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1.
Reumatol. clín. (Barc.) ; 16(6): 437-446, nov.-dic. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-194661

RESUMEN

OBJETIVO: Generar las recomendaciones para la atención de pacientes con enfermedades reumáticas que reciben terapias inmunomoduladoras e inmunosupresoras (fármacos convencionales, biológicos y moléculas pequeñas) durante la pandemia por COVID-19. MATERIALES Y MÉTODOS: Las recomendaciones se realizaron utilizando el método Delphi como herramienta de acuerdo. Se conformó un panel de expertos con trayectoria académica y experiencia en investigación en reumatología. Se realizó la búsqueda de la literatura y se generó el cuestionario del ejercicio Delphi conformado por 42 preguntas. El grado de acuerdo se logró con el 80% de aprobación de los participantes. RESULTADOS: Se conformó un grupo de 11 reumatólogos de 7 ciudades del país. La tasa de respuesta fue del 100% para las 3 rondas de consulta. En la primera ronda se logró acuerdo en 35 preguntas, en la segunda ronda 37 y en la tercera ronda se logró el acuerdo de las 42 preguntas. CONCLUSIÓN: La recomendación para la mayoría de los tratamientos inmunomoduladores utilizados en reumatología es continuar con las terapias en pacientes que no tengan la infección y suspenderlas en aquellos con diagnóstico de SARS-CoV-2/COVID-19


OBJECTIVE: To produce recommendations for patients with rheumatological diseases receiving immunomodulatory and immunosuppressive therapies (conventional drugs, biologicals, and small molecules) during the COVID-19 pandemic. MATERIALS AND METHODS: The recommendations were determined using the Delphi method as an agreement tool. A panel of experts was formed, with academic backgrounds and research experience in rheumatology. A literature search was conducted and 42 questions were generated. The level of agreement was made with 80% of approval by the participants. RESULTS: A group of eleven rheumatologists from 7 cities in the country participated. The response rate was 100% for the three consultation rounds. In the first round, agreement was reached on 35 questions, on 37 in the second round, and on 42 questions in the third round. CONCLUSION: The recommendation for the majority of the pharmacological treatments used in rheumatology is to continue with immunomodulatory or immunosuppressive therapies in patients who do not have the infection, and to suspend it in patients with a diagnosis of SARS-CoV-2/COVID-19


Asunto(s)
Humanos , Enfermedades Reumáticas/tratamiento farmacológico , Factores Inmunológicos/administración & dosificación , Antirreumáticos/administración & dosificación , Infecciones por Coronavirus/tratamiento farmacológico , Enfermedades Reumáticas/complicaciones , Pautas de la Práctica en Medicina , Privación de Tratamiento/tendencias , Infecciones por Coronavirus/epidemiología , Pandemias/estadística & datos numéricos
2.
PLoS One ; 15(11): e0242185, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33175877

RESUMEN

Many affected counties have had experienced a shortage of personal protective equipment (PPE) during the coronavirus disease (COVID-19) pandemic. We aimed to investigate the needs of healthcare professionals and the technical difficulties faced by them during the initial outbreak. A cross-sectional web-based survey was conducted among the healthcare workforce in the most populous cities from three Latin American countries in April 2020. In total, 1,082 participants were included. Of these, 534 (49.4%), 263 (24.3%), and 114 (10.5%) were physicians, nurses, and other professionals, respectively. At least 70% of participants reported a lack of PPE. The most common shortages were shortages in gown coverall suits (643, 59.4%), N95 masks (600, 55.5%), and face shields (569, 52.6%). Professionals who performed procedures that generated aerosols reported shortages more frequently (p<0.05). Professionals working in the emergency department and primary care units reported more shortages than those working in intensive care units and hospital-based wards (p<0.001). Up to 556 (51.4%) participants reported the lack of sufficient knowledge about using PPE. Professionals working in public institutions felt less prepared, received less training, and had no protocols compared with their peers in working private institutions (p<0.001). Although the study sample corresponded to different hospital centers in different cities from the participating countries, sampling was non-random. Healthcare professionals in Latin America may face more difficulties than those from other countries, with 7 out of 10 professionals reporting that they did not have the necessary resources to care for patients with COVID-19. Technical and logistical difficulties should be addressed in the event of a future outbreak, as they have a negative impact on healthcare workers. Clinical trial registration: NCT04486404.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Personal de Salud/psicología , Equipo de Protección Personal/estadística & datos numéricos , Neumonía Viral/diagnóstico , Betacoronavirus/aislamiento & purificación , Brasil , Colombia , Infecciones por Coronavirus/virología , Estudios Transversales , Ecuador , Instituciones de Salud , Humanos , Pandemias , Neumonía Viral/virología , Encuestas y Cuestionarios
3.
Int J Soc Psychiatry ; : 20764020972445, 2020 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-33161822

