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Camacho-Domínguez L, Rojas M, Herrán M, Rodríguez Y, Beltrán S, Galindo PS, Aguirre-Correal N, Espitia M, García S, Bejarano V, Morales-González V, Covaleda-Vargas JE, Rodríguez-Jiménez M, Zapata E, Monsalve DM, Acosta-Ampudia Y, Anaya JM, Ramírez-Santana C. Predictors of mortality in hospitalised patients with COVID-19: a 1-year case-control study. BMJ Open 2024; 14:e072784. [PMID: 38355186 PMCID: PMC10868294 DOI: 10.1136/bmjopen-2023-072784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 01/22/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND A paucity of predictive models assessing risk factors for COVID-19 mortality that extend beyond age and gender in Latino population is evident in the current academic literature. OBJECTIVES To determine the associated factors with mortality, in addition to age and sex during the first year of the pandemic. DESIGN A case-control study with retrospective revision of clinical and paraclinical variables by systematic revision of clinical records was conducted. Multiple imputations by chained equation were implemented to account for missing variables. Classification and regression trees (CART) were estimated to evaluate the interaction of associated factors on admission and their role in predicting mortality during hospitalisation. No intervention was performed. SETTING High-complexity centre above 2640 m above sea level (masl) in Colombia. PARTICIPANTS A population sample of 564 patients admitted to the hospital with confirmed COVID-19 by PCR. Deceased patients (n=282) and a control group (n=282), matched by age, sex and month of admission, were included. MAIN OUTCOME MEASURE Mortality during hospitalisation. MAIN RESULTS After the imputation of datasets, CART analysis estimated 11 clinical profiles based on respiratory distress, haemoglobin, lactate dehydrogenase, partial pressure of oxygen to inspired partial pressure of oxygen ratio, chronic kidney disease, ferritin, creatinine and leucocytes on admission. The accuracy model for prediction was 80.4% (95% CI 71.8% to 87.3%), with an area under the curve of 78.8% (95% CI 69.63% to 87.93%). CONCLUSIONS This study discloses new interactions between clinical and paraclinical features beyond age and sex influencing mortality in COVID-19 patients. Furthermore, the predictive model could offer new clues for the personalised management of this condition in clinical settings.
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Affiliation(s)
- Laura Camacho-Domínguez
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
- Clínica del Occidente, Bogota, Colombia
| | - Manuel Rojas
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, California, USA
| | - María Herrán
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
- Department of Clinical Research, Cleveland Clinic Florida, Weston, Florida, USA
| | - Yhojan Rodríguez
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
- Clínica del Occidente, Bogota, Colombia
- Department of Internal Medicine, University Hospital, Fundación Santa Fe de Bogotá, Bogota, Colombia
| | - Santiago Beltrán
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Paola Saboya Galindo
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Nicolas Aguirre-Correal
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - María Espitia
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Santiago García
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Valeria Bejarano
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Victoria Morales-González
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Jaime Enrique Covaleda-Vargas
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Mónica Rodríguez-Jiménez
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Elizabeth Zapata
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
- Clínica del Occidente, Bogota, Colombia
| | - Diana M Monsalve
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Yeny Acosta-Ampudia
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Juan-Manuel Anaya
- Health Research and Innovation Center at Coosalud, Cartagena, Colombia
| | - Carolina Ramírez-Santana
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
