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Lissa SM, Lapinski BA, Graf ME, Reda S, Debur MDC, Presibella M, Pereira LA, de Carvalho NS, Carvalho de Oliveira J, Raboni SM, Nogueira MB. A Retrospective Cross-Sectional Analysis of Viral SARI in Pregnant Women in Southern Brazil. Microorganisms 2024; 12:1555. [PMID: 39203399 PMCID: PMC11356489 DOI: 10.3390/microorganisms12081555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 06/28/2024] [Accepted: 07/02/2024] [Indexed: 09/03/2024] Open
Abstract
Pregnant women (PW) are at a higher risk of diseases and hospitalization from viral respiratory infections, particularly influenza and SARS-CoV-2, due to cardiopulmonary and immunological changes. This study assessed the impact of viral respiratory infections on PW hospitalized with severe acute respiratory infection (SARI) prior to the COVID-19 pandemic. It is a cross-sectional study with 42 PW and 85 non-pregnant women (NPW) admitted with SARI to two tertiary hospitals between January 2015 and December 2019. The rates of virus prevalence, SARI hospitalization, length of hospital stay, oxygen supplementation, intensive care unit (ICU) admission, and death were comparable between PW and NPW. A multivariate analysis showed that PW had a higher rate of viral SARI hospitalizations (OR = 2.37; 95% CI = 1.02-5.48) as compared to NPW, with the influenza virus being the most prevalent (aOR = 7.58; 95% CI = 1.53-37.66). The length of hospital stays (aOR = 0.83; 95% CI = 0.73-0.95) and admissions to the ICU (aOR = 0.028; 95% CI = 0.004-0.25) were lower in PW as compared to hospitalized NPW. The influenza virus had a greater impact on the frequency of SARI in the group of PW, and these had a better outcome than NPW due to the earlier antiviral treatment they received.
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Affiliation(s)
- Sonia Maria Lissa
- Postgraduate Program in Tocogynecology and Women’s Health, Federal University of Parana Universidade Federal do Paraná, Curitiba 80060-900, Brazil; (S.M.L.)
| | - Bruna Amaral Lapinski
- Postgraduate Program in Internal Medicine and Health Science, Federal University of Parana, Curitiba 80060-900, Brazil;
| | - Maria Ester Graf
- Epidemiology Division, Hospital do Trabalhador, Curitiba 81050-000, Brazil;
| | - Somaia Reda
- Gynecology and Obstetrics Division, Hospital do Trabalhador, Curitiba 81050-000, Brazil;
| | - Maria do Carmo Debur
- Public Health Laboratory, São José dos Pinhais 83060-500, Brazil; (M.d.C.D.); (M.P.)
| | - Mayra Presibella
- Public Health Laboratory, São José dos Pinhais 83060-500, Brazil; (M.d.C.D.); (M.P.)
| | - Luciane Aparecida Pereira
- Virology Laboratory, Hospital de Clínicas, Federal University of Parana, Curitiba 80060-900, Brazil;
| | - Newton Sérgio de Carvalho
- Postgraduate Program in Tocogynecology and Women’s Health, Federal University of Parana Universidade Federal do Paraná, Curitiba 80060-900, Brazil; (S.M.L.)
- Department of Tocogynecology, Federal University of Parana, Curitiba 80060-900, Brazil
| | | | - Sonia Mara Raboni
- Infectious Diseases Division, Hospital de Clínicas, Federal University of Parana, Curitiba 80060-900, Brazil;
| | - Meri Bordignon Nogueira
- Postgraduate Program in Tocogynecology and Women’s Health, Federal University of Parana Universidade Federal do Paraná, Curitiba 80060-900, Brazil; (S.M.L.)
