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Resumen: El objetivo de este trabajo fue evaluar los factores explicativos de la respuesta inmune humoral en adultos mayores de establecimientos de estancia prolongada de Buenos Aires, Argentina, hasta 180 días post vacunación. Se utilizó un diseño de cohorte abierta, prospectiva, multicéntrica, con voluntarios que recibieron dos dosis de vacunas Sputnik V, Sinopharm o AZD1222. Se analizaron muestras de plasma en los tiempos 0, 21 días post primera dosis, 21 días post segunda dosis, 120 y 180 días post primera dosis. Se ajustaron modelos lineales marginales y aditivos generalizados mixtos para evaluar el comportamiento de la concentración de anticuerpos IgG anti-Spike en el tiempo según grupo de exposición (naïve/no-naïve) y vacuna. Las covariables analizadas fueron: ocurrencia de brote de COVID-19 en establecimientos de estancia prolongada y comorbilidades. Se incluyeron en el análisis 773 participantes con una mediana de edad de 83 años (RIQ: 76-89). Al final del estudio, los niveles de anticuerpos del grupo naïve: Sinopharm fueron significativamente menores que el resto de los grupos (p < 0,05); los del no-naïve: Sinopharm resultaron similares a los naïve que recibieron AZD1222 (p = 0,945) o Sputnik V (p = 1). Los participantes expuestos a brotes en establecimientos de estancia prolongada presentaron niveles de anticuerpos significativamente mayores, independientemente del grupo de exposición y la vacuna (p < 0,001). Concluimos que la exposición previa a COVID-19, el tipo de vacuna y la pertenencia a un establecimiento de estancia prolongada con antecedente de brote son factores a considerar frente a futuros eventos epidémicos con dinámicas de transmisión y mecanismos inmunológicos similares al COVID-19, en poblaciones similares a la analizada en este trabajo.
Abstract: This study evaluated the explanatory factors of humoral immune response in older adults admitted to long-term care institutions in Buenos Aires, Argentina, up to 180 days after vaccination. An open-label, prospective, multicenter cohort study was conducted with volunteers who received two doses of the Sputnik V, Sinopharm, or AZD1222 vaccines. Plasma samples were analyzed at 0 and 21 days after the first dose, 21 days after the second dose, and 120 and 180 days after the first dose. Marginal linear models and generalized additives mixed models were adjusted to determine the behavior of anti-spike IgG antibody concentration over time according to exposure group (naïve/no-naïve) and vaccine. Occurrence of an outbreak of COVID-19 in long-term care institutions and comorbidities were the covariates analyzed. A total of 773 participants were included, with a mean age of 83 years (IQR: 76-89). Results showed that antibody levels in the naïve: Sinopharm group were significantly lower to the other groups (p < 0.05). Antibody levels in the no-naïve: Sinopharm group were similar to those in the naïve group who received AZD1222 (p = 0.945) or Sputnik V (p = 1). Participants exposed to outbreaks in long-term care institutions had significantly higher antibody levels, regardless of exposure group and vaccine (p < 0.001). In conclusion, previous exposure to COVID-19, type of vaccine, and admittance into a long-term care institution with a history of outbreaks are factors to be considered in future epidemic events with transmission dynamics and immunological mechanisms similar to COVID-19, in populations similar to the one analyzed.
Resumo: Este estudo teve como objetivo avaliar os fatores explicativos da resposta imune humoral em idosos em instituições de longa permanência em Buenos Aires, Argentina, até 180 dias após a vacinação. Foi realizado um estudo de coorte aberto, prospectivo e multicêntrico, com voluntários que receberam duas doses das vacinas Sputnik V, Sinopharm ou AZD1222. As amostras de plasma foram analisadas nos tempos 0, 21 dias após a primeira dose, 21 dias após a segunda dose, 120 e 180 dias após a primeira dose. Os modelos lineares marginais e os aditivos generalizados mistos foram ajustados para determinar o comportamento da concentração de anticorpos IgG anti-Spike ao longo do tempo de acordo com o grupo de exposição (naïve/no-naïve) e vacina. As covariáveis analisadas foram ocorrência de pico de COVID-19 nas instituições de longa permanência e comorbidades. Foram incluídos 773 participantes, com média de idade de 83 anos (IIQ: 76-89). Os resultados apontaram níveis de anticorpos do grupo naïve: Sinopharm significativamente mais baixos do que os outros grupos (p < 0,05); e as variáveis do grupo no-naïve: Sinopharm foram semelhantes à do grupo naïve que recebeu AZD1222 (p = 0,945) ou Sputnik V (p = 1). Os participantes expostos a picos nas instituições de longa permanência apresentaram níveis de anticorpos significativamente maiores, independentemente do grupo de exposição e da vacina (p < 0,001). Conclui-se que a exposição prévia à COVID-19, tipo de vacina e adesão a uma instituição de longa permanência com histórico de pico são fatores a serem considerados em futuros eventos epidêmicos com dinâmica de transmissão e mecanismos imunológicos semelhantes à COVID-19, em populações semelhantes à analisada neste trabalho.
