The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stands for being the most serious epidemic (so far) of the 21st century. However, only a few computational studies have investigated the molecular mechanisms underlying the neutralization of the spike protein by antibodies of different classes. Hence, bioinformatic methods were employed to unravel the factors contributing to the remarkable neutralization capacity exhibited by specific antibodies. Initially, crystallographic structures of IgA monomeric / dimeric, IgG, and IgM antibodies binding with the receptor-binding domain region of the SARS-CoV-2 spike protein were retrieved. Subsequently, rigid molecular docking and molecular dynamic simulations were performed over 100 ns with explicit water solvation. Lastly, an energy decomposition was conducted to estimate the binding affinity using the last frames from molecular dynamics. The results revealed a higher binding affinity for both monomeric and dimeric forms of IgA antibodies against the spike protein. Additionally, a greater number of hydrogen bonds were observed during their interaction with the spike protein, as well as greater structural instability along the time and especially a more thermodynamically favorable interaction affinity. In this way, the research contributes a small piece to the complex puzzle of understanding the humoral immune response induced by the SARS-CoV-2 virus. SARSCoV2 SARSCoV SARS CoV (SARS-CoV-2 so far st century However classes Hence Initially IgG receptorbinding receptor SARS-CoV- retrieved Subsequently 10 solvation Lastly dynamics Additionally way virus (SARS-CoV- SARS-CoV 1 (SARS-CoV

RESUMO Objetivo: Verificar a utilização e identificar as vantagens dos métodos moleculares para diagnóstico de infecções congênitas no líquido cefalorraquidiano de neonatos. Fontes de dados: A revisão foi registrada na base PROSPERO (International Prospective Register of Systematic Reviews) sob CRD42021274210. A busca bibliográfica foi realizada nas bases de dados PubMed, Biblioteca Virtual em Saúde/ Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde (BVS/BIREME), Scopus, Web of Science, Excerpta Medica database (EMBASE), Cochrane, ProQuest, e EBSCOhost. A busca foi feita no período de agosto a outubro de 2021 e atualizada em dezembro de 2022, respeitando as orientações do Preferred Reporting Items for Systematic Reviews e Meta-Analyises (PRISMA). A sequência da seleção dos estudos foi: 1) Remoção de duplicatas; 2) Exame de títulos e resumos; 3) Recuperação dos textos completos potencialmente relevantes; e 4) Avaliação do texto completo conforme critérios de elegibilidade por dois autores independentes. O critério de inclusão considerou ensaios clínicos randomizados e não randomizados, estudos longitudinais, transversais, revisados por pares, estudos em humanos, publicados em inglês, espanhol, italiano e português, com recém-nascidos de até 28 dias que sofreram neuroinfecções congênitas pelos agentes toxoplasmose, rubéola, citomegalovírus, herpes simples (TORCH), e outros como Treponema pallidum, Zika, parvovírus B-19, varicela zoster, Epstein-Barr, e SARS-CoV-2, diagnosticadas por reação em cadeia de polimerase (PCR). Dois avaliadores extraíram as seguintes informações: autor, ano de publicação, nacionalidade, sujeitos, tipo de estudo, métodos, resultados e conclusão. Síntese dos dados: O patógeno mais estudado foi Herpes Simples. Muitos artigos relataram somente sintomas iniciais inespecíficos, motivando a coleta de líquido cefalorraquidiano e realização da PCR para investigação etiológica. Conclusões: Os métodos moleculares são eficazes para detectar o genoma do patógeno no líquido cefalorraquidiano, o que pode impactar na evolução clínica e no prognóstico neurológico. Objetivo neonatos International CRD42021274210 CRD PubMed LatinoAmericano Latino Americano BVS/BIREME, BVSBIREME BVS/BIREME , BVS BIREME (BVS/BIREME) Scopus Science EMBASE, EMBASE (EMBASE) Cochrane ProQuest EBSCOhost 202 2022 MetaAnalyises Meta Analyises PRISMA. PRISMA . (PRISMA) 1 duplicatas 2 resumos 3 relevantes 4 independentes longitudinais transversais pares humanos inglês espanhol português recémnascidos recém nascidos toxoplasmose rubéola citomegalovírus TORCH, TORCH (TORCH) pallidum Zika B19, B19 B 19, 19 B-19 zoster EpsteinBarr, EpsteinBarr Epstein Barr, Barr Epstein-Barr SARSCoV2, SARSCoV2 SARSCoV SARS CoV 2, SARS-CoV-2 PCR. (PCR) informações autor publicação nacionalidade sujeitos estudo conclusão Simples inespecíficos etiológica Conclusões neurológico CRD4202127421 (BVS/BIREME (EMBASE 20 (PRISMA (TORCH B1 B-1 SARS-CoV- (PCR CRD420212742 B- SARS-CoV CRD42021274 CRD4202127 CRD420212 CRD42021 CRD4202 CRD420 CRD42 CRD4