- Virology Laboratory, Hospital de Clínicas, Federal University of Parana, Curitiba 80060-900, Brazil;
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Özgen-Top Ö, Aysert-Yıldız P, Özger HS, Güzel-Tunçcan Ö. Evaluation of Hospitalized Patients with Community-Acquired Influenza-Like Illness During Two Influenza Seasons. INFECTIOUS DISEASES & CLINICAL MICROBIOLOGY 2023; 5:323-331. [PMID: 38633854 PMCID: PMC10986686 DOI: 10.36519/idcm.2023.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/02/2023] [Indexed: 04/19/2024]
Abstract
Objective Influenza is among the most important respiratory infections affecting all age groups and can lead to hospitalizations. We aimed to determine the frequency of influenza infections among acute admissions with influenza-like illness (ILI) and evaluate the demographic, clinical findings, and outcomes of patients with influenza. Methods This prospective, active surveillance study was conducted in a university hospital between 2015 and 2017. Patients hospitalized for at least 24 hours in the selected units with community-acquired ILI were screened according to certain influenza-predicting ICD-10 codes. Nasopharyngeal and pharyngeal swab samples were taken from patients who were eligible for the study. Patients tested for influenza with real-time polymerase chain reaction. Univariate and multivariate analyses were performed for data. Results Among 440 patients screened according to influenza-related ICD-10 codes, 112 were included. Influenza positivity was detected in 37 of the 112 patients. Clinical findings were similar between influenza positive and negative groups and also between influenza subtypes, excluding sore throat, which was more common in the H1N1 group. Alanine transaminase (ALT), aspartate transaminase (AST), and creatine kinase (CK) elevations were found to be significantly higher in the influenza-positive group. When influenza-positive patients with and without pneumonia were compared, the rate of vaccination in the same season was higher in patients without pneumonia than in patients with pneumonia (38.8% and 10.5%, respectively; p=0.04). Conclusion Integrating molecular tests detecting both influenza and other respiratory viruses into influenza surveillance programs can increase the efficacy and quality of these programs. The elevation of AST, ALT, and CK in influenza cases can be considered in distinguishing influenza from other ILI cases. Vaccination in the same season can reduce the risk of pneumonia in influenza-positive patients.
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Affiliation(s)
- Özge Özgen-Top
- Department of Infectious Diseases and Clinical Microbiology, Gazi University School of Medicine, Ankara, Türkiye
| | - Pınar Aysert-Yıldız
- Department of Infectious Diseases and Clinical Microbiology, Gazi University School of Medicine, Ankara, Türkiye
| | - Hasan Selçuk Özger
- Department of Infectious Diseases and Clinical Microbiology, Gazi University School of Medicine, Ankara, Türkiye
| | - Özlem Güzel-Tunçcan
- Department of Infectious Diseases and Clinical Microbiology, Gazi University School of Medicine, Ankara, Türkiye
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Campelo FS, de Aguiar Cordeiro R, Moura FEA. The role of human bocavirus as an agent of community-acquired pneumonia in children under 5 years of age in Fortaleza, Ceará (Northeast Brazil). Braz J Microbiol 2022; 53:1915-1924. [PMID: 35933553 PMCID: PMC9679084 DOI: 10.1007/s42770-022-00806-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/21/2022] [Indexed: 01/13/2023] Open
Abstract
The human bocavirus (HBoV) is an agent of upper and lower respiratory infections, affecting mainly children under 5 years of age. Community-acquired pneumonia (CAP) is an important public health problem in developing countries, representing one of the main causes of hospitalizations and deaths in children. The aim of this study was to describe the prevalence of HBoV and the clinical and epidemiological characteristics in children diagnosed with CAP. For this purpose, nasopharyngeal aspirates were collected from 545 children aged 0 to 60 months diagnosed with CAP between January 2013 and December 2014 in a reference pediatric hospital in Fortaleza, Ceará, Brazil. The samples were subjected to PCR for detection of HBoV and parainfluenza 4 (PIV4) and indirect immunofluorescence for detection of respiratory syncytial virus (RSV), adenovirus (AdV), influenza A and B (FLU A and FLU B), and parainfluenza 1, 2, and 3 (PIV1, PIV2, PIV3). Clinically, most CAP were non-complicated (487/545; 89.3%); however, 10.7% (58/545) of children were treated in the ICU/resuscitation sector. Among the total samples analyzed, 359 (65.8%) were positive for at least one virus surveyed and 105 (19.2%) samples had two or more viruses. HBoV was detected in 87 samples (15.9%), being the second most prevalent virus. RSV, AdV, FLU A, FLU B, and PIV 1-3 were detected in 150 (27.5%), 45 (8.2%), 30 (5.5%), 3 (0.5%), and 131 (24%) samples, respectively. The age average was 12.1 months in children infected with HBoV, and the most frequent symptoms were dyspnea and cough. In addition, 90.6% of HboV-positive children received antibiotics as empirical treatment. HBoV did not show any circulation pattern; however, it seemed to be more frequent in the first half of the year, totaling 68.9% of the cases. HBoV is a frequent agent of pneumonia in the child population studied.
