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4.
Washington; Organización Panamericana de la Salud; feb. 9, 2021. 3 p.
Non-conventional in Spanish | LILACS | ID: biblio-1151287

ABSTRACT

La secuenciación genómica ha sido una herramienta esencial para generar datos virológicos, impulsar la respuesta del laboratorio y comprender mejor los patrones evolutivos y de dispersión del SARS-CoV-2. Además de la caracterización de los patrones de circulación global, la detección temprana de las variantes del SARS-CoV-2 dentro de cada país es fundamental para complementar la vigilancia epidemiológica y virológica.


Subject(s)
Pneumonia, Viral/genetics , Coronavirus Infections/genetics , Pandemics/prevention & control , Betacoronavirus/isolation & purification , Specimen Handling , Epidemiological Monitoring
8.
Rev. bras. oftalmol ; 80(5): e0043, 2021. tab
Article in English | LILACS | ID: biblio-1347257

ABSTRACT

ABSTRACT Introduction: The SARS-CoV-2 pandemic has been a major challenge for the international scientific community. Since its inception, studies aiming to describe pathophysiological aspects and clinical manifestations of the disease have been conducted, raising hypotheses and confirming possible associations. One aspect of this scientific medical production is the role of the ocular surface as a means of transmission and clinical presentation of viral syndrome. Objectives: To analyze the role of the ocular surface in transmission, pathophysiology, and clinical manifestations of SARS-CoV-2, by means of a systematic review. Methods: The search was carried out in three databases: Cochrane, PubMed Central Journals and MEDLINE, using the following descriptors: "COVID-19, ophthalmology". The filters last five years and studies on humans resulted in 32 studies; in that 12 were excluded for not meeting the purpose of the study. Results: There are still few published studies on the relation between SARS-CoV-2 and the ocular route. Most studies showed an association between the presence of nonspecific ocular manifestations and infection by the new coronavirus, with limitations in the number of patients analyzed and the methodology adopted. Hypotheses about the pathophysiological role are largely anchored in the association of SARS-CoV and the ocular surface evaluated in the past. Comments: The results found are still not sufficient to confirm the role of the ocular surface in the pathophysiology of the disease. Most of these preliminary studies are of considerable importance in raising hypotheses based on the medical analysis of the patients studied. However, larger studies with standardized methodology for diagnostic protocol and laboratory analysis of the individuals assessed are required.


RESUMO Introdução: A pandemia da SARS-CoV-2 tem sido um grande desafio para a comunidade científica internacional. Desde seu surgimento, estudos com a intenção de descrever os aspectos fisiopatológicos e as manifestações clínicas da doença vêm sendo conduzidos, levantando hipóteses e confirmando possíveis associações. Um dos temas dessa produção médica científica é o papel da superfície ocular como meio de transmissão e apresentação clínica da síndrome viral. Objetivo: Analisar o papel da superfície ocular na transmissão, na fisiopatologia e nas manifestações clínicas de SARS-CoV-2, através de uma revisão sistemática. Realizou-se a busca em três bancos de dados Cochrane Database, PubMed® e MEDLINE®, utilizando os descritores "COVID-19 e ophthalmology". Foram definidos como filtros o artigo ter sido publicado nos últimos 5 anos e estudo realizado em humanos, tendo sido encontrados 32 artigos. Destes, foram excluídos 12 por não corresponderem ao objetivo do estudo. Resultados: Ainda são poucos os estudos publicados sobre a relação entre o coronavírus 2 da síndrome respiratória aguda grave (SARS-CoV-2) e a via ocular. A maioria dos estudos mostrou associação entre a presença de manifestações oculares inespecíficas e a infecção pelo novo coronavírus, com limitações no número de pacientes analisados e na metodologia adotada. Hipóteses sobre o papel fisiopatológico se ancoram, em grande parte, na associação estudada entre o SARS-CoV-2 e a superfície ocular no passado. Comentários: Os resultados encontrados ainda não são suficientes para confirmar o papel da superfície ocular na fisiopatologia da doença. Grande parte desses estudos preliminares têm importância considerável ao levantar hipóteses baseadas na análise clínica dos pacientes estudados. No entanto, são necessários estudos maiores e com metodologia padronizada para protocolo diagnóstico e análise laboratorial dos indivíduos avaliados.


