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We report a human coronavirus OC43 infection outbreak in hospitalized patients and healthcare workers in São Paulo, Brazil, occurring after SARS-CoV-2 cases disappeared. Infection was associated with healthcare workers in 5 (29.4%) patients. Routine surveillance including a respiratory virus panel can improve coronavirus detection in both healthcare professionals and patients.
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COVID-19 , Coronaviridae , Humanos , COVID-19/epidemiologia , Brasil/epidemiologia , SARS-CoV-2 , Surtos de DoençasRESUMO
We isolated a novel coronavirus from a medical team member presenting with fever and malaise after travel to Haiti. The virus showed 99.4% similarity with a recombinant canine coronavirus recently identified in a pneumonia patient in Malaysia, suggesting that infection with this virus and/or recombinant variants occurs in multiple locations.
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COVID-19 , Coronavirus Canino , Animais , Cães , Haiti , Humanos , SARS-CoV-2/genética , ViagemRESUMO
The causes of the broad spectrum of severity in COVID-19 are unknown. A protective effect through humoral immunity from previous infections by viruses of the SARS-CoV-2 family could explain a mild form of this disease. This study aimed to address whether the presence of antibodies against human seasonal coronaviruses (HCoVs) could prevent severe manifestations of COVID-19. A cross-sectional study was carried out in 165 participants. The presence of pre-existent antibodies against the seasonal HCoV-OC43, HCoV-HKU1, HCoV-229E, and HCoV-NL63 were detected. From all of the seasonal HCoVs studied, it was only found that being seropositive to HCoV-229E presented an association (p = 0.012) with developing mild clinical symptoms of COVID-19 or being asymptomatic. Multinomial regression analysis showed that being seropositive to HCoV-229E is associated with mild or moderate clinical symptoms for COVID-19. Statistical analysis also showed that being female is associated with being asymptomatic for SARS-CoV-2 infection or developing mild COVID-19. A subgroup analysis taking only seropositive to HCoV-229E revealed that females are more likely to develop asymptomatic SARS-CoV-2 infection (OR = 27.242, 95% CI 2.092-354.706, p = 0.012). Our results suggest that previous infections by HCoV-229E could prevent more serious clinical manifestations of COVID-19, but these are not the only variables that influence this event.
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COVID-19 , Coronavirus Humano 229E , Anticorpos Antivirais , Estudos Transversais , Feminino , Humanos , SARS-CoV-2RESUMO
Introducción: La COVID-19, enfermedad causada por Coronavirus SARS-CoV 2, ha devenido en pandemia en 185 países. Cuba la ha enfrentado sin informar fallecidos en edad pediátrica Objetivo: Examinar aspectos clínicos, epidemiológicos y cardiovasculares en menores de 18 años en período de convalecencia por COVID 19. Métodos: estudio descriptivo transversal en 36 pacientes diagnosticados de marzo a mayo de 2020 en Villa Clara, Cuba y evaluados posterior al alta clínica y epidemiológica en consulta de cardiología del Hospital Universitario "José Luis Miranda". La muestra no probabilística, se conformó por los que asistieron a consulta. Se estudiaron variables: edad, sexo, peso, talla, antecedentes patológicos y epidemiológicos, período de hospitalización, examen físico, exámenes complementarios iniciales y en la convalecencia. Se utilizaron técnicas de estadística descriptiva. Resultados: Predominaron edades mayores de 10 años (60,0 por ciento), sexo femenino (55,5 por ciento), estado nutricional óptimo sin enfermedad crónica previa. En Santa Clara y Camajuaní se presentaron eventos de transmisión local con mayores tasas de incidencia. La mayoría de los niños se encontraban asintomáticos, detectados por historia epidemiológica de contactos, de confirmados y sospechosos (89,0 por ciento). Las alteraciones en fases iniciales de convalecencia fueron miocarditis y pericarditis (13,8 por ciento). Conclusiones: En este estudio se detectaron complicaciones cardiovasculares secundarias a infección viral por coronavirus SARS COV 2, con criterios epidemiológicos, clínicos, electrocardiográficos, radiológicos de tórax y ecocardiográficos(AU)