RESUMEN

BACKGROUND: As the COVID-19 pandemic progresses, the fear of infection increases and, with it, the stigma-discrimination, which makes it an additional problem of the epidemic. However, studies about stigma associated with coronavirus are scarce worldwide. AIMS: To determine the association between stigmatisation and fear of COVID-19 in the general population of Colombia. METHOD: A cross-sectional study was carried out. A total of 1,687 adults between 18 and 76 years old (M = 36.3; SD = 12.5), 41.1% health workers, filled out an online questionnaire on Stigma-Discrimination and the COVID-5 Fear Scale, adapted by the research team. RESULTS: The proportion of high fear of COVID-19 was 34.1%; When comparing the affirmative answers to the questionnaire on stigma-discrimination towards COVID-19, it was found that the difference was significantly higher in the general population compared to health workers in most of the questions evaluated, which indicates a high level of stigmatisation in that group. An association between high fear of COVID-19 and stigma was evidenced in 63.6% of the questions in the questionnaire. CONCLUSION: Stigma-discrimination towards COVID-19 is frequent in the Colombian population and is associated with high levels of fear towards said disease, mainly people who are not health workers.

4.
Eur J Dev Res ; : 1-34, 2020 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-33162688

RESUMEN

Everyone, across borders, race and gender, is affected by the global COVID-19 pandemic-but not equally. In this paper, we examine a burgeoning new literature discussing the employment effects of COVID-19. We explore the extent to which COVID-19 will exacerbate gendered employment disparities, income generation gaps, and, ultimately, poverty gaps, using a simple microsimulation methodology. We test our approach in Colombia, which has implemented an unparalleled number of mitigation measures and has reopened its economy earlier than regional neighbors. We find that COVID-19 increases the poverty headcount to a daunting degree (between 3.0 and 9.1 pp increases). Mitigation measures vary considerably in their individual impact (up to 0.9 pp poverty reduction). A fiscally neutral Universal Basic Income program would cause larger poverty reductions. Importantly, both men and women report similar poverty impacts from the pandemic and mitigation policies, reflecting the magnitude of the downturn, the design of interventions and our own poverty measure.