ABSTRACT Objective: To verify the use and identify advantages of molecular methods for congenital infections diagnosis in cerebrospinal fluid of neonates. Data source: The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO), under CRD42021274210. The literature search was performed in databases: PubMed, Virtual Health Library/ Latin American and Caribbean Center on Health Sciences Information (VHL/BIREME), Scopus, Web of Science, Excerpta Medica database (EMBASE), Cochrane, ProQuest, and EBSCOhost. The search was carried out from August to October 2021 and updated in December 2022, respecting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The selection sequence was: 1) Duplicate title removal; 2) Examination of titles and abstracts; 3) Full-text retrieval of potentially relevant reports; and 4) Evaluation of the full text according to eligibility criteria by two independent authors. Inclusion criteria considered randomized and non-randomized control trials, longitudinal, cross-sectional, and peer-reviewed studies in humans, published in English, Spanish, Italian, and Portuguese, with newborns up to 28 days old who had congenital neuroinfections by toxoplasmosis, rubella, cytomegalovirus, herpes simplex (TORCH), and others such as Treponema pallidum, Zika, parvovirus B-19, varicella zoster, Epstein-Barr, and SARS-CoV2, diagnosed by polymerase chain reaction (PCR). Two evaluators extracted the following information: author, year of publication, nationality, subjects, study type, methods, results, and conclusion. Data synthesis: The most studied pathogen was herpes simplex. Several articles reported only nonspecific initial symptoms, motivating the collection of cerebrospinal fluid and performing PCR for etiological investigation. Conclusions: Molecular methods are effective to detect pathogen genomes in cerebrospinal fluid, which can impact clinical evolution and neurological prognosis. Objective neonates source PROSPERO, PROSPERO , (PROSPERO) CRD42021274210 CRD databases PubMed Library VHL/BIREME, VHLBIREME VHL/BIREME VHL BIREME (VHL/BIREME) Scopus Science EMBASE, EMBASE (EMBASE) Cochrane ProQuest EBSCOhost 202 2022 MetaAnalyses Meta Analyses PRISMA (PRISMA guidelines 1 removal 2 abstracts 3 Fulltext Full reports 4 authors nonrandomized non trials longitudinal crosssectional, crosssectional cross sectional, sectional cross-sectional peerreviewed peer reviewed humans English Spanish Italian Portuguese toxoplasmosis rubella cytomegalovirus TORCH, TORCH (TORCH) pallidum Zika B19, B19 B 19, 19 B-19 zoster EpsteinBarr, EpsteinBarr Epstein Barr, Barr Epstein-Barr SARSCoV2, SARSCoV2 SARSCoV SARS CoV2, CoV2 CoV SARS-CoV2 PCR. . (PCR) information author publication nationality subjects type results conclusion synthesis symptoms investigation Conclusions prognosis (PROSPERO CRD4202127421 (VHL/BIREME (EMBASE 20 (TORCH B1 B-1 SARS-CoV (PCR CRD420212742 B- CRD42021274 CRD4202127 CRD420212 CRD42021 CRD4202 CRD420 CRD42 CRD4

RESUMO Objetivo: Descrever casos de lesão renal aguda (LRA) em crianças diagnosticadas com COVID-19, associando fatores de risco, aspectos clínicos e evolução dos casos. Métodos: Estudo retrospectivo, realizado em hospital pediátrico entre março de 2020 e setembro de 2021, com pacientes com COVID-19 diagnosticados com LRA, que examinou informações presentes em prontuários como comorbidades, idade, sexo e uso de medicações nefrotóxicas. Resultados: Foram estudados 40 casos, sendo o sexo masculino significativamente mais acometido (62,5%; p=0,025). A LRA foi uma complicação grave da infecção por COVID-19, com 100% da amostra necessitando de internação na Unidade de Terapia Intensiva e 22,5% indo a óbito. As comorbidades mais prevalentes analisadas neste estudo foram epilepsia, paralisia cerebral e cardiopatia. A maioria dos pacientes foi classificada pelos critérios Kidney Disease: Improving Global Outcomes (KDIGO) como KDIGO 1 (42,5%) e necessitou de intubação orotraqueal (67,5%). A frequência de uso de medicamentos nefrotóxicos e necessidade de diálise foi baixa, com percentuais de 35 e 17,5%, respectivamente. Entre as crianças que faleceram, 70,4% apresentavam alguma comorbidade e 88,8% receberam ventilação invasiva. Conclusões: A LRA em crianças com infecção por COVID-19 está associada a quadros graves, apesar de a maior parte dos pacientes ter recebido alta hospitalar. Objetivo (LRA COVID19, COVID19 COVID 19, 19 risco Métodos retrospectivo 202 2021 COVID-1 idade nefrotóxicas Resultados 4 62,5% 625 62 5 (62,5% p=0,025. p0025 p p=0,025 . 0 025 p=0,025) 100 225 22 22,5 óbito epilepsia cardiopatia Disease (KDIGO 42,5% 425 42 (42,5% 67,5%. 675 67,5% 67 (67,5%) baixa 3 175 17 17,5% respectivamente faleceram 704 70 70,4 888 88 8 88,8 invasiva Conclusões graves hospitalar COVID1 20 COVID- 62,5 6 (62,5 p002 p=0,02 02 10 2 22, 42,5 (42,5 67,5 (67,5% 17,5 7 70, 88, 62, (62, p00 p=0,0 42, (42, 67, (67,5 17, (62 p0 p=0, (42 (67, (6 p=0 (4 (67 ( p=

ABSTRACT Objective: To describe cases of acute kidney injury (AKI) in children diagnosed with COVID-19, associated risk factors, clinical aspects and outcome of cases. Methods: Retrospective study, carried out in a pediatric hospital between March 2020 and September 2021, with patients with COVID-19 who were diagnosed with AKI, studying information present in medical records such as comorbidities, age, gender and use of nephrotoxic medications. Results: We studied 40 cases, and male individuals were significantly more affected (62.5%; p=0.025). AKI was a severe complication of COVID-19 infection, with 100% of the sample requiring admission to the Intensive Care Unit and 22.5% dying. The most prevalent comorbidities analyzed in this study were epilepsy, cerebral palsy and heart disease. Most patients were classified according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria as KDIGO 1 (42.5%), and required orotracheal intubation (67.5%). The frequency of use of nephrotoxic medications and need for dialysis was low, with percentages of 35 and 17.5%, respectively. Among the children who died, 70.4% had some comorbidity and 88.8% received invasive ventilation. Conclusions: AKI in children with COVID-19 infection is associated with severe conditions. Despite the severity, most patients were discharged alive from the hospital. Objective (AKI COVID19, COVID19 COVID 19, 19 factors Methods 202 2021 COVID-1 age Results 4 62.5% 625 62 5 (62.5% p=0.025. p0025 p p=0.025 . 0 025 p=0.025) 100 225 22 22.5 dying epilepsy disease Disease (KDIGO 42.5%, 425 42.5% , 42 (42.5%) 67.5%. 675 67.5% 67 (67.5%) low 3 175 17 17.5% respectively died 704 70 70.4 888 88 8 88.8 ventilation Conclusions conditions severity COVID1 20 COVID- 62.5 6 (62.5 p002 p=0.02 02 10 2 22. 42.5 (42.5% 67.5 (67.5% 17.5 7 70. 88. 62. (62. p00 p=0.0 42. (42.5 67. (67.5 17. (62 p0 p=0. (42. (67. (6 p=0 (42 (67 ( p= (4

