1
|
Ferrés M, Martínez-Valdebenito C, Henriquez C, Marco C, Angulo J, Barrera A, Palma C, Barriga Pinto G, Cuiza A, Ferreira L, Rioseco ML, Calvo M, Fritz R, Bravo S, Bruhn A, Graf J, Llancaqueo A, Rivera G, Cerda C, Tischler N, Valdivieso F, Vial P, Mertz G, Vial C, Le Corre N. Viral shedding and viraemia of Andes virus during acute hantavirus infection: a prospective study. Lancet Infect Dis 2024:S1473-3099(24)00142-7. [PMID: 38582089 DOI: 10.1016/s1473-3099(24)00142-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/29/2024] [Accepted: 02/19/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Andes virus (ANDV) is a zoonotic Orthohantavirus leading to hantavirus cardiopulmonary syndrome. Although most transmissions occur through environmental exposure to rodent faeces and urine, rare person-to-person transmission has been documented, mainly for close contacts. This study investigates the presence and infectivity of ANDV in body fluids from confirmed cases and the duration of viraemia. METHODS In this prospective study, 131 participants with confirmed ANDV infection were enrolled in Chile in a prospective study between 2008 and 2022. Clinical samples (buffy coat, plasma, gingival crevicular fluid [GCF], saliva, nasopharyngeal swabs [NPS], and urine) were collected weekly for 3 weeks together with clinical and epidemiological data. Samples were categorised as acute or convalescent (up to and after 16 days following onset of symptoms). Infectivity of positive fluids was assessed after the culture of samples on Vero E6 cells and use of flow cytometry assays to determine the production of ANDV nucleoprotein. FINDINGS ANDV RNA was detected in 100% of buffy coats during acute phase, declining to 95% by day 17, and to 93% between days 23-29. ANDV RNA in GCF and saliva decreased from 30% and 12%, respectively, during the acute phase, to 12% and 11% during the convalescent phase. Successful infectivity assays of RT-qPCR-positive fluids, including GCF, saliva, NPS, and urine, were observed in 18 (42%) of 43 samples obtained during the acute phase of infection. After re-culture, the capacity to infect Vero E6 cells was maintained in 16 (89%) of 18 samples. Severity was associated with the presence of ANDV RNA in one or more fluids besides blood (odds ratio 2·58 [95% CI 1·42-5·18]). INTERPRETATION ANDV infection is a systemic and viraemic infection, that affects various organs. The presence of infectious particles in body fluids contributes to our understanding of potential mechanisms for person-to-person transmission, supporting the development of preventive strategies. Detection of ANDV RNA in additional fluids at hospital admission is a predictor of disease severity. FUNDING None. TRANSLATION For the Spanish translation of the abstract see Supplementary Materials section.
Collapse
Affiliation(s)
- Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Laboratorio de Infectología y Virología Molecular, Red Salud UC-Christus, Santiago, Chile.
| | - Constanza Martínez-Valdebenito
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Laboratorio de Infectología y Virología Molecular, Red Salud UC-Christus, Santiago, Chile
| | - Carolina Henriquez
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Marco
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jenniffer Angulo
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Laboratorio de Infectología y Virología Molecular, Red Salud UC-Christus, Santiago, Chile
| | - Aldo Barrera
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carlos Palma
- Laboratorio de Infectología y Virología Molecular, Red Salud UC-Christus, Santiago, Chile
| | - Gonzalo Barriga Pinto
- Laboratory of Emerging Viruses, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Analia Cuiza
- Programa Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | | | - María Luisa Rioseco
- Hospital Regional de Puerto Montt, Universidad San Sebastián, Sede Patagonía, Puerto Montt, Chile
| | - Mario Calvo
- Hospital Regional de Valdivia, Valdivia, Chile
| | | | - Sebastián Bravo
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandro Bruhn
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | | | | | - Nicole Tischler
- Fundación Ciencia & Vida, Universidad San Sebastián, Facultad de Medicina y Ciencia, Laboratorio de Virología Molecular, Santiago, Chile
| | | | - Pablo Vial
- Programa Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Departamento de Pediatría, Clínica Alemana de Santiago, Chile
| | | | - Cecilia Vial
- Programa Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Nicole Le Corre
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Laboratorio de Infectología y Virología Molecular, Red Salud UC-Christus, Santiago, Chile
| |
Collapse
|
2
|
Hormazábal J, Nuñez-Franz L, Rubilar P, Apablaza M, Vial C, Cortés LJ, González N, Vial P, Said M, González C, Olivares K, Aguilera X, Ramírez-Santana M. Factors influencing neutralizing antibody response to the original SARS-CoV-2 virus and the Omicron variant in a high vaccination coverage country, a population-based study. Vaccine X 2023; 15:100372. [PMID: 37693843 PMCID: PMC10492202 DOI: 10.1016/j.jvacx.2023.100372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/27/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
The study compared immunity to the original SARS-CoV-2 virus (Wuhan) and the Omicron variant using neutralizing antibodies (NAbs), that provide a good approximation of protective immunity. The results might help determine immunization strategies. DESIGN AND METHODS Unlike previous studies, we analyzed NAbs in a random sample of 110 IgG positive sera from individuals who participated in a population-based seroprevalence transversal study, carried out in May 2022 in two Chilean cities, a country with high vaccination coverage. RESULTS Our findings indicate that 98.2% of individuals had NAbs against Wuhan, 65.5% against Omicron, and 32.7% tested positive for Wuhan but not Omicron. Factors influencing protective immunity included a prior natural infection and the number of vaccines received. NAbs titers against the original virus were high, demonstrating vaccine effectiveness in the population. However, the level of antibodies decreased when measuring NAbs against Omicron, particularly among older individuals, indicating a decline in vaccine protection. Previous COVID-19 episodes acted as a natural booster, increasing NAbs titers against both virus strains. CONCLUSIONS Protective immunity against the original Wuhan SARS-CoV-2 virus is reduced when compared to Omicron variant. Updating vaccine to target emerging variants and continued monitoring of effectiveness at the population level are necessary.
Collapse
Affiliation(s)
- Juan Hormazábal
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Loreto Nuñez-Franz
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Paola Rubilar
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | | | - Cecilia Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Lina Jimena Cortés
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Natalia González
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Pablo Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Macarena Said
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Claudia González
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Kathya Olivares
- Departamento de Salud Pública, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Ximena Aguilera
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Muriel Ramírez-Santana
- Departamento de Salud Pública, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| |
Collapse
|
3
|
Meza-Fuentes G, López R, Vial C, Cortes LJ, Retamal MA, Delgado I, Vial P. Assessing Pulmonary Epithelial Damage in Hantavirus Cardiopulmonary Syndrome: Challenging the Predominant Role of Vascular Endothelium through sRAGE as a Potential Biomarker. Viruses 2023; 15:1995. [PMID: 37896774 PMCID: PMC10611316 DOI: 10.3390/v15101995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
Hantavirus cardiopulmonary syndrome (HCPS) is a severe respiratory illness primarily associated with microvascular endothelial changes, particularly in the lungs. However, the role of the pulmonary epithelium in HCPS pathogenesis remains unclear. This study explores the potential of soluble Receptors for Advanced Glycation End-products (sRAGE) as a biomarker for assessing pulmonary epithelial damage in severe HCPS, challenging the prevailing view that endothelial dysfunction is the sole driver of this syndrome. We conducted a cross-sectional study on critically ill HCPS patients, categorizing them into mild HCPS, severe HCPS, and negative control groups. Plasma sRAGE levels were measured, revealing significant differences between the severe HCPS group and controls. Our findings suggest that sRAGE holds promise as an indicator of pulmonary epithelial injury in HCPS and may aid in tracking disease progression and guiding therapeutic strategies. This study brings clarity on the importance of investigating the pulmonary epithelium's role in HCPS pathogenesis, offering potential avenues for enhanced diagnostic precision and support in this critical public health concern.
Collapse
Affiliation(s)
- Gabriela Meza-Fuentes
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (G.M.-F.); (C.V.); (L.J.C.); (P.V.)
| | - René López
- Grupo Intensivo, ICIM, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago 7590943, Chile
- Departamento de Paciente Crítico Clínica Alemana de Santiago, Santiago 7610658, Chile
| | - Cecilia Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (G.M.-F.); (C.V.); (L.J.C.); (P.V.)
| | - Lina Jimena Cortes
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (G.M.-F.); (C.V.); (L.J.C.); (P.V.)
| | - Mauricio A. Retamal
- Centro de Fisiología Celular e Integrativa, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago 7610658, Chile;
| | - Iris Delgado
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago 7610658, Chile;
| | - Pablo Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (G.M.-F.); (C.V.); (L.J.C.); (P.V.)
| |
Collapse
|
4
|
Obach A, Cabieses B, Vezzani F, Robledo C, Blukacz A, Vial P. Perceived barriers and facilitators for adhering to COVID-19 preventive measures in Chile: a qualitative study in three large cities. BMC Infect Dis 2023; 23:158. [PMID: 36918829 PMCID: PMC10013282 DOI: 10.1186/s12879-023-08118-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/24/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Globally, it has been reported that different social determinants of health -structural, sociodemographic, economic, living conditions and cultural factors- may affect opportunities to adhere to prevention measures against SARS-CoV-2. The objective of this study was to explore the perceptions around barriers and facilitators for adherence to COVID-19 prevention measures among the adult population residing in three large cities in Chile from a social determinants of health perspective. METHODS Qualitative paradigm, multiple case-study design. Online semi-structured interviews were conducted with men and women aged 18 and over from different socioeconomic groups residing in three large cities. For participant recruitment and selection, purposive contacts were made based on community and social media networks, followed by snowball sampling. Saturation was reached at 61 participants, after which a thematic analysis was carried out with the support of AtlasTi software. The Ethics Committee of the Universidad del Desarrollo in Chile approved this study. RESULTS The main perceived barriers to adherence to COVID-19 preventive measures are linked to structural social determinants of health such as income, occupation, gender, access to basic supplies, and housing. Perceived facilitators are the fear of contagion and the incorporation of measures into daily habits. The social communication of preventive measures by health authorities is perceived as punitive, affecting adherence once the fear of contagion decreased in the country. It is also perceived that the recommended preventive measures are disconnected from communities' cultural practices and people´s identity, as well as affected by gender inequities and socioeconomic conditions that stakeholders in the country do not sufficiently address. CONCLUSION Study findings suggest that adherence to preventive measures, such as social distancing, mask use, and hand washing, could be promoted through their incorporation into the daily life habits of people and communities. These measures should consider the structural social determinants that generate multiple barriers to adherence, like poverty, occupational risks, and overcrowding. Socio-cultural dimensions of health and everyday risks need further understanding among the different communities in the country, allowing for differences in viewpoints and practices based on gender, age, place, and social identity.
