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Rev. bras. ter. intensiva ; 33(4): 544-548, out.-dez. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1357198


RESUMO Objetivo: Avaliar o impacto no número de casos de oxigenação por membrana extracorpórea e as taxas de sobrevivência nos anos seguintes à pandemia de H1N1 de 2009. Métodos: Avaliaram-se dois períodos distintos de utilização de oxigenação por membrana extracorpórea como suporte para insuficiência respiratória em crianças, por meio da análise de conjuntos de dados da Extracorporeal Life Support Organization. Foram construídos modelos autorregressivos integrados de médias móveis para estimar os efeitos da pandemia. O ano de 2009 foi o ano de intervenção (epidemia de H1N1) em um modelo de séries temporais interrompidas. Os dados colhidos entre 2001 e 2010 foram considerados pré-intervenção e os obtidos entre 2010 e 2017 como pós-intervenção. Resultados: Em comparação com o período entre 2001 e 2010, o período entre 2010 e 2017 mostrou aumento das taxas de sobrevivência (p < 0,0001), com melhora significante da sobrevivência quando se realizou oxigenação por membrana extracorpórea nos casos de insuficiência aguda por pneumonia viral. Antes do ponto de nível de efeito (2009), o modelo autorregressivo integrado de médias móveis mostrou aumento de 23 casos de oxigenação por membrana extracorpórea ao ano. Em termos de sobrevivência, a curva mostra que não houve aumento significante das taxas de sobrevivência antes de 2009 (p = 0,41), porém o nível de efeito foi próximo à significância após 2 anos (p = 0,05), com aumento de 6% na sobrevivência. Em 4 anos, ocorreu aumento de 8% (p = 0,03) na sobrevivência, e, 6 anos após 2009, a sobrevivência mostrou aumento de até 10% (p = 0,026). Conclusão: Nos anos após 2009, ocorreu significante e progressivo aumento global das taxas de sobrevivência com oxigenação por membrana extracorpórea para todos os casos, principalmente em razão de melhoras tecnológicas e dos protocolos de tratamento para insuficiência respiratória aguda relacionada à pneumonia viral e a outras condições respiratórias.

ABSTRACT Objective: To evaluate whether there was any impact on the number of pediatric extracorporeal membrane oxygenation runs and survival rates in the years subsequent to the 2009 pandemic. Methods: We studied two different periods of extracorporeal membrane oxygenation support for respiratory failure in children by analyzing datasets from the Extracorporeal Life Support Organization. Autoregressive integrated moving average models were constructed to estimate the effect of the pandemic. The year 2009 was the year of intervention (the H1N1 epidemic) in an interrupted time series model. Data collected from 2001 - 2010 were considered preintervention, and data collected from 2010 - 2017 were considered postintervention. Results: There was an increase in survival rates in the period 2010 - 2017 compared to 2001 - 2010 (p < 0.0001), with a significant improvement in survival when extracorporeal membrane oxygenation was performed for acute respiratory failure due to viral pneumonia. The autoregressive integrated moving average model shows an increase of 23 extracorporeal membrane oxygenation runs per year, prior to the point of the level effect (2009). In terms of survival, the preslope shows that there was no significant increase in survival rates before 2009 (p = 0.41), but the level effect was nearly significant after two years (p = 0.05), with a 6% increase in survival. In four years, there was an 8% (p = 0.03) increase in survival, and six years after 2009, there was up to a 10% (p = 0.026) increase in survival. Conclusion: In the years following 2009, there was a significant, global incremental increase in the extracorporeal membrane oxygenation survival rates for all runs, mainly due to improvements in the technology and treatment protocols for acute respiratory failure related to viral pneumonia and other respiratory conditions.

Humans , Child , Respiratory Distress Syndrome, Newborn , Respiratory Insufficiency/therapy , Respiratory Insufficiency/epidemiology , Extracorporeal Membrane Oxygenation , Influenza A Virus, H1N1 Subtype , Retrospective Studies , Pandemics
J. pediatr. (Rio J.) ; 97(4): 369-377, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1287046