Subject(s)
Humans , Eye Infections, Viral/transmission , Coronavirus Infections/complications , Coronavirus Infections/transmission , Eye Diseases/virology , Eye Manifestations , Tears/virology , Conjunctivitis, Viral/transmission , Conjunctiva/virology , Eye/virology , Betacoronavirus/isolation & purification , SARS-CoV-2 , COVID-19
10.
Rev. Assoc. Med. Bras. (1992) ; 66(12): 1621-1624, Dec. 2020.
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1143661

ABSTRACT

SUMMARY We present the case of 33 weeks + weeks pregnant patient (G1P0), with proven COVID-19 infection by RT-PCR and, at admission, she presented with a dry cough and "tiredness when talking,". Chest computed tomography was performed, which showed the presence of attenuations with ground glass opacification and bilateral consolidations. She then had a cesarean section because of maternal respiratory decompensation. She was transferred to the ICU of the same hospital with an O2 catheter. The newborn was transferred to the neonatal ICU of the same hospital in ambient air and maintained in respiratory and contact isolation. RT-PCR was collected for SARS-COV-2 at 6 h of life, which was positive. Faced with the knowledge gap on vertical transmission, RT-PCR for SARS-COV-2 at 6 h of life gives cause for concern, thus representing the possibility of vertical transmission by SARS-COV-2, although additional investigations are required.


RESUMO Apresentamos o caso de uma paciente grávida de 33 semanas + (G1P0), com infecção de COVID-19 comprovada por RT-PCR que, na admissão, apresentava tosse seca e "cansaço ao falar". Foi realizada tomografia computadorizada do tórax, que mostrou a presença de atenuações com opacidade em vidro fosco e consolidações bilaterais. Ela então passou por uma cesariana devido a descompensação respiratória materna. Em seguida, foi transferida para a UTI do mesmo hospital com um cateter de O2. O recém-nascido foi transferido para a UTI neonatal do mesmo hospital, em ar ambiente, e mantido em isolamento respiratório e de contato. Material para o RT-PCR para SARS-COV-2 foi coletado às 6h de vida, e o resultado do teste foi positivo. Perante a lacuna de conhecimento sobre a transmissão vertical, o resultado positivo do RT-PCR para SARS-COV-2 às 6h de vida é motivo de preocupação, pois representa uma possível transmissão vertical do SARS-COV-2, embora investigações adicionais sejam necessárias.


Subject(s)
Humans , Female , Pregnancy , Child, Preschool , Pregnancy Complications, Infectious/virology , Coronavirus Infections/transmission , Infectious Disease Transmission, Vertical , Cesarean Section , Coronavirus Infections , Betacoronavirus/isolation & purification
11.
Medwave ; 20(11)dic. 2020.
Article in English | LILACS | ID: biblio-1146034

ABSTRACT

OBJETIVO Proporcionar un resumen oportuno, riguroso y continuamente actualizado de la evidencia disponible sobre el papel de los macrólidos para el tratamiento de pacientes con COVID-19. DIDEÑO Revisión Sistemática Viva. BASE DE DATOS: La búsqueda de evidencia se realizó en el repositorio centralizado L·OVE (Living OVerview of Evidence) COVID-19; una plataforma que mapea las preguntas PICO para identificar la evidencia en la base de datos Epistemonikos. En respuesta a la emergencia de COVID-19, L·OVE se adaptó para ampliar el rango de evidencia que cubre y hoy se mantiene a través de búsquedas regulares en 39 bases de datos. MÉTODOS: Se incluyeron estudios experimentales que evaluaban el efecto de los macrólidos, como monoterapia o en combinación con otros fármacos, versus placebo o ningún tratamiento en pacientes con sospecha o confirmación de COVID-19. Se buscó identificar experimentos clínicos aleatorizados que evaluaran macrólidos en infecciones causadas por otros coronavirus, como MERS-CoV y SARS-CoV. Dos revisores examinaron de forma independiente la elegibilidad de cada estudio, extrajeron los datos y evaluaron el riesgo de sesgo. Se evaluó el efecto de los macrólidos sobre la mortalidad por todas las causas; necesidad de ventilación mecánica invasiva; oxigenación por membrana extracorpórea, duración de la estancia hospitalaria, insuficiencia respiratoria, eventos adversos graves, tiempo hasta la negatividad de la RT-PCR del SARS-CoV-2. La certeza de la evidencia para cada desenlace se evaluó siguiendo la aproximación GRADE. Esta revisión se mantendrá viva y disponible abiertamente durante la pandemia de COVID-19. Se someterán actualizaciones de su publicación cada vez que cambien las conclusiones o cuando haya actualizaciones sustanciales. RESULTADOS: Se identificó un experimento clínico aleatorio que evaluó el uso de azitromicina en combinación con hidroxicloroquina en comparación con el uso de hidroxicloroquina sola, en pacientes hospitalizados por COVID 19. Las estimaciones para todos los resultados evaluados resultaron en un poder estadístico insuficiente para llegar a conclusiones válidas. La calidad de la evidencia para los resultados principales fue baja a muy baja. CONCLUSIONES: El uso de macrólidos en el tratamiento de pacientes con COVID 19 no ha mostrado efectos beneficiosos en comparación con el tratamiento estándar. La evidencia para todos los desenlaces no es concluyente. Se necesitan estudios sobre un mayor número de pacientes con COVID 19, para determinar los efectos del uso de macrólidos sobre los desenlaces relacionados con la enfermedad.