Collapse
Affiliation(s)
- Alexandra Obach
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
| | - Báltica Cabieses
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.,Department of Health Sciences, University of York, York, UK
| | - Francisca Vezzani
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Consuelo Robledo
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Alice Blukacz
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Pablo Vial
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
| |
Collapse
|
5
|
Núñez-Franz L, Ramírez-Santana M, Rubilar P, Vial C, Apablaza M, González C, Said M, Olivares K, Cortés LJ, Hormazábal J, Canales L, Vial P, Icaza G, Quezada-Gaete R, Aguilera X. Seroprevalence of Natural and Acquired Immunity against the SARS-CoV-2 Virus in a Population Cohort from Two Chilean Cities, 2020-2022. Viruses 2023; 15:201. [PMID: 36680241 PMCID: PMC9861850 DOI: 10.3390/v15010201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Chile has achieved the highest coverage for vaccines against the SARS-CoV-2 virus worldwide. OBJECTIVE To assess the progression of immunity (natural and acquired by vaccine) in a cohort from two Chilean cities. METHODS Individuals (n = 386) who participated in three phases of population-based serial prevalence studies were included (2020-2021 and 2022). Presence of SARS-CoV-2 antibodies was measured in serum. Data including time of vaccination and type of vaccine received were analysed with descriptive statistics. RESULTS Seroprevalence was 3.6% in the first round and increased to 96.9% in the second and 98.7% in the third. In the third round, 75% of individuals who had received the basal full scheme were seropositive at 180 days or more since their last dose; 98% of individuals who received one booster dose were seropositive at 180 days or more, and 100% participants who received two boosters were seropositive, regardless of time since their last dose. Participants receiving mRNA vaccines had higher seroprevalence rates over time. CONCLUSIONS The high vaccination coverage in Chile enabled the population to maintain high levels of antibodies. Vaccination boosters are essential to maintain immunity over time, which also depends on the type of vaccine administered.
Collapse
Affiliation(s)
- Loreto Núñez-Franz
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Universidad de Talca, Talca 3460000, Chile
| | - Muriel Ramírez-Santana
- Public Health Department, Faculty of Medicine, Universidad Católica del Norte, Coquimbo 1780000, Chile
| | - Paola Rubilar
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7550000, Chile
| | - Cecilia Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 8320000, Chile
| | - Mauricio Apablaza
- Facultad de Gobierno, Universidad del Desarrollo, Santiago 7550000, Chile
| | - Claudia González
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7550000, Chile
| | - Macarena Said
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Universidad de Talca, Talca 3460000, Chile
| | - Kathya Olivares
- Public Health Department, Faculty of Medicine, Universidad Católica del Norte, Coquimbo 1780000, Chile
| | - Lina Jimena Cortés
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 8320000, Chile
| | - Juan Hormazábal
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 8320000, Chile
| | - Luis Canales
- Facultad de Economía y Negocios, Universidad de Talca, Talca 3460000, Chile
| | - Pablo Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 8320000, Chile
| | - Gloria Icaza
- Facultad de Economía y Negocios, Universidad de Talca, Talca 3460000, Chile
| | - Rubén Quezada-Gaete
- Public Health Department, Faculty of Medicine, Universidad Católica del Norte, Coquimbo 1780000, Chile
| | - Ximena Aguilera
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7550000, Chile
| |
Collapse
|
6
|
Rey-Jurado E, Espinosa Y, Astudillo C, Cortés LJ, Hormazabal J, Noguera L, Cofré F, Piñera C, González R, Bataszew A, Muñoz P, Benadof D, Álvarez P, Acevedo V, Vial P, Vial C, Poli MC. Deep immunophenotyping reveals biomarkers of MIS-C in a Latin American cohort. J Allergy Clin Immunol 2022; 150:1074-1085.e11. [PMID: 36116582 PMCID: PMC9476361 DOI: 10.1016/j.jaci.2022.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/27/2022] [Accepted: 09/01/2022] [Indexed: 11/15/2022]
Abstract
Background Multisystemic inflammatory syndrome in children (MIS-C) is a life-threatening disease that occurs 2-5 weeks after SARS-CoV-2 exposure and is characterized by severe multisystemic inflammation. Early recognition of MIS-C is key to prognosis, therefore establishing clinical and laboratory biomarkers that predict complications is urgently needed. Objective To characterize the immune response and clinical features of patients with acute MIS-C and determine biomarkers of disease in a cohort of 42 Latin American patients. Methods Immune characterization was performed using flow cytometry from peripheral mononuclear cells and SARS-CoV-2-specific humoral and cellular response was performed using flow cytometry, ELISPOT, ELISA and neutralizing antibody assays. Results MIS-C is characterized by robust T cell activation and cytokine storm. We uncovered that while CXCL9, IL-10, CXCL8, CXCL10, IL-6 and IL-18 are significantly elevated in patients with shock, while CCL5 was increased in milder disease. Monocyte dysregulation was specifically associated to Kawasaki-like MIS-C. Interestingly, MIS-C patients show an NK cell degranulation defect that is persistent after 6 months of disease presentation, suggesting it could underlie disease susceptibility. Most MIS-C had gastrointestinal involvement and higher levels of neopterin were identified in their stools, potentially representing a biomarker of intestinal inflammation in MIS-C. SARS-CoV2-specific cellular response and neutralizing antibodies were identifiable in convalescent MIS-C patients suggesting sustained immunity. Conclusion Clinical characterization and comprehensive immunophenotyping of Chilean MIS-C cohort provide valuable insights in understanding immune dysregulation in MIS-C and identify relevant biomarkers of disease that could be used to predict severity and organ involvement. CLINICAL IMPLICATIONS STATEMENT MIS-C is distinguished by cytokine storm and decreased NK cell degranulation that is persistent after 6 months. Distinct biomarkers were identified for severe and mild forms of disease.
Collapse
Affiliation(s)
- Emma Rey-Jurado
- Facultad de Medicina Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile; Programa de Inmunogenética y Inmunología Traslacional. Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Yazmin Espinosa
- Unidad de Inmunología y Reumatología, Hospital Roberto del Río, Santiago, Chile
| | - Camila Astudillo
- Unidad de Inmunología y Reumatología, Hospital Roberto del Río, Santiago, Chile
| | - Lina Jimena Cortés
- Facultad de Medicina Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile; Programa de Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Juan Hormazabal
- Facultad de Medicina Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile; Programa de Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Loreani Noguera
- Facultad de Medicina Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile; Programa de Inmunogenética y Inmunología Traslacional. Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Fernanda Cofré
- Unidad de Infectología, Hospital Roberto del Río, Santiago, Chile
| | - Cecilia Piñera
- Hospital Exequiel González Cortés, Santiago, Chile; Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | | | - Alexander Bataszew
- Unidad de Cuidados Intensivos, Hospital Roberto del Río, Santiago, Chile
| | - Paula Muñoz
- Facultad de Medicina Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | - Dona Benadof
- Unidad de Infectología, Hospital Roberto del Río, Santiago, Chile
| | - Patricia Álvarez
- Unidad de Inmunología y Reumatología, Hospital Roberto del Río, Santiago, Chile
| | - Valeria Acevedo
- Unidad de Inmunología y Reumatología, Hospital Roberto del Río, Santiago, Chile
| | - Pablo Vial
- Facultad de Medicina Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile; Programa de Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Cecilia Vial
- Facultad de Medicina Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile; Programa de Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - M Cecilia Poli
- Facultad de Medicina Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile; Programa de Inmunogenética y Inmunología Traslacional. Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile; Unidad de Inmunología y Reumatología, Hospital Roberto del Río, Santiago, Chile.
| |
Collapse
|
7
|
Aguilera X, Hormazábal J, Vial C, Cortes LJ, González C, Rubilar P, Apablaza M, Ramírez-Santana M, Icaza G, Nuñez-Franz L, Castillo-Laborde C, Ramírez-Riffo C, Pérez C, Quezada-Gate R, Said M, Vial P. SARS-CoV-2 Neutralizing Antibodies in Chile after a Vaccination Campaign with Five Different Schemes. Vaccines (Basel) 2022; 10:vaccines10071051. [PMID: 35891215 PMCID: PMC9321248 DOI: 10.3390/vaccines10071051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/20/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022] Open
Abstract
Using levels of neutralizing antibodies (nAbs), we evaluate the successful Chilean SARS-CoV-2 vaccine campaign, which combines different vaccine technologies and heterologous boosters. From a population-based study performed in November 2021, we randomly selected 120 seropositive individuals, organized into six groups of positive samples (20 subjects each) according to natural infection history and the five most frequent vaccination schemes. We conclude that the booster dose, regardless of vaccine technology or natural infection, and mRNA vaccines significantly improve nAbs response.
Collapse
Affiliation(s)
- Ximena Aguilera
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (C.G.); (P.R.); (C.C.-L.)