Abstract Objective This was a systematic review of studies that examined the impact of epidemics or social restriction on mental and developmental health in parents and children/adolescents. Source of data The PubMed, WHO COVID-19, and SciELO databases were searched on March 15, 2020, and on April 25, 2020, filtering for children (0-18 years) and humans. Synthesis of data The tools used to mitigate the threat of a pandemic such as COVID-19 may very well threaten child growth and development. These tools — such as social restrictions, shutdowns, and school closures — contribute to stress in parents and children and can become risk factors that threaten child growth and development and may compromise the Sustainable Development Goals. The studies reviewed suggest that epidemics can lead to high levels of stress in parents and children, which begin with concerns about children becoming infected. These studies describe several potential mental and emotional consequences of epidemics such as COVID-19, H1N1, AIDS, and Ebola: severe anxiety or depression among parents and acute stress disorder, post-traumatic stress, anxiety disorders, and depression among children. These data can be related to adverse childhood experiences and elevated risk of toxic stress. The more adverse experiences, the greater the risk of developmental delays and health problems in adulthood, such as cognitive impairment, substance abuse, depression, and non-communicable diseases. Conclusion Information about the impact of epidemics on parents and children is relevant to policy makers to aid them in developing strategies to help families cope with epidemic/pandemic-driven adversity and ensure their children's healthy development.

Humans , Child , Adolescent , Adult , Child Development , COVID-19 , Anxiety , Parents , Influenza A Virus, H1N1 Subtype , Pandemics , SARS-CoV-2
Medicina (B.Aires) ; 81(3): 389-395, jun. 2021. graf
Article in English | LILACS | ID: biblio-1346474


Abstract Influenza infection is a latent public health problem, affecting millions of people throughout the world, which imposes high morbidity and economic burden on the region. In Argentina, influenza‐associ ated mortality is estimated at 6/100 000 person‐years, and is higher among men ≥ 65 years old. The knowledge of the baseline characteristics and outcomes of hospitalized patients is crucial for public health officials planning interventions to address local outbreaks. Thus, in this retrospective, single-center study, performed in a high-complexity university hospital, we aimed to analyze clinical characteristics, image findings, and laboratory variables of patients with laboratory-confirmed influenza requiring hospitalization in our hospital during 2019. Cases were confirmed by real-time reverse transcription-polymerase chain reaction. One hundred and forty-three patients with influenza were hospitalized during the study period; 141 (98.6%) were infected with influenza virus type A, including 88 (61.5%) with the H1N1 subtype. The median age was 71 years (IQR 60- 82), 111 (77.6%) were older than 70 years, and 126 (88.1%) had at least one coexisting illness; 56 (39.1%) patients required intensive care unit, 16 (11.1%) invasive mechanical ventilation, and 6 (4.1%) died during hospitalization. In this study, in-hospital mortality was similar to that reported in previous series of non-pandemic influenza, even though the majority of the cases in this study were older than 70 years and had at least one coexisting illness.

Resumen La influenza es un problema latente de salud pública que afecta a millones de personas en todo el planeta e impone una alta morbilidad y carga económica para la región. En Argentina, la mortalidad asociada a la influenza se estima en 6/100 000 personas-año y es mayor entre los hombres mayores de 65 años. El conocimiento de las características clínicas y la evolución de los pacientes hospitalizados es fundamental para planificar el abordaje de los brotes locales. En este estudio retrospectivo, realizado en un hospital universitario de alta complejidad, nuestro objetivo fue analizar las características clínicas, los hallazgos de imágenes y las variables de laboratorio en 143 pacientes con influenza confirmada por laboratorio que requirieron hospitalización durante 2019. Los casos fueron confirmados mediante la reacción en cadena de la polimerasa con transcripción inversa en tiempo real. El 98.6% (n: 141) estaban infectados por influenza tipo A y 61.5% (n: 88) correspondía al subtipo H1N1. La mediana de edad fue 71 años (IQR 60-82), el 77.6% (n: 111) tenía más de 70 años y el 88.1% (n: 126) al menos una enfermedad coexistente. El 39.1% (n: 56) requirió internación en unidad de cuidados intensivos, el 11.1% (n: 16) ventilación mecánica invasiva y seis pacientes (4.1%) fallecieron durante la hospitalización. En este estudio, la mortalidad hospitalaria fue similar a la publicada en series previas de influenza no pandémica, aunque la mayoría de los pacientes eran mayores de 70 años y presentaban al menos una enfermedad coexistente.

