RESUMO
Introducción: El incremento exponencial de casos confirmados con el nuevo coronavirus SARS-CoV-2 obligó a las autoridades de la Organización Mundial de la Salud a declarar como pandemia esta emergencia sanitaria. Objetivo: Caracterizar a niños y adultos confirmados con la COVID-19 desde los puntos de vista clínico y epidemiológico. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 74 pacientes confirmados con la COVID-19, quienes estuvieron ingresados en el Hospital Clinicoquirúrgico Docente Dr. Joaquín Castillo Duany de Santiago de Cuba, desde marzo hasta mayo de 2020. Los datos se obtuvieron de las historias clínicas de los afectados. Entre las variables analizadas figuraron: edad, sexo, letalidad, estado al egreso, lugar de procedencia de los casos e inicio de síntomas de la COVID-19 antes del ingreso hospitalario. Resultados: Se halló un predominio del sexo masculino (52,7 %). Hubo una tendencia al ingreso hospitalario de pacientes asintomáticos confirmados, de ellos 50,0 % del grupo de 1 a 17 años de edad; 94,5 % de los afectados egresaron vivos de la institución. Ningún niño fue notificado como grave o crítico. La tos (60,0 %), la fiebre (34,5 %) y la falta de aire (21,8 %) fueron las manifestaciones clínicas más referidas. Conclusiones: Con un enfoque biosocial se informa una primera experiencia en la atención a pacientes confirmados con la COVID-19 en Santiago de Cuba. El diagnóstico clínico y epidemiológico favoreció a registrar la mayor incidencia de esta enfermedad en adultos jóvenes sintomáticos e identificar otros pacientes que transmitieron el virus sin manifestar síntomas.
Introduction: The exponential increment of confirmed cases with the new coronavirus SARS-CoV-2 forced the authorities of the Health World Organization to declare as pandemic this health emergency. Objective: to characterize children and adults confirmed with the COVID-19 from the clinical and epidemiological points of view. Methods: An observational, descriptive and cross-sectional study of 74 patients confirmed with the COVID-19 who were admitted to Dr. Joaquín Castillo Duany Teaching Clinical Surgical Hospital was carried out in Santiago de Cuba, from March to May, 2020. The data were obtained from the medical records of the affected patients. Among the analyzed variables we have: age, sex, lethality, discharge state, place of origin of the cases and beginning of COVID-19 symptoms before admission to hospital. Results: A prevalence of the male sex (52.7 %) was found. There was a tendency to the hospital admission of confirmed asymptomatic patients, of them 50.0 % of the 1 to 17 age group; 94.5 % of the affected patients were alive when discharged of the institution. No kids were notified in serious or critical condition. Cough (60.0 %), fever (34.5 %) and breathlessness (21.8 %) were the most referred clinical features. Conclusions: With a biosocial approach a first experience is informed in the care to confirmed patients with COVID-19 in Santiago de Cuba. The clinical and epidemiological diagnosis favored to register the highest incidence in this disease in symptomatic young adults and to identify other patients that transmitted the virus without manifesting symptoms.
Assuntos
Atenção Secundária à Saúde , COVID-19/diagnóstico , COVID-19/epidemiologia , Portador Sadio , Criança , Pré-Escolar , AdultoRESUMO
Abstract Diagnosing cases of coronavirus disease (COVID-19) with only non-respiratory symptoms has been challenging. We reported the diagnosis of a child who tested positive for COVID-19 with abdominal pain/diarrhea and tracked his family cluster. One member of the family tested positive for COVID-19 on real-time reverse-transcription polymerase chain reaction assay and three other family members had anti-SARS-CoV-2 antibodies.
Assuntos
Humanos , Masculino , Pneumonia Viral/diagnóstico , Infecções por Coronavirus/diagnóstico , Coronavirus/isolamento & purificação , Diarreia/diagnóstico , Pandemias , Faringite/etiologia , Dor Abdominal/etiologia , Análise por Conglomerados , Busca de Comunicante , Infecções por Coronavirus , Técnicas de Laboratório Clínico , Diarreia/etiologia , Febre/etiologia , BetacoronavirusRESUMO
Saint Louis encephalitis virus (SLEV) is a mosquito-borne flavivirus that occurs throughout the Americas, and is considered a public health threat. In Brazil, SLEV has been detected from human cases associated with dengue-like disease, but no neurological symptoms were reported. Furthermore, the epidemiology of SLEV in human populations is still poorly explored in the country. We reported serological and molecular detection of SLEV in a healthy population of equids and humans from rural areas in Southeast Brazil. A plaque reduction neutralization test was applied, and neutralizing antibodies were detected in 11 individuals (4.6%) and 60 horses (21.5%). A qPCR targeting the 5'UTR region and reverse transcription-PCR (RT-PCR) targeting the non-structural protein (NS5) gene were performed and three individuals tested positive in both assays. Subsequent phylogenetic analysis confirmed SLEV circulation and its findings suggest the occurrence of an asymptomatic or subclinical presence in human and animal cases, correlating with the risks for outbreaks and consequently burden of SLEV infections to public health. Preventive strategies should include improved surveillance in regions with a high probability of SLEV occurrence, improvement in diagnostic methods, and evaluation of exposure/risk factors that can favor SLEV emergence.