Variantes Alpha y Gamma del SARS-CoV-2: revisión rápida para contribuir en la toma de decisiones / Alpha and Gamma variants of SARS-CoV-2: rapid review to aid decision-making

Resumen Objetivo: Describir el riesgo de transmisión y severidad de las variantes de preocupación Alpha y Gamma del SARS-CoV-2 en comparación con otras variantes. Materiales y métodos: Revisión rápida y narrativa de literatura realizada en PubMed hasta mayo 10 de 2021. Resultados: La búsqueda capturó 262 artículos, de los cuales se incluyeron 15 estudios. Cuatro fueron incluidos en el control de referencias. De los 19 estudios, 6 corresponden con literatura gris. La mayoría de los estudios analizaron la variante de preocupación Alpha, solo uno para Gamma. La variante de preocupación Alpha es consistente con mayor riesgo de transmisión (entre el 35 y 89 % mayor riesgo), de hospitalización (entre 64 y 234 % mayor riesgo) y de muerte (entre 36 y 140 % mayor riesgo) en comparación con otras variantes. La variante de preocupación Gamma reporta una posible correlación fuerte y positiva entre proporción positivos y las muertes (Rho 0,71; p <0,01). Conclusiones: Se encuentra más información de la variante de preocupación Alpha que de Gamma. La variante de preocupación Alpha reporta mayor riesgo de transmisión, hospitalización y muerte en comparación con otras variantes; pero estos resultados deben tomarse con precaución.

Abstract Objective: To describe the transmission and severity risk of the Alpha and Gamma variants concerning SARS-CoV-2 compared with other variants. Materials and methods: Narrative and rapid review conducted in PubMed up to May 10, 2021. Results: The search captured 262 articles, of which 15 studies were included. Four studies were included from the reference control. Six out of the 19 studies were gray literature. Most of the studies analyzed the variant of concern, Alpha, and only one for the Gamma variant. The variant of concern, Alpha, is consistent with a higher risk of transmission (between 35 and 89% higher risk), hospitalization (between 64 and 234% higher risk) and death (between 36 and 140% higher risk) compared to other variants. The Gamma variant reports a possible strong and positive correlation between positive proportions and deaths (Rho 0.71; p <0.01). Conclusions: There is more information regarding the variant of concern Alpha than Gamma. The variant of concern Alpha reports a higher risk of transmission, hospitalization, and death; but these results should be viewed with caution.

Primary cutaneous T-cell lymphoma: experience from the Peruvian National Cancer Institute

Abstract: Background: Primary cutaneous T-cell lymphomas constitute a heterogeneous and rare group of diseases with regional particularities in Latin America. Objective: To determine the clinicopathological features, relative frequency and survival among patients from a Peruvian institution. Methods: Primary cutaneous T-cell lymphomas were defined based on the absence of extracutaneous disease at diagnosis. Classification was performed following the 2008 World Health Organization Classification of Neoplasms of the Hematopoietic and Lymphoid tissues. Risk groups were established according to the 2005 World Health Organization-EORTC classification for cutaneous lymphomas. Data of patients admitted between January 2008 and December 2012 were analyzed. Results: 74 patients were included. Mean age was 49.5 years. In order of frequency, diagnoses were: mycosis fungoides (40.5%), peripheral T-cell lymphoma not otherwise specified (22.95%), adult T-cell lymphoma/leukemia (18.9%), CD30+ lymphoproliferative disorders (6.8%), hydroa vacciniforme-like lymphoma (5.4%), extranodal NK/T-cell lymphoma (4.1%) and Sézary syndrome (1.4%). Predominant clinical patterns were observed across different entities. Mycosis fungoides appeared mainly as plaques (93%). Peripheral T-cell lymphoma not otherwise specified and adult T-cell lymphoma/leukemia presentation was polymorphic. All patients with hydroa vacciniforme-like lymphoma presented with facial edema. All cases of extranodal NK/T-cell lymphoma appeared as ulcerated nodules/tumors. Disseminated cutaneous involvement was found in 71.6% cases. Forty-six percent of patients were alive at 5 years. Five-year overall survival was 76.4% and 19.2%, for indolent and high-risk lymphomas, respectively (p<0.05). High risk group (HR: 4.6 [2.08-10.18]) and increased DHL level (HR: 3.2 [1.57-6.46]) emerged as prognostic factors for survival. Study limitations: Small series. Conclusion: Primary cutaneous T-cell lymphomas other than mycosis fungoides or CD30+ lymphoproliferative disorders are aggressive entities with a poor prognosis.