5.
Infect Genet Evol ; 86: 104616, 2020 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-33157300

RESUMEN

INTRODUCTION: Venezuela and Colombia both adopted measures of containment early in response to the COVID-19 pandemic. However, Venezuela's ongoing humanitarian crisis has decimated its health care system, and forced millions of Venezuelans to flee through its porous border with Colombia. The extensive shared border, and illegal cross-border transit through improvised trails between the two countries are major challenges for public health authorities. We report the first SARS-CoV-2 genomes from Venezuela, and present a snapshot of the SARS-CoV-2 epidemiologic landscape in the Colombian-Venezuelan border region. METHODS: We sequenced and assembled viral genomes from total RNA extracted from nasopharyngeal (NP) clinical specimens using a custom reference-based analysis pipeline. Three assemblies obtained were subjected to typing using the Phylogenetic Assignment of Named Global Outbreak LINeages 'Pangolin' tool. A total of 376 publicly available SARS-CoV-2 genomes from South America were obtained from the GISAID database to perform comparative genomic analyses. Additionally, the Wuhan-1 strain was used as reference. RESULTS: We found that two of the SARS-CoV-2 genomes from Venezuela belonged to the B1 lineage, and the third to the B.1.13 lineage. We observed a point mutation in the Spike protein gene (D614G substitution), previously reported to be associated with increased infectivity, in all three Venezuelan genomes. Additionally, three mutations (R203K/G204R substitution) were present in the nucleocapsid (N) gene of one Venezuelan genome. CONCLUSIONS: Genomic sequencing demonstrates similarity between SARS-CoV-2 lineages from Venezuela and viruses collected from patients in bordering areas in Colombia and from Brazil, consistent with cross-border transit despite administrative measures including lockdowns. The presence of mutations associated with increased infectivity in the 3 Venezuelan genomes we report and Colombian SARS-CoV-2 genomes from neighboring borders areas may pose additional challenges for control of SARS-CoV-2 spread in the complex epidemiological landscape in Latin American countries. Public health authorities should carefully follow the progress of the pandemic and its impact on displaced populations within the region.

6.
Emerg Infect Dis ; 26(12): 2854-2862, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33219646

RESUMEN

Coronavirus disease (COVID-19) in Colombia was first diagnosed in a traveler arriving from Italy on February 26, 2020. However, limited data are available on the origins and number of introductions of COVID-19 into the country. We sequenced the causative agent of COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), from 43 clinical samples we collected, along with another 79 genome sequences available from Colombia. We investigated the emergence and importation routes for SARS-CoV-2 into Colombia by using epidemiologic, historical air travel, and phylogenetic observations. Our study provides evidence of multiple introductions, mostly from Europe, and documents >12 lineages. Phylogenetic findings validate the lineage diversity, support multiple importation events, and demonstrate the evolutionary relationship of epidemiologically linked transmission chains. Our results reconstruct the early evolutionary history of SARS-CoV-2 in Colombia and highlight the advantages of genome sequencing to complement COVID-19 outbreak investigations.

8.
Biomedica ; 40(Supl. 2): 27-33, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152185

RESUMEN

COVID-19 is the viral infection caused by SARS-CoV-2 declared by the World Health Organization (WHO) as a pandemic. Patients with cancer have a higher risk to acquire the infection and worse prognosis as they have to attend more medical visits in healthcare institutions, receive medical and surgical treatments, and be subjected to diagnostic studies such as PET/CT in nuclear medicine services where the infection may be an incidental finding. We present here F18-FDG PET/CT (Positron Emission Tomography and Computed Tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose), images with findings of COVID-19 from patients with different oncological conditions but no respiratory symptoms.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico por imagen , Hallazgos Incidentales , Neoplasias/complicaciones , Neumonía Viral/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Adulto , Anciano , Enfermedades Asintomáticas , Carcinoma de Células en Anillo de Sello/complicaciones , Carcinoma de Células en Anillo de Sello/diagnóstico por imagen , Carcinoma de Células en Anillo de Sello/secundario , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Femenino , Radioisótopos de Flúor , Fluorodesoxiglucosa F18 , Humanos , Metástasis Linfática/diagnóstico por imagen , Linfoma no Hodgkin/complicaciones , Linfoma no Hodgkin/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Neoplasias/diagnóstico por imagen , Pandemias , Derrame Pleural/diagnóstico por imagen , Derrame Pleural/etiología , Neumonía Viral/complicaciones , Radiofármacos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Seminoma/complicaciones , Seminoma/diagnóstico por imagen , Seminoma/secundario , Neoplasias Gástricas
9.
Biomedica ; 40(Supl. 2): 34-43, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152186