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The COVID-19 pandemic has particularly affected older adults residing in nursing homes, resulting in high rates of hospitalisation and death. Here, we evaluated the longitudinal humoral response and neutralising capacity in plasma samples of volunteers vaccinated with different platforms (Sputnik V, BBIBP-CorV, and AZD1222). A cohort of 851 participants, mean age 83 (60-103 years), from the province of Buenos Aires, Argentina were included. Sequential plasma samples were taken at different time points after vaccination. After completing the vaccination schedule, infection-naïve volunteers who received either Sputnik V or AZD1222 exhibited significantly higher specific anti-Spike IgG titers than those who received BBIBP-CorV. Strong correlation between anti-Spike IgG titers and neutralising activity levels was evidenced at all times studied (rho=0.7 a 0.9). Previous exposure to SARS-CoV-2 and age <80 years were both associated with higher specific antibody levels. No differences in neutralising capacity were observed for the infection-naïve participants in either gender or age group. Similar to anti-Spike IgG titers, neutralising capacity decreased 3 to 9-fold at 6 months after initial vaccination for all platforms. Neutralising capacity against Omicron was between 10-58 fold lower compared to ancestral B.1 for all vaccine platforms at 21 days post dose 2 and 180 days post dose 1. This work provides evidence about the humoral response and neutralising capacity elicited by vaccination of a vulnerable elderly population. This data could be useful for pandemic management in defining public health policies, highlighting the need to apply reinforcements after a complete vaccination schedule.
Assuntos
COVID-19 , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais , Argentina/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , ChAdOx1 nCoV-19 , Humanos , Imunoglobulina G , Pandemias , SARS-CoV-2 , VacinaçãoRESUMO
Due to the high incidence of COVID-19 case numbers internationally, the World Health Organization (WHO) declared a Public Health Emergency of global relevance, advising countries to follow protocols to combat pandemic advance through actions that can reduce spread and consequently avoid a collapse in the local health system. This study aimed to evaluate the dynamics of the evolution of new community cases, and mortality records of COVID-19 in the State of Pará, which has a subtropical climate with temperatures between 20 and 35 °C, after the implementation of social distancing by quarantine and adoption of lockdown. The follow-up was carried out by the daily data from the technical bulletins provided by the State of Pará Public Health Secretary (SESPA). On 18 March 2020, Pará notified the first case of COVID-19. After 7 weeks, the number of confirmed cases reached 4756 with 375 deaths. The results show it took 49 days for 81% of the 144 states municipalities, distributed over an area of approximately 1 248 000 km2 to register COVID-19 cases. Temperature variations between 24.5 and 33.1 °C did not promote the decline in the new infections curve. The association between social isolation, quarantine and lockdown as an action to contain the infection was effective in reducing the region's new cases registration of COVID-19 in the short-term. However, short periods of lockdown may have promoted the virus spread among peripheral municipalities of the capital, as well as to inland regions.
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COVID-19/epidemiologia , Transmissão de Doença Infecciosa/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , COVID-19/mortalidade , COVID-19/prevenção & controle , COVID-19/transmissão , Criança , Pré-Escolar , Comorbidade , Diabetes Mellitus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Cardiopatias/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Distanciamento Físico , Quarentena , Chuva , SARS-CoV-2 , Temperatura , Tempo (Meteorologia) , Adulto JovemRESUMO
Infection with Toxoplasma gondii is very common in humans throughout the world, the intake of raw or undercooked meat with tissue cysts and fruits, vegetables and water contaminated with parasite oocysts being the main routes of infection. Here, we analyzed the seroprevalence of anti-T. gondii antibodies in pregnant females (age 13-44 years; nâ¯=â¯920) between April 2014 and December 2017 from Chascomús (Argentina), a city immersed in a rural area. Altogether 320 tested positive for immunoglobulin G antibodies, yielding an overall seroprevalence of 34.8% (CI 95%: 31.7-37.9). No association was observed between seropositivity and age. In addition, by using the QGIS 3.2.1 software we analyzed the geographical distribution of 769 (83.6%) pregnant females in two main areas of the city: Urban (nâ¯=â¯157) and Peri-urban (nâ¯=â¯612) with a seroprevalence of 26.8% (CI 95%: 19.8-33.7) and 36.4% (CI 95%: 32.6-40.3) respectively, and this difference was statistically significant (pâ¯=â¯0.023). Furthermore, we assessed through a questionnaire survey, between April 2016 to December 2017, possible risk factors such as activity (urban and rural), home water supply, animal husbandry, presence of cats as pets, gardening and consumption of meat and its derivatives (pork, sheep meat and sausages) and their frequencies (consumption per week), not finding significant association with seropositivity. Significant differences was found when the seroprevalence was analyzed between the urban and peri-urban neighborhoods of the city of Chascomús. The higher seroprevalence in peri-urban neighborhoods could be due to an unfavorable socioeconomic situation and/or to undeveloped peri-urban environments, which is a risk factor that should be taken into account when planning the health care of pregnant females.