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Fernández Villalobos NV, Marsall P, Torres Páez JC, Strömpl J, Gruber J, Lotto Batista M, Pohl D, Concha G, Frickmann H, de la Hoz Restrepo FP, Schneiderhan-Marra N, Krause G, Dulovic A, Strengert M, Kann S. Humoral immune response to SARS-CoV-2 and endemic coronaviruses in urban and indigenous children in Colombia. COMMUNICATIONS MEDICINE 2023; 3:151. [PMID: 37864073 PMCID: PMC10589283 DOI: 10.1038/s43856-023-00376-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/29/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Although anti-SARS-CoV-2 humoral immune responses and epidemiology have been extensively studied, data gaps remain for certain populations such as indigenous people or children especially in low- and middle-income countries. To address this gap, we evaluated SARS-CoV-2 seroprevalence and humoral immunity towards the parental B.1 strain, local SARS-CoV-2 variants, and endemic coronaviruses in children from Colombia from March to April 2021. METHODS We performed a cross-sectional seroprevalence study with 80 children from Bogotá and expanded our analysis by comparing results with an independent observational study of 82 children from the Wiwa community living in the north-eastern Colombian territories. Antibody IgG titers towards SARS-CoV-2 and the endemic coronaviruses as well as ACE2 binding inhibition as a proxy for neutralization towards several SARS-CoV-2 variants were analyzed using two multiplex-based immunoassays. RESULTS While we find seroprevalence estimates of 21.3% in children from Bogotá, seroprevalence is higher with 34.1% in Wiwa children. We observe a robust induction of antibodies towards the surface-exposed spike protein, its S1-, S2- and receptor-binding-subdomains in all SARS-CoV-2 seropositive children. Only nucleocapsid-specific IgG is significantly lower in the indigenous participants. ACE2 binding inhibition is low for all SARS-CoV-2 variants examined. We observe a dominance of NL63 S1 IgG levels in urban and indigenous children which suggests an early exposure to this respiratory virus independent of living conditions and geographic location. SARS-CoV-2 seropositivity does not correlate with antibody levels towards any of the four endemic coronaviruses indicating the absence of cross-protective immunity. CONCLUSIONS Overall, antibody titers, but in particular ACE2 binding inhibition are low within Colombian samples, requiring further investigation to determine any potential clinical significance.
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Affiliation(s)
| | - Patrick Marsall
- Multiplex Immunoassays, NMI Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | - Johanna Carolina Torres Páez
- Department of Epidemiology, PhD Programme, Helmholtz Centre for Infection Research (HZI), Braunschweig-Hannover, Germany
| | - Julia Strömpl
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
| | - Jens Gruber
- Multiplex Immunoassays, NMI Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | - Martín Lotto Batista
- Department of Epidemiology, PhD Programme, Helmholtz Centre for Infection Research (HZI), Braunschweig-Hannover, Germany
- Global Health Resilience, Barcelona Supercomputing Center (BSC), Barcelona, Spain
| | - Daria Pohl
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
| | - Gustavo Concha
- Organization Wiwa Yugumaiun Bunkauanarrua Tayrona (OWYBT), Department Health Advocacy, Valledupar, Colombia
| | - Hagen Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Hamburg, Germany
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
| | | | - Nicole Schneiderhan-Marra
- Multiplex Immunoassays, NMI Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
- German Centre for Infection Research (DZIF), Braunschweig-Hannover, Germany
- TWINCORE, Centre for Experimental and Clinical Infection Research, a joint venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
| | - Alex Dulovic
- Multiplex Immunoassays, NMI Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | - Monika Strengert
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany.
- TWINCORE, Centre for Experimental and Clinical Infection Research, a joint venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany.
