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Gomes RDSR, do Valle ACF, Freitas DFS, de Macedo PM, Oliveira RDVC, Almeida-Paes R, Zancopé-Oliveira RM, Gutierrez-Galhardo MC. Sporotrichosis in Older Adults: A Cohort Study of 911 Patients from a Hyperendemic Area of Zoonotic Transmission in Rio de Janeiro, Brazil. J Fungi (Basel) 2023; 9:804. [PMID: 37623575 PMCID: PMC10455193 DOI: 10.3390/jof9080804] [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: 06/26/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
Generally, older people tend to suffer from more severe infections than younger adults. In addition, there are accumulations of comorbidities and immune senescence in some cases. This cohort study evaluated the clinical and epidemiological characteristics of older adults (≥60 years old) with sporotrichosis. The cohort consisted of 911 patients with a median age of 67 years, most of whom were female (72.6%), white (62.1%), and afflicted with comorbidities (64.5%). The lymphocutaneous form occurred in 62% of the patients, followed by the fixed form (25.7%), cutaneous disseminated form (8.9%), and extracutaneous/disseminated forms (3.3%). In this study, we draw attention to the frequency of osteoarticular involvement (2.1%) secondary to skin lesions such as osteomyelitis and/or tenosynovitis. A clinical cure was achieved in 87.3% of cases. Itraconazole was used in 81.1% of cases, while terbinafine was used in 22.7% of cases, usually in low doses. Survival analysis showed that the median treatment time was 119 days, and the multiple Cox model demonstrated that the presentation of a black coloration and diabetes was associated with a longer treatment time required to establish a cure. Therefore, these subgroups should be monitored more closely to reduce possible difficulties during treatment. It would be interesting to conduct more studies analyzing older adults with sporotrichosis from different geographic areas to better comprehend the disease in this group.
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Affiliation(s)
- Rachel da Silva Ribeiro Gomes
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Antonio Carlos Francesconi do Valle
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Dayvison Francis Saraiva Freitas
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Priscila Marques de Macedo
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil
| | | | - Rodrigo Almeida-Paes
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil
| | - Maria Clara Gutierrez-Galhardo
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil
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Colnago M, Benvenuto GA, Casaca W, Negri RG, Fernandes EG, Cuminato JA. Risk Factors Associated with Mortality in Hospitalized Patients with COVID-19 during the Omicron Wave in Brazil. Bioengineering (Basel) 2022; 9:bioengineering9100584. [PMID: 36290552 PMCID: PMC9598428 DOI: 10.3390/bioengineering9100584] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Considering the imminence of new SARS-CoV-2 variants and COVID-19 vaccine availability, it is essential to understand the impact of the disease on the most vulnerable groups and those at risk of death from the disease. To this end, the odds ratio (OR) for mortality and hospitalization was calculated for different groups of patients by applying an adjusted logistic regression model based on the following variables of interest: gender, booster vaccination, age group, and comorbidity occurrence. A massive number of data were extracted and compiled from official Brazilian government resources, which include all reported cases of hospitalizations and deaths associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Brazil during the “wave” of the Omicron variant (BA.1 substrain). Males (1.242; 95% CI 1.196–1.290) aged 60–79 (3.348; 95% CI 3.050–3.674) and 80 years or older (5.453; 95% CI 4.966–5.989), and hospitalized patients with comorbidities (1.418; 95% CI 1.355–1.483), were more likely to die. There was a reduction in the risk of death (0.907; 95% CI 0.866–0.951) among patients who had received the third dose of the anti-SARS-CoV-2 vaccine (booster). Additionally, this big data investigation has found statistical evidence that vaccination can support mitigation plans concerning the current scenario of COVID-19 in Brazil since the Omicron variant and its substrains are now prevalent across the entire country.
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Affiliation(s)
- Marilaine Colnago
- Institute of Chemistry, São Paulo State University (UNESP), Araraquara 14800-060, Brazil
| | - Giovana A. Benvenuto
- Faculty of Science and Technology (FCT), São Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil
| | - Wallace Casaca
- Institute of Biosciences, Letters and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto 15054-000, Brazil
- Correspondence:
| | - Rogério G. Negri
- Science and Technology Institute, São Paulo State University (UNESP), São José dos Campos 12247-004, Brazil
| | - Eder G. Fernandes
- Immunization Division—Centre of Epidemiology Surveillance of the São Paulo State Health Department, São Paulo 01246-000, Brazil
| | - José A. Cuminato
- Institute of Mathematics and Computer Science, São Paulo University (USP), São Carlos 13566-590, Brazil
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