•The Brazilian Government has taken precautions to prevent transmission of the SARS-CoV-2 virus.•Screening studies are important for planning prevention of the new coronavirus spread.•Screening ...articles can be a subsidy for government and public health decisions.•The clinical presentation of Covid-19 was different in the studied groups.•This article may be useful within the scope of diagnosis, treatment and prevention.
A retrospective study was conducted to identify the prevalence of COVID-19 through serology and RT-PCR in children, adolescents and adults. A database of the COVID-19 Tracking Program in school children was used.
The data comprised sociodemographic and clinical variables, results of serological tests (IgM and IgG), and real-time-polymerase chain reaction (RT-PCR) results of IgM-positive individuals. The statistical analysis was performed with a 5% significance level.
Among 423 children, 107 (25.3%) exhibited seroprevalence with IgG, IgM or IgG/IgM; among 854 adolescents, 250 (29.2%) had positive serology; and among 282 adults, 59 (20.9%) were positive. The frequency of positivity on RT-PCR for SARS-CoV-2 was 3.5%, 3.6% and 6.0% in children, adolescents and adults, respectively. Children had a lower incidence of symptoms than adolescents (p = 0.001) and adults (p = 0.003); the most frequent were fever, ageusia, anosmia, headache, dry cough, sore throat, muscle pain, runny nose, dyspnoea, and diarrhoea.
The prevalence rate for all groups was 26.7% in serology and 4.04% in RT-PCR. Children had lower rates of IgM and fewer symptoms compared with adolescents and adults. The data suggest the potential for transmissibility in all age groups.
Effective vaccination against coronavirus mitigates the risk of hospitalisation and mortality; however, it is unclear whether vaccination status influences long COVID symptoms in patients who require ...hospitalisation. The available evidence is limited to outpatients with mild disease. Here, we evaluated 412 patients (age: 60 ± 16 years, 65% males) consecutively admitted to two Hospitals in Brazil due to confirmed coronavirus disease 2019 (COVID-19). Compared with patients with complete vaccination (n = 185) before infection or hospitalisation, those with no or incomplete vaccination (n = 227) were younger and had a lower frequency of several comorbidities. Data during hospitalisation revealed that the no or incomplete vaccination group required more admissions to the intensive care unit (ICU), used more corticosteroids, and had higher rates of pulmonary embolism or deep venous thrombosis than the complete vaccination group. Ninety days after hospital discharge, patients with no or incomplete vaccination presented a higher frequency of symptoms (≥ 1) than patients with complete vaccination (40 vs. 27%; p = 0.013). After adjusting for confounders, no or incomplete vaccination (odds ratio OR 1.819; 95% confidence interval CI 1.175-2.815), female sex (OR 2.435; 95% CI 1.575-3.764) and ICU admission during hospitalisation (OR 1.697; 95% CI 1.062-2.712) were independently associated with ≥ 1 symptom 90 days after hospital discharge. In conclusion, even in patients with severe COVID-19, vaccination mitigates the probability of long COVID symptoms.
•Among 1,996 asymptomatic HCW, we found a seroprevalence of SARS-CoV-2 of 5.5%.•Cleaners and male gender were more likely to be infected.•Working at dedicated COVID-19 units was not an independent ...risk factor for seropositivity.
We evaluated the seroprevalence of SARS-CoV-2 and risk factors among 1,996 oligo/asymptomatic health care workers. The seroprevalence was 5.5% and risk factors associated with being infected with SARS-CoV-2 was professional category of cleaning (adj odds ratio 2.22, 95% confidence interval: 1.12-4.44, P: .023) and male gender (adj odds ratio: 1.54, 95% confidence interval: 1.03-2.32, P: .035).Working at dedicated COVID-19 units (high-risk group) was not an independent risk factor for seropositivity.
