Epidemiological and clinical characteristics of COVID-19 in a Brazilian public hospital

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has become a major health concern worldwide. In that context, the understanding of epidemiological and clinical features associated with the disease and its severity is crucial for the establishment of strategies aimed at disease control and remedy.

AIM

To describe epidemiological features, signs, symptoms, and laboratory findings among severely ill COVID-19 patients from an intensive care unit in northeastern Brazil as well as to evaluate predictor factors for disease outcomes.

METHODS

This is a prospective single-center study that evaluated 115 patients admitted to the intensive care unit in a northeastern Brazilian hospital.

RESULTS

The patients had a median age of 65.60 ± 15.78 years. Dyspnea was the most frequent symptom, affecting 73.9% of the patients, followed by cough (54.7%). Fever was reported in approximately one-third of patients and myalgia in 20.8% of the patients. At least two comorbidities were found in 41.7% of the patients, and hypertension was the most prevalent (57.3%). In addition, having two or more comorbidities was a predictor of mortality, and lower platelet count was positively associated with death. Nausea and vomiting were two symptoms that were predictors of death, and the presence of a cough was a protective factor.

CONCLUSION

This is the first report of a negative correlation between cough and death in severely ill severe acute respiratory syndrome coronavirus 2-infected individuals. The associations between comorbidities, advanced age, and low platelet count and the outcomes of the infection were similar to the results of previous studies, highlighting the relevance of these features.

Qualitative analysis of the vaginal microbiota of healthy cattle and cattle with genital-tract disease

The microbial community of the reproductive appara-tus, when known, can provide information about the health of the host. Metagenomics has been used to characterize and obtain genetic infor-mation about microbial communities in various environments and can relate certain diseases with changes in this community composition. In this study, samples of vaginal surface mucosal secretions were col-lected from five healthy cows and five cows that showed symptoms of reproductive disorders. Following high-throughput sequencing of the isolated microbial DNA, data were processed using the Mothur soft-ware to remove low-quality sequences and chimeras, and released to the Ribosomal Database Project for classification of operational taxo-nomic units (OTUs). Local BLASTn was performed and results were loaded into the MEGAN program for viewing profiles and taxonomic microbial attributes. The control profile comprised a total of 15 taxa, with Bacteroides, Enterobacteriaceae, and Victivallis comprising the highest representation of OTUs; the reproductive disorder-positive profile comprised 68 taxa, with Bacteroides, Enterobacteriaceae, His-tophilus, Victivallis, Alistipes, and Coriobacteriaceae being the taxa with the most OTU representation. A change was observed in both the community composition as well as in the microbial attributes of the profiles, suggesting that a relationship might exist between the patho-gen and representative taxa, reflecting the production of metabolites to disease progression.

[Clinical profile and criteria for the diagnosis of schistosomal myeloradiculopathy]

During 20 year period (1972-1992) 56 patients with a diagnosis of schistosomal myeloradiculopathy were admitted in three hospitals of Belo Horizonte-Minas Gerais. Data from patients were collected retrospectively from their medical records. In all cases, the diagnosis was inferred in a presumably way and was based on the following considerations: 1) the finding of low thoracic/upper lumbar neurological symptoms; 2) positive epidemiology for schistosomiasis; 3) demonstration of exposure to schistosomiasis through parasitologic or serologic techniques; and 4) the exclusion of other known causes of transverse myelitis and myeloradiculitis. Several clinical and epidemiological aspects were studied to determine the diagnosis profiles of the schistosomal myeloradiculopathy in this sample and are presented in this paper. In recognizing the many problems in diagnosis of schistosomal myeloradiculopathy we emphasize how important is thinking about this entity and criteria to improve diagnostic evaluation are suggested.

[Severe Raynaud's phenomenon associated with interferon-beta therapy for multiple sclerosis: case report]

Interferon-beta (IFN-beta) is administered for treatment of multiple sclerosis (MS). We report on a woman with MS who presented with severe Raynaud's phenomenon, livedo-reticularis and digital necrosis two weeks after beginning therapy with IFN-beta. Symptoms improved after the IFN-beta was discontinued and anticoagulation associated with cyclophosphamide and corticoid were introduced. Raynaud's phenomenon is probably a side effect of IFN-beta therapy for multiple sclerosis.

[Myasthenia gravis: results of thymectomy in 52 patients]

From 1971 to 1993, 52 myasthenics without thymomas (7 men and 45 women) were thymectomized. The results were categorized in remissions and non-remissions. The remission rate was 48%. In the remission group there were 5 men and 20 women and in the non-remission group 2 men and 25 women. The follow-up time was 5.5 years in both groups. There were 16 patients in Osserman category II A, 11 achieving remission; 36 patients were in categories IIB and III, and 14 achieved remission. The duration of disease was 1.8 years and 4.3 years in the remission and non-remission groups, respectively. All patients with remission had less than four years of disease but among the 43 patients with less than four years of symptoms, 42% did not achieve remission. Our data reinforce the need for early thymectomy in myasthenia gravis.