Humans , Male , Aged , Influenza, Human/epidemiology , Influenza A Virus, H1N1 Subtype , Argentina/epidemiology , Seasons , Retrospective Studies , Hospitalization
Rev. Assoc. Med. Bras. (1992) ; 67(1): 115-119, Jan. 2021. tab, graf
Article in English | LILACS | ID: biblio-1287787


SUMMARY OBJECTIVE: We aimed to compare the clinical, epidemiological, and prognostic features of the H1N1 pandemic in 2009 and the severe acute respiratory syndrome coronavirus 2 pandemic in 2020. METHODS: This retrospective study involved subjects from seven centers that were admitted and found to be positive for H1N1 or COVID-19 real-time polymerase chain reaction test. RESULTS: A total of 143 patients with H1N1 and 309 patients with COVID-19 were involved in the study. H1N1 patients were younger than COVID-19 ones. While 58.7% of H1N1 patients were female, 57.9% of COVID-19 patients were male. Complaints of fever, cough, sputum, sore throat, myalgia, weakness, headache, and shortness of breath in H1N1 patients were statistically higher than in COVID-19 ones. The duration of symptoms until H1N1 patients were admitted to the hospital was shorter than that for COVID-19 patients. Leukopenia was more common in COVID-19 patients. C-reactive protein levels were higher in COVID-19 patients, while lactate dehydrogenase levels were higher in H1N1 ones. The mortality rate was also higher in H1N1 cases. CONCLUSIONS: The severe acute respiratory syndrome coronavirus 2 pandemic is a major public health problem that continues to affect the world with its high rate of contagion. In addition, no vaccines or a specific drug for the benefit of millions of people have been found yet. The H1N1 pandemic is an epidemic that affected the whole world about ten years ago and was prevented by the development of vaccines at a short period. Experience in the H1N1 pandemic may be the guide to prevent the COVID-19 pandemic from a worse end.

Humans , Male , Female , Influenza A Virus, H1N1 Subtype , COVID-19 , Retrospective Studies , Pandemics , SARS-CoV-2
Article in Chinese | WPRIM | ID: wpr-878989


In this paper, Asarum polysaccharides(AP) were extracted, and its composition was analyzed to study the activity against H1 N1 influenza virus in vitro and its intervention effect on mice with kidney Yang deficiency syndrome. AP was prepared by the strategy of water extraction and alcohol precipitation, the content was determined, and its monosaccharide composition was analyzed. The cell Real-time monitoring system and Reed-Muench model were adopted to evaluate the antiviral activity of AP in vitro. And the mouse model of kidney Yang deficiency syndrome was established in vivo to compare the efficacy of Mahuang Xixin Fuzi Decoction(MXF) and AP. MXF group and AP group were treated with clinical equivalent doses of 1.8 g·kg~(-1)·d~(-1) and 0.077 g·kg~(-1)·d~(-1) respectively, once a day for 6 consecutive days. Real-time PCR was used to detect the relative expression of M gene of H1 N1 influenza virus and cytokines in lung tissue. The content of AP in Asarum was 25.22%, and the protein content was 0.8%. And the monosaccharide composition was identified as L-rhamnose, D-arabinose, D-xylose, D-glucose, D-galactose and D-mannose. TI values of Tamiflu, MXF and AP were 30.00, 8.06 and 10.33, respectively. Three different doses of AP could significantly reduce the concentration of virus in supernatant. Compared with the model mice, lung indexes of MXF group and AP group decreased significantly(P<0.05), and the relative expression of M gene decreased significantly(P<0.05). The relative expressions of IL-10 and IFN-γ were up-regulated to varying degrees, while the relative gene expressions of IL-1β, IL-6 and MCP-1 were down-regulated to different degrees. In addition, AP could significantly enhance the expression of TNF-α(P<0.01). AP had a good anti-influenza virus activity in vitro, and could protect mice with kidney Yang deficiency syndrome by reducing the viral load in lung tissue, decreasing inflammation damage in lung tissue, and regulating the expression of inflammatory cytokines. Compared with the prescription of MXF, AP had a better antiviral activity.