Resumo Fundamento Em regiões endêmicas da doença de Chagas, por muitos anos, existe uma observação empírica recorrente de que a doença arterial coronariana (DAC) é incomum em pacientes com doença de ...Chagas. Estudos anteriores baseados em análise patológica ou angiografia coronária invasiva apresentam resultados controversos. Objetivo Investigar se a DAC é menos prevalente e menos grave em pacientes com doença de Chagas crônica em comparação a uma população pareada controle, com perfil de risco para DAC similar. Métodos Um total de 86 participantes, 43 pacientes com doença de Chagas crônica consecutivos e 43 indivíduos assintomáticos, sem qualquer história prévia de doença cardíaca ou doença DAC conhecida (grupo controle), foram incluídos no estudo. Pacientes e controles foram pareados quanto sexo, idade e escore de risco de Framingham. Todos os pacientes foram analisados quanto ao escore de cálcio coronário (ECC) e submetidos à angiotomografia coronária usando um tomógrafo de 320 detectores. O nível de significância estatística adotado foi de p < 0,05. Resultados O ECC foi significativamente mais baixo em pacientes com doença de Chagas em comparação aos controles (p<0,05). A presença de placas ateroscleróticas coronárias foi significativamente menos frequente em pacientes com doença de Chagas que nos controles (20,9% versus 41,9%, p=0,037). Após ajuste quanto ao escore de Framingham, o odds ratio para a presença de qualquer calcificação coronária foi de 0,26 (IC95%: 0,07-0,99, p=0,048). O padrão é similar para escore de cálcio coronário (ECC) > 10 (OR: 0,11, IC95%: 0,01-0,87, p=0,04), e para a presença de estenose (OR: 0,06, IC95%: 0,01-0,47, p=0,001). O pareamento por escore de propensão também mostrou um efeito da doença de Chagas no ECC (-21,6 pontos no escore absoluto e 25% menos pacientes com ECC > 10; p=0,015). Conclusões A prevalência e a gravidade da DAC são mais baixas nos pacientes com doença de Chagas crônica em comparação a uma população pareada e perfil de risco para DAC similar. (Arq Bras Cardiol. 2020; 115(6):1051-1060)
COVID-19 has been associated with a significant burden to those who survive the acute phase. We aimed to describe the quality of life and symptoms of anxiety, depression, and posttraumatic stress ...disorder (PTSD) at 90 days after hospital discharge of COVID-19 patients.
Patients with COVID-19 admitted to a private hospital in the city of São Paulo, Brazil, between April of 2020 and April of 2021 were interviewed by telephone at 30 and 90 days after discharge to assess the quality of life and symptoms of depression, anxiety, and PTSD.
A total of 2,138 patients were included. The mean age was 58.6 ± 15.8 years, and the median length of hospital stay was 9.0 (5.0-15.8) days. Between the two time points, depression increased from 3.1% to 7.2% (p < 0.001), anxiety increased from 3.2% to 6.2% (p < 0.001), and PTSD increased from 2.3% to 5.0% (p < 0.001). At least one physical symptom related to COVID-19 diagnosis persisted in 32% of patients at day 90.
Persistence of physical symptoms was high even at 90 days after discharge. Although the prevalence of symptoms of anxiety, depression, and PTSD was low, these symptoms persisted for three months, with a significant increase between the time points. This finding indicates the need to identify at-risk patients so that they can be given an appropriate referral at discharge.
In Chagas' disease endemic regions, there has been for many years a recurrent empirical observation that coronary artery disease (CAD) is uncommon in patients with Chagas' disease. Previous ...pathological and invasive coronary angiography studies led to controversial results.
We sought to investigate whether CAD is less prevalent and less severe in patients with chronic Chagas' disease when compared with a matched population with a similar CAD risk profile.
A total of 86 participants, 43 consecutive patients with chronic Chagas' disease and 43 asymptomatic individuals, without any prior history of cardiac disease or known CAD (control group), were included. Patients and controls were matched according to gender, age, and Framingham risk score. All participants underwent coronary calcium scoring and coronary computed tomography angiography on a 320-row detector scanner. Statistical significance level adopted was p < 0.05.
The coronary artery calcium score (CACS) was significantly lower in patients with Chagas' disease than in controls (p<0.05). The presence of coronary atherosclerotic plaques was significantly less frequent in patients with Chagas' disease than in controls (20.9% versus 41.9%, p=0.037). After adjustment for the Framingham score, the odds ratio for the presence of any coronary artery calcium (CAC) in Chagas patients was 0.26 (95%CI: 0.07-0.99, p=0.048). The pattern is similar for CACS > 10 (OR: 0.11, 95%CI: 0.01-0.87, p=0.04) and for the presence of any stenosis (OR: 0.06, 95%CI: 0.01-0.47, p=0.001). Propensity score matching also indicated an effect of Chagas disease on the CACS (-21.6 points in the absolute score and 25% less of patients with CACS >10, p=0.015).