- Correspondence: ; Tel.: +56-2-23279308
| | - Juan Hormazábal
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (J.H.); (C.V.); (L.J.C.); (C.R.-R.); (P.V.)
| | - Cecilia Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (J.H.); (C.V.); (L.J.C.); (C.R.-R.); (P.V.)
| | - Lina Jimena Cortes
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (J.H.); (C.V.); (L.J.C.); (C.R.-R.); (P.V.)
| | - Claudia González
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (C.G.); (P.R.); (C.C.-L.)
| | - Paola Rubilar
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (C.G.); (P.R.); (C.C.-L.)
| | - Mauricio Apablaza
- Facultad de Gobierno, Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile;
| | - Muriel Ramírez-Santana
- Public Health Department, Faculty of Medicine, Universidad Católica del Norte, Larrondo 1281, Coquimbo 1780000, Chile; (M.R.-S.); (R.Q.-G.)
| | - Gloria Icaza
- Instituto de Matemáticas, Universidad de Talca, Avenida Uno Poniente #1141, Talca 3460000, Chile;
| | - Loreto Nuñez-Franz
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Universidad de Talca, Avenida Uno Poniente #1141, Talca 3460000, Chile; (L.N.-F.); (M.S.)
| | - Carla Castillo-Laborde
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (C.G.); (P.R.); (C.C.-L.)
| | - Carolina Ramírez-Riffo
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (J.H.); (C.V.); (L.J.C.); (C.R.-R.); (P.V.)
| | - Claudia Pérez
- Escuela de Enfermería, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile;
| | - Rubén Quezada-Gate
- Public Health Department, Faculty of Medicine, Universidad Católica del Norte, Larrondo 1281, Coquimbo 1780000, Chile; (M.R.-S.); (R.Q.-G.)
| | - Macarena Said
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Universidad de Talca, Avenida Uno Poniente #1141, Talca 3460000, Chile; (L.N.-F.); (M.S.)
| | - Pablo Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (J.H.); (C.V.); (L.J.C.); (C.R.-R.); (P.V.)
- Clínica Alemana de Santiago, Avenida Vitacura #5951, Vitacura, Santiago 7650568, Chile
| |
Collapse
|
8
|
Aguilera X, González C, Apablaza M, Rubilar P, Icaza G, Ramírez-Santana M, Pérez C, Cortes LJ, Núñez-Franz L, Quezada-Gaete R, Castillo-Laborde C, Correa J, Said M, Hormazábal J, Vial C, Vial P. Immunization and SARS-CoV-2 Antibody Seroprevalence in a Country with High Vaccination Coverage: Lessons from Chile. Vaccines (Basel) 2022; 10:vaccines10071002. [PMID: 35891166 PMCID: PMC9322351 DOI: 10.3390/vaccines10071002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 02/05/2023] Open
Abstract
Chile is among the most successful nations worldwide in terms of its COVID-19 vaccine rollout. By 31 December 2021, 84.1% of the population was fully vaccinated, and 56.1% received booster doses using different COVID-19 vaccines. In this context, we aimed to estimate the prevalence of anti-SARS-CoV-2 antibodies following the infection and vaccination campaign. Using a three-stage stratified sampling, we performed a population-based cross-sectional serosurvey based on a representative sample of three Chilean cities. Selected participants were blood-sampled on-site and answered a short COVID-19 and vaccination history questionnaire using Wantai SARS-CoV-2 Ab ELISA to determine seroprevalence. We recruited 2198 individuals aged 7–93 between 5 October and 25 November 2021; 2132 individuals received COVID-19 vaccinations (97%), 67 (3.1%) received one dose, 2065 (93.9%) received two doses, and 936 received the booster jab (42.6%). Antibody seroprevalence reached 97.3%, ranging from 40.9% among those not vaccinated to 99.8% in those with booster doses (OR = 674.6, 154.8–2938.5). SARS-CoV-2 antibodies were associated with vaccination, previous COVID-19 diagnosis, age group, and city of residence. In contrast, we found no significant differences in the type of vaccine used, education, nationality, or type of health insurance. We found a seroprevalence close to 100%, primarily due to the successful vaccination program, which strongly emphasizes universal access.
Collapse
Affiliation(s)
- Ximena Aguilera
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (C.G.); (P.R.); (C.C.-L.)
- Correspondence:
| | - Claudia González
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (C.G.); (P.R.); (C.C.-L.)
| | - Mauricio Apablaza
- Facultad de Gobierno, Universidad del Desarrollo, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile;
| | - Paola Rubilar
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (C.G.); (P.R.); (C.C.-L.)
| | - Gloria Icaza
- Instituto de Matemáticas, Universidad de Talca, Talca 3460000, Chile;
| | - Muriel Ramírez-Santana
- Public Health Department, Faculty of Medicine, Universidad Católica del Norte, Coquimbo 1780000, Chile; (M.R.-S.); (R.Q.-G.)
| | - Claudia Pérez
- Escuela de Enfermería, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile;
| | - Lina Jimena Cortes
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile; (L.J.C.); (J.H.); (C.V.); (P.V.)
| | - Loreto Núñez-Franz
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Universidad de Talca, Avenida Uno Poniente #1141, Talca 3460000, Chile; (L.N.-F.); (M.S.)
| | - Rubén Quezada-Gaete
- Public Health Department, Faculty of Medicine, Universidad Católica del Norte, Coquimbo 1780000, Chile; (M.R.-S.); (R.Q.-G.)
| | - Carla Castillo-Laborde
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, San Carlos de Apoquindo, Las Condes, Santiago 7610658, Chile; (C.G.); (P.R.); (C.C.-L.)
| | - Juan Correa
- Centro Producción del Espacio, Universidad de las Américas, Santiago 7500975, Chile;
| | - Macarena Said
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Universidad de Talca, Avenida Uno Poniente #1141, Talca 3460000, Chile; (L.N.-F.); (M.S.)
| | - Juan Hormazábal
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile; (L.J.C.); (J.H.); (C.V.); (P.V.)
| | - Cecilia Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile; (L.J.C.); (J.H.); (C.V.); (P.V.)
| | - Pablo Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile; (L.J.C.); (J.H.); (C.V.); (P.V.)
| |
Collapse
|
9
|
Rubilar P, Hirmas M, Matute I, Browne J, Little C, Ruz G, Aguilera X, Ávila C, Vial P, Gutknecht Mackenzie T. Seroprevalence and estimation of the impact of SARS-CoV-2 infection in older adults residing in Long-term Care Facilities in Chile. Medwave 2022; 22:e8715. [PMID: 35435888 DOI: 10.5867/medwave.2022.03.002553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/16/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Older adults are at a higher risk of severe illness and death from COVID-19. This vulnerability increases in those who live in long-term care facilities due to overcrowding, greater physical dependence, and contact with health workers. Evidence on the impact of the pandemic on these establishments in lowand middle-income countries has been scant. This study aims to determine the seroprevalence of SARS-CoV-2 in older people residing in long-term care facilities and estimate the impact of infection after the first wave of the pandemic. Methods A cross-sectional design with 2099 residents in three regions of Chile was carried out between September and November 2020. Measurement of antibodies was performed with a rapid test. The impact of SARS-CoV-2 infection was estimated with seropositive residents, those who had a history of positive polymerase chain reaction tests, and those who died from COVID-19. Bivariate analysis with the region, sex, age, history of COVID-19, physical dependence, and serological results were performed. In addition, we performed a correlation analysis between the seroprevalence of the centers by the municipality and the rate of confirmed cases. Results The seroprevalence of SARS-CoV-2 antibodies in the three regions was 14.7% (95% confidence interval: 13.2 to 16.3%), the infection impact was 46.4%, and the fatality rate was 19.6%. A significant correlation was found between the seroprevalence of older adults residing in long-term care facilities and the cumulative incidence by municipalities. Conclusions The seroprevalence of older adults residing in long-term care facilities was higher than the general population. The high impact of infection among this population at the end of the first wave of the COVID-19 pandemic is similar to other countries. The centers' environment is directly related to COVID-19 infection. Morbidity and mortality monitoring systems should be implemented promptly to establish prevention and control measures.
Collapse
Affiliation(s)
- Paola Rubilar
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. Address: Av. Plaza 680 San Carlos de Apoquindo, Las Condes, Santiago, Chile. . ORCID: 0000-0003-3578-459X
| | - Macarena Hirmas
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. ORCID: 0000-0002-0959-0946
| | - Isabel Matute
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. ORCID: 0000-0002-6288-4601
| | - Jorge Browne
- Servicio Nacional del Adulto Mayor, Santiago, Chile. ORCID: 0000-0001-6586-7084
| | - Cedric Little
- Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibáñez, Santiago, Chile. ORCID: 0000-0002-2419-8512
| | - Gonzalo Ruz
- Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibáñez, Santiago, Chile. ORCID: 0000-0001-7740-9865
| | - Ximena Aguilera
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. ORCID: 0000-0002-8153-6733
| | - Carlos Ávila
- Ministerio de Ciencia, Tecnología, Conocimiento e Innovación, Santiago, Chile. ORCID: 0000-0002-5327-1731
| | - Pablo Vial
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. ORCID: 0000-0002-4135-0416
| | | |
Collapse
|
10
|
Vial P, González C, Icaza G, Ramirez-Santana M, Quezada-Gaete R, Núñez-Franz L, Apablaza M, Vial C, Rubilar P, Correa J, Pérez C, Florea A, Guzmán E, Lavín ME, Concha P, Nájera M, Aguilera X. Seroprevalence, spatial distribution, and social determinants of SARS-CoV-2 in three urban centers of Chile. BMC Infect Dis 2022; 22:99. [PMID: 35090398 PMCID: PMC8795965 DOI: 10.1186/s12879-022-07045-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/11/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Seroprevalence studies provide an accurate measure of SARS-CoV-2 spread and the presence of asymptomatic cases. They also provide information on the uneven impact of the pandemic, pointing out vulnerable groups to prioritize which is particularly relevant in unequal societies. However, due to their high cost, they provide limited evidence of spatial spread of the pandemic specially in unequal societies. Our objective was to estimate the prevalence of SARS-CoV-2 antibodies in Chile and model its spatial risk distribution. METHODS During Oct-Nov 2020, we conducted a population-based serosurvey in Santiago, Talca, and Coquimbo-La Serena (2493 individuals). We explored the individual association between positive results and socio-economic and health-related variables by logistic regression for complex surveys. Then, using an Empirical Bayesian Kriging model, we estimated the infection risk spatial distribution using individual and census information, and compared these results with official records. RESULTS Seroprevalence was 10.4% (95% CI 7.8-13.7%), ranging from 2% (Talca) to 11% (Santiago), almost three times the number officially reported. Approximately 36% of these were asymptomatic, reaching 82% below 15 years old. Seroprevalence was associated with the city of residence, previous COVID-19 diagnosis, contact with confirmed cases (especially at household), and foreign nationality. The spatial model accurately interpolated the distribution of disease risk within the cities finding significant differences in the predicted probabilities of SARS-CoV-2 infection by census zone (IQR 2.5-15.0%), related to population density and education. CONCLUSIONS Our results underscore the transmission heterogeneity of SARS-CoV-2 within and across three urban centers of Chile. Socio-economic factors and the outcomes of this seroprevalence study enable us to identify priority areas for intervention. Our methodological approach and results can help guide the design of interdisciplinary strategies for urban contexts, not only for SARS-CoV-2 but also for other communicable diseases.
