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Introdução/Objetivo Os fatores associados ao risco de hospitalização por COVID19 não são completamente conhecidos. O objetivo deste estudo foi descrever o risco de hospitalização dos participantes ambulatoriais com diagnóstico exclusivo para rinovírus, SARS-CoV-2 e codetecção entre esses dois agentes, durante a pandemia no sul do Brasil. Métodos Participantes ambulatoriais (> 18 anos) com sinais agudos de tosse, febre ou dor de garganta foram recrutados prospectivamente nas tendas de atendimento do Hospital Moinhos de Vento e Hospital Restinga e Extremo Sul, entre maio e novembro de 2020, e foram acompanhados por 28 dias através de entrevistas telefônicas. Para a detecção de SARS-CoV-2 bem como para o painel respiratório, foi utilizada a técnica de RT-PCR. Para detecção de SARS-CoV-2 foi utilizado kit TaqManTM 2019-nCoV Assay Kit v1 (genes S, N e ORF1ab) a partir de swabs orofaríngeo e nasofaríngeo bilateral. Em coleta de outro swab nasofaríngeo foi realizado painel respiratório para detecção de: Bordetella pertussis; Chlamydophila pneumoniae; Mycoplasma pneumoniae; adenovírus; bocavírus; coronavírus tipos HKU1, 229E, NL63 e OC43; vírus influenza A tipos H1 e H3; vírus influenza B; enterovírus humano; metapneumovírus humano; vírus parainfluenza tipos 1, 2 e 3; RSV tipos A e B; e rinovírus). Todas as amostras foram analisadas no Laboratório de Biologia Molecular do Hospital Moinhos de Vento. Resultados Foram recrutados 609 participantes, com idade mediana de 36 anos, sendo a maioria mulheres (63,2%). 282 (46,4%) participantes tiveram detectado apenas rinovírus, seguido por 234 (38,4%) com SARS-CoV-2 exclusivamente. A codetecção entre estes dois agentes ocorreu em 93 (15,3%) dos 608 participantes. Deste total, 26 (4,3%) participantes necessitaram hospitalização após a busca por atendimento ambulatorial. Participantes com codetecção viral apresentaram maior proporção de hospitalização quando comparados aos participantes com SARS-CoV-2 e rinovírus detectados como agentes únicos (9,7% (9/93) vs 6,8% (16/234) vs 0,4% (1/282), p < 0.001). Entretanto, quando comparadas as proporções de coinfecção com SARS-CoV-2 (como agente único), a diferença não é significativa (9,7% (9/93) vs 6,8% (16/234), p = 0.373). Conclusão O rinovírus foi o principal patógeno detectado em adultos, e apesar da alta prevalência não foi associado ao aumento na hospitalização, sendo o maior risco atribuído à detecção de SARS-CoV-2 nessa população.
Introdução/Objetivo Apesar do predomínio do SARS-CoV-2 como etiologia das infecções virais em adultos durante o ano de 2020, outros agentes infecciosos podem fazer parte do diagnóstico diferencial. O objetivo deste estudo foi descrever a prevalência dos patógenos respiratórios em adultos internados em dois hospitais no sul do Brasil durante a pandemia e comparar os desfechos de gravidade na internação entre participantes com diagnóstico de COVID-19 comparado com outros agentes infecciosos. Métodos Participantes adultos (> 18 anos) hospitalizados com sinais agudos de tosse, febre ou dor de garganta foram recrutados prospectivamente entre maio e novembro de 2020, e seguidos até o final da internação. A técnica de RT-PCR foi utilizada para detecção de SARS-CoV-2 e demais agentes infecciosos. Para SARS-CoV-2 foram coletados swabs oro e nasofaríngeo bilateral tendo como alvos os genes S, N e ORF1ab. Outro swab nasofaríngeo foi coletado para realização de painel respiratório através sondas de expressão gênica que avaliou a presença de: Bordetella pertussis; Chlamydophila pneumoniae; Mycoplasma pneumoniae; adenovírus; bocavírus; coronavírus tipos HKU1, 229E, NL63 e OC43; vírus influenza A tipos H1 e H3; vírus influenza B; enterovírus; metapneumovírus; vírus parainfluenza tipos 1, 2 e 3; RSV tipos A e B; e rinovírus. Todas as amostras foram analisadas no Laboratório de Biologia Molecular do Hospital Moinhos de Vento. Resultados Foram incluídos 156 participantes, sendo a maioria homens (57,1%) com idade mediana de 58 anos. A mediana de dias de sintomas foi 8 dias. O SARS-CoV-2 foi o agente mais prevalente, sendo detectado exclusivamente em 101 (65.0%) de 156 participantes, seguido pela detecção única de rinovírus (4,0%, 6/154). A codetecção desses dois agentes ocorreu em 28 (18,0%) dos 154 participantes. Os demais patógenos (adenovírus, coronavírus HKU1 e enterovírus) foram detectados em 5 participantes. A comparação dos desfechos de gravidade (uso de oxigênio suplementar, ventilação mecânica invasiva e óbito) não apresentou diferença quanto à codetecção versus detecção exclusiva de SARS-CoV-2 (60,7% (17/28) vs 62,4% (63/101), P = 1,00; 21,4% (6/28) vs 15,8% (16/101), P = 0,57; 7,1% (2/28) vs 5,9% (6/101), P = 0,68). Conclusão O SARS-CoV-2 foi o principal patógeno detectado seguido pelo rinovírus, com uma importante queda na detecção de outros patógenos. A detecção de rinovírus simultânea ao SARS-CoV-2 não foi associada a maior gravidade.