Animals , Antiviral Agents/therapeutic use , Asarum , Cytokines/genetics , Drugs, Chinese Herbal , Influenza A Virus, H1N1 Subtype , Influenza, Human/genetics , Lung , Mice , Polysaccharides
Rev. méd. Minas Gerais ; 31: 31112, 2021.
Article in English, Portuguese | LILACS | ID: biblio-1354570


Introdução: de destaque como agente etiológico em várias doenças respiratórias, os vírus, tem grande importância dentro da Pneumologia Pediátrica. Objetivo: estudar os vírus identificados de secreções respiratórias de pacientes pediátricos, hospitalizados na enfermaria e UTI pediátrica, durante o período de janeiro de 2019 a dezembro de 2020. Metodologia: levantamento de resultados do RT-PCR (reação da transcriptase reversa seguida pela reação em cadeia da polimerase) de secreções respiratórias de pacientes pediátricos, através do GAL (Gerenciamento de Análises Laboratoriais) aplicando os filtros necessários para selecionar os pacientes da instituição e o período estipulado. Resultados: Foram realizadas 30 coletas em 2019 e 196 em 2020 de secreções respiratórias devido ao quadro de Síndrome Respiratória. As amostras coletadas em 2019 foram positivas para vírus em 56,7% dos casos investigados, sendo 6,7% para Influenza e 50% para Vírus Sincicial Respiratório (VSR), enquanto que em 2020 as amostras foram positivas em 21,4% dos casos, sendo todos eles para SARS-CoV-2. O período do ano com maior número de coletas de secreção foi em maio e junho considerando o ano de 2019 (60% das coletas de 2019), e julho, agosto e dezembro considerando o ano de 2020 (42,8% das coletas de 2020), com uma positividade de 77,7% (2019) e 25% (2020) para os vírus solicitados para pesquisa. Conclusão: Pôde-se perceber uma importante mudança no perfil dos vírus identificados dos quadros respiratórios entre 2019 e 2020, comparáveis ao perfil apresentado pelos Boletins Epidemiológicos do Ministério da Saúde, principalmente no ano de 2020 com o surgimento do novo coronavírus e sua pandemia. A etiologia viral presente na grande maioria dos quadros respiratórios da pediatria, deve sempre ser valorizada e os testes de identificação viral são ferramentas de grande aplicabilidade na clínica.

Introduction: highlighted as an etiological agent in several respiratory diseases, viruses, has great importance in Pediatric Pulmonology. Objective: study the viruses identified from respiratory secretions of pediatric patients hospitalized in the pediatric ward and ICU, during the period from January 2019 to December 2020. Methodology: survey of results of the RT-PCR (reverse transcriptase reaction followed by polymerase chain reaction) of respiratory secretions of pediatric patients, through the LAM (Laboratory Analysis Management) applying the necessary filters to select the patients of the institution and the stipulated period. Results: Thirty collections were performed in 2019 and 196 in 2020 for respiratory secretions due to the Respiratory Syndrome. The samples collected in 2019 were positive for viruses in 56.7% of the investigated cases, with 6.7% for Influenza and 50% for Respiratory Syncytial Virus (RSV), while in 2020 the samples were positive in 21.4% of the cases, all of which were for SARS-Cov-2. The period of the year with the highest number of secretion collections was in May and June considering 2019 (60% of 2019 collections), and July, August and December considering 2020 (42.8% of 2020 collections), with a positivity of 77.7% (2019) and 25% (2020) for viruses requested for research. Conclusion: It was possible to notice an important change in the profile of the viruses identified in respiratory conditions between 2019 and 2020, comparable to the profile presented by the Epidemiological Bulletins of the Ministry of Health, especially in the year 2020 with the emergence of the new coronavirus and its pandemic. The viral etiology present in the vast majority of pediatric respiratory conditions should always be valued and viral identification tests are tools of great applicability in the clinic.

Humans , Child , Adolescent , Pediatrics , Respiratory Syncytial Viruses , Coronavirus , Influenza A Virus, H1N1 Subtype , Influenza A Virus, H3N2 Subtype
Rev. bras. epidemiol ; 24: e210014, 2021. tab
Article in English | LILACS | ID: biblio-1156023


ABSTRACT: Objective: To investigate sociodemographic factors associated with the willingness to take the pandemic influenza vaccine. Methods: This is a cross-sectional study of Brazilian civil servants participating in the fourth wave (2012-2013) of the longitudinal Pró-Saúde Study. Associations were expressed as odds ratios (OR) and 95% confidence intervals (95%CI), estimated by multivariate logistic regression models. Results: Among 2,828 participants, 15.9% would not be willing to vaccinate in the future if the Brazilian Ministry of Health promoted a new vaccination campaign against pandemic influenza. Not willing to vaccinate in the future was strongly associated with not taking the pandemic influenza vaccine in 2010 (OR = 9.0, 95%CI 6.9 - 11.6). Among the unvaccinated, females, those aged > 60 years, and non-health care workers were less willing to vaccinate in the future. Again, in the vaccinated group, females were less willing to vaccinate. Conclusion: Multidisciplinary efforts should be encouraged in order to identify reasons for refusing vaccination, focusing on the individual and group perceptions of susceptibility, severity, benefits, and barriers to vaccination. Such information is needed to identify target groups for the delivery of customized interventions towards preventing emerging pandemics, such as avian influenza and COVID-19.