OBJECTIVE This living, systematic review aims to provide a timely, rigorous, and continuously updated summary of the evidence available on the role of macrolides for treating patients with COVID-19. DESIGN: a living, systematic review. DATABASE: We conducted searches in the centralized repository L·OVE (Living OVerview of Evidence). L·OVE is a platform that maps PICO questions to evidence from the Epistemonikos database. In response to the COVID-19 emergency, L·OVE was adapted to expand the range of evidence it covers and customized to group all COVID-19 evidence in one place. Today it is maintained through regular searches in 39 databases.METHODS: We included randomized trials evaluating the effect of macrolides ­ as monotherapy or in combination with other drugs ­ versus placebo or no treatment in patients with COVID-19. Randomized trials evaluating macrolides in infections caused by other coronaviruses, such as MERS-CoV and SARS-CoV, and non-randomized studies in COVID-19 were searched in case we found no direct evidence from randomized trials. Two reviewers independently screened each study for eligibility, extracted data, and assessed the risk of bias. Measures included all-cause mortality; the need for invasive mechanical ventilation; extracorporeal membrane oxygenation, length of hospital stay, respiratory failure, serious adverse events, time to SARS-CoV-2 RT-PCR negativity. We applied the GRADE approach to assess the certainty of the evidence for each outcome. A living, web-based version of this review will be openly available during the COVID-19 pandemic. We will resubmit it every time the conclusions change or whenever there are substantial updates. RESULTS: The search in the L·OVE platform retrieved 424 references. We considered 260 as potentially eligible and were reviewed in full texts. We included one randomized clinical trial that evaluated the use of azithromycin in combination with hydroxychloroquine compared to hydroxychloroquine alone in hospitalized patients with COVID 19. The estimates for all outcomes evaluated resulted in insufficient power to draw conclusions. The quality of the evidence for the main outcomes was low to very low. CONCLUSIONS: Macrolides in the management of patients with COVID 19 showed no beneficial effects compared to standard of care. The evidence for all outcomes is inconclusive. Larger trials are needed to determine the effects of macrolides on pulmonary and other outcomes in COVID-19 patients.


Subject(s)
Humans , Pneumonia, Viral/drug therapy , Coronavirus Infections/drug therapy , Macrolides/therapeutic use , Pneumonia, Viral/mortality , Respiration, Artificial/statistics & numerical data , Randomized Controlled Trials as Topic , Treatment Outcome , Coronavirus Infections/mortality , Betacoronavirus/isolation & purification
12.
Medwave ; 20(10)18 nov. 2020.
Article in English, Spanish | LILACS | ID: biblio-1145808