RESUMO Objetivo: Comparar a presença de anticorpos neutralizantes contra o SARS-CoV-2 no leite materno e no sangue das lactantes vacinadas em relação àquelas não vacinadas. Fontes de dados: Foi efetuado registro no International Prospective Register of Systematic Reviews — PROSPERO (CRD42021287554) e foram seguidas as diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Foram elegíveis estudos de coorte, caso-controle e transversais que avaliaram anticorpos contra o SARS-CoV-2 no leite e no sangue de lactantes vacinadas e tiveram como grupo controle lactantes não vacinadas. Utilizaram-se os Descritores em Ciências da Saúde (DeCs), Medical Subject Heading (MeSH) e Emtree para as bases Biblioteca Virtual em Saúde (BVS), Medical Literature Analysis and Retrieval System Online (Medline/PubMed) e Embase, respectivamente. Na Web of Science e Scopus foi feita adaptação da estratégia. Não foram estabelecid as restrições quanto ao período de publicação e idioma. Síntese dos dados: As buscas identificaram 233 registros. Foram excluídos 128 duplicados e 101 fora dos critérios de inclusão, e quatro estudos de coorte foram elegíveis. As lactantes vacinadas com Pfizer-BioNTech e Moderna apresentaram anticorpos contra SARS-CoV-2 no sangue e no leite materno. Conclusões: As mulheres lactantes vacinadas apresentaram níveis mais elevados de imunoglobulina G (IgG) e A (IgA) no soro e no leite materno em comparação com as mulheres não vacinadas. Objetivo SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- dados CRD42021287554 CRD (CRD42021287554 MetaAnalysis Meta PRISMA. PRISMA . (PRISMA) casocontrole caso Utilizaramse Utilizaram se DeCs, DeCs , (DeCs) MeSH (MeSH BVS, BVS (BVS) Medline/PubMed MedlinePubMed Medline PubMed (Medline/PubMed Embase respectivamente estratégia idioma 23 registros 12 10 inclusão PfizerBioNTech Pfizer BioNTech Conclusões IgG (IgG IgA (IgA SARS-CoV CRD4202128755 (CRD4202128755 (PRISMA (DeCs (BVS 1 CRD420212875 (CRD420212875 CRD42021287 (CRD42021287 CRD4202128 (CRD4202128 CRD420212 (CRD420212 CRD42021 (CRD42021 CRD4202 (CRD4202 CRD420 (CRD420 CRD42 (CRD42 CRD4 (CRD4 (CRD

ABSTRACT Objective: To compare the presence of neutralizing antibodies against SARS-CoV-2 found in the breast milk and blood of vaccinated lactating women with those not vaccinated. Data source: The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42021287554 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort, case-control, and cross-sectional studies that evaluated antibodies against SARS-CoV-2 in the milk and blood of vaccinated mothers and had as control group unvaccinated mothers were eligible. Health Sciences Descriptors (DeCs), Medical Subject Headings (MeSH) and Emtree descriptors were used for the Virtual Health Library (VHL), Medical Literature Analysis and Retrieval System Online (Medline/Pubmed), and Embase databases, respectively. In the Web of Science and Scopus, the strategy was adapted. No restrictions on the publication period and language were set. Data synthesis: The search identified 233 records, of which 128 duplicates and 101 papers that did not meet the inclusion criteria were excluded. Hence, four cohort studies were eligible. Nursing mothers vaccinated with the Pfizer-BioNTech and Moderna vaccines showed antibodies against SARS-CoV-2 in their blood and breast milk. Conclusions: Vaccinated lactating women had higher levels of immunoglobulin G (IgG) and A (IgA) in serum and breast milk than unvaccinated women. Objective SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- source PROSPERO (PROSPERO CRD CRD4202128755 MetaAnalyses Meta Analyses PRISMA (PRISMA guidelines Cohort casecontrol, casecontrol case control, case-control crosssectional cross sectional eligible DeCs, DeCs , (DeCs) MeSH (MeSH VHL, VHL (VHL) Medline/Pubmed, MedlinePubmed Medline/Pubmed Medline Pubmed (Medline/Pubmed) databases respectively Scopus adapted set synthesis 23 records 12 10 excluded Hence PfizerBioNTech Pfizer BioNTech Conclusions IgG (IgG IgA (IgA SARS-CoV CRD420212875 (DeCs (VHL (Medline/Pubmed 1 CRD42021287 CRD4202128 CRD420212 CRD42021 CRD4202 CRD420 CRD42 CRD4