Introduction: COVID-19 is caused by SARS-CoV-2 coronavirus and it has become a pandemic in 185 countries. Cuba has faced this pandemic without having any deaths in the pediatric ages. Objective: Examine clinical, epidemiological and cardiovascular aspects in patients under 18 years' old who are convalescents of COVID-19. Methods: Descriptive cross-sectional study in 36 patients diagnosed with COVID-19 from March to May, 2020 in Villa Clara province, Cuba; whom were attended after the clinical and epidemiological discharge in the Cardiology consultation of "José Luis Miranda" University Hospital in July, 2020.The non-probabilistic sample was formed with the patients that went to the consultation. The variables studied were: age, sex, weight, size, personal and epidemiological pathologic background, period of hospitalization, physical exam, initial and during recovery's complementary tests. The results were expressed in absolute and relative values. Results: There was a predominance of patients older than 10 years (60.0 percent), female sex (55.5 percent), optimal nutritional state and no chronic diseases. Santa Clara and Camajuaní presented events of local transmission and showed higher incidence rates. Most of the patients there were asymptomatic, and were detected mainly due to the epidemiological record of confirmed and suspicious cases (89.0 percent). Complications in the initial phases of convalescents were myocarditis and pericarditis (13.8 percent). Conclusions: There were detected cardiovascular complications as a consequence of the viral infection by SARS-CoV-2 coronavirus, with epidemiological, clinical, electrocardiographic, thorax radiology and echocardiographic criteria(AU)
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Humanos , Adolescente , Encaminhamento e Consulta , Cardiologia , Coronavirus , Síndrome Respiratória Aguda GraveRESUMO
Background: Most of the countries facing the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic are still trying to understand the dynamics of the behavior of the virus and dissemination of the new agent. Objectives: A retrospective descriptive epidemiological study of the 26 state capitals of Brazil and its capital, Brasilia, was performed to investigate the behavior of the infection and disease caused by SARS-CoV-2. Study design: The data presented were obtained from the State Health Departments and the Brazilian Ministry of Health. Seven epidemiological markers (including the incidence, mortality and case fatality rates and the growth of the epidemic measured by the ratios observed on days 30, 60 and 90) were compared for the initial 90 days of the epidemic for each city. Results: The epidemic spread to the country within 25 days, and deaths occurred as early as nine days from initiation. The incidence and mortality rates ranged from 70 to almost 1,599/100,000 and less than 1 to 1,171/1,000,000, respectively, at the end of the 90-day period of observation. The CFR was less than two up to 12.31%. The magnitude of each marker clustered the cities in different groups. The epidemic was managed differently in each city, with differences in qualified medical services and medical preparedness to face the emergency situation. Conclusions: Although modeling the epidemic has been a constant task, epidemiological data should be pursued to define actual information, such as the prevalence and incidence rates, to understand the unpredictable nature of this emerging infection, including the present policy of vaccination campaigns.
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Resumen El estándar de oro actual para la detección de SARS-CoV-2, agente causal de la pandemia de neumonía atípica (COVID-19) que apareció por primera vez en la ciudad de Wuhan (provincia de Hubei, China) en diciembre de 2019 (1), es la RT-qPCR. El protocolo estándar implica la transcripción inversa de ARN de SARS-CoV-2 en cadenas de ADN complementarias (ADNc), seguida de la amplificación de regiones específicas del ADNc. Este procedimiento demanda varias horas para ser completado y deriva en que la información final del estado de la infección pueda demorar hasta 24 horas. Ante la necesidad de disminuir el riesgo de una posible propagación viral dentro de la población originada por la rápida transmisión del SARS-CoV-2, se ha buscado prevenir el contagio, la propagación nosocomial y la transmisión comunitaria posterior, a través de la identificación rápida de casos sospechosos, y predecir las posteriores ondas infecciosas de recurrencia viral. Para esto, se vienen desarrollando métodos de laboratorio rápidos o point of care testing (POCT), que disminuyen el tiempo de diagnóstico y minimizan el riesgo de contagio por parte de los operadores.
