Multisystem Inflammatory Syndrome and COVID-19 in children and adolescents: epidemiological aspects, Brazil, 2020-20211

ABSTRACT This study describes epidemiological aspects of the Multisystemic Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 and mortality by COVID-19 in children (0-9 years old) and adolescents (10-19 years old). The data sources, for 2020-2021, were the Epidemiological Surveillance System for MIS-C and Mortality Information System for COVID-19, both managed by the Ministry of Health. There were 1,503 cases, more frequent in children (77%) than in adolescents (23%), and 93 reported deaths due to MIS-C in 26 of the 27 States of the Country. The highest number of cases in children was reported in São Paulo (268), but the highest incidence took place in the Federal District (7.8 per 100,000 inhabitants). The rate of deaths due to MIS-C was 5.4% in children and 8.7% in adolescents. There were 2,329 deaths due to COVID-19 in the population under 20 years old, with a higher rate in adolescents (4.4 per 100,000 inhabitants) than in children (2.7); the highest rate occurred in Roraima. We recommend intensifying immunization against COVID-19 in such population, increasing protection against the negative effects of COVID-19 and MIS-C, which may have short, medium and/or long-term consequences, so as not to compromise the full integration of these citizens into society.

Síndrome Inflamatória Multissistêmica e Covid-19 em crianças e adolescentes: aspectos epidemiológicos, Brasil, 2020-2021

RESUMO Este estudo descreve aspectos epidemiológicos da Síndrome Inflamatória Multissistêmica Pediátrica (SIM-P) associada à Covid-19 e óbitos por Covid-19 em crianças (0-9 anos de idade) e adolescentes (10-19 anos de idade). As fontes de dados, de 2020-2021, foram os Sistemas de Vigilância Epidemiológica para SIM-P e de Informação sobre Mortalidade para Covid-19, gerenciados pelo Ministério da Saúde. Foram notificados 1.503 casos, mais frequentes em crianças (77%) do que em adolescentes (23%); e 93 óbitos por SIM-P em 26 das 27 Unidades da Federação. O maior número de casos em crianças foi notificado em São Paulo (268), contudo, a maior incidência ocorreu no Distrito Federal (7,8/100 mil habitantes). A proporção de óbitos por SIM-P foi 5,4% em crianças e 8,7% em adolescentes. No período avaliado, houve 2.329 óbitos por Covid-19 em menores de 20 anos de idade, com maior taxa em adolescentes (4,4/100 mil habitantes) do que em crianças (2,7/100 mil habitantes), com maiores taxas em Roraima. Recomenda-se intensificação da imunização contra Covid-19 nessa população, aumentando a proteção contra os efeitos negativos dessa doença e da SIM-P, que podem apresentar consequências em curto, médio e/ou longo prazo, de modo a não comprometer a inserção plena destes cidadãos na sociedade.

Health collapse in Manaus: the burden of not adhering to non-pharmacological measures to reduce the transmission of Covid-19

ABSTRACT This article aims to compare the evolution of Covid-19 in Manaus and Fortaleza, two epicenters of the pandemic in 2020, analyzing legal measures by local governments and levels of social isolation. An algorithm was defined to calculate the Homestay Index (HSI), using data from the Google Mobility Report. We analyzed the decree’s timeline, the HSI evolution, the Covid-19 incidence and the number of deaths from March/2020 to January/2021. The population of Fortaleza was exposed to more consistent measures of social distancing than that of Manaus. Longer homestay was observed from March to May 2020 and Fortaleza achieved higher and more lasting levels. As of June 2020, the HSI fell, notably in Manaus, reaching levels below zero in late December. As an aggravating factor, the government decreed broad isolation in Manaus on December 23, 2020, but after protests it was repealed on December 26, 2020. A judicial decision determined the complete closure in Manaus on January 2nd 2021, but it was too late: the SUS collapsed with an exponential increase in deaths. In Fortaleza, the demand for health services was high, but under control. We consider that only the strict application of non-pharmacological measures and mass immunization can prevent further deaths.