| | - Simone Kann
- Medical Mission Institute, Würzburg, Germany
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Beltrán EO, Martignon S, Coronel-Ruiz C, Velandia-Romero ML, Romero-Sanchez C, Avila V, Castellanos JE. Seroprevalence, infection, and personal protective equipment use among Colombian healthcare workers during the COVID-19 pandemic. Front Public Health 2023; 11:1225037. [PMID: 37900032 PMCID: PMC10602893 DOI: 10.3389/fpubh.2023.1225037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/28/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Healthcare workers (HCWs) are at the forefront of the COVID-19 response and frequently come into close contact with patients and their virus-contaminated body fluids. Recent studies have identified differential risks of infection and the use of personal protective equipment (PPE) among HCWs. However, available data might be interpreted with caution because of differences in the national health systems, local implementation issues, and adherence limitations to guidelines. A comprehensive description of infection, exposure at work, and biosafety habits during the COVID-19 pandemic has not been conducted among the HCW groups in Latin American populations. Objective To describe SARS-CoV-2 seroprevalence, infections, and extent of PPE use during the COVID-19 pandemic among HCWs at three different times, including dental practitioners (DP), nursing assistants (NA), physicians (P), and respiratory therapists (RT), from Bogotá, Colombia. Methods: After IRB approval, this cross-sectional study included 307 HCWs. Participants provided nasopharyngeal swabs and blood samples to detect viral RNA (RT-qPCR) and IgM/IgG anti-SARS-CoV-2 (ELFA-ELISA) at baseline (BL) and two follow-ups. Infection prevalence was defined as the number of positive-tested participants (RT-qPCR and/or IgM). Data on clinical status and biosafety habits were collected each time. Results Differential infection prevalence was found among HCWs through the study timeline (BL: RT-qPCR = 2.6%, IgM = 1.6%; follow-up 1 (45 days after BL): RT-qPCR = 4.5%, IgM = 3.9%; follow-up 2 (60 days after BL): RT-qPCR = 3.58%, IgM = 1.3%. Dental practitioners showed a higher infection frequency in BL and follow-up 1. IgG-positive tested HCWs percentage progressively increased from BL to follow-ups among the whole sample while index values decreased. Limitations in N95 availability and a high perception of occupational risk were reported. Conclusion A low prevalence of active SARS-CoV-2 infections among HCWs groups was found. Over time, there was an increase in participants showing IgG antibodies, although the levels of these antibodies in the blood decreased. Additionally, HCWs reported limitations in the availability of PPE as well as a variation in their safety practices.
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Affiliation(s)
- Edgar O. Beltrán
- Universidad El Bosque, Research Department, UNICA—Caries Research Unit, Bogotá, Colombia
| | - Stefania Martignon
- Universidad El Bosque, Research Department, UNICA—Caries Research Unit, Bogotá, Colombia
| | - Carolina Coronel-Ruiz
- Universidad El Bosque, Vicerrectoría de Investigaciones, Grupo de Virología, Bogotá, Colombia
| | | | - Consuelo Romero-Sanchez
- Universidad El Bosque, Cellular and Molecular Immunology Group, InmuBO, School of Dentistry, Bogotá, Colombia
- Universidad Militar Nueva Granada, Clinical Immunology Group-Hospital Militar, School of Medicine, Bogotá, Colombia
| | - Viviana Avila
- Universidad El Bosque, Research Department, UNICA—Caries Research Unit, Bogotá, Colombia
| | - Jaime E. Castellanos
- Universidad El Bosque, Vicerrectoría de Investigaciones, Grupo de Virología, Bogotá, Colombia
- Universidad Nacional de Colombia, Grupo de Investigaciones Básicas y Aplicadas en Odontología, Bogotá, Colombia
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Jimenez-Silva C, Rivero R, Douglas J, Bouckaert R, Villabona-Arenas CJ, Atkins KE, Gastelbondo B, Calderon A, Guzman C, Echeverri-De la Hoz D, Muñoz M, Ballesteros N, Castañeda S, Patiño LH, Ramirez A, Luna N, Paniz-Mondolfi A, Serrano-Coll H, Ramirez JD, Mattar S, Drummond AJ. Genomic epidemiology of SARS-CoV-2 variants during the first two years of the pandemic in Colombia. COMMUNICATIONS MEDICINE 2023; 3:97. [PMID: 37443390 DOI: 10.1038/s43856-023-00328-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The emergence of highly transmissible SARS-CoV-2 variants has led to surges in cases and the need for global genomic surveillance. While some variants rapidly spread worldwide, other variants only persist nationally. There is a need for more fine-scale analysis to understand transmission dynamics at a country scale. For instance, the Mu variant of interest, also known as lineage B.1.621, was first detected in Colombia and was responsible for a large local wave but only a few sporadic cases elsewhere. METHODS To better understand the epidemiology of SARS-Cov-2 variants in Colombia, we used 14,049 complete SARS-CoV-2 genomes from the 32 states of Colombia. We performed Bayesian phylodynamic analyses to estimate the time of variants' introduction, their respective effective reproductive number, and effective population size, and the impact of disease control measures. RESULTS Here, we detect a total of 188 SARS-CoV-2 Pango lineages circulating in Colombia since the pandemic's start. We show that the effective reproduction number oscillated drastically throughout the first two years of the pandemic, with Mu showing the highest transmissibility (Re and growth rate estimation). CONCLUSIONS Our results reinforce that genomic surveillance programs are essential for countries to make evidence-driven interventions toward the emergence and circulation of novel SARS-CoV-2 variants.