RESUMO: Objetivo: Investigar fatores sociodemográficos associados à disposição em adotar a vacina contra influenza pandêmica. Métodos: Estudo transversal entre servidores técnico-administrativos participantes da quarta onda (2012-2013) do estudo longitudinal Pró-Saúde. Associações foram expressas como razões de chances (RC) e intervalos de confiança de 95% (IC 95%), estimados mediante modelos de regressão logística multivariada. Resultados: Entre os 2.828 participantes, 15,9% não estariam dispostos a serem vacinados no futuro se o Ministério da Saúde do Brasil promovesse uma nova campanha de vacinação contra influenza pandêmica. Não estar disposto a ser vacinado no futuro foi fortemente associado a não receber a vacina contra influenza pandêmica em 2010 (RC = 9,0, IC95% 6,9 - 11,6). Entre os não vacinados, mulheres, maiores de 60 anos e profissionais de outras áreas que não a saúde estavam menos dispostos a serem vacinados no futuro. Novamente, para aqueles vacinados, as mulheres estavam menos dispostas a serem vacinadas. Conclusão: Abordagens multidisciplinares devem ser estimuladas para identificar as razões para recusa vacinal, com foco nas percepções individual e coletivas sobre suscetibilidade, gravidade, benefícios e barreiras à vacinação. Essas informações são necessárias para identificar grupos-alvo para a oferta de intervenções particularizadas para a prevenção de pandemias emergentes, como a de influenza aviária e de covid-19.

Humans , Male , Female , Middle Aged , Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Influenza, Human/epidemiology , Influenza A Virus, H1N1 Subtype , Government Employees/psychology , Government Employees/statistics & numerical data , Brazil/epidemiology , Patient Acceptance of Health Care/statistics & numerical data , Cross-Sectional Studies , Vaccination/psychology
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 781-792, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142605


Abstract Introduction: The SARS-CoV-2 virus causes COVID-19, and it is responsible for the largest pandemic since the 1918 H1N1 influenza outbreak. The classic symptoms of the disease have been well defined by the World Health Organization; however, olfactory/gustatory disorders have been reported in some studies, but there are still several missing points in the understanding and in the consensus about the clinical management of these cases. Objective: To identify evidence in the scientific literature about olfactory/gustatory disorders, their clinical presentation, prevalence and possible specific treatments associated with COVID-19. Methods: A systematic review of articles published up to April 25, 2020 was performed in Medline, Cochrane Clinical Trials, ScienceDirect, Lilacs, Scopus and Google Schoolar,, DissOnline, The New York Academy of Medicine and Reasearch Gate. Inclusion criteria: (1) Studies on patients with COVID-19; (2) Records of COVID-19 signs/symptoms, and olfactory/gustatory functions. Exclusion criteria: (1) Studies on non-human coronavirus; (2) Review articles; (3) Experimental studies (in animals or in vitro); (4) Olfactory/gustatory disorders initiated prior to SARS-CoV-2 infection. The risk assessment of bias of the selected studies was performed using the Newcastle-Ottawa scale. Results: Six articles from the 1788 records met the inclusion criteria and were analyzed. A total of 1457 patients of different ethnicities were assessed; of them, 885 (60.7%) and 822 (56.4%) had smell and taste disorders, respectively, with women being most often affected. There were olfactory/gustatory disorders even without nasal obstruction/rhinorrhea and beginning even before the signs/symptoms of COVID-19; the recovery of smell/taste, when it occurs, usually happened in the first two weeks after COVID-19 resolution. There is evidence that olfactory/gustatory disorders are strong predictors of infection by SARS-CoV-2, and it is possible to recommend patient isolation, as early as of the medical consultation, preventing the spread of the virus. No scientific evidence has been identified for effective treatments for any of the disorders. Conclusion: Olfactory/gustatory disorders may occur at varying intensities and prior to the general symptoms of COVID-19 and should be considered as part of the clinical features of COVID-19, even in mild cases. There is still no scientific evidence of specific treatments for such disorders in COVID-19 disease.