Collapse
Grants
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
- , ANID COVID 19-0589 Agencia Nacional de Investigación y Desarrollo
Collapse
Affiliation(s)
- Pablo Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, 7610658, Las Condes, Santiago, Chile
| | - Claudia González
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, 7610658, Las Condes, Santiago, Chile
| | - Gloria Icaza
- Instituto de Matemáticas, Universidad de Talca, Avenida Uno Poniente #1141, 3460000, Talca, Chile
| | - Muriel Ramirez-Santana
- Public Health Department, Faculty of Medicine, Universidad Católica del Norte, Larrondo 1281, 1780000, Coquimbo, Chile
| | - Rubén Quezada-Gaete
- Public Health Department, Faculty of Medicine, Universidad Católica del Norte, Larrondo 1281, 1780000, Coquimbo, Chile
| | - Loreto Núñez-Franz
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Universidad de Talca, Avenida Uno Poniente #1141, 3460000, Talca, Chile
| | - Mauricio Apablaza
- Facultad de Gobierno, Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, 7610658, Las Condes, Santiago, Chile
| | - Cecilia Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, 7610658, Las Condes, Santiago, Chile
| | - Paola Rubilar
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, 7610658, Las Condes, Santiago, Chile
| | - Juan Correa
- Centro Producción del Espacio, Universidad de Las Américas, Avenida Manuel Montt #948, 7500975, Providencia, Santiago, Chile
| | - Claudia Pérez
- Escuela de Enfermería, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, 7610658, Las Condes, Santiago, Chile
| | - Andrei Florea
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, 7610658, Las Condes, Santiago, Chile
| | - Eugenio Guzmán
- Facultad de Gobierno, Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, 7610658, Las Condes, Santiago, Chile
| | - María-Estela Lavín
- Facultad de Gobierno, Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, 7610658, Las Condes, Santiago, Chile
| | - Paula Concha
- Escuela de Enfermería, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, 7610658, Las Condes, Santiago, Chile
| | - Manuel Nájera
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, 7610658, Las Condes, Santiago, Chile
| | - Ximena Aguilera
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Av. Plaza #680, San Carlos de Apoquindo, 7610658, Las Condes, Santiago, Chile.
| |
Collapse
|
11
|
Mills MG, Bruce E, Huang ML, Crothers JW, Hyrien O, Oura CAL, Blake L, Brown Jordan A, Hester S, Wehmas L, Mari B, Barby P, Lacoux C, Fassy J, Vial P, Vial C, Martinez JRW, Oladipo OO, Inuwa B, Shittu I, Meseko CA, Chammas R, Santos CF, Dionísio TJ, Garbieri TF, Parisi VA, Mendes-Correa MC, de Paula AV, Romano CM, Góes LGB, Minoprio P, Campos AC, Cunha MP, Vilela APP, Nyirenda T, Mkakosya RS, Muula AS, Dumm RE, Harris RM, Mitchell CA, Pettit S, Botten J, Jerome KR. An international, interlaboratory ring trial confirms the feasibility of an extraction-less "direct" RT-qPCR method for reliable detection of SARS-CoV-2 RNA in clinical samples. PLoS One 2022; 17:e0261853. [PMID: 35025926 PMCID: PMC8758094 DOI: 10.1371/journal.pone.0261853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/11/2021] [Indexed: 11/29/2022] Open
Abstract
Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) is used worldwide to test and trace the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). "Extraction-less" or "direct" real time-reverse transcription polymerase chain reaction (RT-PCR) is a transparent and accessible qualitative method for SARS-CoV-2 detection from nasopharyngeal or oral pharyngeal samples with the potential to generate actionable data more quickly, at a lower cost, and with fewer experimental resources than full RT-qPCR. This study engaged 10 global testing sites, including laboratories currently experiencing testing limitations due to reagent or equipment shortages, in an international interlaboratory ring trial. Participating laboratories were provided a common protocol, common reagents, aliquots of identical pooled clinical samples, and purified nucleic acids and used their existing in-house equipment. We observed 100% concordance across laboratories in the correct identification of all positive and negative samples, with highly similar cycle threshold values. The test also performed well when applied to locally collected patient nasopharyngeal samples, provided the viral transport media did not contain charcoal or guanidine, both of which appeared to potently inhibit the RT-PCR reaction. Our results suggest that direct RT-PCR assay methods can be clearly translated across sites utilizing readily available equipment and expertise and are thus a feasible option for more efficient COVID-19 coronavirus disease testing as demanded by the continuing pandemic.
Collapse
Affiliation(s)
- Margaret G. Mills
- Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Emily Bruce
- Division of Immunobiology, Department of Medicine, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, Vermont, United States of America
| | - Meei-Li Huang
- Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
| | - Jessica W. Crothers
- Division of Immunobiology, Department of Medicine, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, Vermont, United States of America
| | - Ollivier Hyrien
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Christopher A. L. Oura
- School of Veterinary Medicine, University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Lemar Blake
- School of Veterinary Medicine, University of the West Indies, St. Augustine, Trinidad and Tobago
| | | | - Susan Hester
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, United States of America
| | - Leah Wehmas
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, United States of America
| | - Bernard Mari
- Université Côte d’Azur, CNRS, Institut de Pharmacologie Moléculaire et Cellulaire, FHU-OncoAge, Valbonne, France
| | - Pascal Barby
- Université Côte d’Azur, CNRS, Institut de Pharmacologie Moléculaire et Cellulaire, FHU-OncoAge, Valbonne, France
| | - Caroline Lacoux
- Université Côte d’Azur, CNRS, Institut de Pharmacologie Moléculaire et Cellulaire, FHU-OncoAge, Valbonne, France
| | - Julien Fassy
- Université Côte d’Azur, CNRS, Institut de Pharmacologie Moléculaire et Cellulaire, FHU-OncoAge, Valbonne, France
| | - Pablo Vial
- Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Programa Hantavirus, Instituto de Ciencias e Innovación en Medicina, Santiago, Chile
| | - Cecilia Vial
- Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Programa Hantavirus, Instituto de Ciencias e Innovación en Medicina, Santiago, Chile
| | - Jose R. W. Martinez
- Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Programa Hantavirus, Instituto de Ciencias e Innovación en Medicina, Santiago, Chile
| | | | - Bitrus Inuwa
- Infectious and Transboundary Animal Diseases, National Veterinary Research Institute, Vom, Nigeria
| | - Ismaila Shittu
- Infectious and Transboundary Animal Diseases, National Veterinary Research Institute, Vom, Nigeria
| | - Clement A. Meseko
- Infectious and Transboundary Animal Diseases, National Veterinary Research Institute, Vom, Nigeria
| | - Roger Chammas
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia e Oncologia, Centro de Investigação Translacional em Oncologia, Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil
| | - Carlos Ferreira Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Thiago José Dionísio
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Thais Francini Garbieri
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Viviane Aparecida Parisi
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Anderson V. de Paula
- Department of Infectious Diseases, Institute of Tropical Medicine of São Paulo, São Paulo, Brazil
| | - Camila M. Romano
- Department of Infectious Diseases, Institute of Tropical Medicine of São Paulo, São Paulo, Brazil
| | - Luiz Gustavo Bentim Góes
- Scientific Platform Pasteur-USP, Universidade de São Paulo, São Paulo, Brazil
- Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil
| | - Paola Minoprio
- Scientific Platform Pasteur-USP, Universidade de São Paulo, São Paulo, Brazil
| | - Angelica C. Campos
- Scientific Platform Pasteur-USP, Universidade de São Paulo, São Paulo, Brazil
| | - Marielton P. Cunha
- Scientific Platform Pasteur-USP, Universidade de São Paulo, São Paulo, Brazil
| | - Ana Paula P. Vilela
- Scientific Platform Pasteur-USP, Universidade de São Paulo, São Paulo, Brazil
| | - Tonney Nyirenda
- Department of Pathology, College of Medicine, University of Malawi, Blantyre, Malawi
| | | | - Adamson S. Muula
- Department of Public Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Rebekah E. Dumm
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Rebecca M. Harris
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Constance A. Mitchell
- Health and Environmental Sciences Institute, Washington, DC, United States of America
| | - Syril Pettit
- Health and Environmental Sciences Institute, Washington, DC, United States of America
| | - Jason Botten
- Division of Immunobiology, Department of Medicine, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, Vermont, United States of America
- Department of Microbiology and Molecular Genetics, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, Vermont, United States of America
| | - Keith R. Jerome
- Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States of America
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| |
Collapse
|
12
|
Ferrés M, Martínez-Valdebenito C, Angulo J, Henríquez C, Vera-Otárola J, Vergara MJ, Pérez J, Fernández J, Sotomayor V, Valdés MF, González-Candia D, Tischler ND, Vial C, Vial P, Mertz G, Le Corre N. Mother-to-Child Transmission of Andes Virus through Breast Milk, Chile 1. Emerg Infect Dis 2021; 26:1885-1888. [PMID: 32687024 PMCID: PMC7392419 DOI: 10.3201/eid2608.200204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Andes virus (ANDV) is the only hantavirus transmitted between humans through close contact. We detected the genome and proteins of ANDV in breast milk cells from an infected mother in Chile who transmitted the virus to her child, suggesting gastrointestinal infection through breast milk as a route of ANDV person-to-person transmission.