CAD is less prevalent and less severe in patients with chronic Chagas' disease when compared with a matched population with a similar CAD risk profile. (Arq Bras Cardiol. 2020; 115(6):1051-1060).
Background: The hemodynamic effects of noninvasive ventilation with positive pressure in patients with pulmonary hypertension without left ventricular dysfunction are not clearly established. ...Objectives: Analyze the impact of increasing airway pressure with continuous positive airway pressure on hemodynamic parameters and, in particular, on cardiac output in patients with variable degrees of pulmonary hypertension. Methods: The study included 38 patients with pulmonary hypertension caused by mitral stenosis without left ventricular dysfunction or other significant valvulopathy. The hemodynamic state of these patients was analyzed in three conditions: baseline, after continuous positive pressure of 7 cmH2O and, finally, after pressure of 14 cmH2O. Results: The population was composed of predominantly young and female individuals with significant elevation in pulmonary arterial pressure (mean systolic pressure of 57 mmHg). Of all variables analyzed, only the right atrial pressure changed across the analyzed moments (from the baseline condition to the pressure of 14 cmH2O there was a change from 8 ± 4 mmHg to 11 ± 3 mmHg, respectively, p = 0.031). Even though there was no variation in mean cardiac output, increased values in pulmonary artery pressure were associated with increased cardiac output. There was no harmful effect or other clinical instability associated with use application of airway pressure. Conclusion: In patients with venocapillary pulmonary hypertension without left ventricular dysfunction, cardiac output response was directly associated with the degree of pulmonary hypertension. The application of noninvasive ventilation did not cause complications directly related to the ventilation systems.
The present study aimed to investigate an abortion outbreak in a dairy goat herd in the municipality of Arapoti, Parana, Brazil. At the beginning of the outbreak, blood samples were collected from 33 ...goats with clinical signs; later, of the whole goat herd, two cats and two dogs. Milk samples were collected from 78 lactating goats. Four environmental soil samples and four samples of feed residue from goat feeders were collected too. Immunofluorescence antibody test (IFA) was used for serodiagnosis, the molecular analysis was conducted by means of the polymerase chain reaction (PCR), for the isolation of the etiological agent the bioassay was used. The results of the IFA revealed that 76.53% (137/179) of the goats, two dogs and two cats were seropositive for Toxoplasma gondii. Bioassay revealed one buffy coat and two milk sample having viable T. gondii. In the PCR, 11 whole blood samples, eight milk, three feeder troughs, and all soil samples were positive. The findings of the present study confirmed an outbreak caused by environmental contamination (of soil and feed) with T. gondii oocysts that could have been shed by kittens that lived on the farm and had access to the stock of goat food, facilitating this contamination, which reinforces the need for veterinary assistance and good management practices on farms.
RESUMO: O presente estudo teve como objetivo investigar um surto de aborto em um rebanho de cabras leiteiras no município de Arapoti, Paraná, Brasil. No início do surto, foram coletadas amostras de sangue de 33 cabras com sinais clínicos; mais tarde, de todo o rebanho caprino, dois gatos e dois cachorros. Foram obtidas amostras de leite das 78 cabras em lactação. Quatro amostras ambientais de solo e quatro de resíduos de comedouro também foram coletadas. O teste de imunofluorescência (IFI) foi utilizado para o sorodiagnóstico, a análise molecular foi conduzida por meio da reação em cadeia da polimerase (PCR), para isolamento do agente etiológico utilizou-se o bioensaio. Os resultados da IFI revelaram que 76,53% (137/179) das cabras, todos os cães e gatos eram soropositivos para Toxoplasma gondii. O bioensaio revelou uma amostra de camada leucocitária e duas de leite contaminadas com T. gondii viável. Na PCR, 11 amostras de sangue total, oito de leite, três resíduos alimentares e todas as amostras de solo foram positivas. Os resultados do presente estudo confirmaram um surto causado por contaminação ambiental (de solo e alimentos) com oocistos de T. gondii que, provavelmente, foram eliminados por gatos que permaneceram na fazenda e tinham acesso ao estoque de alimento dos caprinos, reforçando a necessidade de assistência técnica veterinária e boas práticas de manejo.
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