Resumo Introdução: O vírus SARS-CoV-2 causa a COVID-19 e é responsável pela maior pandemia desde o surto de influenza H1N1 de 1918. Os sintomas clássicos da doença já foram bem definidos pela Organização Mundial da Saúde; entretanto, distúrbios olfativo-gustativos têm sido relatados em alguns estudos, mas ainda com várias lacunas no entendimento e no consenso sobre a condução clínica desses casos. Objetivo: Identificar evidências na literatura científica sobre os distúrbios olfativo-gustativos acerca da apresentação clínica, prevalência e possíveis tratamentos específicos associados à COVID-19. Método: Revisão sistemática de artigos publicados até 25 de abril de 2020 nas bases de dados: Medline, Cochrane Clinical Trials, ScienceDirect, Lilacs, Scopus e Google Schoolar,, DissOnline, The New York Academy of Medicine e Research Gate. Foram critérios de inclusão: 1) Estudos com indivíduos com COVID-19; 2) Registro dos sinais/sintomas da COVID-19 e das funções olfativo-gustativa. Foram critérios de exclusão: 1) Estudos sobre coronavírus não humano; 2) Artigos de revisão; 3) Estudos experimentais (em animais ou in vitro); 4) Distúrbios olfativos-gustativos iniciados previamente à infecção pelo SARS-CoV-2. A avaliação de risco de viés dos estudos selecionados foi feita por meio da escala de Newcastle-Ottawa. Resultados: Seis artigos dos 1.788 registros foram selecionados. Um total de 1.457 pacientes de diversas etnias foi avaliado; desses, 885 (60,7%) apresentaram perda do olfato e 822 (56,4%) perda do paladar, sendo as mulheres as mais afetadas. Os distúrbios olfativo-gustativos estiveram presentes mesmo sem obstrução nasal/rinorreia e com início mesmo antes dos sinais/sintomas clínicos da COVID-19; a recuperação do olfato/paladar, quando ocorre, geralmente se dá nas duas primeiras semanas após a resolução da doença. Há evidências de que os distúrbios olfativo-gustativos sejam fortes preditores de infecção pelo SARS-CoV-2, podendo-se recomendar o isolamento do paciente, já a partir da consulta médica, para evitar a disseminação do vírus. Não foram identificadas evidências científicas para tratamentos eficazes para qualquer dos distúrbios. Conclusão: Podem ocorrer distúrbios olfativo-gustativos em intensidades variáveis e prévios aos sintomas gerais da COVID-19, devem ser considerados como parte dos sintomas da doença, mesmo em quadros leves. Não há ainda evidências científicas de tratamentos específicos para tais distúrbios na COVID-19.

Humans , Male , Female , Pneumonia, Viral/complications , Coronavirus Infections/complications , Influenza A Virus, H1N1 Subtype , Pandemics , Olfaction Disorders/etiology , Olfaction Disorders/epidemiology , Smell , Taste Disorders/etiology , Taste Disorders/epidemiology , Nutrition Surveys , Betacoronavirus
Rev. colomb. anestesiol ; 48(4): e401, Oct.-Dec. 2020. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1144319


Abstract Introduction The use of extracorporeal membrane oxygenation (ECMO) has increased exponentially in recent years and has shown to be effective in treating adult respiratory distress syndrome (ARDS) secondary to HiNi-related pneumonia. However, evidence remains controversial. This study describes a case series of ECMO in ARDS secondary to viral pneumonia. Methods A search was conducted in the ECMO database of Fundación Cardiovascular de Colombia for the 20132017 period. A case series report was written of patients diagnosed with ARDS secondary to confirmed or suspected viral pneumonia. Results Nineteen patients with ECMO support and ARDS due to viral pneumonia were included in the study. The survival rate upon discharge was 11 patients (58%) and weaning from ECMO support was successful in 13 patients (68%). Hemorrhagic complications were the most frequent: gastrointestinal bleeding, 10 patients (53%); intracranial bleeding, 2 (10%); alveolar hemorrhage, 2 (10%);' hemothorax requiring thoracostomy with chest tube drainage, 2 (10%); cannulation site bleeding, 9 patients (47%); and surgical site bleeding in 3 patients (25%) who required tracheostomy. Other complications were: pneumothorax, 1 patient (5%); sepsis, 6 patients (32%); and growth of microorganisms in bronchial lavage, 6 patients (32%). Conclusions This study supports the use of veno-venous ECMO to achieve a higher survival rate than expected in patients with severe ARDS and refractory hypoxemia secondary to viral pneumonia. Early initiation of the therapy should improve overall results.