RESUMEN

The current SARS-CoV-2 pandemic has caused a huge global public health problem. We report the case of a young adult patient with laboratory-confirmed SARS-CoV-2. We describe the identification of the virus and the clinical course, diagnosis, and treatment of the infection including her rapid clinical deterioration from the mild initial symptoms, which progressed to multilobar pneumonia requiring admission to the intensive care unit. This case highlights the importance of establishing a diagnosis based on the clinical findings and the patient's history bearing in mind the possibility of gastrointestinal symptoms in addition to respiratory ones. Besides, the presence of risk factors should be investigated; in this case, we proposed obesity as a possible risk factor. Furthermore, limitations in diagnostic tests and the possibility of co-infection with other respiratory pathogens are highlighted. We describe the imaging, laboratory findings, and treatment taking into account the limited current evidence.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Coinfección/virología , Infecciones por Coronavirus/complicaciones , Enterovirus/aislamiento & purificación , Infecciones por Picornaviridae/complicaciones , Neumonía Viral/complicaciones , Rhinovirus/aislamiento & purificación , Adulto , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , Técnicas de Laboratorio Clínico , Terapia Combinada , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/terapia , Cuidados Críticos , Enfermedad Crítica , Progresión de la Enfermedad , Infecciones por Enterovirus/complicaciones , Infecciones por Enterovirus/diagnóstico , Femenino , Humanos , Tiempo de Internación , Pandemias , Infecciones por Picornaviridae/diagnóstico , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/terapia , Respiración Artificial , Síndrome de Dificultad Respiratoria del Adulto/etiología , Síndrome de Dificultad Respiratoria del Adulto/terapia
10.
Biomedica ; 40(Supl. 2): 50-67, 2020 10 30.
Artículo en Español | MEDLINE | ID: mdl-33152188

RESUMEN

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


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/complicaciones , Fallo Renal Crónico/complicaciones , Neumonía Viral/complicaciones , Diálisis Renal , Adulto , Bacteriemia/complicaciones , Técnicas de Laboratorio Clínico , Colombia/epidemiología , Terapia Combinada , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/terapia , Diabetes Mellitus Tipo 2/complicaciones , Susceptibilidad a Enfermedades , Femenino , Humanos , Hipertensión/complicaciones , Fallo Renal Crónico/sangre , Fallo Renal Crónico/terapia , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Diálisis Renal/métodos , Factores Socioeconómicos , Infecciones Estafilocócicas/complicaciones
11.
Biomedica ; 40(Supl. 2): 68-72, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152189

RESUMEN

Despite the positive response of Colombia's health system to the arrival of Venezuelan migrants, the new challenges that accompany the COVID-19 pandemic have triggered a closed-borders response that runs the risk of encouraging a negative view of migrants and increasing their health risks. This manuscript discusses the recommendations that could be proposed in the case of a country with limited resources such as Colombia to respond to the needs of the Venezuelan mixed migrant flows.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Emigración e Inmigración/legislación & jurisprudencia , Pandemias/prevención & control , Neumonía Viral/prevención & control , Migrantes , Colombia/epidemiología , Infecciones por Coronavirus/epidemiología , Desinfección de las Manos , Disparidades en Atención de Salud , Humanos , Neumonía Viral/epidemiología , Salud Pública/legislación & jurisprudencia , Política Pública , Cuarentena , Venezuela/etnología , Poblaciones Vulnerables
12.
Biomedica ; 40(Supl. 2): 77-79, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152191

RESUMEN

The COVID-19 pandemic has generated a revolution of such magnitude that no aspect of human life will be the same from now on. The provision of health services and health education are not unrelated to this new normality imposed by the disease, and its consequences have been reflected in the need to use protocols and resources based on virtuality that most of us had not valued in their real dimension. Telehealth and telemedicine will be basic tools for professionals and teachers and it is our obligation to know them, apply them, and innovate to adapt to this reality.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Telemedicina/tendencias , Colombia/epidemiología , Confidencialidad , Infecciones por Coronavirus/prevención & control , Educación a Distancia , Programas de Gobierno , Instituciones de Salud , Accesibilidad a los Servicios de Salud , Humanos , Difusión de la Información , Pandemias/prevención & control , Neumonía Viral/prevención & control , Utilización de Procedimientos y Técnicas , Telemedicina/métodos , Telemedicina/organización & administración , Telemedicina/estadística & datos numéricos , Universidades , Recursos Humanos
13.
Biomedica ; 40(Supl. 2): 96-103, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152193