Background: The emergence of SARS-CoV-2 variants is a current public health concern possibly impacting COVID-19 disease diagnosis, transmission patterns and vaccine effectiveness. Objectives: To describe the SARS-CoV-2 lineages circulating early pandemic among samples with S gene dropout and characterize a novel mutation in receptor-binding domain (RBD) of viral spike protein. Study design: Adults and children older than 2 months with signs and symptoms of COVID-19 were prospectively enrolled from May to October 2020 in Porto Alegre, Brazil. All participants performed RT-PCR assays for diagnosing SARS-CoV-2, samples with S gene dropout and Ct < 30 (cycle threshold) were submitted to whole genome sequencing (WGS), and homology modeling and physicochemical properties analysis were performed. Results: 484/1,557 participants tested positive for SARS-CoV-2. The S gene dropout was detected in 7.4% (36/484) as early as May, and a peak was observed in early August. WGS was performed in 8 samples. The B.1.1.28, B.1.91 and B.1.1.33 lineages were circulating in early pandemic. The RBD novel mutation (Y380Q) was found in one sample occurring simultaneously with C379W and V395A, and the B.1.91 lineage in the spike protein. Conclusion: Mutations in the SARS-CoV-2 spike region were detected early in the COVID-19 pandemic in Southern Brazil, regarding the B.1.1.28, B.1.91 and B.1.1.33 lineages identified. The novel mutation (Y380Q) with C379W, modifies important RBD properties, which may interfere with the binding of neutralizing antibodies (CR3022, EY6A, H014, S304).
Background/Objectives The aim of this study was to evaluate the association between obesity and hospitalization in mild COVID-19 adult outpatients in Brazil. Subjects/Methods Adults with signs and symptoms suggestive of acute SARS-CoV-2 infection who sought two hospitals (one public and one private) emergency department were prospectively enrolled. Patients with confirmed COVID-19 at inclusion were followed by phone calls at day (D) D7, D14 and D28. Multivariable logistic regression models were employed to explore the association between obesity and other potential predictors for hospitalization. Results A total of 1,050 participants were screened, 310 were diagnosed with COVID-19 by RT-PCR. Median age was 37.4 (IQR 29.8-45.0) years, and 186 (60.0%) were female. Duration of symptoms was 3.0 (IQR 2.0-5.0) days, and 10.0 (IQR 8.0-12.0) was the median number of symptoms at inclusion. A total of 98 (31.6%) were obese, and 243 (78.4%) had no previous medical conditions. Twenty three participants (23/310, 7.4%) required hospitalization during the period. After adjusting, obesity (BMI≥30.0 kg/m2) (OR=2.69, 95%CI 1.63-4.83, P<0.001) and older age (OR=1.05, 95%CI 1.01-1.09, P<0.001), were significantly associated with higher risks of hospitalization. Conclusions Obesity, followed by aging, was the main factor associated with hospital admission for COVID-19 in a young population in a low-middle income country. Our findings highlighted the need for actions to promote additional protection for obese population, such as vaccination, and to encourage lifestyle changes.
Objective: To evaluate the association between obesity and hospitalization in mild COVID-19 adult outpatients in Brazil. Subjects and methods: Adults with signs and symptoms suggestive of acute SARS-CoV-2 infection who sought treatment in two hospital (public and private) emergency departments were prospectively enrolled. Patients with confirmed COVID-19 at inclusion were followed by phone calls at days D7, D14 and D28. Multivariable logistic regression models were employed to explore the association between obesity and other potential predictors for hospitalization. Results: A total of 1,050 participants were screened, and 297 completed the 28-day follow-up and were diagnosed with COVID-19 by RT-PCR. The median age was 37.2 (IQR 29.7-44.6) years, and 179 (60.0%) were female. The duration of symptoms was 3.0 (IQR 2.0-5.0) days, and 10.0 (IQR 8.0-12.0) was the median number of symptoms at inclusion. Ninety-five (32.0%) individuals had obesity, and 233 (78.5%) had no previous medical conditions. Twentythree participants (7.7%) required hospitalization during the follow-up period. After adjusting, obesity (BMI ≥ 30.0 kg/m 2 ) (OR = 2.69, 95% CI 1.63-4.83, P < 0.001) and older age (OR = 1.05, 95% CI 1.01-1.09, P < 0.001) were significantly associated with higher risks of hospitalization. Conclusion: Obesity, followed by aging, was the main factor associated with hospital admission for COVID-19 in a young population in a lowmiddle income country. Our findings highlighted the need to promote additional protection for individuals with obesity, such as vaccination, and to encourage lifestyle changes.
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