The in silico study aimed to suggest phytochemicals from Commiphora leptophloeos leaves essential oil as therapies against coronavirus disease (COVID-19) (or severe acute respiratory syndrome coronavirus 2, SARS-CoV-2). For that, we used molecular docking (MD), absorption, distribution, metabolism, excretion, and toxicity (ADMET) parameters, and pharmacokinetic analysis. MD showed the presence of hydrophobic and hydrogen bonds for nine compounds. β-Selinene and bicyclogermacrene showed the best interaction values with the protein Mpro (ID: 6Y2F) (-5.9) and chimeric receptor complexed with its receptor human ACE2 (ID: 6VW1) (-6.1 and -5.5) proteins, as well as low gastrointestinal and high epithelial absorptions, medium permeability for Caco-2 cells and high epithelial permeability, low oral excretion, and were inhibitors of CYP2C19 and CYP2C9 enzymes. On the other hand, both were not permeable to the blood-brain barrier and inhibitors or substrates for glycoprotein-D, and showed carcinogenic potential, but only β-selinene was considered mutagenic. Although little bioavailable, both presented aspects structurally adequate, being compounds with moderate synthesis difficulty. Therefore, more analyses are necessary to evaluate the mechanism of action and unsatisfactory parameters foreseen in bioinformatic assays. COVID19 COVID 19 (COVID-19 2 SARSCoV2. SARSCoV2 SARSCoV SARS CoV . SARS-CoV-2) that MD, , (MD) absorption distribution metabolism excretion ADMET (ADMET analysis βSelinene β Selinene ID (ID 6Y2F YF Y F 5.9 59 5 9 (-5.9 ACE 6VW1 VW 6.1 61 6 1 (-6. 5.5 55 -5.5 proteins absorptions Caco2 Caco Caco- CYPC CYP C CYP2C1 CYP2C enzymes hand bloodbrain blood brain glycoproteinD, glycoproteinD glycoprotein D, D glycoprotein-D potential βselinene selinene mutagenic bioavailable adequate difficulty Therefore assays COVID1 (COVID-1 SARS-CoV-2 (MD 5. (-5. 6VW 6. (-6 -5. (COVID- SARS-CoV- (-5 (- -5 (COVID SARS-CoV ( -

ABSTRACT Unvaccinated identical twins developed bilateral anterior uveitis soon after the onset of coronavirus disease 2019 symptoms. During follow-up, both patients developed choroiditis, and one twine developed posterior scleritis and serous retinal detachment. Prompt treatment with oral prednisone ameliorated the lesions, and no recurrence was observed at the 18-month follow-up. Choroiditis may rarely be associated with severe acute respiratory syndrome coronavirus 2 infection, and it responds well to corticosteroid therapy. Although the exact mechanism is unknown, we hypothesize that the virus may act as an immunological trigger for choroiditis. 201 symptoms followup, followup follow up, up follow-up choroiditis detachment lesions 18month month 18 followup. up. infection therapy unknown 20 1

The coronavirus disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a profound impact on global health and socio-economic conditions. To date, various vaccines have been administered worldwide in an effort to curb the spread of the virus. Despite vaccination efforts, there have been complications. Existing antiviral drugs have shown limited effectiveness, prompting the use of computational methods to understand the dynamics of the virus and develop suitable treatments. The current study focuses on using biocompatible para-sulfonato-calix[4]arenes to dock against two key proteins of SARS-CoV-2, namely ribonucleic acid (RNA)-dependent RNA polymerase, and helicase. Docking results indicate a strong binding affinity of these compounds to the target proteins, with higher scores compared to commonly used medications. Molecular dynamics (MD) simulation validates the docking results, showing stable protein-ligand complexes over time. The compounds are also screened for absorption, distribution, metabolism, and excretion properties and toxicity, suggesting their potential as lead candidates for inhibiting the virus’s key proteins. However, further in vivo and in vitro studies are recommended to confirm these findings. COVID19 COVID 19 (COVID-19 pandemic SARSCoV2, SARSCoV2 SARSCoV SARS CoV , (SARS-CoV-2) socioeconomic socio economic conditions date efforts complications effectiveness treatments parasulfonatocalix4arenes parasulfonatocalixarenes para sulfonato calix 4 arenes 2, SARS-CoV-2 RNAdependent dependent polymerase helicase medications MD (MD proteinligand protein ligand time absorption distribution metabolism toxicity viruss s However findings COVID1 1 (COVID-1 (SARS-CoV-2 parasulfonatocalix SARS-CoV- (COVID- (SARS-CoV- SARS-CoV (COVID (SARS-CoV

Objetivo: Esse estudo teve por objetivo investigar um surto de covid-19 entre PS no serviço de nefrologia de um hospital universitário no Rio de Janeiro em março de 2020 e identificar fatores de risco para infecção pelo SARS-CoV-2. Métodos: Para caracterizar o surto em relação a tríade pessoa-lugar-tempo foi definida como população fonte uma equipe de 59 PS, que foram recrutados e submetidos a entrevistas digitais para reconhecer a ocorrência de sinais e sintomas, comorbidades, de hospitalização durante o período de 1 a 23 de março de 2020. A análise dos dados consistiu na construção e interpretação da curva epidêmica e na identificação de fatores de risco para a infecção durante o surto. Resultados: Dos 59 profissionais do serviço de nefrologia, 43 (73%) participaram do estudo. Eram predominatemente médicos (58%), do sexo feminino (67%), com idade variando de 24 a 69 anos e média de 40 anos. O surto ocorreu entre 1º de março e 23 de março de 2020 e teve pico em 12 e 13 de março. Trinta e dois participantes foram classificados com casos prováveis ​​ou confirmados de covid-19. Entre os casos predominavam mulheres (71%), com idade de 37 anos, predominantemente médicos (45%). Apenas um participante foi hospitalizado. Fatores de risco para covid-19 foram ser médico, trabalhar em outro hospital e ser mulher. Conclusão: Concluímos que houve um surto de covid-19 entre profissionais de saúde do serviço de nefrologia do HUPE em março de 2020. Foram sugeridas medidas de proteção a todos profissionais e exames para infeção para SARS-CoV-2 nos sintomáticos.