RESUMEN

Introduction: The COVID pandemic is a challenge for public health surveillance and an opportunity to assess its strengths and weaknesses to improve the response. Objective: To evaluate the performance of the Colombian public health surveillance system during the first 50 days of the COVID-19 pandemic in the country. Materials and methods: We analyzed the data published between March 6 and April 24, 2020, by the Instituto Nacional de Salud and the World Health Organization (WHO). We evaluated: i) the quality of the data according to the fulfillment of Benford's law, and ii) the timeliness of the information measured as the difference in dates between the data generated by the Instituto Nacional de Salud and WHO's situational reports. We assessed the fulfillment of Benford's law using the p values of the log-likelihood ratio, the chi square or Moreno's exact tests. Results: Until April 24 there were 4,881 cases of COVID-19 in Colombia. During most of the first 50 days of the pandemic, Benford's law was fulfilled except the first days of the epidemic. The difference between Instituto Nacional de Salud and WHO reports largely depends on the different reporting times. Conclusion: In general, the Colombian public health surveillance system fulfilled Benford's law suggesting that there was quality in the data. Future studies comparing the performance of the departments and districts will improve the diagnosis of the Colombian surveillance system.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Recolección de Datos/normas , Pandemias , Neumonía Viral/epidemiología , Vigilancia de la Población , Salud Pública , Colombia/epidemiología , Recolección de Datos/métodos , Recolección de Datos/estadística & datos numéricos , Brotes de Enfermedades , Humanos , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/epidemiología , Internet , Vigilancia de la Población/métodos , Control de Calidad , Distribuciones Estadísticas , Infección por el Virus Zika/epidemiología
14.
Biomedica ; 40(Supl. 2): 116-130, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152195

RESUMEN

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


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Pandemias , Neumonía Viral/mortalidad , Adulto , Anciano , Antígenos de Grupos Sanguíneos , Índice de Masa Corporal , Enfermedades Cardiovasculares/epidemiología , Colombia/epidemiología , Comorbilidad , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/terapia , Diabetes Mellitus/epidemiología , Femenino , Mortalidad Hospitalaria , Humanos , Pacientes Internos/estadística & datos numéricos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Neumonía Viral/sangre , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/terapia , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Insuficiencia Renal Crónica/epidemiología , Síndrome de Dificultad Respiratoria del Adulto/etiología , Síndrome de Dificultad Respiratoria del Adulto/mortalidad , Estudios Retrospectivos , Factores de Riesgo , Fumar/epidemiología
15.
Biomedica ; 40(Supl. 2): 131-138, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152196

RESUMEN

Introduction: Public health surveillance together with good sanitary decisions is essential for the proper management of the SARS-CoV-2 pandemic. Objective: To compare the performance of Colombian departments based on the quality of the data and to build the national ranking. Materials and methods: We analyzed the accumulated cases published between March 6 and September 1, 2020, by the Instituto Nacional de Salud. To achieve comparability, the analyses considered the day the first case was diagnosed as the first analysis date for each department. The fulfillment of Benford's law was assessed with p-values in the log-likelihood ratio or chi-square tests. The analysis was completed with the lethality observed in each department and then the performance ranking was established. Results: Bogotá and Valle del Cauca had optimal public health surveillance performance all along. The data suggest that Antioquia, Nariño, and Tolima had good containment and adequate public health surveillance after the economic opening beginning on June 1, 2020. Conclusion: We obtained the ranking of the departments regarding the quality of public health surveillance data. The best five departments can be case studies to identify the elements associated with good performance.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Vigilancia de la Población , Benchmarking , Colombia/epidemiología , Notificación de Enfermedades , Geografía Médica , Humanos , Población Rural/estadística & datos numéricos , Distribuciones Estadísticas , Análisis de Supervivencia , Población Urbana/estadística & datos numéricos
16.
Biomedica ; 40(Supl. 2): 139-147, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152197