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At the mouth of the Amazon River, a widespread carbonate ecosystem exists below the river plume, generating a hard-bottom reef (â¼9500 km2) that includes mainly large sponges but also rhodolith beds. The mesozooplankton associated with the pelagic realm over the reef formation was characterized, considering the estuarine plume and oceanic influence. Vertical hauls were carried out using a standard plankton net with 200 µm mesh size during September 2014. An indicator index was applied to express species importance as ecological indicators in community. Information on functional traits was gathered for the most abundant copepod species. Overall, 179 zooplankton taxa were recorded. Copepods were the richest (92 species), most diverse and most abundant group, whereas meroplankton were rare and less abundant. Species diversity (>3.0 bits.ind-1) and evenness (>0.6) were high, indicating a complex community. Small holoplanktonic species dominated the zooplankton, and the total density varied from 107.98 ind. m-3 over the reef area to 2,609.24 ind. m-3 in the estuarine plume, with a significant difference between coastal and oceanic areas. The most abundant copepods were the coastal species ithona plumifera and Clausocalanus furcatus and early stages copepodites of Paracalanidae. The holoplanktonic Oikopleura, an important producer of mucous houses, was very abundant on the reefs. The indicator species index revealed three groups: (1) indicative of coastal waters under the influence of the estuarine plume [Euterpina acutifrons, Parvocalanus crassirostris, Oikopleura (Vexillaria) dioica and Hydromedusae]; (2) characterized coastal and oceanic conditions (Clausocalanus); (3) characterized the reef system (O. plumifera). Two major copepods functional groups were identified and sorted according to their trophic strategy and coastal-oceanic distribution. The species that dominated the coastal area and the area over the rhodolith beds are indicators of the estuarine plume and are mixed with species of the North Brazil Current. These species practically disappear offshore, where occur oceanic species commonly found in other oligotrophic tropical areas. This ecosystem shows a mixture of estuarine, coastal and oceanic communities coexisting in the waters over the Amazon reefs, with no significant differences among these areas. However, the MDS clearly separated the communities along the salinity gradient in the plume.
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OBJECTIVE: To compare videofluoroscopy swallowing study (VFSS) with the fiberoptic endoscopic evaluation of swallowing (FEES) in children and to determine the accuracy of FEES in the diagnosis of specific swallowing disorders. STUDY DESIGN: Cross-sectional study. SETTING: Hospital da Criança Santo Antônio, affiliated with Santa Casa de Misericórdia Hospital Complex, Porto Alegre, RS, Brazil. SUBJECTS AND METHODS: FEES findings were compared to those of VFSS in 30 children. Kappa coefficients for interobserver agreement were calculated. Thereafter, these coefficients were evaluated in terms of agreement between FEES and VFSS. In addition, the sensitivity, specificity, positive predictive value, and negative predictive value of FEES were calculated for four swallowing parameters (posterior spillover, pharyngeal residues, laryngeal penetration, and laryngotracheal aspiration). RESULTS: Interobserver agreement rates greater than 70 percent were obtained for all FEES parameters analyzed, except for pharyngeal residues with puree consistency (agreement = 66.7%, kappa = 0.296, P = 0.091). Laryngeal aspiration and penetration yielded the best level of agreement (100%, kappa = 1) for the laryngeal aspiration of puree residues. CONCLUSION: The diagnostic agreement between FEES (both observers) and VFSS was low. Regarding the analyzed parameters, laryngeal penetration and aspiration yielded the highest interobserver agreement in terms of FEES, and also showed the highest specificity and positive predictive value when compared to VFSS.