Resumen Introducción El uso de la oxigenación por membrana extracorpórea (ECMO) ha tenido un incremento exponencial en los últimos años y ha demostrado ser efectivo en el manejo del síndrome de dificultad respiratoria del adulto (SDRA) secundario a neumonía por H1N1, si bien la evidencia sigue siendo controvertida. En este estudio describimos una serie de casos de ECMO por SDRA secundario a neumonía viral. Métodos Se realizó una búsqueda en la base de datos de ECMO de la Fundación Cardiovascular desde el año 20132017. Reportamos una serie de casos donde se incluyeron pacientes diagnosticados con SDRA secundario a neumonía viral sospechosa o confirmada. Resultados Se incluyeron en el estudio 19 pacientes con soporte de ECMO y SDRA por neumonía viral. La sobrevida al alta fue 11 pacientes (58%) y el destete del ECMO fue exitoso en 13 pacientes (68%). Las complicaciones hemorrágicas presentadas fueron: sangrado digestivo, 10 pacientes (53%), sangrado cerebral, 2 (10%), hemorragia alveolar, 2 (10%), hemotórax con requerimiento de toracostomía a drenaje cerrado, 2 (10%), sangrado activo por sitio de canulación, 9 pacientes (53%), y 3 pacientes traqueostomizados (25%) que sangraron por el sitio quirúrgico. Otras complicaciones presentadas fueron: neumotórax, 1 paciente (5%), septicemia, 6 (32%) y crecimiento de microorganismos en lavados bronquiales 6 (32%). Conclusion El presente estudio permite indicar que el uso de la ECMO VV viabiliza una sobrevida mayor a la esperada en pacientes con SDRA severo e hipoxemia refractaria secundario a neumonía viral. Su inicio tempranamente debe mejorar los resultados globales.

Humans , Male , Female , Middle Aged , Pneumonia, Viral , Poisons , Respiratory Distress Syndrome, Newborn , Extracorporeal Membrane Oxygenation , Chest Tubes , Hemothorax , Pneumothorax , Thoracostomy , Tracheostomy , Catheterization , Survival Rate , Sepsis , Bronchoalveolar Lavage , Influenza A Virus, H1N1 Subtype
Rev. epidemiol. controle infecç ; 10(3): 1-11, jul.-set. 2020. ilus
Article in Portuguese | LILACS | ID: biblio-1247766


Justificativa e Objetivos: Em 2009, o Brasil enfrentou a pandemia de influenza A/H1N1pdm09 que infectou, pelo menos, 50 mil pessoas. Em 2020, enfrenta outra pandemia causada pelo vírus SARS-Cov-2 (COVID-19). Por se tratar de uma doença nova, há muita especulação sobre a mesma, assim como comparação com outros cenários, muitas vezes com base em informações falsas. Este estudo compara os impactos e diferenças epidemiológicas da Influenza A/H1N1 e COVID-19 no Brasil. Métodos: Estudo quantitativo, descritivo, epidemiológico, de base documental, cujos dados foram coletados nas plataformas de informação do Ministério da Saúde do Brasil e da Organização Mundial da Saúde, além de artigos científicos. Os dados sobre Influenza A/H1N1 referem-se ao ano de 2009 e os de COVID-19 ao período de março a 30 de abril de 2020. Resultados: Constata-se que no Brasil, em apenas dois meses, o número de casos da COVID-19 (85.380) já ultrapassou o total de casos de influenza A/H1N1pdm09 (50.482) ocorridos em todo o ano de 2009 e provocou o triplo de óbitos. Portanto, a COVID-19 apresenta-se de forma mais severa, dada as proporções alcançadas em letalidade, pela falta de vacina e tratamento específico dos casos. Conclusão: A pandemia da COVID-19 é mais impactante para o Brasil que a pandemia da influenza A/H1N1pdm09.(AU)

