BackgroundDown's syndrome (DS) is a genetic anomaly, which undergoes increased morbidity and mortality when associated with congenital heart disease (CHD). The aims of the study were to determine the prevalence of CHD and pulmonary hypertension (PH) in DS.MethodsOne hundred twenty-seven patients with DS living in Mexico City were evaluated by physical exam, electrocardiogram and echocardiogram.ResultsCHD was found in 40%. In 80% (n = 102) PH was present [systolic pulmonary artery pressure (SPAP) of 47 ± 19 mm Hg and mean pulmonary artery pressure (MPAP) of 32 ± 11 mm Hg]. Patients with CHD and PH were classified as having 1) no shunt (n = 18) with SPAP of 37 ± 9 mm Hg and MPAP of 25 ± 6 mm Hg and 2) with shunt (n = 26) with PASP of 57 ± 29 mm Hg and MPAP of 38 ± 19 mm Hg (p ≤ 0.001). In those without CHD or with CHD without shunt (n = 76), SPAP was 37 ± 19 mm Hg and the MPAP 25 ± 6 mm Hg. The prevalence of PH in DS was 5.9% at one year and 15% at 10 years. The odds ratio of PH in DS with CHD was 7.3 vs. 3 without CHD.ConclusionDS has a high prevalence of CHD and PH. PH prevalence increases when it is associated with CHD. The pathophysiology of PH in DS without CHD should be studied in the near future. Echocardiography is an indispensible tool for evaluation of DS.

In‐house assays for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) by quantitative reverse‐transcription polymerase chain reaction (qRT‐PCR), are feasible alternatives, particularly in developing countries. Cycle threshold (Ct) values obtained by qRT‐PCR were compared with clinical and laboratory data from saliva of inpatients with COVID‐19 and asymptomatic health workers (AHW) were studied. Saliva specimens from 58 inpatients confirmed by qRT‐PCR for SARS‐CoV‐2 using nasopharyngeal specimens, and 105 AHW were studied by qRT‐PCR using three sets of primers for the N (N1, N2, and N3) gene of SARS‐CoV‐2, according to the CDC Diagnostic Panel protocol, showing a positivity of 88% for inpatients and 8% for AHW. Bivariate analysis revealed an association between Ct < 38.0 values for N2 and mechanical ventilation assistance among patients (p = .013). In addition, values of aspartate‐transaminase, lactate dehydrogenase, and ferritin showed significant correlations with Ct values of N1 and N3 genes in inpatients. Therefore, our results show that Ct values correlate with some relevant clinical data for inpatients with COVID‐19.

BackgroundIn the present study, we obtained cycle threshold (Ct) values by qRT-PCR and compared them with clinical and laboratory data from saliva specimens of inpatients with COVID-19 and asymptomatic health workers (AHW).MethodsSaliva specimens from inpatients with COVID-19 and AHW were studied by qRT-PCR using three sets of primers for the N (N1, N2, and N3) gene of SARS-CoV-2. The Ct values obtained were compared with the clinical and laboratory data.ResultsData from 58 inpatients (37 critically ill patients and 21 patients with severe disease) and 105 AHW were analysed. In our system, the limit of viral detection corresponded to a Ct =46.5; therefore, our analysis focused on comparing the positivity rate obtained when using Ct <40 as the cut-off with that obtained using Ct <46 as the cut-off. The positivity rate was increased when the Ct cut-off of 46 was used as the criterion, yielding a sensitivity of 87.9% for patients and a sensitivity of 43% for AHW. The bivariate analysis revealed an association between Ct <40 for N2 and mechanical ventilation assistance among patients (p=0.013). In addition, the serological values of alanine transaminase (ALT), aspartate-transaminase (AST), lactate dehydrogenase (LDH), ferritin and creatine kinase–MB (CK-MB) showed significant correlations with the Ct values of N1 and N3.ConclusionDue to the intrinsic characteristics of the qRT-PCR process, obtaining amplification curves implies the presence of an active viral replication process, while Ct values may correlate with some clinical data. Our results support the claim that physicians should be informed of the Ct values obtained during the amplification of viral markers, as well as the Ct values that correspond to the limit of detection for viral RNA, which vary according to the characteristics of each system and amplification protocol used.