Collapse
|
13
|
Iruretagoyena M, Vial MR, Spencer-Sandino M, Gaete P, Peters A, Delgado I, Perez I, Calderon C, Porte L, Legarraga P, Anderson A, Aguilera X, Vial P, Weitzel T, Munita JM. Longitudinal assessment of SARS-CoV-2 IgG seroconversionamong front-line healthcare workers during the first wave of the Covid-19 pandemic at a tertiary-care hospital in Chile. BMC Infect Dis 2021; 21:478. [PMID: 34039287 PMCID: PMC8149923 DOI: 10.1186/s12879-021-06208-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/12/2021] [Indexed: 12/18/2022] Open
Abstract
Background Healthcare workers (HCWs) are at high risk of exposure to SARS-CoV-2. Cross-sectional studies have provided variable rates of seroprevalence in HCWs. Longitudinal assessments of the serological response to Covid-19 among HCWs are crucial to understanding the risk of infection and changes in antibody titers over time. We aimed to investigate seroprevalence and risk factors associated with seroconversion in a prospective cohort of HCWs during the peak of the first wave of the Covid-19 pandemic. Methods We conducted a longitudinal study among 446 front-line HCWsin a tertiary-care hospital in Chile from April to July 2020. IgG was determined monthly using two different ELISAs in serum samples of HCWs, during the three-month period. In each visit, demographic data, symptoms, risk factors, and exposure risks were also assessed. Results The overall seroprevalence at the end of the study period was 24% (95% CI20.2–28.3), with 43% of seropositive HCWs reporting no prior symptoms. Seroconversion rates significantly differed over the study period, from 2.1% to as high as 8.8% at the peak of the epidemic. There were no statistically significant differences observed between HCWs in direct clinical care of patients with Covid-19 and those working in low risk areas. Antibody titers appeared to wane over time. Conclusions HCWs were severely affected with a high rate of seroconversion that appeared to mirror the local epidemiological situation. A significant amount of participants underwent an asymptomatic infection, highlighting the need for improved surveillance policies. Antibody titers appear to wane over time; further studies to understand this finding’s impact on the risk of reinfection are warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06208-2.
Collapse
Affiliation(s)
- Mirentxu Iruretagoyena
- Laboratorio Clínico, Clínica Alemana de Santiago, Santiago, Chile.,Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Macarena R Vial
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Maria Spencer-Sandino
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina CAS-UDD, Santiago, Chile.,Millennium Initiative for Collaborative Research on Bacterial Resistance (MICROB-R), Santiago, Chile
| | - Pablo Gaete
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Anne Peters
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina CAS-UDD, Santiago, Chile.,Millennium Initiative for Collaborative Research on Bacterial Resistance (MICROB-R), Santiago, Chile
| | - Iris Delgado
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile.,Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina CAS-UDD, Santiago, Chile
| | - Inia Perez
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Claudia Calderon
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Lorena Porte
- Laboratorio Clínico, Clínica Alemana de Santiago, Santiago, Chile.,Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Paulette Legarraga
- Laboratorio Clínico, Clínica Alemana de Santiago, Santiago, Chile.,Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Alicia Anderson
- Laboratorio Clínico, Clínica Alemana de Santiago, Santiago, Chile.,Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Ximena Aguilera
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile.,Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina CAS-UDD, Santiago, Chile
| | - Pablo Vial
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile.,Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina CAS-UDD, Santiago, Chile
| | - Thomas Weitzel
- Laboratorio Clínico, Clínica Alemana de Santiago, Santiago, Chile.,Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile.,Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina CAS-UDD, Santiago, Chile
| | - Jose M Munita
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile. .,Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina CAS-UDD, Santiago, Chile. .,Millennium Initiative for Collaborative Research on Bacterial Resistance (MICROB-R), Santiago, Chile.
| |
Collapse
|
14
|
Mills MG, Bruce E, Huang ML, Crothers JW, Hyrien O, Oura CAL, Blake L, Jordan AB, Hester S, Wehmas L, Mari B, Barby P, Lacoux C, Fassy J, Vial P, Vial C, Martinez JRW, Oladipo OO, Inuwa B, Shittu I, Meseko CA, Chammas R, Santos CF, José Dionísio T, Garbieri TF, Parisi VA, Mendes-Correa MC, dePaula AV, Romano CM, Góes LGB, Minoprio P, Campos AC, Cunha MP, Vilela APP, Nyirenda T, Mkakosya RS, Muula AS, Dumm RE, Harris RM, Mitchell CA, Pettit S, Botten J, Jerome KR. An international, interlaboratory ring trial confirms the feasibility of an open-source, extraction-less "direct" RT-qPCR method for reliable detection of SARS-CoV-2 RNA in clinical samples. medRxiv 2021:2021.04.10.21254091. [PMID: 33880478 PMCID: PMC8057246 DOI: 10.1101/2021.04.10.21254091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) is used worldwide to test and trace the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). "Extraction-less" or "direct" real time-reverse transcription polymerase chain reaction (RT-PCR) is an open-access qualitative method for SARS-CoV-2 detection from nasopharyngeal or oral pharyngeal samples with the potential to generate actionable data more quickly, at a lower cost, and with fewer experimental resources than full RT-qPCR. This study engaged 10 global testing sites, including laboratories currently experiencing testing limitations due to reagent or equipment shortages, in an international interlaboratory ring trial. Participating laboratories were provided a common protocol, common reagents, aliquots of identical pooled clinical samples, and purified nucleic acids and used their existing in-house equipment. We observed 100% concordance across laboratories in the correct identification of all positive and negative samples, with highly similar cycle threshold values. The test also performed well when applied to locally collected patient nasopharyngeal samples, provided the viral transport media did not contain charcoal or guanidine, both of which appeared to potently inhibit the RT-PCR reaction. Our results suggest that open-access, direct RT-PCR assays are a feasible option for more efficient COVID-19 coronavirus disease testing as demanded by the continuing pandemic.
Collapse
|
15
|
Vial MR, Peters A, Pérez I, Spencer-Sandino M, Barbé M, Porte L, Weitzel T, Aylwin M, Vial P, Araos R, Munita JM. Covid-19 in South America: clinical and epidemiological characteristics among 381 patients during the early phase of the pandemic in Santiago, Chile. BMC Infect Dis 2020. [PMID: 33317458 DOI: 10.1186/s12879‐020‐05665‐5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Understanding the characteristics of the Covid-19 pandemic in different geographical regions, ethnic and socioeconomic settings are of emerging importance. This study presents the demographic and clinical features of SARS-CoV-2 infected patients in a large private healthcare center in Santiago, Chile, during the first month of the pandemic. METHODS We analyzed the demographics, laboratory and clinical characteristics including severity and outcome of all patients diagnosed with Covid-19 during the first month of the pandemic. SARS-2-CoV infection was confirmed by RT-PCR in nosopharyngeal samples. The primary outcome was a composite of ICU admission or all-cause, in-hospital mortality. Clinical and laboratory parameters of hospitalized patients were analyzed regarding their association with the primary outcome. RESULTS From March 3 to April 4, 2020, 3679 individuals were tested for SARS-CoV-2 in our hospital. Of those, 381 had Covid-19 and were included into this analysis. Most patients (99.2%) were Chileans, 12% returning from recent travel. The median age was 39 years (IQR 31-49) and 52% were female. A total of 88 patients (23.1%) were hospitalized; 18 (3.7%) required ICU and/or died. The overall mortality was 0.7%. Increased body mass index (BMI) and elevated C-reactive protein (CRP) were independently associated with ICU care or death. CONCLUSION During the first weeks of the pandemic in Chile, most Covid-19 patients were young, with low rates of hospitalization, ICU requirement, and fatality. BMI and CRP on admission were predictors for severity. Our data provide important information on the clinical course and outcome of Covid-19 in a Latin American setting.
Collapse
Affiliation(s)
- Macarena R Vial
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Anne Peters
- Facultad de Medicina CAS-UDD, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago, Chile
| | - Inia Pérez
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - María Spencer-Sandino
- Facultad de Medicina CAS-UDD, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago, Chile
| | - Mario Barbé
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Lorena Porte
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Thomas Weitzel
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile.,Facultad de Medicina CAS-UDD, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago, Chile
| | - Mabel Aylwin
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Pablo Vial
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile.,Facultad de Medicina CAS-UDD, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago, Chile
| | - Rafael Araos
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile.,Facultad de Medicina CAS-UDD, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago, Chile.,Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile
| | - Jose M Munita
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile. .,Facultad de Medicina CAS-UDD, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago, Chile. .,Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile.
| | | |
Collapse
|
16
|
Vial MR, Peters A, Pérez I, Spencer-Sandino M, Barbé M, Porte L, Weitzel T, Aylwin M, Vial P, Araos R, Munita JM. Covid-19 in South America: clinical and epidemiological characteristics among 381 patients during the early phase of the pandemic in Santiago, Chile. BMC Infect Dis 2020; 20:955. [PMID: 33317458 PMCID: PMC7734456 DOI: 10.1186/s12879-020-05665-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/24/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Understanding the characteristics of the Covid-19 pandemic in different geographical regions, ethnic and socioeconomic settings are of emerging importance. This study presents the demographic and clinical features of SARS-CoV-2 infected patients in a large private healthcare center in Santiago, Chile, during the first month of the pandemic. METHODS We analyzed the demographics, laboratory and clinical characteristics including severity and outcome of all patients diagnosed with Covid-19 during the first month of the pandemic. SARS-2-CoV infection was confirmed by RT-PCR in nosopharyngeal samples. The primary outcome was a composite of ICU admission or all-cause, in-hospital mortality. Clinical and laboratory parameters of hospitalized patients were analyzed regarding their association with the primary outcome. RESULTS From March 3 to April 4, 2020, 3679 individuals were tested for SARS-CoV-2 in our hospital. Of those, 381 had Covid-19 and were included into this analysis. Most patients (99.2%) were Chileans, 12% returning from recent travel. The median age was 39 years (IQR 31-49) and 52% were female. A total of 88 patients (23.1%) were hospitalized; 18 (3.7%) required ICU and/or died. The overall mortality was 0.7%. Increased body mass index (BMI) and elevated C-reactive protein (CRP) were independently associated with ICU care or death. CONCLUSION During the first weeks of the pandemic in Chile, most Covid-19 patients were young, with low rates of hospitalization, ICU requirement, and fatality. BMI and CRP on admission were predictors for severity. Our data provide important information on the clinical course and outcome of Covid-19 in a Latin American setting.