Nonlinear Biosynthetic Assembly of Alpiniamide by a Hybrid cis/trans-AT PKS-NRPS

Alpiniamide A is a linear polyketide produced by Streptomyces endophytic bacteria. Despite its relatively simple chemical structure suggestive of a linear assembly line biosynthetic construction involving a hybrid polyketide synthase-nonribosomal peptide synthetase enzymatic protein machine, we report an unexpected nonlinear synthesis of this bacterial natural product. Using a combination of genomics, heterologous expression, mutagenesis, isotope-labeling, and chain terminator experiments, we propose that alpiniamide A is assembled in two halves and then ligated into the mature molecule. We show that each polyketide half is constructed using orthogonal biosynthetic strategies, employing either cis- or trans-acyl transferase mechanisms, thus prompting an alternative proposal for the operation of this PKS-NRPS.

Direct Protocol for Ambient Mass Spectrometry Imaging on Agar Culture

Herein we describe a new protocol that allows direct mass spectrometry imaging (IMS) of agar cultures. A simple sample dehydration leads to a thin solid agar, which enables the direct use of spray-based ambient mass spectrometry techniques. To demonstrate its applicability, metal scavengers siderophores were imaged directly from agar culture of S. wadayamensis, and well resolved and intense images were obtained using both desorption electrospray ionization (DESI) and easy ambient sonic-spray ionization (EASI) with well-defined selective spatial distributions for the free and the metal-bound molecules, providing clues for their roles in cellular metabolism.

Nature-inspired enzymatic cascades to build valuable compounds

Biocatalysis currently is focusing on enzymatic and multi-enzymatic cascade processes instead of single steps imbedded into chemical pathways. Alongside this scientific revolution, this review provides an overview on multi-enzymatic cascades that are responsible for the biosynthesis of some terpenes, alkaloids and polyethers, which are important classes of natural products. Herein, we illustrate the development of studies inspired by multi- and chemo-enzymatic approaches to build the core moieties of polyethers, polypeptide alkaloids, piperidines and pyrrolidines promoted by the joint action of oxidoreductases, hydrolases, cyclases, transaminases and imine reductases.

Site-specific modification of the anticancer and antituberculosis polyether salinomycin by biosynthetic engineering

The complex bis-spiroacetal polyether ionophore salinomycin has been identified as a uniquely selective agent against cancer stem cells and is also strikingly effective in an animal model of latent tuberculosis. The basis for these important activities is unknown. We show here that deletion of the salE gene abolishes salinomycin production and yields two new analogues, in both of which the C18C19 cis double bond is replaced by a hydroxy group stereospecifically located at C19, but which differ from each other in the configuration of the bis-spiroacetal. These results identify SalE as a novel dehydratase and demonstrate that biosynthetic engineering can be used to redirect the reaction cascade of oxidative cyclization to yield new salinomycin analogues for use in mechanism-of-action studies.

TOPS-MODE based QSARs derived from heterogeneous series of compounds. Applications to the design of new anti-inflammatory compounds

A new application of TOPological Sub-structural MOlecular DEsign (TOPS-MODE) was carried out in anti-inflammatory compounds using computer-aided molecular design. Two series of compounds, one containing anti-inflammatory and the other containing nonanti-inflammatory compounds were processed by a k-means cluster analysis in order to design the training and prediction sets. A linear classification function to discriminate the anti-inflammatory from the inactive compounds was developed. The model correctly and clearly classified 88% of active and 91% of inactive compounds in the training set. More specifically, the model showed a good global classification of 90%, that is, (399 cases out of 441). While in the prediction set, they showed an overall predictability of 88% and 84% for active and inactive compounds, being the global percentage of good classification of 85%. Furthermore this paper describes a fragment analysis in order to determine the contribution of several fragments towards anti-inflammatory property, also the present of halogens in the selected fragments were analyzed. It seems that the present TOPS-MODE based QSAR is the first alternate general 'in silico' technique to experimentation in anti-inflammatory discovery.