Objetivo: Este estudio tuvo como objetivo investigar un brote de covid-19 entre el personal sanitario del servicio de nefrología de un hospital universitario de Río de Janeiro en marzo de 2020 e identificar factores de riesgo para la infección por SARS-CoV-2. Métodos: Para caracterizar el brote en relación con la tríada persona-lugar-tiempo, se definió como población fuente un equipo de 59 PS, quienes fueron reclutados y sometidos a entrevistas digitales para reconocer la aparición de signos y síntomas, comorbilidades y hospitalización. durante el período del 1 al 23 de marzo de 2020. El análisis de datos consistió en construir e interpretar la curva epidémica e identificar factores de riesgo de infección durante el brote. Resultados: De los 59 profesionales del servicio de nefrología, participaron del estudio 43 (73%). Eran predominantemente médicos (58%), mujeres (67%), con edades comprendidas entre 24 y 69 años y una media de 40 años. El brote se produjo entre el 1 y el 23 de marzo de 2020 y alcanzó su punto máximo el 12 y 13 de marzo. Treinta y dos participantes fueron clasificados como casos probables o confirmados de covid-19. Entre los casos predominaron las mujeres (71%), con edad de 37 años, predominantemente médicos (45%). Sólo un participante fue hospitalizado. Los factores de riesgo para el Covid-19 fueron ser médico, trabajar en otro hospital y ser mujer. Conclusión: Concluimos que hubo un brote de covid-19 entre los profesionales de la salud del servicio de nefrología del HUPE en marzo de 2020. Se sugirieron medidas de protección para todos los profesionales y pruebas de infección por SARS-CoV-2 en pacientes sintomáticos.

Objective: This study aimed to investigate a COVID-19 outbreak among HCWs in the nephrology department of a university hospital in Rio de Janeiro in March 2020 and to identify risk factors for SARS-CoV-2 infection. Methods: To characterize the outbreak in relation to the person-place-time triad, a team of 59 HCWs was defined as the source population. They were recruited and submitted to digital interviews to recognize the occurrence of signs and symptoms, comorbidities, and hospitalization during the period from March 1 to 23, 2020. Data analysis consisted of constructing and interpreting the epidemic curve and identifying risk factors for infection during the outbreak. Results: Of the 59 professionals in the nephrology department, 43 (73%) participated in the study. They were predominantly physicians (58%), female (67%), with an age ranging from 24 to 69 years, and an average of 40 years. The outbreak occurred between March 1 and March 23, 2020, and peaked on March 12 and 13. Thirty-two participants were classified as having probable or confirmed cases of COVID-19. The majority of cases were women (71%), aged 37 years, and predominantly physicians (45%). Only one participant was hospitalized. Risk factors for COVID-19 were being a physician, working in another hospital, and being a woman. Conclusion: We conclude that there was an outbreak of COVID-19 among healthcare professionals in the nephrology department of HUPE in March 2020. Protective measures were suggested for all professionals and tests for SARS-CoV-2 infection in symptomatic individuals.

A vigilância em saúde, como vigilância de agravos e doenças, tem um escopo bastante amplo. Discutiremos aqui a face mais conhecida, que é a vigilância de doenças transmissíveis, e assumiremos como mote a pandemia causada pelo vírus SARS-CoV-2. No desenvolvimento do texto, a abordagem se amplia para uma reflexão sobre tecnologias, modelo e organização do sistema. A mais grave epidemia de nossa época, classificada como pandemia, por atingir simultaneamente todo o planeta, tem obrigado a reflexões que envolvem múltiplos campos do conhecimento. O sofrimento decorrente deve inibir a tentação de associá-la a qualquer imagem positiva, ainda que tenha havido oportunidade para aprender e, em algumas circunstâncias, testemunhar a capacidade humana de agir solidariamente. Poucas coisas são tão didáticas como tragédias e erros. Cabe explorá-los cuidadosamente e extrair a necessária retroalimentação para corrigir rumos da atuação em saúde. Neste texto, trataremos das condições que levaram a vigilância em saúde no Brasil a falhar fragorosamente em sua missão frente à emergência desencadeada pela doença do novo coronavírus 2019 e levantaremos pontos que merecem atenção em uma reestruturação do sistema de vigilância em saúde.

The term "health surveillance" encompasses a wide range of activities, including the monitoring and observation of illnesses and diseases. In this section, we will examine the most well-known aspect of health surveillance, namely the monitoring of communicable diseases. To illustrate our discussion, we will use the ongoing pandemic caused by the SARS-CoV-2 virus as a case study. As the text progresses, the focus shifts to an examination of technologies, models, and the structure of the system. The most severe epidemic of our era, classified as a pandemic due to its global impact, has compelled us to reflect on a multitude of disciplines. The resulting suffering should preclude any association with positive images, despite the opportunity to learn and, in some instances, observe the capacity of humans to act in solidarity. It is often observed that few things are as didactic as tragedies and mistakes. It is therefore important to explore them carefully to extract the necessary feedback to correct the course of action in health. In this text, we will discuss the conditions that led health surveillance in Brazil to fail miserably in its mission in the face of the emergency triggered by the novel coronavirus disease 2019. We will also present points that deserve attention in a restructuring of the health surveillance system.