Collapse
Affiliation(s)
- Macarena R Vial
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Anne Peters
- Facultad de Medicina CAS-UDD, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago, Chile
| | - Inia Pérez
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - María Spencer-Sandino
- Facultad de Medicina CAS-UDD, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago, Chile
| | - Mario Barbé
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Lorena Porte
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Thomas Weitzel
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
- Facultad de Medicina CAS-UDD, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago, Chile
| | - Mabel Aylwin
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
| | - Pablo Vial
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
- Facultad de Medicina CAS-UDD, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago, Chile
| | - Rafael Araos
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile
- Facultad de Medicina CAS-UDD, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago, Chile
- Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile
| | - Jose M Munita
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo (CAS-UDD), Santiago, Chile.
- Facultad de Medicina CAS-UDD, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago, Chile.
- Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile.
| |
Collapse
|
17
|
Napolitano C, Larraguibel-González C, Cepeda-Mercado AA, Vial P, Sanderson J. New records of Leopardus guigna in its northern-most distribution in Chile: implications for conservation. Rev Chil de Hist Nat 2020. [DOI: 10.1186/s40693-020-00095-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
AbstractWe report new records of the wild felid Leopardus guigna in its northern-most distribution, in the southern Coquimbo and northern Valparaíso regions, in northern-central Chile. To our knowledge, these are the northern-most confirmed guigna records to date. We discuss implications for the conservation of these fragile populations in the face of different anthropic threats.
Collapse
|
18
|
Reyes F, Ferrés M, Vial P, Vollrath V, Camponovo R, Montecinos L, Hirsch T, Valenzuela P, Perret C. [Interactive, semi-automatized and open source computational model applied to respiratory viruses surveillance]. Rev Chilena Infectol 2020; 37:69-75. [PMID: 32730403 DOI: 10.4067/s0716-10182020000100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/07/2020] [Indexed: 11/17/2022] Open
Abstract
Acute respiratory infections (ARI) are an important cause of morbidity and mortality worldwide, affecting mainly children and the elderly. They are associated with a high economic burden, increased number of medical visits and hospitalizations. The surveillance of the circulation of respiratory viruses can reduce the health care associated costs, and to optimize the health response. A platform based on R and its package Shiny was designed, to create an interactive and friendly web interface for gathering, analysis and publication of the data. The data from the Chilean metropolitan respiratory viruses surveillance network, available since 2006, was uploaded into the platform. Using this platform, the researcher spends less than 1 minute to upload the data, and the analysis and publication is immediate, available to be seen by any user with a device connected to Internet, who can choose the variables to be displayed. With a very low cost, in a short time, and using the R programming language, it was possible to create a simple, and interactive platform, considerably decreasing the upload and analysis time, and increasing the impact and availability of this surveillance.
Collapse
Affiliation(s)
- Felipe Reyes
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Pablo Vial
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Chile
| | | | | | - Luisa Montecinos
- Laboratorio de Microbiología y Medicina Molecular, Hospital de Enfermedades Infecciosas Dr. Lucio Córdova, Chile
| | - Tamara Hirsch
- Departamento de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Patricia Valenzuela
- Departamento de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Cecilia Perret
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| |
Collapse
|
19
|
Porte L, Legarraga P, Vollrath V, Aguilera X, Munita JM, Araos R, Pizarro G, Vial P, Iruretagoyena M, Dittrich S, Weitzel T. Evaluation of a novel antigen-based rapid detection test for the diagnosis of SARS-CoV-2 in respiratory samples. Int J Infect Dis 2020; 99:328-333. [PMID: 32497809 PMCID: PMC7263236 DOI: 10.1016/j.ijid.2020.05.098] [Citation(s) in RCA: 233] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/16/2020] [Accepted: 05/24/2020] [Indexed: 12/17/2022] Open
Abstract
Due to the rapidly emerging SARS-CoV-2 pandemic and its tremendous public health challenges worldwide, there is a critical demand for rapid and easy to perform diagnostic assays. The rapid antigen detection test evaluated here had a high diagnostic sensitivity and specificity in respiratory samples obtained from patients who mainly presented during the first week of COVID-19. Rapid antigen detection has the potential to become an important tool for the early diagnosis of SARS-CoV-2, particularly in situations with limited access to molecular methods.
Objectives In the context of the coronavirus disease 2019 (COVID-19) pandemic, the development and validation of rapid and easy-to-perform diagnostic methods are of high priority. This study was performed to evaluate a novel rapid antigen detection test (RDT) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory samples. Methods The fluorescence immunochromatographic SARS-CoV-2 antigen test (Bioeasy Biotechnology Co., Shenzhen, China) was evaluated using universal transport medium with nasopharyngeal (NP) and oropharyngeal (OP) swabs from suspected COVID-19 cases. Diagnostic accuracy was determined in comparison to SARS-CoV-2 real-time (RT)-PCR. Results A total of 127 samples were included; 82 were RT-PCR-positive. The median patient age was 38 years, 53.5% were male, and 93.7% were from the first week after symptom onset. Overall sensitivity and specificity were 93.9% (95% confidence interval 86.5–97.4%) and 100% (95% confidence interval 92.1–100%), respectively, with a diagnostic accuracy of 96.1% and Kappa coefficient of 0.9. Sensitivity was significantly higher in samples with high viral loads. Conclusions The RDT evaluated in this study showed a high sensitivity and specificity in samples mainly obtained during the first week of symptoms and with high viral loads, despite the use of a non-validated sample material. The assay has the potential to become an important tool for early diagnosis of SARS-CoV-2, particularly in situations with limited access to molecular methods.
Collapse
Affiliation(s)
- Lorena Porte
- Laboratorio Clínico, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
| | - Paulette Legarraga
- Laboratorio Clínico, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Valeska Vollrath
- Laboratorio Clínico, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Ximena Aguilera
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - José M Munita
- Servicio de Infectología, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile
| | - Rafael Araos
- Servicio de Infectología, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile
| | - Gabriel Pizarro
- Laboratorio Clínico, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Pablo Vial
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | | | - Sabine Dittrich
- Foundation for Innovative New Diagnostics (FIND), Malaria and Fever Program, Geneva, Switzerland; Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Thomas Weitzel
- Laboratorio Clínico, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
| |
Collapse
|
20
|
Weitzel T, Perret C, Valdivieso F, Abarca K, Vial P. Yellow fever vaccination for Chilean tourists visiting Brazil. Practical considerations. Rev Chilena Infectol 2019; 35:587-590. [PMID: 30725008 DOI: 10.4067/s0716-10182018000500587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 10/21/2018] [Indexed: 11/17/2022] Open
Abstract
Due to the recent yellow fever outbreak affecting the costal region of Brazil, including main touristic destinations, there is a high demand of yellow fever vaccination. This publication addresses the most relevant practical issues regarding this vaccine for tourists visiting Brazil and aims to serve as a guideline for non-expert physicians in Chile and elsewhere.
Collapse
Affiliation(s)
- Thomas Weitzel
- Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Cecilia Perret
- Centro de Medicina del Viajero, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisca Valdivieso
- Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Katia Abarca
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Vial
- Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| |
Collapse
|
21
|
Brace O, Alhujali S, Deshpande S, Vial P, Metcalfe P, Lerch M, Petasecca M, Rosenfeld A. EP-1753 A dual detector system for in-vivo dosimetry: transit dose verification and error identification. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32173-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
22
|
Vinod S, Choong C, Vial P, Kron T, Ball D. PO-0769 Lung Organ-at-Risk volumes – The need for a better definition in the era of 4DCT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31189-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
23
|
Weitzel T, Vial P, Perret C, Aguilera X. Shortage of yellow fever vaccination: A travel medicine emergency for Chilean travellers. Travel Med Infect Dis 2019; 28:1-2. [DOI: 10.1016/j.tmaid.2019.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 01/28/2019] [Indexed: 10/27/2022]
|
24
|
Martínez-Valdebenito C, Angulo J, Le Corre N, Marco C, Vial C, Miquel JF, Cerda J, Mertz G, Vial P, Lopez-Lastra M, Ferrés M. A Single-Nucleotide Polymorphism of α Vβ₃ Integrin Is Associated with the Andes Virus Infection Susceptibility. Viruses 2019; 11:v11020169. [PMID: 30791508 PMCID: PMC6409546 DOI: 10.3390/v11020169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/11/2019] [Accepted: 02/15/2019] [Indexed: 01/06/2023] Open
Abstract
The AndesOrthohantavirus (ANDV), which causes the hantavirus cardiopulmonary syndrome, enters cells via integrins, and a change from leucine to proline at residue 33 in the PSI domain (L33P), impairs ANDV recognition. We assessed the association between this human polymorphism and ANDV infection. We defined susceptible and protective genotypes as “TT” (coding leucine) and “CC” (coding proline), respectively. TT was present at a rate of 89.2% (66/74) among the first cohort of ANDV cases and at 60% (63/105) among exposed close-household contacts, who remained uninfected (p < 0.05). The protective genotype (CC) was absent in all 85 ANDV cases, in both cohorts, and was present at 11.4% of the exposed close-household contacts who remained uninfected. Logistic regression modeling for risk of infection had an OR of 6.2–12.6 (p < 0.05) in the presence of TT and well-known ANDV risk activities. Moreover, an OR of 7.3 was obtained when the TT condition was analyzed for two groups exposed to the same environmental risk. Host genetic background was found to have an important role in ANDV infection susceptibility, in the studied population.