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Affiliation(s)
- Cinthy Jimenez-Silva
- Centre for Computational Evolution, University of Auckland, Auckland, New Zealand.
- School of Biological Sciences, University of Auckland, Auckland, New Zealand.
| | - Ricardo Rivero
- Instituto de Investigaciones Biológicas del Trópico (IIBT), Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia.
- Paul G. Allen School for Global Health, Washington State University, Pullman, Washington, USA.
| | - Jordan Douglas
- Centre for Computational Evolution, University of Auckland, Auckland, New Zealand
- Department of Physics, University of Auckland, Auckland, New Zealand
| | - Remco Bouckaert
- Centre for Computational Evolution, University of Auckland, Auckland, New Zealand
- School of Computer Science, University of Auckland, Auckland, New Zealand
| | - Ch Julian Villabona-Arenas
- Centre for Mathematical Modelling of Infectious Diseases and Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Katherine E Atkins
- Centre for Mathematical Modelling of Infectious Diseases and Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Global Health, Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
| | - Bertha Gastelbondo
- Instituto de Investigaciones Biológicas del Trópico (IIBT), Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
- Grupo de Investigaciones Microbiológicas y Biomédicas de Córdoba-GIMBIC, Universidad de Córdoba, Monteria, Colombia
- Grupo de Salud Pública y Auditoría en Salud, Corporación Universitaria del Caribe- CECAR, Sincelejo, Colombia
| | - Alfonso Calderon
- Instituto de Investigaciones Biológicas del Trópico (IIBT), Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Camilo Guzman
- Instituto de Investigaciones Biológicas del Trópico (IIBT), Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
- Grupo de Investigación, Evaluación y Desarrollo de Farmacos y Afines - IDEFARMA, Universidad de Córdoba, Montería, Colombia
| | - Daniel Echeverri-De la Hoz
- Instituto de Investigaciones Biológicas del Trópico (IIBT), Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Marina Muñoz
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Nathalia Ballesteros
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Sergio Castañeda
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Luz H Patiño
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Angie Ramirez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Nicolas Luna
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Alberto Paniz-Mondolfi
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-based Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Hector Serrano-Coll
- Instituto Colombiano de Medicina Tropical-Universidad CES, Medellín, Colombia
| | - Juan David Ramirez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-based Medicine, Icahn School of Medicine at Mount Sinai, New York, USA.
| | - Salim Mattar
- Instituto de Investigaciones Biológicas del Trópico (IIBT), Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia.
