ABSTRACT
BACKGROUND There is interest in lingering non-specific symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, referred to as Long coronavirus disease 2019 (Long COVID-19). It remains unknown whether the risk of Long COVID-19 is associated with pre-existing comorbidities or initial COVID-19 severity, including infections due to new Omicron lineages which predominated in 2023. OBJECTIVES The aim of this case report was to characterize the clinical features of acute XBB.1.5 infection followed by Long COVID-19. METHODS We followed a 73-year old female resident of Rio de Janeiro with laboratory-confirmed SARS-CoV-2 during acute infection and subsequent months. The SARS-CoV-2 lineage was determined by genome sequencing. FINDINGS The participant denied comorbidities and had completed a two-dose vaccination schedule followed by two booster doses eight months prior to SARS-CoV-2 infection. Primary infection by viral lineage XBB.1.5. was clinically mild, but the participant subsequently reported persistent fatigue. MAIN CONCLUSIONS This case demonstrates that Long COVID-19 may develop even after mild disease due to SARS-CoV-2 in fully vaccinated and boosted individuals without comorbidities. Continued monitoring of new SARS-CoV-2 lineages and associated clinical outcomes is warranted. Measures to prevent infection should continue to be implemented including development of new vaccines and antivirals effective against novel variants.
ABSTRACT
Abstract Due to intense ongoing urbanization in the Amazon, the urban pattern of malaria may be changing, both in its spatial distribution and epidemiological profile. The purpose of this paper is to analyze how the process of production of urban space in Porto Velho, the capital of the state of Rondonia, Brazil has contributed to the occurrence and maintenance of urban malaria. Using data collected from the Malaria Epidemiological Surveillance System (SIVEP-Malaria), we calculated malaria indices for the districts of Porto Velho from 2005 to 2018. We also developed two typologies for classifying urban space based on functional characteristics and features of the landscape. While the former considers characteristics of urban space in Porto Velho, the latter is based on suitability for malaria vectors. We found that the annual parasite index declined in Porto Velho during the study period. However, changes in the index were not uniform across the districts of the city. Periurban areas showed no decline in the index, which we attribute to these areas' high vegetation density and hydrological characteristics.
Resumo A Amazônia tem passado por um intenso processo de urbanização em anos recentes, produzindo transformações na organização espacial da região que podem estar refletindo no padrão espaço temporal da malária urbana. O objetivo deste trabalho é compreender como o processo de produção do espaço urbano do município de Porto Velho-RO, tem corroborado para a ocorrência e manutenção da malária urbana. Os dados levantados no Sistema de Vigilância Epidemiológica (SIVEP-Malária) possibilitaram o cálculo do Índice Parasitário Anual (IPA) de malária para os bairros da cidade de Porto Velho dos anos de 2005 a 2018 e a construção de duas tipologias da paisagem do espaço urbano. A primeira considerou o processo de produção do espaço urbano de Porto Velho; a segunda se baseou nas condições de receptividade para o vetor da malária. A ocorrência da malária em Porto Velho vem declinando de forma diferenciada ao longo do território, havendo uma tendência de permanência nas áreas periurbanas com maior densidade de vegetação e hidrografia.