RESUMEN

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


Asunto(s)
Anticuerpos Antivirales/sangre , Betacoronavirus/inmunología , Técnicas de Laboratorio Clínico , Comercio/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Medicina del Trabajo/métodos , Pandemias , Neumonía Viral/diagnóstico , Adulto , Infecciones Asintomáticas/epidemiología , Colombia/epidemiología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/inmunología , Femenino , Humanos , Relaciones Interpersonales , Masculino , Neumonía Viral/sangre , Neumonía Viral/inmunología , Estudios Prospectivos , Sensibilidad y Especificidad , Evaluación de Síntomas
17.
Biomedica ; 40(Supl. 2): 148-158, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152198

RESUMEN

Introduction: SARS-CoV-2 has been identified as the new coronavirus causing an outbreak of acute respiratory disease in China in December, 2019. This disease, currently named COVID-19, has been declared as a pandemic by the World Health Organization (WHO). The first case of COVID-19 in Colombia was reported on March 6, 2020. Here we characterize an early SARS-CoV-2 isolate from the pandemic recovered in April, 2020. Objective: To describe the isolation and characterization of an early SARS-CoV-2 isolate from the epidemic in Colombia. Materials and methods: A nasopharyngeal specimen from a COVID-19 positive patient was inoculated on different cell lines. To confirm the presence of SARS-CoV-2 on cultures we used qRT-PCR, indirect immunofluorescence assay, transmission and scanning electron microscopy, and next-generation sequencing. Results: We determined the isolation of SARS-CoV-2 in Vero-E6 cells by the appearance of the cytopathic effect three days post-infection and confirmed it by the positive results in the qRT-PCR and the immunofluorescence with convalescent serum. Transmission and scanning electron microscopy images obtained from infected cells showed the presence of structures compatible with SARS-CoV-2. Finally, a complete genome sequence obtained by next-generation sequencing allowed classifying the isolate as B.1.5 lineage. Conclusion: The evidence presented in this article confirms the first isolation of SARSCoV-2 in Colombia. In addition, it shows that this strain behaves in cell culture in a similar way to that reported in the literature for other isolates and that its genetic composition is consistent with the predominant variant in the world. Finally, points out the importance of viral isolation for the detection of neutralizing antibodies, for the genotypic and phenotypic characterization of the strain and for testing compounds with antiviral potential.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/virología , Pandemias , Neumonía Viral/virología , ARN Viral/genética , Animales , Betacoronavirus/genética , Betacoronavirus/fisiología , Betacoronavirus/ultraestructura , Chlorocebus aethiops , Colombia/epidemiología , Convalecencia , Infecciones por Coronavirus/epidemiología , Efecto Citopatogénico Viral , Técnica del Anticuerpo Fluorescente Indirecta , Genoma Viral , Humanos , Microscopía Electrónica , Tipificación Molecular , Nasofaringe/virología , Neumonía Viral/epidemiología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Análisis de Secuencia de ARN , Especificidad de la Especie , Células Vero , Virión/ultraestructura , Cultivo de Virus
18.
Biomedica ; 40(Supl. 2): 159-165, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152199

RESUMEN

INTRODUCTION: Healthcare personnel plays an important role in the prevention of acute respiratory infections in hospital settings. OBJECTIVE: Our aim was to establish the level of knowledge about respiratory virus infections and the attitudes and practices among healthcare workers, leaders of infection control committees in hospitals of Bogotá, Colombia. MATERIALS AND METHODS: We used a self-administered questionnaire of 28 items during the monthly meeting sponsored by the local health authority. "Yes or no" and "true or false" questions were applied to measure knowledge. Attitudes and practices were measured with a Likert-type scale according to the agreement degree. RESULTS: We surveyed 70 healthcare workers. Respondents demonstrated a good level of knowledge as 80% of them answered correctly more than five questions. A total of 54.4% showed a low degree of agreement when asked if their institutions have the policy to stay home when they are sick with respiratory symptoms and 67.1% never or rarely remain at home under such conditions. CONCLUSION: Healthcare worker leaders of infection control committees in Bogotá's ospitals have adequate knowledge about the prevention of seasonal respiratory viruses. There is a need for implementing urgent sick leave policies as a measure to prevent the spread of potential coronavirus infections in hospitals.