| | - Alexei J Drummond
- Centre for Computational Evolution, University of Auckland, Auckland, New Zealand
- School of Biological Sciences, University of Auckland, Auckland, New Zealand
- School of Computer Science, University of Auckland, Auckland, New Zealand
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Patiño LH, Ballesteros N, Muñoz M, Ramírez AL, Luna N, Castañeda S, Gutierrez-Marin R, Mendoza-Ibarra JA, Rodriguez R, Bohada DP, Ramírez JD, Paniz-Mondolfi A. Mu SARS-CoV-2 (B.1.621) variant: A genomic snapshot across the Colombian-Venezuelan border. J Med Virol 2023; 95:e28766. [PMID: 37185861 DOI: 10.1002/jmv.28766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 05/17/2023]
Affiliation(s)
- Luz Helena Patiño
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nathalia Ballesteros
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Marina Muñoz
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Angie L Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Nicolas Luna
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Sergio Castañeda
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Reinaldo Gutierrez-Marin
- Grupo de investigación en enfermedades parasitarias tropicales e infecciosas (GIEPATI), Universidad de Pamplona, Cúcuta, Colombia
| | - Jesús A Mendoza-Ibarra
- Grupo de investigación en ciencias agropecuarias (GICA), Universidad de Pamplona, Cúcuta, Colombia
| | - Raúl Rodriguez
- Grupo de investigación en recursos naturales (GIRN), Universidad de Pamplona, Cúcuta, Colombia
| | - Diana Patricia Bohada
- Grupo de investigación en recursos naturales (GIRN), Universidad de Pamplona, Cúcuta, Colombia
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alberto Paniz-Mondolfi
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Segnini-Rodríguez FJ, Vega-Peña NV, Gamboa MP, Domínguez LC, Lotero JD, Flórez MS. Estudio de los desenlaces perioperatorios de la apendicitis aguda durante la pandemia por COVID-19: un estudio observacional analítico de cohorte. REVISTA COLOMBIANA DE CIRUGÍA 2023. [DOI: 10.30944/20117582.2281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Introducción. La condición de pandemia por COVID-19 impactó a la sociedad y los sistemas de salud a nivel mundial. Las adaptaciones institucionales procuraron mantener la calidad de la atención a pesar de un contexto organizacional desfavorable. La apendicitis aguda requirió ser manejada en un nuevo escenario institucional. El objetivo de este estudio fue evaluar la efectividad del tratamiento quirúrgico de la apendicitis durante la pandemia.
Métodos. Estudio observacional analítico, retrospectivo, en el que se incluyeron pacientes sometidos a apendicectomía, antes y durante la pandemia por COVID-19. Se evaluaron las complicaciones, infección del sitio operatorio, reingresos y estancia hospitalaria. Adicionalmente, se analizaron los desenlaces en los 3 picos epidemiológicos de la pandemia. Se efectuaron estadísticas descriptivas y analíticas entre los grupos a comparar.
Resultados. Se incluyeron 1521 pacientes con apendicitis, 48,3 % operados antes y 51,7 % durante la pandemia. No hubo diferencias entre los grupos en complicaciones (p=0,352), infección del sitio operatorio (p=0,191), reingreso en los primeros 30 días (p=0,605) y estancia hospitalaria (p=0,514). El manejo de la apendicitis durante el tercer pico fue similar a las prácticas habituales. El tiempo de evolución fue mayor durante la pandemia (p=0,04) y los pacientes fueron llevados a cirugía más pronto que previo a la pandemia (p<0,001). > <0,001).
Conclusiones. No se evidenció un incremento de complicaciones quirúrgicas, reingresos, estancia hospitalaria ni infección del sitio operatorio en los pacientes operados durante la pandemia. Hubo un efecto favorable para los pacientes como consecuencia de la adaptación institucional en la pandemia por COVID-19.
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Martínez C, Serrano-Coll H, Faccini Á, Contreras V, Galeano K, Botero Y, Herrera Y, Garcia A, Garay E, Rivero R, Contreras H, López Y, Guzmán C, Miranda J, Arrieta G, Mattar S. SARS-CoV-2 in a tropical area of Colombia, a remarkable conversion of presymptomatic to symptomatic people impacts public health. BMC Infect Dis 2022; 22:644. [PMID: 35883062 PMCID: PMC9321267 DOI: 10.1186/s12879-022-07575-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background The ability of SARS-CoV-2 to remain in asymptomatic individuals facilitates its dissemination and makes its control difficult. Objective. To establish a cohort of asymptomatic individuals, change to the symptomatic status, and determine the most frequent clinical manifestations. Methods Between April 9 and August 9, 2020, molecular diagnosis of SARS-CoV-2 infection was confirmed in 154 asymptomatic people in contact with subjects diagnosed with COVID-19. Nasopharyngeal swabs were performed on these people in different hospitals in Córdoba, the Caribbean area of Colombia. The genes E, RdRp, and N were amplified with RT-qPCR. Based on the molecular results and the Cq values, the patients were subsequently followed up through telephone calls to verify their health conditions. Results Overall, of 154 asymptomatic individuals, 103 (66.9%) remained asymptomatic, and 51 (33.1%) changed to symptomatic. The most frequent clinical manifestations in young people were anosmia and arthralgia. Adults showed cough, ageusia, and odynophagia; in the elderly were epigastralgia, dyspnea, and headache. Mortality was 8%. Conclusions A proportion of 33% of presymptomatic individuals was found, of which four of them died. This high rate could indicate a silent transmission, contributing significantly to the epidemic associated with SARS-CoV-2. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07575-0.