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Affiliation(s)
- Felipe Serra Campelo
- Postgraduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, Brazil
| | - Rossana de Aguiar Cordeiro
- Postgraduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, Brazil ,Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, Brazil
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Grunberg M, Sno R, Adhin MR. Epidemiology of respiratory viruses in patients with severe acute respiratory infections and influenza-like illness in Suriname. Influenza Other Respir Viruses 2020; 15:72-80. [PMID: 32881286 PMCID: PMC7767960 DOI: 10.1111/irv.12791] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/12/2020] [Indexed: 12/13/2022] Open
Abstract
Background Influenza has been well studied in developed countries with temperate climates, in contrast to low‐ and middle‐income (LMIC) countries, thus hampering the effort to attain representative global data. Furthermore, data on non‐influenza respiratory infections are also limited. Insight in viral respiratory infections in Suriname, a tropical LMIC in South America, would contribute to improved local preventive measures and a better global understanding of respiratory viruses. Methods From May 2016 through April 2018, all patients (n = 1096) enrolled in the national severe acute respiratory infection and influenza‐like illness surveillance were screened for the presence of 10 respiratory viruses with singleplex RT‐PCR. Results The overall viral‐positive detection rate was 45.3%, specified as RSV (19.4%), influenza (15.5%), hMPV (4.9%), AdV (4.6%), and parainfluenza (3.8%). Co‐infections were detected in 6.2% of the positive cases. Lower overall positivity was observed in the SARI vs ILI surveillance and influenza prevalence was higher in outpatients (45.0% vs 6.7%), while RSV exhibited the reverse (4.8% vs 23.8%). Respiratory infections in general were more common in children than in adults (54.4% vs 29.5%), although children were significantly less affected by influenza (11.5% vs 22.7%). None of the respiratory viruses displayed a clear seasonal pattern, and viral interference was observed between RSV and influenza. Conclusions The comprehensive information presented for Suriname, including first data on non‐influenza respiratory viruses, displayed distinct differences between the viruses, in seasonality, within age groups and between SARI/ILI, accentuating the need, especially for tropical LMIC countries to continue ongoing surveillance and accumulate local data.
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Affiliation(s)
- Meritha Grunberg
- Prof. Dr. Paul C. Flu" Institute for Biomedical Sciences, Paramaribo, Suriname
| | - Rachel Sno
- Prof. Dr. Paul C. Flu" Institute for Biomedical Sciences, Paramaribo, Suriname
| | - Malti R Adhin
- Prof. Dr. Paul C. Flu" Institute for Biomedical Sciences, Paramaribo, Suriname.,Department of Biochemistry, Faculty of Medical Sciences, Anton de Kom Universiteit van Suriname, Paramaribo, Suriname
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Góes LGB, Zerbinati RM, Tateno AF, de Souza AV, Ebach F, Corman VM, Moreira-Filho CA, Durigon EL, da Silva Filho LVRF, Drexler JF. Typical epidemiology of respiratory virus infections in a Brazilian slum. J Med Virol 2019; 92:1316-1321. [PMID: 31769524 PMCID: PMC7228228 DOI: 10.1002/jmv.25636] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 11/21/2019] [Indexed: 02/01/2023]
Abstract
Host population size, density, immune status, age structure, and contact rates are critical elements of virus epidemiology. Slum populations stand out from other settings and may present differences in the epidemiology of acute viral infections. We collected nasopharyngeal specimens from 282 children aged ≤5 years with acute respiratory tract infection (ARI) during 2005 to 2006 in one of the largest Brazilian slums. We conducted real‐time reverse transcription‐polymerase chain reaction (RT‐PCR) for 16 respiratory viruses, nested RT‐PCR‐based typing of rhinoviruses (HRVs), and collected clinical symptoms. Viruses were common causes of respiratory disease; with ≥1 virus being detected in 65.2% of patients. We detected 15 different viruses during 1 year with a predominance of HRV (33.0%) and human respiratory syncytial virus (hRSV, 12.1%) infections, and a high rate of viral coinfections (28.3%). We observed seasonality of hRSV, HRV and human coronavirus infections, more severe symptoms in hRSV and influenza virus (FLU) infections and prolonged circulation of seven HRV clusters likely