ABSTRACT

Objetivo Proporcionar una revisión de la literatura sobre la presencia de SARS-CoV-2 en los fluidos sexuales de pacientes con COVID-19 y su posible transmisión sexual de manera oportuna, rigurosa y continuamente actualizada. Fuentes de datos Realizaremos búsquedas en PubMed / Medline, Embase, Registro Cochrane Central de Ensayos Controlados (CENTRAL), literatura gris y en un repositorio centralizado en L · OVE (Living OVerview of Evidence). L · OVE es una plataforma que mapea las preguntas PICO a la evidencia de la base de datos Epistemonikos. En respuesta a la emergencia de COVID-19, L · OVE se adaptó para ampliar el rango de evidencia que cubre y se personalizó para agrupar todas las pruebas de COVID-19 en un solo lugar. La búsqueda cubrirá el período hasta el día anterior al envío a una revista. Criterios de elegibilidad para la selección de estudios y métodos Adaptamos un protocolo común ya publicado para múltiples revisiones sistemáticas paralelas a las especificidades de esta pregunta. Incluiremos ensayos aleatorios que evalúen la transmisión sexual del virus SARS-CoV-2. Se buscarán ensayos aleatorizados que evalúen la transmisión sexual de otros coronavirus, como MERS-CoV y SARS-CoV, y estudios no aleatorizados en COVID-19 en caso de que no se encuentre evidencia directa de ensayos aleatorizados, o si la evidencia directa proporciona una - o certeza muy baja para resultados críticos. Dos revisores evaluarán de forma independiente la elegibilidad de cada estudio, extraerán datos y evaluarán el riesgo de sesgo. Realizaremos metanálisis de efectos aleatorios y utilizaremos GRADE para evaluar la certeza de la evidencia para cada resultado. Una versión viva basada en la web de esta revisión estará disponible abiertamente durante la pandemia de COVID-19. Lo volveremos a enviar si las conclusiones cambian o hay actualizaciones sustanciales Registro PROSPERO (CRD42020189368).


Subject(s)
Humans , Pneumonia, Viral/transmission , Sexually Transmitted Diseases, Viral/transmission , Coronavirus Infections/transmission , Betacoronavirus/isolation & purification , Pneumonia, Viral/epidemiology , Research Design , Coronavirus Infections/epidemiology , Controlled Clinical Trials as Topic , Systematic Reviews as Topic
13.
Washington; Organización Panamericana de la Salud; Oct. 27, 2020. 4 p.
Non-conventional in Spanish | LILACS | ID: biblio-1127580

ABSTRACT

Este documento brinda consideraciones prácticas para la implementación de la prueba rápida de detección de antígenos (Ag-RDT) para COVID-19 en la Región de las Américas. Se han publicado consideraciones generales para el uso de las Ag-RDT en el diagnóstico de la infección por SARS-CoV-2 (1, 2), y varios ensayos se han evaluado de forma independiente y / o se han incluido en el Listado de Uso de Emergencia de la OMS. La evidencia científica y técnica sobre la detección de la infección por SARS-CoV-2 está evolucionando con rapidez; este documento se actualizará según sea necesario.


Subject(s)
Pneumonia, Viral/diagnosis , Polymerase Chain Reaction/methods , Coronavirus Infections/diagnosis , Pandemics/prevention & control , Betacoronavirus/isolation & purification
14.
Washington; Organización Panamericana de la Salud; Oct. 27, 2020. 6 p.
Non-conventional in Spanish | LILACS | ID: biblio-1127581

ABSTRACT

A través de este documento, la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) alienta a los Estados Miembros a recopilar evidencia sobre los casos de reinfección por el SARS-CoV-2, con el fin de contribuir a ampliar el conocimiento de la COVID-19 y en consecuencia con su prevención, control y manejo clínico.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Pandemics/prevention & control , Epidemiological Monitoring , Betacoronavirus/isolation & purification
15.
Rev. bras. ginecol. obstet ; 42(9): 562-568, Sept. 2020.
Article in English | LILACS | ID: biblio-1137873

ABSTRACT

Abstract Objective The present comprehensive review aims to show the full extent of what is known to date and provide a more thorough view on the effects of SARS-CoV2 in pregnancy. Methods Between March 29 and May, 2020, the words COVID-19, SARS-CoV2, COVID- 19 and pregnancy, SARS-CoV2 and pregnancy, and SARS and pregnancy were searched in the PubMed and Google Scholar databases; the guidelines from well-known societies and institutions (Royal College of Obstetricians and Gynaecologists [RCOG], American College of Obstetricians and Gynecologists [ACOG], International Society of Ultrasound in Obstetrics & Gynecology [ISUOG], Centers for Disease Control and Prevention [CDC], International Federation of Gynecology and Obstetrics [FIGO]) were also included. Conclusion The COVID-19 outbreak resulted in a pandemic with > 3.3 million cases and 230 thousand deaths until May 2nd. It is caused by the SARS-CoV2 virus and may lead to severe pulmonary infection and multi-organ failure. Past experiences show that unique characteristics in pregnancy make pregnant women more susceptible to complications from viral infections. Yet, this has not been reported with this new virus. There are risk factors that seem to increase morbidity in pregnancy, such as obesity (body mass index [BMI] > 35), asthma and cardiovascular disease. Current reports describe an increased rate of pretermbirth and C-section. Vertical transmission