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Affiliation(s)
- Caty Martínez
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Héctor Serrano-Coll
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia.,Instituto Colombiano de Medicina Tropical-Universidad CES, Medellín, Colombia
| | - Álvaro Faccini
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Verónica Contreras
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Ketty Galeano
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Yesica Botero
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Yonairo Herrera
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Alejandra Garcia
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Evelin Garay
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Ricardo Rivero
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Héctor Contreras
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Yesica López
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Camilo Guzmán
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Jorge Miranda
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Germán Arrieta
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Salim Mattar
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia.
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Rojas M, Rodríguez Y, Hernández JC, Díaz-Coronado JC, Vergara JAD, Vélez VP, Mancilla JP, Araujo I, Yepes JT, Ricaurte OB, Pardo-Oviedo JM, Monsalve DM, Acosta-Ampudia Y, Ramírez-Santana C, García PG, Landinez LA, Correales LD, Grass JS, Pérez CR, López GS, Mateus N, Mancera L, Devia RR, Orjuela JE, Parra-Moreno CR, Buitrago AA, Ordoñez IE, Osorio CF, Ballesteros N, Patiño LH, Castañeda S, Muñoz M, Ramírez JD, Bastard P, Gervais A, Bizien L, Casanova JL, Camacho B, Gallo JE, Gómez O, Rojas-Villarraga A, Pérez CE, Manrique R, Mantilla RD, Anaya JM. Safety and efficacy of convalescent plasma for severe COVID-19: a randomized, single blinded, parallel, controlled clinical study. BMC Infect Dis 2022; 22:575. [PMID: 35761219 PMCID: PMC9235185 DOI: 10.1186/s12879-022-07560-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Convalescent plasma (CP) has been widely used to treat COVID-19 and is under study. However, the variability in the current clinical trials has averted its wide use in the current pandemic. We aimed to evaluate the safety and efficacy of CP in severe coronavirus disease 2019 (COVID-19) in the early stages of the disease. Methods A randomized controlled clinical study was conducted on 101 patients admitted to the hospital with confirmed severe COVID-19. Most participants had less than 14 days from symptoms onset and less than seven days from hospitalization. Fifty patients were assigned to receive CP plus standard therapy (ST), and 51 were assigned to receive ST alone. Participants in the CP arm received two doses of 250 mL each, transfused 24 h apart. All transfused plasma was obtained from "super donors" that fulfilled the following criteria: titers of anti-SARS-CoV-2 S1 IgG ≥ 1:3200 and IgA ≥ 1:800 antibodies. The effect of transfused anti-IFN antibodies and the SARS-CoV-2 variants at the entry of the study on the overall CP efficacy was evaluated. The primary outcomes were the reduction in viral load and the increase in IgG and IgA antibodies at 28 days of follow-up. The per-protocol analysis included 91 patients. Results An early but transient increase in IgG anti-S1-SARS-CoV-2 antibody levels at day 4 post-transfusion was observed (Estimated difference [ED], − 1.36; 95% CI, − 2.33 to − 0.39; P = 0.04). However, CP was not associated with viral load reduction in any of the points evaluated. Analysis of secondary outcomes revealed that those patients in the CP arm disclosed a shorter time to discharge (ED adjusted for mortality, 3.1 days; 95% CI, 0.20 to 5.94; P = 0.0361) or a reduction of 2 points on the WHO scale when compared with the ST group (HR adjusted for mortality, 1.6; 95% CI, 1.03 to 2.5; P = 0.0376). There were no benefits from CP on the rates of intensive care unit admission (HR, 0.82; 95% CI, 0.35 to 1.9; P = 0.6399), mechanical ventilation (HR, 0.66; 95% CI, 0.25 to 1.7; P = 0.4039), or mortality (HR, 3.2; 95% CI, 0.64 to 16; P = 0.1584). Anti-IFN antibodies and SARS-CoV-2 variants did not influence these results. Conclusion CP was not associated with viral load reduction, despite the early increase in IgG anti-SARS-CoV-2 antibodies. However, CP is safe and could be a therapeutic option to reduce the hospital length of stay. Trial registration NCT04332835
Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07560-7.