Somatic sensory cortical regions of the agouti, Dasyprocta aguti

The localization and organization of primary (SmI) and secondary (SmI) somatic sensory cortical regions in agoutis, have been studied with micro- and macroelectrode-evoked potential techniques. For SmI, the mean surface area determined using microelectrodes was 13% smaller than that obtained using macroelectrodes. The location and organization of SmI are similar to those of other rodents: the largest representations were those of the vibrissae, the perioral regions and the first digit of the hand. As in some other animals, SmII is related to both sides of the body. It shows excellent somatopic differentiation and was located lateral and posterior to SmI, in relation to which it is arranged as a reduced mirror image. The area of SmII represents 31% of that of SmI in agoutis. The large size of the forepaw representation in SmI is reflected in SmII, that of the face representation is not; this agrees with similar findings from several other species. SmI was completely mapped using light touch stimuli, and contains many projections from vibrissae and hairs along with some proprioceptive projections. SmI overlaps with visual projections. SmII receives less light touch, vibrissae and hair projections than SmI, and it receives numerous deep mechanical and auditory projections. In SmII latencies were 10.96 msec for somesthetic and 13.39 msec for auditory stimuli; in SmI latencies were 13.25 msec for somesthetic and 39.80 msec for visual stimuli. One sulcus separates the SmI projections of the forelimb from those of the hindlimb, and another is often found marking the posterolateral boundary of SmII.

[Cellulose acetate electrophoresis of cerebrospinal fluid: normal values]

Determinating the total protein contents by the Meulemans method and using strips of celulose acetate "Cellogel" for electrophoresis the authors have studied the CSF of 19 patients between 10 and 54 years old. Total proteins was found between 10 and 28 mg%. The proteins were separated in six fractions with the following results: preé-albumin 4.3%; albumin 54.8%; alpha1-globulin 5.9%; alpha2 globulin 8.3%; beta-globulins 15.5% and delta-globulins 11.2%.

[Myotubular or centronuclear myopathy; report of a case and review of the literature]

A case of centronuclear or myotubular myopathy in a 13-year-old boy who was admitted with hypotonia and congenital ptosis is reported. Clinical, electromyographic and pathologic studies are discussed. A review of the electron microscopic features and comparison with out findings is included. Review of the literature disclosed near 50 cases of centronuclear myopathy. The diferential diagnosis is discussed.

Comparisons between brains of a large and a small hystricomorph rodent: capybara, Hydrochoerus and guinea pig, Cavia; neocortical projection regions and measurements of brain subdivisions

Somatic sensory, auditory and visual areas of cerebral neocortex were mapped in anesthetized capybaras using surface macroelectrode-evoked potential recording methods. The cortical motor area was mapped using electrical stimulation methods. The results of these experiments in the largest living rodent were similar to those found for the cortical sensory and motor areas of guinea pigs, a small rodent in a closely related family. The representation of the perioral skin in SI cortex was relatively large in capybaras and guinea pigs. In capybara, several cortical sulci reliably demarcate different cortical projection areas from one another. Quantitive neuroanatomical comparisons of volumes and neuron numbers in several major prosencephalic nuclei revealed that all nuclear masses are larger in capybara than in guinea pig, but that different nuclei are enlarged to different degrees. Possible causes of larger brains in larger animals are discussed.

Species differences in mechanosensory projections from the mouth to the ventrobasal thalamus

To determine whether the largely ipsilateral, inverted representation of mouth parts in the ventrobasal thalamus of sheep was unique to that species or an expansion of a general mammalian pattern, the corresponding thalamic projections were mapped electrophysiologically in a selected series of mammals (oppossums, agoutis, squirrel monkeys, cats, raccoons, and sheep) representing major branches of evolution among therian mammals. In mapping, tungsten microelectrodes were used to record multi-unit discharges in the thalamus in response to mechanical stimulation of oral surfaces. The pattern of projections seen in sheep is not a general mammalian pattern; there is extensive variability among mammals in the laterality and internal orgainzation of the projections from the mouth. In spite of the great variability, the results suggest an hypothesis concerning phylogenetic trends: descendants of palaeoryctoid insectivores (cats, raccoons, and sheep in our sample) have extensive ipsilateral projections from the mouth, in other therian mammals (opossums, agoutis, and squirrel monkeys in our sample) the ipsilateral component is small or absent.