Collapse
Affiliation(s)
- Constanza Martínez-Valdebenito
- Departamento de Enfermedades Infecciosas e Inmunologia Pediatricas, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Jenniffer Angulo
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia (IMII), Santiago 8330024, Chile.
| | - Nicole Le Corre
- Departamento de Enfermedades Infecciosas e Inmunologia Pediatricas, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Claudia Marco
- Departamento de Enfermedades Infecciosas e Inmunologia Pediatricas, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Cecilia Vial
- Facultad de Medicina, Center for Genetics and Genomics, Clínica Alemana Universidad del Desarrollo, Santiago 7650568, Chile.
| | - Juan Francisco Miquel
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Jaime Cerda
- Facultad de Medicina Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Gregory Mertz
- University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA.
| | - Pablo Vial
- Departamento de Pediatria, Facultad de Medicina, Clínica Alemana Santiago, Universidad del Desarrollo, Santiago 7650568, Chile.
| | - Marcelo Lopez-Lastra
- Departamento de Enfermedades Infecciosas e Inmunologia Pediatricas, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia (IMII), Santiago 8330024, Chile.
| | - Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunologia Pediatricas, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| |
Collapse
|
25
|
Martinez-Valdebenito C, Ferres M, Corre NL, Angulo J, Vial C, Vial P, Mertz G, Valdivieso F, Galeno H, Villagra E, Vera L, Lagos N, Becerra N, Mora J, Lopez-Lastra M. 2502. Host Susceptibility to Andes Hantavirus Infection Associates to a Single Nucleotide Polymorphism at the αVβ3 Integrin. Open Forum Infect Dis 2018. [PMCID: PMC6255019 DOI: 10.1093/ofid/ofy210.2154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Methods Results Conclusion Disclosures
Collapse
Affiliation(s)
| | - Marcela Ferres
- Dpto De Enfermedades Infecciosas e Inmunología Pediátrica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicole Le Corre
- Dpto Infectologia e Inmunologia Pediatrica, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jenniffer Angulo
- Dpto Infectologia e Inmunologia Pediatrica, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Cecilia Vial
- Center for Genetics and Genomics, Universidad del Desarrollo, Santiago, Chile
| | - Pablo Vial
- Pediatrics, University Del Desarrolo, Santiago, Chile
| | - Gregory Mertz
- Internal Medicine, University of New Mexico, Albuquerque, New Mexico
| | | | - Hector Galeno
- Subdepartamento De Virología Clínica, Departamento Laboratorio Biomédico Nacional y De Referencia, Instituto de Salud Publica, Santiago, Chile
| | - Eliecer Villagra
- Subdepartamento De Virología Clínica, Departamento Laboratorio Biomédico Nacional y De Referencia, Instituto de Salud Publica, Santiago, Chile
| | - Lilian Vera
- Subdepartamento De Virología Clínica, Departamento Laboratorio Biomédico Nacional y De Referencia, Instituto de Salud Publica, Santiago, Chile
| | - Natalia Lagos
- Subdepartamento De Virología Clínica, Departamento Laboratorio Biomédico Nacional y De Referencia, Instituto de Salud Publica, Santiago, Chile
| | - Natalia Becerra
- Subdepartamento De Virología Clínica, Departamento Laboratorio Biomédico Nacional y De Referencia, Instituto de Salud Publica, Santiago, Chile
| | - Judith Mora
- Subdepartamento De Virología Clínica, Departamento Laboratorio Biomédico Nacional y De Referencia, Instituto de Salud Publica, Santiago, Chile
| | - Marcelo Lopez-Lastra
- Dpto Infectologia e Inmunologia Pediatrica, Pontificia Universidad Catolica de Chile, Santiago, Chile
| |
Collapse
|
26
|
Pogson E, Arumugam S, Hansen C, Currie M, Blake S, Roberts N, Carolan M, Vial P, Alharthi T, Holloway L, Thwaites D. Comparison of multi-institutional pre-treatment verification for VMAT of nasopharynx with delivery errors. Phys Med 2018; 53:25-31. [DOI: 10.1016/j.ejmp.2018.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/19/2018] [Accepted: 07/21/2018] [Indexed: 10/28/2022] Open
|
27
|
Brace O, Alhujaili S, Deshpande S, Vial P, Metcalfe P, Lerch M, Petasecca M, Rosenfeld A. EP-1773: Dual detector prototype for on line dose verification during patient radiotherapy treatment. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32082-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
28
|
Deshpande S, Blake S, Holloway L, Vial P. EP-1791: Evaluation of a water equivalent EPID model for flattening filter free (FFF) beam transit dosimetry. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32100-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
29
|
Roach D, Rønn Hansen C, Wortel G, Jensen H, Ochoa C, Damen E, Vial P, Janssen T. EP-1897: A multi-centre comparison of automated treatment planning for prostate cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32206-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
30
|
Olea A, Matute I, González C, Delgado I, Poffald L, Pedroni E, Alfaro T, Hirmas M, Nájera M, Gormaz A, López D, Loayza S, Ferreccio C, Gallegos D, Fuentes R, Vial P, Aguilera X. Case-Control Study of Risk Factors for Meningococcal Disease in Chile. Emerg Infect Dis 2018. [PMID: 28628448 PMCID: PMC5512488 DOI: 10.3201/eid2307.160129] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
An outbreak of meningococcal disease with a case-fatality rate of 30% and caused by predominantly serogroup W of Neisseria meningitidis began in Chile in 2012. This outbreak required a case−control study to assess determinants and risk factors for infection. We identified confirmed cases during January 2012−March 2013 and selected controls by random sampling of the population, matched for age and sex, resulting in 135 case-patients and 618 controls. Sociodemographic variables, habits, and previous illnesses were studied. Analyses yielded adjusted odds ratios as estimators of the probability of disease development. Results indicated that conditions of social vulnerability, such as low income and overcrowding, as well as familial history of this disease and clinical histories, especially chronic diseases and hospitalization for respiratory conditions, increased the probability of illness. Findings should contribute to direction of intersectoral public policies toward a highly vulnerable social group to enable them to improve their living conditions and health.
Collapse
|
31
|
Deshpande S, Blake SJ, Xing A, Metcalfe PE, Holloway LC, Vial P. A simple model for transit dosimetry based on a water equivalent EPID. Med Phys 2018; 45:1266-1275. [DOI: 10.1002/mp.12742] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 11/10/2017] [Accepted: 12/18/2017] [Indexed: 01/20/2023] Open
Affiliation(s)
- S. Deshpande
- Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute; Liverpool NSW 2170 Australia
- Centre for Medical Radiation Physics; University of Wollongong; Wollongong NSW 2522 Australia
| | - S. J. Blake
- Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute; Liverpool NSW 2170 Australia
- School of Physics; Institute of Medical Physics; University of Sydney; Sydney NSW 2006 Australia
| | - A. Xing
- Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute; Liverpool NSW 2170 Australia
| | - P. E. Metcalfe
- Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute; Liverpool NSW 2170 Australia
- Centre for Medical Radiation Physics; University of Wollongong; Wollongong NSW 2522 Australia
| | - L. C. Holloway
- Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute; Liverpool NSW 2170 Australia
- Centre for Medical Radiation Physics; University of Wollongong; Wollongong NSW 2522 Australia
- School of Physics; Institute of Medical Physics; University of Sydney; Sydney NSW 2006 Australia
- School of Medicine; South West Sydney Clinical School; University of NSW; Liverpool NSW 2052 Australia
| | - P. Vial
- Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute; Liverpool NSW 2170 Australia
- School of Physics; Institute of Medical Physics; University of Sydney; Sydney NSW 2006 Australia
| |
Collapse
|
32
|
Miri N, Legge K, Lehmann J, Vial P, Zwan B, Greer P. PO-0907: Remote auditing of IMRT/VMAT deliveries. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31344-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
33
|
Greer P, Legge K, Miri N, Vial P, Fuangrod T, Lehmann J. OC-0537: A remote EPID-based dosimetric auditing method for VMAT delivery using a digital phantom concept. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
34
|
Vial P, Blake S, Cheng Z, Deshpande S, Atakaramians S, Lu M, Meikle S, Greer P, Kuncic Z. PO-0767: Revisiting EPID design for modern radiotherapy requirements. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31204-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
35
|
Thwaites D, Pogson E, Arumugam S, Hansen C, Currie M, Blake S, Roberts N, Carolan M, Vial P, Juresic J, Ochoa C, Yakobi J, Haman A, Trtovac A, Al-Harthi T, Holloway L. PO-0808: Comparison of multi-institutional QA for VMAT of Nasopharynx with simulated delivery errors. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31245-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
36
|
Liney GP, Dong B, Begg J, Vial P, Zhang K, Lee F, Walker A, Rai R, Causer T, Alnaghy SJ, Oborn BM, Holloway L, Metcalfe P, Barton M, Crozier S, Keall P. Technical Note: Experimental results from a prototype high-field inline MRI-linac. Med Phys 2017; 43:5188. [PMID: 27587049 DOI: 10.1118/1.4961395] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The pursuit of real-time image guided radiotherapy using optimal tissue contrast has seen the development of several hybrid magnetic resonance imaging (MRI)-treatment systems, high field and low field, and inline and perpendicular configurations. As part of a new MRI-linac program, an MRI scanner was integrated with a linear accelerator to enable investigations of a coupled inline MRI-linac system. This work describes results from a prototype experimental system to demonstrate the feasibility of a high field inline MR-linac. METHODS The magnet is a 1.5 T MRI system (Sonata, Siemens Healthcare) was located in a purpose built radiofrequency (RF) cage enabling shielding from and close proximity to a linear accelerator with inline (and future perpendicular) orientation. A portable linear accelerator (Linatron, Varian) was installed together with a multileaf collimator (Millennium, Varian) to provide dynamic field collimation and the whole assembly built onto a stainless-steel rail system. A series of MRI-linac experiments was performed to investigate (1) image quality with beam on measured using a macropodine (kangaroo) ex vivo phantom; (2) the noise as a function of beam state measured using a 6-channel surface coil array; and (3) electron contamination effects measured using Gafchromic film and an electronic portal imaging device (EPID). RESULTS (1) Image quality was unaffected by the radiation beam with the macropodine phantom image with the beam on being almost identical to the image with the beam off. (2) Noise measured with a surface RF coil produced a 25% elevation of background intensity when the radiation beam was on. (3) Film and EPID measurements demonstrated electron focusing occurring along the centerline of the magnet axis. CONCLUSIONS A proof-of-concept high-field MRI-linac has been built and experimentally characterized. This system has allowed us to establish the efficacy of a high field inline MRI-linac and study a number of the technical challenges and solutions.