representing distinct serotypes according to genomic sequence distances. Potentially unusual findings included the absence of human metapneumovirus detections and lack of typical FLU seasonal patterns, which may be linked to the population size and density of the slum. Nonetheless, most epidemiological patterns were similar to other studies globally, suggesting surprising similarities of virus‐associated ARI across highly diverse settings and a complex impact of population characteristics on respiratory virus epidemiology. Large epidemiological study of respiratory viruses in children from one of the biggest Brazilian slums using sensitive molecular PCR assays Viruses are common causes of respiratory disease in pediatric patients from a Brazilian slum 15 distinct viruses circulate in the Brazilian slum, with highest prevalence of rhinoviruses and human respiratory syncytial virus The epidemiology of virus‐associated respiratory infections presents surprising similarities worldwide despite drastic differences in socioeconomic status and population characteristics
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Affiliation(s)
- Luiz Gustavo Bentim Góes
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Laboratório de Virologia Clínica e Molecular, Departamento de Microbiologia - ICB-II, Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Fabian Ebach
- Institute of Virology, University of Bonn Medical Center, Bonn, Germany
| | - Victor M Corman
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,German Center for Infection Research (DZIF), associated partner site Charité, Berlin, Germany
| | | | - Edison Luiz Durigon
- Laboratório de Virologia Clínica e Molecular, Departamento de Microbiologia - ICB-II, Universidade de São Paulo, São Paulo, Brazil
| | | | - Jan Felix Drexler
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,German Center for Infection Research (DZIF), associated partner site Charité, Berlin, Germany.,Martsinovsky Institute of Medical Parasitology, Tropical and Vector-Borne Diseases, Sechenov University, Moscow, Russia
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Primo D, Pacheco GT, Timenetsky MDCST, Luchs A. Surveillance and molecular characterization of human adenovirus in patients with acute gastroenteritis in the era of rotavirus vaccine, Brazil, 2012–2017. J Clin Virol 2018; 109:35-40. [DOI: 10.1016/j.jcv.2018.10.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/10/2018] [Accepted: 10/25/2018] [Indexed: 10/28/2022]
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Post-discharge mortality in patients with traumatic spinal cord injury in a Brazilian hospital: a retrospective cohort. Spinal Cord 2018; 57:134-140. [PMID: 30089892 DOI: 10.1038/s41393-018-0183-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 06/24/2018] [Accepted: 07/03/2018] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Retrospective cohort. OBJECTIVE To evaluate the survival outcomes in patients with traumatic spinal cord injury (TSCI). SETTING A teaching hospital in Brazil. METHODS A total of 434 patients diagnosed with TSCI (2004-2014) were included. Overall survival, standardized mortality ratios (SMR), and causes of death were assessed by Student's t-test, χ2 test, Kaplan-Meier analysis, and Cox proportional-hazards regression. RESULTS The mean follow-up was 4.8 years (±3.3 years). Individuals with tetraplegia had a median survival of 11 years, with participants in the paraplegia group not reaching median survival. The overall mortality rate was 37 per 1000 person-years. Age-adjusted SMR was 28.8 (95% CI: 22.8-36). There were 77 deaths with 56 defined causes, of which pneumonia was the most frequent (35.7%). Combined infectious etiologies caused 55.3% of deaths. Multivariate analysis revealed higher mortality among individuals with tetraplegia vs. paraplegia in the first 2 years post injury (HR = 8.28, 95% CI: 2.76-24.80), after 2 years post injury (HR = 2.35, 95% CI: 1.31-4.24), and in all years combined (HR = 3.36, 95% CI: 2.04-5.52). CONCLUSION Mortality among patients with TSCI was 28.8 times higher than in the reference population. In more than half of the cases, the cause of death was linked to infectious diseases. Pneumonia caused two times more deaths in individuals with tetraplegia than in individuals with paraplegia, with a higher impact in the first 2 years post injury. Reported findings indicate the need for a surveillance and prevention program with emphasis on vaccination and respiratory rehabilitation.
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