Abstract The gold test to detect SARS-CoV-2, the etiologic agent that leads to the pandemic of atypical pneumonia (COVID 2019) that first appeared in Wuhan City, Hubei Province of China in December 2019 (1), is the RT-qPCR. The standard protocol involves reverse transcription of SARS-CoV-2 RNA into complementary DNA strands (cDNA), followed by the amplification of cDNA specific regions, a procedure that takes several hours to complete and which results in the final information from the infection status can take up to 24 hours. For this reason, and due to the need to reduce the risk of possible viral spread within the population caused by the fast transmission of SARS-CoV-2, in order to prevent nosocomial spread and subsequent community transmission through the quick identification of suspected cases, and to predict the further infectious waves of viral recurrence, rapid laboratory methods or Point of Care Testing (POCT) are being developed to reduce the diagnosis time and minimize the risk of contagion by the operators. These tests are discussed below.
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Humanos , COVID-19 , Pneumonia , DNA Complementar , Transmissão de Doença Infecciosa , Testes ImediatosRESUMO
OBJECTIVE: To analyze the increase in sentinel cases of COVID-19 in Mexico calculated from the effective number of reproductions of the infection (Rt) and compare its evolution with that reported by Italy, Spain and the United States of America during the first twenty weeks of evolution of the epidemic. METHOD: In an analytical cross-sectional design, the total number of cases of COVID-19 in Mexico from February 29 to July 24, 2020 was studied, and compared with sentinel cases calculated from the Rt. A descriptive and comparative analysis of prevalence, cumulative incidence and case fatality was performed to summarize the epidemiological data for Mexico and in relation to information for Italy, Spain, and the United States of North America. RESULTS: In Mexico, until July 24, 2020, there are a total of 390,516 cases of COVID-19 and 43,680 deaths from this disease; with the use of Rt to calculate the correction of cases and unidentified deaths, the figure increases to 3,780,195 cases (p = 0.0002) and 211,469 deaths (p = 0.001). This suggests underreporting in the identification of cases and deaths and is associated with one of the highest case fatality rates in the world for SARS-CoV-2 infection. CONCLUSIONS: In Mexico, the sentinel model presents a significant loss of unquantified information. It is necessary to reinforce epidemiological surveillance through a better case detection strategy in our country and continue to apply measures that allow the containment and mitigation of the COVID-19 pandemic.
OBJETIVO: Analizar el incremento de los casos centinela de COVID-19 en México calculados a partir del número efectivo de reproducción de la infección (Rt) y comparar su evolución con lo reportado por Italia, España y los Estados Unidos de Norteamérica durante las primeras 20 semanas de evolución de la pandemia. MÉTODO: En un diseño transversal analítico se estudió el total de casos de COVID-19 en México del 29 de febrero al 24 de julio de 2020, y se comparó con los casos centinela calculados a partir del Rt. Se realizó un análisis descriptivo y comparativo de la prevalencia, la incidencia acumulada y la letalidad para resumir los datos epidemiológicos para México y en relación con la información de Italia, España y los Estados Unidos de Norteamérica. RESULTADOS: En México, hasta el 24 de julio de 2020 se habían producido 390,516 casos de COVID-19 y 43,680 defunciones por esta enfermedad; con el uso del Rt para el cálculo de la corrección de casos y defunciones no identificadas, la cifra aumenta a 3,780,195 casos (p = 0.0002) y 211,469 defunciones (p = 0.001). Lo anterior sugiere un subregistro en la identificación de casos y defunciones, y se asocia con una de las tasas de letalidad más altas del mundo para la infección por SARS-CoV-2. CONCLUSIONES: El modelo centinela presenta una pérdida importante de información no cuantificada. Es necesario reforzar la vigilancia epidemiológica mediante una mejor estrategia de detección de casos en nuestro país y seguir aplicando medidas que permitan la contención y la mitigación de la pandemia de COVID-19.