ABSTRACT This study aimed to describe the characteristics of multisystemic inflammatory syndrome associated with COVID-19 (MIS-C) in the first three years of the pandemic in children in a pediatric hospital in Peru. We conducted an observational, descriptive study with data from 73 patients and described the clinical and laboratory characteristics, treatment and complications according to the wave of the pandemic and whether they had shock. The median age was 6 years, gastrointestinal and mucocutaneous manifestations were frequent in the three waves. Kawasaki disease-like phenotype was present in 34 (46.6%) patients and 21 (28.8%) patients developed shock. The most commonly used treatment was immunoglobulin (95.9%), followed by acetylsalicylic acid (94.5%) and corticosteroid (86.3%). Five (7%) patients had coronary aneurysm and 17 (23.3%) were admitted to the intensive care unit (ICU). Patients with shock had greater laboratorial alteration and need for mechanical ventilation. In conclusion, MIS-C has decreased in the first three years of the pandemic, possibly due to COVID-19 vaccination in children.

RESUMEN El propósito del estudio fue describir las características del síndrome inflamatorio multisistémico asociado a COVID-19 (SIM-C) en los primeros tres años de pandemia en niños de un hospital pediátrico del Perú. Se realizó un estudio observacional, descriptivo con datos de 73 pacientes y se describieron las características clínicas, laboratoriales, tratamiento y complicaciones según la ola de la pandemia y si tuvieron shock. La mediana de edad fue 6 años, las manifestaciones gastrointestinales y mucocutáneas fueron frecuentes en las tres olas. El fenotipo similar a enfermedad de Kawasaki se presentó en 34 (46,6%) pacientes y 21 (28,8%) pacientes desarrollaron shock. El tratamiento más usado fue la inmunoglobulina (95,9%), ácido acetil salicílico (94,5%) y corticoide (86,3%). Cinco (7%) pacientes tuvieron aneurisma coronario y 17 (23,3%) ingresaron a la unidad de cuidados intensivos (UCI). Los pacientes con shock tuvieron mayor alteración laboratorial y necesidad de ventilación mecánica. En conclusión, el SIM-C ha disminuido en los primeros tres años de pandemia posiblemente por la vacunación de COVID-19 en niños.

RESUMEN Introducción. Debido a la reactividad cruzada entre SARS-CoV-2 y los coronavirus humanos comunes, las infecciones previas con estos virus podrían contribuir a la protección cruzada serológica o celular contra la COVID-19 grave. Sin embargo, la inmunidad protectora puede no desarrollarse o la inmunidad preexistente podría generar COVID-19 grave. Objetivo. Determinar la seroprevalencia de anticuerpos IgG frente a HCoV-NL63 y HCoV-HKU1, y correlacionar su previa exposición con los signos de COVID-19 en pacientes de Villavicencio. Materiales y métodos. Se realizó un estudio retrospectivo observacional analítico y transversal. Se utilizó la técnica ELISA para buscar anticuerpos IgG contra HCoV-NL3 y HCoV-HKU1 en pacientes con resultado positivo de RT-qPCR para SARS-CoV-2. Los pacientes se agruparon según los signos de COVID-19 en cuatro grupos: grupo 1: asintomáticos (n = 23); grupo 2: hospitalizados (n = 24); grupo 3: unidad de cuidados intensivos (n = 24), y grupo 4: fallecidos (n = 22). Resultados. La seroprevalencia general de IgG anti-HCoV fue de 74.2 % (n = 69; IC95%: 65,3-83,1), con 66,7 % de HCoV-NL63 (n = 62; IC95%: 57,1-76,2) y 25,8 % de HCoV-HKU1 (n = 24; [IC95%:16,9-34,7). Según el análisis de las tablas de contingencia, la exposición previa a HCoV-NL63 se asoció con protección de una COVID-19 grave (p = 0,042; OR ajustado = 0,159; IC95%: 0,027-0,938) y la previa coinfección de HCoV-NL63 y HCoV-HKU1 se asoció con padecimiento de signos clínicos graves por COVID-19 (p = 0,048; OR ajustado = 16,704; IC95%: 1,020- 73,670). Conclusión. Según la literatura revisada hasta la fecha, este es el primer estudio sobre la seroprevalencia de anticuerpos IgG de HCoV en Colombia y Latinoamérica. La exposición previa a HCoV-NL63 podría proteger contra la COVID-19 grave, mientras que los pacientes con coinfección subyacente de HCoV-NL63 y HCoV-HKU1 podrían resultar hospitalizados con signos graves de COVID-19.

ABSTRACT Introduction. Due to the cross-reactivity between SARS-CoV-2 and common human coronaviruses, previous infections with these viruses could contribute to serological or cellular cross-protection against severe COVID-19. However, protective immunity may not develop, or pre-existing immunity could increase COVID-19 severity. Objective. To determine the seroprevalence of IgG antibodies against HCoV-NL63 and HCoV-HKU1 and correlate previous exposure with COVID-19 signs in patients from Villavicencio. Materials and methods. A cross-sectional retrospective study was conducted. ELISA technique was used to search for IgG antibodies against HCoV-NL3 and HCoV-HKU1 in patients with positive RT-qPCR results for SARS-CoV-2. Patients were grouped according to COVID-19 clinical characteristics in four groups: group 1: asymptomatic (n = 23); group 2: hospitalized (n = 24); group 3: intensive care units (n = 24), and group 4: dead (n = 22). Results. The overall seroprevalence of IgG antibodies against HCoV was 74.2% (n = 69; 95% CI: 65.3-83.1), with 66.7% of HCoV-NL63 (n = 62; 95% CI: 57,1-76,2), and 25.8% of HCoV-HKU1 (n = 24; 95% CI: 16,9-34,7). Based on crosstab analysis, prior exposure to HCoV-NL63 was associated with protection against severe COVID-19 (p = 0.042; adjusted OR = 0.159; 95% CI: 0.027-0.938), and previous coinfection of HCoV-NL63 and HCoV-HKU1 was considered a positive association to severe COVID-19 (p = 0.048; adjusted OR = 16.704; 95% CI: 1.020 - 273.670). Conclusion. To our knowledge, this is the first study addressing seroprevalence of HCoV IgG antibodies in Colombia and Latin America. Previous exposure to HCoV-NL63 could protect against severe COVID-19, whereas patients with underlying HCoV-NL63 and HCoV-HKU1 coinfection could be hospitalized with severe signs of COVID-19.