Resumo Objetivo A presente revisão detalhada busca fornecer dados objetivos para avaliar o que se sabe até o momento e possibilitar uma visãomais ampla dos efeitos do SARSCoV2 na gravidez. Métodos Entre 29 demarço e 2 de maio de 2020, foi realizada uma busca nos bancos de dados PubMed e Google Scholar com as palavras COVID-19, SARS-CoV2, COVID-19 e gravidez, SARS-CoV2 e gravidez, e SARS e gravidez. As recomendações dos principais órgãos sobre o tema também foram acessadas. Conclusão O surto de COVID-19 resultou em uma pandemia com> 3.3 milhões de casos e 230 mil mortes até 2 de maio. É uma condição causada pelo vírus SARS-CoV2 e pode levar ao acometimento pulmonar difuso e à falência de múltiplos órgãos. Características únicas da gestante tornam essa população mais propensas a complicações de infecções virais. Até o momento, essa tendência não foi observada para esse novo vírus. Os fatores que parecem estar associados à maior morbidade materno-fetal são obesidade (índice demassa corporal [IMC] > 35), asma e doença cardiovascular. Há descrição de aumento de parto prematuro e parto cesáreo. Não se pode descartar a possibilidade de transmissão vertical da doença, devido a relatos de positividade de reação em cadeia de polimerase (RT-PCR) de swab nasal, RT-PCR de líquido amniótico e imunoglobulina M (IgM) de recém-nascidos. Tratamentos devem ser analisados caso a caso, dada a falta de qualidade de estudos que comprovem a sua eficácia e segurança na gravidez. O corpo clínico deve utilizar equipamentos de proteção individual (EPI) ao manusear pacientes suspeitos ou confirmados e ficar atento aos sinais de descompensação respiratória.


Subject(s)
Humans , Female , Pregnancy , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Pneumonia, Viral/transmission , Pneumonia, Viral/epidemiology , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/therapy , Pregnancy Complications, Infectious/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Coronavirus Infections/transmission , Coronavirus Infections/epidemiology , Pandemics , Betacoronavirus/isolation & purification , Cesarean Section/statistics & numerical data , Global Health , Risk Factors , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Perinatal Care/methods , Infectious Disease Transmission, Vertical/prevention & control , Premature Birth/epidemiology , Premature Birth/virology , SARS-CoV-2 , COVID-19
16.
J. Health NPEPS ; 5(2)set. 2020.
Article in Portuguese | LILACS, BDENF | ID: biblio-1120029

ABSTRACT

Objetivo: verificar a persistência do SARS-CoV-2 nas diferentes superfícies e medidas preventivas contra a transmissão do vírus. Método: revisão sistemática norteada pelo método PRISMA. Foram utilizadas as bases de buscas PubMed e LILACS de janeiro a junho de 2020, com os descritores: "2019-nCOV" OR "SARS-CoV-2" OR "COVID-19" AND "transmission" OR "transmission route" AND "viability" AND "surface" OR "inanimate surface" AND "prevention". As informações extraídas foram autor/ano, país, tipo de publicação, nome da revista, idioma, país da publicação e base de dados. Resultados: foram identificadas 178 publicações, com exclusão de 164 artigos, nove por idioma, 12 por outras doenças e/ou patógenos e 143 pelo título e/ou resumo. Foram incluídos 14 artigos qualitativos, oito artigos de revisões narrativas, uma comunicação breve, dois artigos originais e um editorial. Treze artigos foram publicados em inglês e um em português. Conclusão: coronavírus humanos (HCoV 229E) podem se manter em diferentes superfícies durante duas horas até nove dias. Baixas temperaturas e reduzida umidade relativa do ar favorecem a sobrevivência do SARS-CoV-2, sendo mais estável em plásticos e aço inoxidável do que em cobre e papelão. A recomendação é higienização de superfícies e mãos com água, sabão ou higienizadores à base de álcool.(AU)