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COVID-19/epidemiologia , SARS-CoV-2 , Vigilância de Evento Sentinela , COVID-19/diagnóstico , COVID-19/mortalidade , Teste para COVID-19 , Estudos Transversais , Humanos , Incidência , Itália/epidemiologia , México/epidemiologia , Prevalência , Espanha/epidemiologia , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: To describe the main neurological manifestations related to coronavirus infection in humans. METHODOLOGY: A systematic review was conducted regarding clinical studies on cases that had neurological manifestations associated with COVID-19 and other coronaviruses. The search was carried out in the electronic databases PubMed, Scopus, Embase, and LILACS with the following keywords: "coronavirus" or "Sars-CoV-2" or "COVID-19" and "neurologic manifestations" or "neurological symptoms" or "meningitis" or "encephalitis" or "encephalopathy," following the Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Seven studies were included. Neurological alterations after CoV infection may vary from 17.3% to 36.4% and, in the pediatric age range, encephalitis may be as frequent as respiratory disorders, affecting 11 % and 12 % of patients, respectively. The Investigation included 409 patients diagnosed with CoV infection who presented neurological symptoms, with median age range varying from 3 to 62 years. The main neurological alterations were headache (69; 16.8 %), dizziness (57, 13.9 %), altered consciousness (46; 11.2 %), vomiting (26; 6.3 %), epileptic crises (7; 1.7 %), neuralgia (5; 1.2 %), and ataxia (3; 0.7 %). The main presumed diagnoses were acute viral meningitis/encephalitis in 25 (6.1 %) patients, hypoxic encephalopathy in 23 (5.6 %) patients, acute cerebrovascular disease in 6 (1.4 %) patients, 1 (0.2 %) patient with possible acute disseminated encephalomyelitis, 1 (0.2 %) patient with acute necrotizing hemorrhagic encephalopathy, and 2 (1.4 %) patients with CoV related to Guillain-Barré syndrome. CONCLUSION: Coronaviruses have important neurotropic potential and they cause neurological alterations that range from mild to severe. The main neurological manifestations found were headache, dizziness and altered consciousness.
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INTRODUCTION: As of March 23, 2020, suspension of non-essential activities was declared in Mexico throughout the country in order to mitigate the spread of the COVID-19 pandemic. OBJECTIVE: To analyze data on the first 1,510 laboratory-confirmed cases of COVID-19 in Mexico, and to describe the geographical distribution of the disease and its transmission dynamics. METHOD: Description of the first COVID-19 cases with real-time RT-PCR-positive test, as well as evaluation of epidemiological measures, cumulative incidence, rate of transmission, and mortality and lethality rates during the first month of the epidemic. RESULTS: Average age was 43 years, and 58 % were males; 44 % of initial cases were imported. Lethality in the population during the first month went from 1.08 to 3.97 per 100 cases; however, the trend is linear and similar to that observed in Europe. CONCLUSIONS: In Mexico, social distancing is being applied, but studies are still required on the dynamics of the epidemic, person-to-person transmission, incidence of subclinical infections, and patient survival.
INTRODUCCIÓN: A partir del 23 de marzo de 2020, en México se declaró la suspensión de actividades no esenciales en todo el país para mitigar la diseminación de la pandemia de COVID-19. OBJETIVO: Analizar los datos sobre los primeros 1510 casos de COVID-19 confirmados por laboratorio en México, describir la distribución geográfica de la enfermedad y su dinámica de transmisión. MÉTODO: Descripción de los primeros casos de COVID-19 con prueba positiva de RT-PCR en tiempo real, así como evaluación de las medidas epidemiológicas, incidencia acumulada, razón de contagios y tasas de mortalidad y letalidad durante el primer mes de la epidemia. RESULTADOS: La edad promedio fue de 43 años y 58 % fue del sexo masculino; 44 % de los casos iniciales fue importado. La letalidad en la población durante el primer mes pasó de 1.08 a 3.97 por 100 casos; sin embargo, la tendencia es lineal y similar a la observada en Europa. CONCLUSIONES: En México se está aplicando el distanciamiento social, pero aún se requieren estudios sobre la dinámica de la epidemia, la transmisión de persona a persona, la incidencia de infecciones subclínicas y la supervivencia de los enfermos.
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Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Reação em Cadeia da Polimerase em Tempo Real/métodos , Isolamento Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19 , Criança , Pré-Escolar , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Sobrevida , Adulto JovemRESUMO
Resumen Introducción: A partir del 23 de marzo de 2020, en México se declaró la suspensión de actividades no esenciales en todo el país para mitigar la diseminación de la pandemia de COVID-19. Objetivo: Analizar los datos sobre los primeros 1510 casos de COVID-19 confirmados por laboratorio en México, describir la distribución geográfica de la enfermedad y su dinámica de transmisión. Método: Descripción de los primeros casos de COVID-19 con prueba positiva de RT-PCR en tiempo real, así como evaluación de las medidas epidemiológicas, incidencia acumulada, razón de contagios y tasas de mortalidad y letalidad durante el primer mes de la epidemia. Resultados: La edad promedio fue de 43 años y 58 % fue del sexo masculino; 44 % de los casos iniciales fue importado. La letalidad en la población durante el primer mes pasó de 1.08 a 3.97 por 100 casos; sin embargo, la tendencia es lineal y similar a la observada en Europa. Conclusiones: En México se está aplicando el distanciamiento social, pero aún se requieren estudios sobre la dinámica de la epidemia, la transmisión de persona a persona, la incidencia de infecciones subclínicas y la supervivencia de los enfermos.
