ABSTRACT
ABSTRACT Background: Knowledge about COVID-19 in pregnancy is limited, and evidence on the impact of the infection during pregnancy and postpartum is still emerging. Aim: To analyze maternal morbidity and mortality due to severe acute respiratory infections (SARI), including COVID-19, in Brazil. Methods: National surveillance data from the SIVEP-Gripe (Sistema de Informação de Vigilância Epidemiológica da Gripe) was used to describe currently and recently pregnant women aged 10-49 years hospitalized for SARI from January through November, 2020. SARI cases were grouped into: COVID-19; influenza or other detected agent SARI; and SARI of unknown etiology. Characteristics, symptoms and outcomes were presented by SARI type and region. Binomial proportion and 95% confidence intervals (95% CI) for outcomes were obtained using the Clopper-Pearson method. Results: Of 945,460 SARI cases in the SIVEP-Gripe, we selected 11,074 women aged 10-49 who were pregnant (7964) or recently pregnant (3110). COVID-19 was confirmed in 49.4% cases; 1.7% had influenza or another etiological agent; and 48.9% had SARI of unknown etiology. The pardo race/ethnic group accounted for 50% of SARI cases. Hypertension/Other cardiovascular diseases, chronic respiratory diseases, diabetes, and obesity were the most common comorbidities. A total of 362 women with COVID-19 (6.6%; 95%CI 6.0-7.3) died. Mortality was 4.7% (2.2-8.8) among influenza patients, and 3.3% (2.9-3.8) among those with SARI of unknown etiology. The South-East, Northeast and North regions recorded the highest frequencies of mortality among COVID-19 patients. Conclusion: Mortality among pregnant and recently pregnant women with SARIs was elevated among those with COVID-19, particularly in regions where maternal mortality is already high.
Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Respiratory Tract Infections/epidemiology , COVID-19 , Brazil/epidemiology , Pregnant Women , SARS-CoV-2ABSTRACT
Objective To understand the epidemiological characteristics of common respiratory viruses among influenza-like illness (ILI) and severe acute respiratory infections (SARI) in Pudong New Area, Shanghai , so as to help estimate the disease burden and conduct the valuable control strategies . Methods Respiratory specimen ( throat swab or sputum ) from cases older than 65 years old with ILI/SARI were collected from outpatient and inpatient settings in four sentinel hospitals in Pudong New Area . Each specimen was tested by multiplex PCR for eight target viral etiologies , including influenza virus , human rhinoviruses ( HRV ) , human para-influenza virus ( PIV ) , adenoviruses ( ADV ) , respiratory syncytial virus ( RSV ) , human metapneumovirus ( hMPV ) , human coronavirus ( hCoV ) and human bocavirus ( hBoV) .Chi-square tests or Fisher's Exact Test were used to compare and analyze . Results From January 1st, 2014 to June 30st, 2016, a total of 363 elderly cases with ILI/SARI were enrolled, with 202 (55.65%) male and a median age of 70 years old.142(39.12%) patients were detected posi-tive for any one of the eight viruses.Influenza was the predominant virus (20.94%, 76/363), with the positive proportion of ( 29 .83%) among ILI cases and ( 12 .09%) among SARI cases .The Influenza infection presented two seasonal peaks in winter ( December to February ) and summer ( July to September ) . Conclusion Influenza is identified as the leading viral pathogen both among ILI and SARI cases older than 65 years old, and two seasonal epidemic peaks areobserved in Shanghai .Influenza vacci-nation strategy should be advocated for the elderly population in Shanghai .
ABSTRACT
El Metapneumovirus Humano (MPVh) ha sido asociado con Infecciones Respiratorias Agudas (IRA) en pacientes de todas las edades. Estudios epidemiológicos indican la prevalencia del MPVh alrededor del mundo, sin embargo, en Venezuela poco se conoce sobre su comportamiento en la población. Este estudio pretende describir el comportamiento epidemiológico de la infección por MPVh en pacientes venezolanos. Se evaluaron por RT-PCR multiplex 1812 hisopados nasales (HN) provenientes de pacientes con diagnóstico de IRA e IRA grave (IRAG) con resultados negativos a virus Influenza, referidos al INHRR entre los años 2010 y 2013. De los Virus Respiratorios no Influenza (VRnI), el MPVh resultó ser el cuarto virus mas detectado con una frecuencia de 9,1%. El 42,02 % de los casos positivos a MPVh fueron niños ≤ 5 años con 29 casos (29/69). Los pacientes positivos a MPVh cursaron IRA alta con fiebre, tos, congestión nasal, disnea/tiraje/rinorrea, malestar general y estridor; e IRAG con hospitalización (58%), neumonía (36,2%), bronquitis aguda (10,1%), bronconeumonía (2,8%), rinofaringitis y laringotraqueobronquitis en el 1,4%. El análisis filogenético de los MPVh demostró la aparente relación de los genotipos A2 y B2 con IRAG. Este estudio permite demostrar la importancia de la detección de otros agentes virales respiratorios y su posible relación con el desarrollo de IRA/IRAG, así como fortalece la vigilancia epidemiológica de las enfermedades respiratoria en Venezuela.
Human metapneumovirus (hMPV) has been associated with acute respiratory infections (ARI) in patients of all ages. Epidemiological studies indicate hMPV prevalence around the world, but in Venezuela little is known about its behavior in the population. This study aims to describe the epidemiological behavior of hMPV infection in Venezuelan patients. Were evaluated by RT-PCR multiplex 1812 nasal swabs (HN) from patients diagnosed with ARF and severe ARI (SARI) Influenza virus with negative results, referring to INHRR between 2010 and 2013. Of the non Respiratory Influenza Virus ( VRNI), the fourth hMPV virus proved more detected at a frequency of 9.1%. The 42.02% of hMPV positive cases were children ≤ 5 years with 29 cases (29/69). HMPV positive patients were enrolled IRA with high fever, cough, nasal congestion, dyspnea/ printing / rhinorrhea, malaise and stridor; and SARI inpatient (58%), pneumonia (36.2%), acute bronchitis (10.1%), bronchopneumonia (2.8%), nasopharyngitis and croup at 1.4%. Phylogenetic analysis of the hMPV showed the apparent relationship of the A2 and B2 genotypes with SARI. This study can prove the importance of the detection of other respiratory viral agents and their possible relationship with the development of IRA / SARI and strengthens epidemiological surveillance of respiratory diseases in Venezuela.