Objective: to verify the persistence of SARS-CoV-2 on different types of surfaces and the preventive measures against the transmission of the virus. Method: a systematic review was carried out, using the PRISMA method. The PubMed and LILACS databases from January to June 2020 were used, with the following descriptors: "2019-nCOV" OR "SARS-CoV-2" OR "COVID-19" AND "transmission" OR "transmission route" AND "viability" AND "surface" OR "inanimate surface" AND "prevention". Information extracted was author/year, country, type of publication, journal name, language, country of publication and database. Results: 178 publications were identified. 164 articles were excluded, nine by language, 12 by other diseases and/or pathogens and 143 by title and/or abstract. 14 qualitative articles were included, eight articles of narrative reviews, one short communication, two original articles and one editorial. Thirteen articles were published in English and one in Portuguese. Conclusion: human coronaviruses (HCoV 229E) can persist on different surfaces for two hours up to nine days. Low temperatures and low relative humidity of the air favor the survival of SARS-CoV-2, which is more stable on plastics and on stainless steel than on copper and cardboard. The recommendation is frequent surface and hand hygiene with water, soap or alcohol-based rubs.(AU)


Objetivo: verificar la persistencia del SARS-CoV-2 en diferentes superficies y las medidas preventivas contra la transmisión del virus. Método: se realizó una revisión sistemática, utilizando el método PRISMA. Se utilizaron las bases de datos de búsqueda de PubMed y LILACS de enero a junio de 2020, con los descriptores: "2019-nCOV" O "SARS-CoV-2" O "COVID-19" Y "transmisión" O "ruta de transmisión" Y "viabilidad" Y "superficie" O "superficie inanimada" Y "prevención". Las informaciones extraídas fueron autor / año, país, tipo de publicación, nombre de la revista, idioma, país de publicación y base de datos. Resultados: se identificaron 178 publicaciones. Se excluyeron 164 artículos, nueve por idioma, 12 por otras enfermedades y/o patógenos y 143 por título y/o resumen, incluidos 14 artículos cualitativos, ocho artículos de revisiones narrativas, una comunicación breve, dos artículos originales y uno editorial. Se publicaron trece artículos en inglés y uno en portugués. Conclusión: los coronavirus humanos (HCoV 229E) pueden matenerse en diferentes superficies durante dos horas hasta nueve días. Las bajas temperaturas y la reducida humedad relativa del aire favorecen la supervivencia del SARS-CoV-2, siendo más estable en plásticos y acero inoxidable que en cobre y carton. La recomendación es limpiar superficies y manos con agua, jabón o limpiadores a base de alcohol.(AU)


Subject(s)
Humans , Coronavirus Infections/prevention & control , Disease Prevention , Microbial Viability , Betacoronavirus/isolation & purification , Hand Hygiene
17.
Gac. méd. Méx ; 156(4): 348-351, Jul.-Aug. 2020. graf
Article in English | LILACS | ID: biblio-1249923

ABSTRACT

Abstract Introduction: Reports of dermatological manifestations in patients with COVID-19 suggest a possible cutaneous tropism of SARS-CoV-2; however, the capacity of this virus to infect the skin is unknown. Objective: To determine the susceptibility of the skin to SARS-CoV-2 infection based on the expression of viral entry factors ACE2 and TMPRSS2 in this organ. Method: A comprehensive analysis of human tissue gene expression databases was carried out looking for the presence of the ACE2 and TMPRSS2 genes in the skin. mRNA expression of these genes in skin-derived human cell lines was also assessed. Results: The analyses showed high co-expression of ACE2 and TMPRSS2 in the gastrointestinal tract and kidney, but not in the skin. Only the human immortalized keratinocyte HaCaT cell line expressed detectable levels of ACE2, and no cell line originating in the skin expressed TMPRSS2. Conclusions: Our results suggest that cutaneous manifestations in patients with COVID-19 cannot be directly attributed to the virus. It is possible that cutaneous blood vessels endothelial damage, as well as the effect of circulating inflammatory mediators produced in response to the virus, are the cause of skin involvement.