Asunto(s)
Planificación en Desastres , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/psicología , Pandemias/prevención & control , Infecciones del Sistema Respiratorio/prevención & control , Absentismo , Adulto , Colombia/epidemiología , Estudios Transversales , Femenino , Humanos , Control de Infecciones/organización & administración , Masculino , Persona de Mediana Edad , Política Organizacional , Ausencia por Enfermedad , Encuestas y Cuestionarios
19.
Biomedica ; 40(Supl. 2): 166-172, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152200

RESUMEN

Introduction: The 2019 coronavirus pandemic (COVID-19) has caused around 25 million cases worldwide. Asymptomatic patients have been described as potential sources of transmission. However, there are difficulties to detect them and to establish their role in the dynamics of virus transmission, which hinders the implementation of prevention strategies. Objective: To describe the behavior of asymptomatic SARS-CoV-2 virus infection in a cohort of workers at the El Dorado "Luis Carlos Galán Sarmiento" International Airport in Bogotá, Colombia. Materials and methods: A prospective cohort of 212 workers from the El Dorado airport was designed. The follow-up began in June, 2020. A survey was used to characterize health and work conditions. Every 21 day, a nasopharyngeal swab was taken to identify the presence of SARS-CoV-2 using RT-PCR. We analyzed the behavior of the cycle threshold (ORF1ab and N genes) according to the day of follow-up. Results: In the first three follow-ups of the cohort, we found an incidence of SARS-CoV-2 infection of 16.51%. The proportion of positive contacts was 14.08%. The median threshold for cycle threshold was 33.53. Conclusion: We characterized the asymptomatic SARS-CoV-2 infection in a cohort of workers. The identification of asymptomatic infected persons continues to be a challenge for epidemiological surveillance systems.


Asunto(s)
Aeropuertos , Infecciones Asintomáticas , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Nasofaringe/virología , Pandemias , Neumonía Viral/diagnóstico , Adulto , Infecciones Asintomáticas/epidemiología , Betacoronavirus/genética , Betacoronavirus/fisiología , Colombia , Trazado de Contacto , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Proteínas de la Nucleocápside/genética , Neumonía Viral/epidemiología , Neumonía Viral/virología , Estudios Prospectivos , ARN Viral/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Encuestas y Cuestionarios , Proteínas Virales/genética , Replicación Viral/genética , Lugar de Trabajo
20.
Biomedica ; 40(Supl. 2): 180-187, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152202

RESUMEN

The pandemic caused by COVID19 is associated with an increase in the number of cases of cardiorespiratory arrest, which has resulted in ethical concerns regarding the enforceability of cardiopulmonary resuscitation, as well as the conditions to carry it out. The risk of aerosol transmission and the clinical uncertainties about the efficacy, the potential sequelae, and the circumstances that could justify limiting this procedure during the pandemic have multiplied the ethical doubts on how to proceed in these cases. Based on ethical and legal grounds, this paper offers a practical guide on how to proceed in the clinical setting in cases of cardiopulmonary arrest during the pandemic. The criteria of justice, benefit, no harm, respect for autonomy, precaution, integrity, and transparency are asserted in an organized and practical framework for decision-making regarding cardiopulmonary resuscitation.


Asunto(s)
Betacoronavirus , Reanimación Cardiopulmonar/ética , Infecciones por Coronavirus/complicaciones , Paro Cardíaco/terapia , Pandemias , Neumonía Viral/complicaciones , Guías de Práctica Clínica como Asunto , Directivas Anticipadas , Aerosoles , Microbiología del Aire , Reanimación Cardiopulmonar/métodos , Toma de Decisiones Clínicas , Colombia/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Paro Cardíaco/etiología , Humanos , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Inutilidad Médica , Exposición Profesional , Pandemias/prevención & control , Autonomía Personal , Equipo de Protección Personal , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Justicia Social
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