Collapse
Affiliation(s)
- G P Liney
- Department of Medical Physics, Ingham Institute for Applied Medical Research, Liverpool NSW 2170, Australia; Radiation Physics, Liverpool Cancer Therapy Centre, Liverpool NSW 2170, Australia; School of Medicine, University of New South Wales, Sydney NSW 2170, Australia; and Centre for Medical Radiation Physics, University of Wollongong, NSW 2522, Australia
| | - B Dong
- Department of Medical Physics, Ingham Institute for Applied Medical Research, Liverpool NSW 2170, Australia
| | - J Begg
- Radiation Physics, Liverpool Cancer Therapy Centre, Liverpool NSW 2170, Australia
| | - P Vial
- Radiation Physics & Liverpool Cancer Therapy Centre, Liverpool, NSW 2170, Australia and Radiation Physics Laboratory, Sydney Medical School, University of Sydney, NSW 2006, Australia
| | - K Zhang
- Department of Medical Physics, Ingham Institute for Applied Medical Research, Liverpool NSW 2170, Australia
| | - F Lee
- Radiation Physics Laboratory, Sydney Medical School, University of Sydney, NSW 2006, Australia
| | - A Walker
- Medical Physics, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia and Radiation Physics, Liverpool Cancer Therapy Centre, Liverpool NSW 2170, Australia
| | - R Rai
- Medical Physics, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia and Radiation Physics, Liverpool Cancer Therapy Centre, Liverpool NSW 2170, Australia
| | - T Causer
- Centre for Medical Radiation Physics, University of Wollongong, NSW 2522, Australia
| | - S J Alnaghy
- Centre for Medical Radiation Physics, University of Wollongong, NSW 2522, Australia
| | - B M Oborn
- Centre for Medical Radiation Physics, University of Wollongong, NSW 2522, Australia and Illawarra Cancer Care Centre, Wollongong Hospital, NSW 2500, Australia
| | - L Holloway
- Department of Medical Physics, Ingham Institute for Applied Medical Research, Liverpool NSW 2170, Australia; Radiation Physics, Liverpool Cancer Therapy Centre, Liverpool NSW 2170, Australia; School of Medicine, University of New South Wales, Sydney NSW 2170, Australia; Centre for Medical Radiation Physics, University of Wollongong, NSW 2522, Australia; and Radiation Physics Laboratory, Sydney Medical School, University of Sydney, NSW 2006, Australia
| | - P Metcalfe
- Centre for Medical Radiation Physics, University of Wollongong, NSW 2522, Australia
| | - M Barton
- Department of Medical Physics, Ingham Institute for Applied Medical Research, Liverpool NSW 2170, Australia and School of Medicine, University of New South Wales, Sydney NSW 2170, Australia
| | - S Crozier
- School of Information Technology & Electrical Engineering, University of Queensland, Brisbane, QLD 4072, Australia
| | - P Keall
- Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Sydney NSW 2170, Australia
| |
Collapse
|
37
|
Blake SJ, Cheng J, Vial P, Lu M, Atakaramians S, Meikle S, Kuncic Z. WE-DE-BRA-06: Evaluation of the Imaging Performance of a Novel Water-Equivalent EPID. Med Phys 2016. [DOI: 10.1118/1.4957835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
38
|
Deshpande S, Alhujaili S, Vial P, Holloway L, Petasecca M, Rozenfeld A, Metcalfe P. SU-C-201-05: Silicon Array Dosimeter in Situ with Electronic Portal Image Device for Simultaneous Transit Dose and Image Verification in Radiotherapy. Med Phys 2016. [DOI: 10.1118/1.4955545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
39
|
Keall P, Dong B, Vial P, Walker A, Zhang K, Begg J, Rai R, Holloway L, Barton M, Crozier S, Liney G. TH-AB-BRA-12: Experimental Results From the First High-Field Inline MRI-Linac. Med Phys 2016. [DOI: 10.1118/1.4958064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
40
|
Legge K, Lehmann J, Vial P, Miri N, Greer P. SU-D-201-06: Remote Dosmetric Auditing of VMAT Deliveries for Clinical Trials Using EPID. Med Phys 2016. [DOI: 10.1118/1.4955618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
41
|
Miri N, Lehmann J, Vial P, Legge K, Greer P. TU-FG-201-06: Remote Dosimetric Auditing for Clinical Trials Using EPID Dosimetry: A Pilot Study. Med Phys 2016. [DOI: 10.1118/1.4957529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
42
|
Miri N, Lehmann J, Vial P, Greer P. SU-F-T-240: EPID-Based Quality Assurance for Dosimetric Credentialing. Med Phys 2016. [DOI: 10.1118/1.4956380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
43
|
Barber J, Vial P. SU-F-T-296: Modulated Therapy Down Under: A Survey of IMRT & VMAT Physics Practice in Australia and New Zealand. Med Phys 2016. [DOI: 10.1118/1.4956481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
44
|
Begg J, Holloway L, Liney G, Dong B, Alnaghy S, Causer T, AlHarthi T, George A, Goozee G, Vial P, Arumugam S, Glaubes L, Whelan B, Oborn B, Metcalfe P, Thwaites D, Keall P. PO-0951: Radiation beam alignment and baseline dosimetry measurements for the Australian MRI-linac program. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
45
|
Matute I, Olea A, López D, Loayza S, Nájera M, González C, Poffald L, Hirmas M, Delgado I, Pedroni E, Alfaro T, Gormaz AM, Sanhueza G, Vial P, Dabanch J, Gallegos D, Aguilera X. [Clinical features and prognostic factors of meningococcal disease: a case series study in Chile during the 2012-2013 outbreak]. Rev Chilena Infectol 2015; 32:505-16. [PMID: 26633106 DOI: 10.4067/s0716-10182015000600003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 10/06/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Meningococcal disease (MD) is a major global problem because of its case fatality rate and sequels. Since 2012 cases of serogroup W have increased in Chile, with nonspecific clinical presentation, high case fatality rate and serious consequences. OBJECTIVE To characterize the evolution and outcome of MD cases between January 2012 and March 2013 in Chile. MATERIAL AND METHODS Case series considering 149 MD cases of 7 regions. A questionnaire was applied and clinical records were reviewed, including individual, agent, clinical course and healthcare process variables. The analysis allowed to obtain estimates of the OR as likelihood of dying. RESULTS 51.5% was meningococcemia, the case fatality rate reached 27%, prevailing serogroup W (46.6%). Factors that increased the probability of dying: > age, belonging to indigenous people, having lived a stressful event, having diarrhea, impaired consciousness, cardiovascular symptoms, low oxygen saturation and low Glasgow coma scale score. DISCUSSION The case fatality rate exceeded normal levels and was higher in serogroup W. Increasing in this serogroup, associated to the increased presence of nonspecific symptoms or rapid progression to septicemia, hit a health system accustomed to more classic meningococcal disease presentation, which could partly explain the observed increased fatality rate.
Collapse
|
46
|
Deshpande S, Blake S, Metcalfe P, Holloway L, Vial P. Incorporating a Water Equivalent EPID into a Radiation Therapy Treatment Planning System for In Vivo Dosimetry. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
47
|
Lehmann J, Miri N, Vial P, Hatton J, Zwan B, Craig A, Beenstock V, Molloy T, Sloan K, Greer P. MO-D-213-08: Remote Dosimetric Credentialing for Clinical Trials with the Virtual EPID Standard Phantom Audit (VESPA). Med Phys 2015. [DOI: 10.1118/1.4925324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
48
|
Arumugam S, Xing A, Vial P, Thwaites D, Holloway L. SU-E-T-76: A Software System to Monitor VMAT Plan Complexity in a Large Radiotherapy Centre. Med Phys 2015. [DOI: 10.1118/1.4924437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
49
|
Blake SJ, McNamara AL, Vial P, Holloway L, Kuncic Z. Optimisation of the imaging and dosimetric characteristics of an electronic portal imaging device employing plastic scintillating fibres using Monte Carlo simulations. Phys Med Biol 2014; 59:6827-40. [DOI: 10.1088/0031-9155/59/22/6827] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
50
|
Blake S, Vial P, Holloway L, Kuncic Z. WE-E-18A-08: Towards a Next-Generation Electronic Portal Device for Simultaneous Imaging and Dose Verification in Radiotherapy. Med Phys 2014. [DOI: 10.1118/1.4889460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|