Resumen Introducción: Reportes de manifestaciones dermatológicas en pacientes con COVID-19 sugieren un posible tropismo cutáneo del virus SARS-CoV-2; sin embargo, se desconoce la capacidad de este virus para infectar la piel. Objetivo: Determinar la susceptibilidad de la piel a la infección por SARS-CoV-2 con base en la expresión de los factores de entrada viral ACE2 y TMPRSS2 en dicho órgano. Método: Se buscaron los genes ACE2 y TMPRSS2 en la piel, para lo cual se realizó un análisis extenso de las bases de datos de expresión genética en tejidos humanos. Asimismo, se evaluó la expresión de dichos genes en líneas celulares humanas derivadas de la piel. Resultados: Los análisis mostraron alta expresión conjunta de ACE2 y TMPRSS2 en el tracto gastrointestinal y en los riñones, pero no en la piel. Solo la línea celular de queratinocitos humanos inmortalizados HaCaT expresó niveles detectables de ACE2 y ninguna línea celular de origen cutáneo expresó TMPRSS2. Conclusiones: Los resultados sugieren que las manifestaciones dermatológicas en pacientes con COVID-19 no pueden ser atribuidas directamente al virus; es posible que sean originadas por el daño endotelial a los vasos sanguíneos cutáneos y el efecto de los mediadores inflamatorios circulantes producidos en respuesta al virus.


Subject(s)
Humans , Pneumonia, Viral/complications , Serine Endopeptidases/genetics , Skin Diseases, Viral/virology , Coronavirus Infections/complications , Peptidyl-Dipeptidase A/genetics , Pneumonia, Viral/genetics , Skin/virology , Cell Line , Gene Expression Regulation , Coronavirus Infections/genetics , Genetic Predisposition to Disease , Virus Internalization , Viral Tropism/physiology , Pandemics , Betacoronavirus/isolation & purification , Angiotensin-Converting Enzyme 2 , SARS-CoV-2 , COVID-19
18.
Gac. méd. Méx ; 156(4): 335-339, Jul.-Aug. 2020.
Article in English | LILACS | ID: biblio-1249921

ABSTRACT

Abstract The disease caused by the new SARS-CoV-2 coronavirus (COVID-19) spread rapidly from China to the entire world. Approximately one third of SARS-CoV-2-infected patients have neurological disorders, especially those classified as severe cases and that require mechanical ventilation. On the other hand, almost nine out of 10 patients admitted to an Intensive Care Unit could not breathe spontaneously, thus requiring invasive and non-invasive ventilatory support. So far, whether early neurological disorders such as hyposmia or anosmia, dysgeusia or ageusia, headache and vertigo are significant in the progression to the severe form of the disease or whether they are related to entry to the central nervous system via peripheral nerves has not been determined. Considering the great similarity between SARS-CoV and SARS-CoV-2, and that the severity of the condition that leads to death cannot be explained solely by lung involvement, it is important to determine whether SARS-CoV-2 potential invasion to the central nervous system is partially responsible for the severe respiratory component observed in patients with COVID-19.


Resumen La enfermedad (COVID-19) producida por el nuevo coronavirus SARS-CoV-2 se extendió rápidamente desde China a todo el mundo. Aproximadamente una tercera parte de los pacientes infectados de SARS-CoV-2 presenta alteraciones neurológicas, con mayor frecuencia los clasificados como graves que requirieron ventilación mecánica. Por otro lado, casi nueve de cada 10 pacientes admitidos en una unidad de cuidados intensivos no podían respirar espontáneamente, por lo que ameritaron apoyo ventilatorio invasivo y no invasivo. Hasta el momento no se ha determinado si las alteraciones neurológicas tempranas como la hiposmia o anosmia, disgeusia o ageusia, cefalea y vértigo son significativas en la progresión a la forma grave de la enfermedad y se relacionan con la entrada al sistema nervioso central a través de los nervios periféricos. Considerando la gran similitud entre SARS-CoV y SARS-CoV-2 y que la severidad del cuadro que conduce a la muerte no puede ser explicado únicamente por la afección pulmonar, es importante determinar si la invasión potencial del SARS-CoV-2 al sistema nervioso central es parcialmente responsable del componente respiratorio severo que presentan los pacientes con COVID-19.


