growth spread diseases throughout the planet, generating threats, and that epidemics/pandemics transformed societies and quite possibly have decisively changed the course of history, as happened with the COVID-19 pandemic.

El hospital Muñiz es una institución con patrimonio histórico, cultural y sanitario. Se realiza aquí un análisis histórico de las diferentes epidemias/pandemias y brotes, valorando los manejos epidemiológicos (vigilancia, prevención, control y gestión de emergencias) en la institución y el porqué de su arquitectura. Para tal fin se lleva a cabo una revisión sistemática de la literatura sobre la historia del hospital Muñiz y sus referentes desde 1980 hasta 2023, siguiendo el formato PRISMA. Se encontraron 36 publicaciones que cumplieron con los criterios metodológicos y epidemiológicos requeridos. La revisión muestra los problemas relevantes en salud, los eventos presentes en una epidemia/pandemia, la importancia de medidas de prevención y de evaluar la necesidad de un sistema de vigilancia epidemiológica continuo, así como el aporte de referentes históricos metodológicos que permita obtener información útil en el área de salud. Hemos abordado grandes momentos históricos en la epidemiología explicando el manejo de las enfermedades o epidemias/pandemias en el hospital Muñiz, las cuales se relacionaron en gran medida a la sociedad de la época (paradigmas). Cabe resaltar que el crecimiento poblacional extendió las enfermedades a lo largo del planeta generando amenazas y que las epidemias/ pandemias transformaron las sociedades y muy posiblemente han cambiado decisivamente el curso de la historia, tal como paso con la pandemia por COVID-19.

COVID-19 , Humanos , COVID-19/epidemiología , Pandemias , Argentina/epidemiología , Brotes de Enfermedades , Hospitales
Travel Med Infect Dis ; 54: 102604, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37315827


BACKGROUND: Several gastrointestinal complications have been reported in patients with COVID-19, including motility disorders, such as acute colonic pseudo-obstruction (ACPO). This affection is characterized by colonic distention in the absence of mechanical obstruction. ACPO in the context of severe COVID-19 may be related to neurotropism and direct damage of SARS-CoV-2 in enterocytes. METHOD: We conducted a retrospective study of patients who were hospitalized for critical COVID-19 and developed ACPO between March 2020 and September 2021. The diagnostic criteria to define ACPO was the presence of 2 or more of the following: abdominal distension, abdominal pain, and changes in the bowel movements, associated with distension of the colon in computed tomography. Data of sex, age, past medical history, treatment, and outcomes were collected. RESULTS: Five patients were detected. All required admission to the Intensive Care Unit. The ACPO syndrome developed with a mean of 33.8 days from the onset of symptoms. The mean duration of the ACPO syndrome was 24.6 days. The treatment included colonic decompression with placement of rectal and nasogastric tubes, endoscopy decompression in two patients, bowel rest, fluid, and electrolytes replacement. One patient died. The remaining resolved the gastrointestinal symptoms without surgery. CONCLUSIONS: ACPO is an infrequent complication in patients with COVID-19. It occurs especially in patients with critical condition, who require prolonged stays in intensive care and multiple pharmacological treatments. It is important to recognize its presence early and thus establish an appropriate treatment, since the risk of complications is high.

Viruses ; 15(6)2023 06 16.
Artículo en Inglés | MEDLINE | ID: mdl-37376681


The second wave of COVID-19 occurred in South America in early 2021 and was mainly driven by Gamma and Lambda variants. In this study, we aimed to describe the emergence and local genomic diversity of the SARS-CoV-2 Lambda variant in Argentina, from its initial entry into the country until its detection ceased. Molecular surveillance was conducted on 9356 samples from Argentina between October 2020 and April 2022, and sequencing, phylogenetic, and phylogeographic analyses were performed. Our findings revealed that the Lambda variant was first detected in Argentina in January 2021 and steadily increased in frequency until it peaked in April 2021, with continued detection throughout the year. Phylodynamic analyses showed that at least 18 introductions of the Lambda variant into the country occurred, with nine of them having evidence of onward local transmission. The spatial--temporal reconstruction showed that Argentine clades were associated with Lambda sequences from Latin America and suggested an initial diversification in the Metropolitan Area of Buenos Aires before spreading to other regions in Argentina. Genetic analyses of genome sequences allowed us to describe the mutational patterns of the Argentine Lambda sequences and detect the emergence of rare mutations in an immunocompromised patient. Our study highlights the importance of genomic surveillance in identifying the introduction and geographical distribution of the SARS-CoV-2 Lambda variant, as well as in monitoring the emergence of mutations that could be involved in the evolutionary leaps that characterize variants of concern.

COVID-19 , SARS-CoV-2 , Humanos , Argentina/epidemiología , SARS-CoV-2/genética , Filogenia , COVID-19/epidemiología , Mutación