Abstract Introduction: Obesity is an ongoing pandemic that coincided with the COVID-19 pandemic, and it has been recognized as a significant risk factor for severe COVID-19 cases. This study aims to analyze the relationship between excess malnutrition and the severity of COVID-19 in minors through a systematic review. Methods: A systematic review was conducted following PRISMA guidelines. The search was carried out in PubMed/MEDLINE and SciELO databases using keywords, covering the period from 2020 to 2023. Studies of children and adolescents reporting age and nutritional status in English and Spanish were included. Studies with other pathologies, animal studies, pregnant women, and other reviews were excluded. The study was registered on the PROSPERO platform. Results: A total of 28 articles met the search criteria, of which 18 found a relationship between childhood obesity and increased severity, associated with longer hospital stays, mechanical ventilation requirements, and death. Additionally, out of 7 studies addressing Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C), 3 found a relationship between obesity and the risk of developing MIS-C. Conclusion: Obesity is a risk factor for severe COVID-19 and an increased risk of developing and worsening MIS-C in children and adolescents. Identifying high-risk groups for severe COVID-19 could help guide hospital admissions and SARS-CoV-2 vaccination strategies.

Resumen Introducción: La obesidad es una pandemia en curso que coincidió con la pandemia de la COVID-19, y ha sido reconocida como un factor de riesgo significativo en los casos graves de COVID-19. Este estudio tiene como objetivo analizar la relación entre la malnutrición por exceso y la severidad de la COVID-19 en menores de edad mediante una revisión sistemática. Métodos: Se realizó una revisión siguiendo las guías PRISMA. La búsqueda se llevó a cabo en las bases de datos PubMed/MEDLINE y SciELO, usando palabras clave, abarcando el periodo entre 2020 y 2023. Se incluyeron estudios de niños y adolescentes que reportaran edad y estado nutricional, y que estuvieran en inglés o español. Se excluyeron estudios con otras patologías, estudios en animales, embarazadas y otras revisiones. El estudio fue registrado en la plataforma PROSPERO. Resultados: Se incluyeron 28 artículos que cumplían con los criterios de búsqueda, de los cuales 18 encontraron una relación entre la obesidad infantil y una mayor gravedad de la COVID-19, asociada a hospitalizaciones más prolongadas, requerimiento de ventilación mecánica y fallecimientos. Además, de los 7 estudios que abordaron el Síndrome Inflamatorio Multisistémico en niños asociado a la COVID-19 (SIM-C), 3 mostraron una relación entre la obesidad y el riesgo de desarrollar SIM-C. Conclusión: La obesidad es un factor de riesgo para una COVID-19 severa y un mayor riesgo de desarrollo y gravedad del SIM-C en niños y adolescentes. Identificar los grupos de alto riesgo de COVID-19 grave podría ayudar a orientar la estrategia de hospitalización y vacunación contra el SARS-CoV-2.

RESUMEN Introducción: el SARS-CoV-2 desde el 2020 generó innumerables desafíos. El decúbito prono se utilizó para mejorar la oxigenación, y la terapia nutricional se adaptó para cubrir los requerimientos y reducir complicaciones. Objetivos: evaluar la tolerancia de la nutrición enteral y su adecuación energética en pacientes ventilados en decúbito prono con infección por SARS-CoV-2, en sala respiratoria del Departamento de Cuidados Intensivos Adultos del Hospital de Clínicas-Facultad de Ciencias Médicas - Universidad Nacional de Asunción, de marzo a julio 2021. Metodología: estudio observacional, descriptivo, retrospectivo, de corte transversal, de casos consecutivos, con información obtenida de fichas de pacientes de terapia intensiva, que recibieron soporte nutricional en posición prona. Se tomaron datos demográficos, clínicos y nutricionales. Se evaluó la tolerancia nutricional durante la posición prona, definiéndola como la presencia de un volumen de residuo gástrico < 500 mL cada 6 h.. La adecuación energética fue determinada teniendo en cuenta el porcentaje cumplido de la prescripción nutricional. Resultados: se reclutaron 41 pacientes. El 60,9 % eran hombres; la mediana de edad fue 55 años (RIC=23). Las principales comorbilidades fueron obesidad (57,3 %) e hipertensión arterial (43,9 %). El 85,4 % presentó buena tolerancia gástrica en posición prono, con residuo gástrico menor a 500 ml. El porcentaje de adecuación energética fue de 84 %. Conclusión: la terapia nutricional enteral en decúbito prono fue bien tolerada por la mayoría de nuestros pacientes, posibilitando alcanzar los requerimientos nutricionales indicados.

ABSTRACT Introduction: SARS-CoV-2 since 2020 has generated countless challenges. Prone position was used to improve oxygenation, and nutritional therapy was adapted to meet requirements and reduce complications. Objectives: evaluate the tolerance of enteral nutrition and its energetic adequacy in ventilated patients in the prone position with SARS-CoV-2 infection, in the respiratory room of the Adult Intensive Care Department of the Hospital de Clínicas - Facultad de Ciencias Médicas - Universidad Nacional de Asunción, from March to July 2021. Methodology: observational, descriptive, retrospective, cross-sectional study of consecutive cases, with information obtained from records of intensive care patients, who received nutritional support in a prone position. Demographic, clinical and nutritional data were taken. Nutritional tolerance was evaluated during the prone position, defining it as the presence of a volume of gastric residue < 500 mL every 6 h. Energy adequacy was determined taking into account the percentage fulfilled of the nutritional prescription. Results: 41 patients were recruited. 60.9 % were men; the median age was 55 years (IQR=23). The main comorbidities were obesity (57.3 %) and high blood pressure (43.9 %). 85.4 % had good gastric tolerance in the prone position, with gastric residue less than 500 ml. The percentage of energy adequacy was 84 %. Conclusion: enteral nutritional therapy in the prone position was well tolerated by the majority of our patients, making it possible to achieve the indicated nutritional requirements.