Subject(s)
Humans , Pneumonia, Viral/complications , Coronavirus Infections/complications , Betacoronavirus/isolation & purification , Nervous System Diseases/virology , Pneumonia, Viral , Pneumonia, Viral/epidemiology , Respiration, Artificial/statistics & numerical data , Severity of Illness Index , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Disease Progression , Viral Tropism , Pandemics , SARS-CoV-2 , COVID-19 , Intensive Care Units/statistics & numerical data , Nervous System Diseases , Nervous System Diseases/physiopathology
19.
Gac. méd. Méx ; 156(4): 330-334, Jul.-Aug. 2020.
Article in English | LILACS | ID: biblio-1249920

ABSTRACT

Abstract COVID-19 arrived to Latin America early in March 2020. Currently, strategies are being developed in Colombia focusing on the quarantine and social and economic capital reactivation, whereby the expected results are not being obtained. In this article, we propose to review scientific evidence-based literature where information on the operation and adaptation of health systems, and social, economic and solidarity sectors of Colombia is presented. The purpose is to identify COVID-19 implications in the network that provides health services, quality of life and health-disease prognosis in the country, which is not prepared to face crises of social nature and of health systems, as well as the economic and solidarity impacts that are brought about by pandemics and crude episodes of disease.


Resumen COVID-19 llegó a Latinoamérica a principios de marzo de 2020. Actualmente, en Colombia se desarrollan estrategias enfocadas en la cuarentena y la reactivación del capital social y económico, con las cuales no se están obteniendo los resultados esperados. En este artículo se propone revisar literatura basada en evidencia científica en la que se exponga información del funcionamiento y adaptación de los sistemas de salud, sectores sociales, económicos y solidarios de Colombia. El objetivo es identificar las implicaciones de COVID-19 en la red prestadora de servicios de salud, calidad de vida, pronóstico de salud-enfermedad en el país, el cual no está preparado para afrontar crisis de orden social, de sistemas de salud e impactos económicos y solidarios que conllevan las pandemias y episodios graves de enfermedad.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Public Health , Coronavirus Infections/epidemiology , Delivery of Health Care/organization & administration , Quality of Life , Colombia/epidemiology , Pandemics , Betacoronavirus/isolation & purification , SARS-CoV-2 , COVID-19
20.
Gac. méd. Méx ; 156(4): 324-329, Jul.-Aug. 2020. graf
Article in English | LILACS | ID: biblio-1249919

ABSTRACT

Abstract In the efforts to explain COVID-19 pathophysiology, studies are being carried out on the correspondence between the expression of SARS-CoV-2 cell receptors and viral sequences. ACE2, CD147 and TMPRSS2 receptors expression could indicate poorly explored potential infection targets. For the genomic analysis of SARS-CoV-2 receptors, using BioGPS information was decided, which is a portal that centralizes genetic annotation resources, in combination with that of The Human Protein Atlas, the largest portal of human transcriptome and proteome data. We also reviewed the most recent articles on the subject. RNA and viral receptor proteins expression was observed in numerous anatomical sites, which partially coincides with the information reported in the literature. High expression in testicular cells markedly stood out, and it would be therefore important ruling out whether this anatomical site is a SARS-CoV-2 reservoir; otherwise, germ cell damage, as it is observed in infections with other RNA viruses, should be determined.


Resumen En el afán por explicar la fisiopatogenia de COVID-19 se están realizando estudios en torno a la correspondencia entre la expresión de receptores celulares de SARS-CoV-2 y las secuencias virales. La expresión de los receptores ACE2, CD147 y TMPRSS2 podría indicar blancos de infección poco explorados. Para el análisis genómico de los receptores de SARS-CoV-2 se optó por utilizar la información del BioGPS, un portal que centraliza los recursos de anotación genética, en combinación con la de The Human Protein Atlas, el portal más grande de datos del transcriptoma y proteoma humanos. También se revisaron los artículos más recientemente respecto al tema. En numerosos sitios anatómicos se observó la expresión de ARN y proteínas de los receptores del virus, que coinciden parcialmente con la información reportada en la literatura. Resaltó la alta expresión en las células de los testículos, por lo que sería importante descartar si este sitio anatómico es un reservorio de SARS-CoV-2; de no ser así, determinar el daño en las células germinales, tal como sucede en infecciones por otros virus ARN.


Subject(s)
Humans , Pneumonia, Viral/virology , Testis/virology , Coronavirus Infections/virology , Betacoronavirus/isolation & purification , Pneumonia, Viral/physiopathology , Serine Endopeptidases/genetics , Gene Expression Regulation , Virus Latency , Coronavirus Infections/physiopathology , Peptidyl-Dipeptidase A/genetics , Basigin/genetics , Pandemics , Angiotensin-Converting Enzyme 2 , SARS-CoV-2 , COVID-19
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