Abstract Introduction As of March 23, 2020, suspension of non-essential activities was declared in Mexico throughout the country in order to mitigate the spread of the COVID-19 pandemic. Objective: To analyze data on the first 1510 laboratory-confirmed cases of COVID-19 in Mexico, and to describe the geographical distribution of the disease and its transmission dynamics. Method: Description of the first COVID-19 cases with real-time RT-PCR-positive test, as well as evaluation of epidemiological measures, cumulative incidence, rate of transmission, and mortality and lethality rates during the 1st month of the epidemic. Results: Average age was 43 years, and 58% were males; 44% of initial cases were imported. Lethality in the population during the 1st month went from 1.08 to 3.97 per 100 cases; however, the trend is linear and similar to that observed in Europe. Conclusions: In Mexico, social distancing is being applied, but studies are still required on the dynamics of the epidemic, person-to-person transmission, incidence of subclinical infections, and patient survival.
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Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Pneumonia Viral/epidemiologia , Isolamento Social , Infecções por Coronavirus/epidemiologia , Reação em Cadeia da Polimerase em Tempo Real/métodos , Pneumonia Viral/transmissão , Sobrevida , Incidência , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Pandemias/prevenção & controle , COVID-19 , México/epidemiologiaRESUMO
Human coronaviruses (HCoVs) are an important cause of respiratory tract infection and are responsible for causing the common cold in the general population. Thus, adequate surveillance of HCoV is essential. This study aimed to analyze the impact of HCoV infections and their relation to severe acute respiratory infection (SARI) in a hospitalized population in Southern Brazil. A cross-sectional study was conducted at a tertiary care hospital, and assessed inpatients under investigation for SARI by the hospital epidemiology department, and all patients who had nasopharyngeal aspirates collected from January 2012 to December 2013 to detect respiratory viruses (RVs). Viral infection was detected by multiplex reverse transcriptase polymerase chain reaction (RT-PCR), with primers specific to the subtypes HCoV-229E/NL63 and OC43/HKU1. The overall positivity rate was 58.8% (444/755), and HCoVs were detected in 7.6% (n = 34) of positive samples. Children below two years of age were most frequently affected (62%). Comorbidities were more likely to be associated with HCoVs than with other RVs. Immunosuppression was an independent risk factor for HCoV infection (OR = 3.5, 95% CI 1.6-7.6). Dyspnea was less frequently associated with HCoV infection (p < 0.001), and HCoV accounted for 6% of the SARI cases. Three patients infected with HCoV (9%) died from respiratory infection. HCoVs are important respiratory pathogens, especially in hospitalized children under 2 years of age and in immunosuppressed patients. They may account for a small proportion of SARI diagnoses, increased need for mechanical ventilation, intensive care unit admission, and death.
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Infecções por Coronavirus/diagnóstico , Coronavirus/genética , Brasil , Estudos Transversais , Humanos , Lactente , Infecções Respiratórias/epidemiologia , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
The incidence and clinical features of human coronaviruses (HCoVs) among Brazilian patients with respiratory illness are not well known. We investigated the prevalence of HCoVs among Brazilian outpatients and hospitalised patients with respiratory illnesses during 2009 and 2010. To identify the HCoVs, pancoronavirus and species-specific reverse-transcriptase polymerase chain reaction assays were performed. Five of 394 samples were positive for HCoVs (1.2%): 1/182 (0.5%) outpatients and 4/212 (1.8%) hospitalised patients. The OC43 and NL63 HCoVs were identified. Two patients were admitted to the intensive care unit. Underlying chronic disease was reported in cases and one diabetic adult died. HCoVs can cause lower respiratory infections and hospitalisation. Patients with pre-existing conditions and respiratory infections should be evaluated for HCoV infections.