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Patiño LH, Castañeda S, Muñoz M, Ballesteros N, Ramirez AL, Luna N, Guerrero-Araya E, Pérez J, Correa-Cárdenas CA, Duque MC, Méndez C, Oliveros C, Shaban MV, Paniz-Mondolfi AE, Ramírez JD. Epidemiological Dynamics of SARS-CoV-2 Variants During Social Protests in Cali, Colombia. Front Med (Lausanne) 2022; 9:863911. [PMID: 35433760 PMCID: PMC9008484 DOI: 10.3389/fmed.2022.863911] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/10/2022] [Indexed: 01/29/2023] Open
Abstract
BackgroundThe third wave of the global health crisis attributed to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus reached Colombia in March 2021. Over the following 6 months, it was interpolated by manifestations of popular disapproval to the actual political regime—with multiple protests sprouting throughout the country. Large social gatherings seeded novel coronavirus disease 2019 (COVID-19) variants in big cities and propagated their facile spread, leading to increased rates of hospitalizations and deaths.MethodsIn this article, we evaluate the effective reproduction number (Rt) dynamics of SARS-CoV-2 in Cali, Colombia, between 4 April 2021 and 31 July 2021 based on the analysis of 228 genomes.ResultsOur results showed clear contrast in Rt values between the period of frequent protests (Rt > 1), and the preceding and following months (Rt < 1). Genomic analyses revealed 16 circulating SARS-CoV-2 lineages during the initial period—including variants of concern (VOCs) (Alpha, Gamma, and Delta) and variants of interest (VOIs) (Lambda and Mu). Furthermore, we noticed the Mu variant dominating the COVID-19 distribution schema as the months progressed. We identified four principal clusters through phylogenomic analyses—each one of potentially independent introduction to the city. Two of these were associated with the Mu variant, one associated with the Gamma variant, and one with the Lambda variant.ConclusionOur results chronicle the impact of large group assemblies on the epidemiology of COVID-19 during this intersection of political turmoil and sanitary crisis in Cali, Colombia. We emphasize upon the effects of limited biosecurity strategies (which had characterized this time period), on the spread of highly virulent strains throughout Cali and greater Colombia.
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Affiliation(s)
- Luz H. Patiño
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Sergio Castañeda
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Marina Muñoz
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Agencia Nacional de Investigación y Desarrollo (ANID)—Millennium Science Initiative Program—Millennium Nucleus in the Biology of the Intestinal Microbiota, Santiago, Chile
| | - Nathalia Ballesteros
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Angie L. Ramirez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Nicolas Luna
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Enzo Guerrero-Araya
- Agencia Nacional de Investigación y Desarrollo (ANID)—Millennium Science Initiative Program—Millennium Nucleus in the Biology of the Intestinal Microbiota, Santiago, Chile
- Microbiota-Host Interactions and Clostridia Research Group, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago, Chile
| | - Julie Pérez
- Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Laboratorio de Referencia e Investigación, Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Camilo A. Correa-Cárdenas
- Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Laboratorio de Referencia e Investigación, Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Maria Clara Duque
- Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Laboratorio de Referencia e Investigación, Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Claudia Méndez
- Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Laboratorio de Referencia e Investigación, Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Carolina Oliveros
- Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Laboratorio de Referencia e Investigación, Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Maryia V. Shaban
- Incubadora Venezolana de la Ciencia (IVC), Centro de Investigaciones Biomédicas IDB, Barquisimeto, Venezuela
| | - Alberto E. Paniz-Mondolfi
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- *Correspondence: Juan David Ramírez, ;
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