RESUMEN Introducción: El estudio de los viajeros es importante y ha resultado una variable asociada significativamente con el número de casos de covid-19. Objetivo: Caracterizar a los viajeros infectados por el SARS-CoV-2 según variables epidemiológicas y sociodemográficas de interés. Métodos: Se realizó un estudio ecológico de series temporales, de viajeros procedentes del exterior, residentes en Santiago de Cuba o cuyo destino final era esta provincia, que arribaron al país entre el 11 de marzo del 2020 y el 11 de noviembre del 2022. Las fuentes de información fueron los registros de viajeros establecidos por el Centro Provincial de Higiene, Epidemiologia y Microbiología de esta provincia y del Laboratorio Provincial de Microbiología. Resultados: Fueron recibidos 64 984 viajeros, de los cuales 568 resultaron positivos, con predominio de los asintomáticos y del diagnóstico al quinto día del arribo. Conclusiones: El control sobre los viajeros influyó en el patrón de transmisión de la enfermedad; en tanto, la realización de una segunda prueba al quinto día permitió hallar un porcentaje elevado de positividad. Algunas características de la morbilidad en este grupo de casos se diferenciaron de la incidencia en la población general, tales como las formas clínicas, la edad y la distribución espacial.

ABSTRACT Introduction: The study of travelers is important and has been a variable significantly associated with the number of covid-19 cases. Objective: To characterize the travelers infected with SARS-CoV-2 according to epidemiologic and sociodemographic variables of interest. Methods: An ecological study of temporary series was carried out, of travelers from abroad, residents in Santiago de Cuba or whose final destination was this province, that arrived at the country between March 11, 2020 and November 11, 2022. The sources of information were the travelers’ records established by the Provincial Center of Hygiene, Epidemiology and Microbiology of this province and the results of polymerase chain reaction tests of the Provincial Laboratory of Microbiology. Results: Sixty-four thousand nine-hundred eighty four travelers were received, of which 568 were positive, with prevalence of the asymptomatic and the diagnosis at the fifth day of arrival. Conclusions: The control on the travelers influenced in the pattern of transmission of the disease; as long as, the realization of a second test at the fifth day allowed to find a high percentage of positivity. Some characteristics of morbidity in this group of cases differed from the incidence in the general population, such as the clinical forms, age and space distribution.

Resumen Introducción : El objetivo de este estudio fue evaluar los efectos adversos y la respuesta inmune de anticuer pos IgG anti S1 SAEA-CoV-2 en el personal de Salud del Hospital del Milagro de la ciudad de Salta, posterior a recibir dos dosis de vacuna COVID-19. Métodos : Se realizó un estudio prospectivo de co horte desde marzo de 2021 hasta abril 2022. Se reco pilaron datos demográficos, clínicos, eventos adversos supuestamente atribuidos a la vacunación (ESAVI) y se tomaron dos muestras de sangre para medir los niveles de anticuerpos. Resultados : Participaron 408 voluntarios, 401 (98%) fueron vacunados con Sputnik- V. La edad promedio fue de 45.5 años con predominio del sexo femenino (71%). Los ESAVI fueron reportados en 188 (46.1%) y 121 (29.7%) luego de la primera y segunda dosis respectivamente (p<0.001). Estos eventos fueron mayormente de carácter leve y transitorios, más frecuentes luego de la primera dosis. El primer dosaje de anticuerpos fue positivo en 99% con una media de títulos de 9.7 (SD 3.7). El segundo dosaje fue positivo en 88% con una media de títulos de 6.4 (SD 4.4). Los participantes con antecedentes de infección y dosajes previos positivos mostraron títulos significativamente más altos de anticuerpos (p<0.001). Conclusión : Los ESAVI reportados fueron mayorita riamente leves y transitorios. La vacunación masiva y la administración de la dosis recomendada son esenciales para lograr una inmunidad colectiva efectiva. La mayoría de los trabajadores de la salud vacunados desarrollaron anticuerpos y aquellos que cursaron la enfermedad previa a la vacunación presentaron títulos significativos más elevados de anticuerpos.

Abstract Introduction : The aim of this study was to evaluate the adverse effects and immune response associated with IgG anti S1 SAEA-CoV-2 antibodies among health care workers at Señor del Milagro Hospital in Salta city, after receiving two doses of COVID-19 vaccine. Methods : A prospective cohort study was carried out from March 2021 to April 2022. Demographic, clinical data, adverse events supposedly attributed to vaccina tion (AEFIs) were collected and two samples were taken to measure serum antibody levels. Results : 408 volunteers participated, 401 (98%) were vaccinated with Sputnik-V. The average age was 45.5 years with a predominance of the female sex (71%). AEFIs were reported in 188 (46.1%) and 121 (29.7%) after the first and second doses respectively (p<0.001). These events were mostly mild and transient, more frequent after the first dose. The first antibody test was positive in 99% with a mean titer of 9.7 (SD 3.7). The second dosage was positive in 88% with a mean titer of 6.4 (SD 4.4). Participants with a history of infection and previous positive testing showed significantly higher antibody titers (p<0.001). Conclusion : The AEFIs reported were mostly mild and transient. Mass vaccination and administration of the recommended dose are essential to achieve effective herd immunity. The majority of vaccinated healthcare workers developed antibodies and those who had the disease prior to vaccination had significant antibody titers.