RESUMO
AIM: Older adults are the main risk group for coronavirus disease 2019 (COVID-19). This study aimed to describe the clinical manifestations and factors associated with mortality from COVID-19 among older adults in Brazil. METHODS: A cross-sectional observational study was carried out with data from 9807 cases of COVID-19 among older adults in the state of Alagoas, Brazil. We determined the case fatality rate between age groups and clinical factors associated with mortality. RESULTS: A total of 52.5% (n = 5145) were women, and with an average age of 70.21 ± 8.37 years. The fatality rate was 11.9%, with a higher rate in men (14.4%) compared with women (9.8%). The fatality rate increased with age. The most common manifestations were fever (n = 4926; 50.2%), cough (n = 5737; 58.5%), headache (n = 1980; 20.2%) and fatigue (n = 2022; 20.6%). The most prevalent comorbidities were diabetes (n = 1528; 5.6%), cardiovascular disease (n = 1528; 15.6%) and systemic arterial hypertension (n = 597; 6.1%). The factors associated with mortality were male sex (OR 1.54), age ≥75 years (OR 2.40), dyspnea (OR 2.92), diabetes (OR 2.33), hypertension (OR 1.53) and chronic kidney disease (OR 2.02). CONCLUSIONS: The profile and the risk factors evidenced show the need to adopt mechanisms to protect the elderly population.
Assuntos
COVID-19/epidemiologia , COVID-19/mortalidade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil , COVID-19/diagnóstico , COVID-19/fisiopatologia , Doenças Cardiovasculares/epidemiologia , Comorbidade , Tosse , Estudos Transversais , Diabetes Mellitus/epidemiologia , Dispneia/epidemiologia , Fadiga , Feminino , Febre , Cefaleia , Humanos , Hipertensão/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pandemias , Insuficiência Renal Crônica/epidemiologia , Estudos Retrospectivos , Fatores de RiscoRESUMO
Post-translational and co-translational enzymatic addition of glycans (glycosylation) to proteins, lipids, and other carbohydrates, is a powerful regulator of the molecular machinery involved in cell cycle, adhesion, invasion, and signal transduction, and is usually seen in both in vivo and in vitro cancer models. Glycosyltransferases can alter the glycosylation pattern of normal cells, subsequently leading to the establishment and progression of several diseases, including cancer. Furthermore, a growing amount of research has shown that different oxygen tensions, mainly hypoxia, leads to a markedly altered glycosylation, resulting in altered glycan-receptor interactions. Alteration of intracellular glucose metabolism, from aerobic cellular respiration to anaerobic glycolysis, inhibition of integrin 3α1ß translocation to the plasma membrane, decreased 1,2-fucosylation of cell-surface glycans, and galectin overexpression are some consequences of the hypoxic tumor microenvironment. Additionally, increased expression of gangliosides carrying N-glycolyl sialic acid can also be significantly affected by hypoxia. For all these reasons, it is possible to realize that hypoxia strongly alters glycobiologic events within tumors, leading to changes in their behavior. This review aims to analyze the complexity and importance of glycoconjugates and their molecular interaction network in the hypoxic context of many solid tumors.