Background and Objectives: In 2009, Brazil faced the influenza A/H1N1pdm09 pandemic that infected at least 50 thousand people. In 2020, it faces another pandemic caused by the SARS-Cov-2 virus (COVID-19). Because it is a new disease, there is much speculation about it and comparison with other scenarios, often based on fake news. This study compares the impacts and epidemiological differences of Influenza A / H1N1 and COVID-19 in Brazil. Methods: Quantitative, descriptive, epidemiological study, based on documents, whose data were collected on the information platforms of the Ministry of Health of Brazil and the World Health Organization, in addition to scientific articles. The data on Influenza A/H1N1 refer to the year 2009 and the data on COVID-19 to the period from March to April 30, 2020. Results: It appears that in Brazil, in just two months the number of cases of COVID-19 (85,380) has already exceeded the total cases of influenza A/H1N1pdm09 (50,482) that occurred in the whole year of 2009 and caused a triple of deaths. Therefore, COVID-19 presents itself more severely, given the proportions reached in lethality, due to the lack of vaccine and specific treatment of cases. Conclusion: The COVID-19 pandemic is more impactful for Brazil than the influenza A/H1N1pdm09 pandemic.(AU)

Justificación y Objetivos: En 2009, Brasil se enfrentó a la pandemia de influenza A / H1N1pdm09 que infectó al menos a 50,000 personas. En 2020, se enfrenta a otra pandemia causada por el virus SARS-Cov-2 (COVID-19). Como se trata de una enfermedad nueva, se especula mucho y se compara con otros escenarios, a menudo basados en información falsa. Este estudio compara los impactos y las diferencias epidemiológicas de la Influenza A / H1N1 y COVID-19 en Brasil. Métodos: Estudio epidemiológico cuantitativo, descriptivo, basado en documentos, cuyos datos fueron recolectados en las plataformas de información del Ministerio de Salud de Brasil y de la Organización Mundial de la Salud, además de artículos científicos. Los datos sobre Influenza A / H1N1 se refieren al año 2009 y los datos sobre COVID-19 al período de marzo al 30 de abril de 2020. Resultados: Parece que en Brasil, en solo dos meses, el número de casos de COVID-19 (85,380) ya excedió el número total de casos de influenza A / H1N1pdm09 (50,482) que ocurrieron en todo el año de 2009 y causaron un triple de muertes. Por lo tanto, COVID-19 se presenta más severamente, dadas las proporciones alcanzadas en la letalidad, debido a la falta de vacuna y al tratamiento específico de los casos. Conclusión: La pandemia de COVID-19 es más impactante para Brasil que la pandemia de influenza A / H1N1pdm09.(AU)

Humans , Brazil , Epidemiology , Coronavirus Infections , Influenza A Virus, H1N1 Subtype , Influenza in Birds
Hist. ciênc. saúde-Manguinhos ; 27(2): 391-409, abr.-jun. 2020.
Article in Spanish | LILACS | ID: biblio-1134063


Resumen El artículo explora el pensamiento médico en torno al impacto de la pandemia de influenza de 1918 en México. Se analizan las ideas científicas sobre la etiología de la gripe, las cuales se reflejaron en el tipo de remedios y recetas médicas que se publicaron en la prensa y en boletines de salud. Para adentrarse en este tema profundizamos en el contexto histórico internacional dominado por la guerra. En México, años de conflictos armados a consecuencia de la Revolución agravaron las condiciones de vida de la población: hambre, tifo, viruela y otros padecimientos infecciosos se presentaron antes y durante el brote de la pandemia. El trabajo se apoya en documentación de archivo, boletines de salud, prensa de la época y bibliografía actualizada.

Abstract This article explores medical thought on the impact of the influenza pandemic of 1918 in Mexico. It analyzes scientific ideas on the etiology of the flu, as reflected in the types of remedies and medical prescriptions published in the press and in health bulletins. It then goes deeper into the topic by examining the international historic context, dominated by the war. In Mexico, years of armed conflict unleashed by the Revolution exacerbated living conditions among the population: starvation, typhus, smallpox and other infectious diseases were present before and during the outbreak of the pandemic. This study is based on archival documentation, health bulletins, press sources from the period, and modern bibliography.

Humans , History, 20th Century , World War I , Influenza, Human/history , Pandemics/history , Influenza Pandemic, 1918-1919/history , Propaganda , Armed Conflicts/history , Influenza, Human/therapy , Influenza, Human/transmission , Influenza, Human/epidemiology , Influenza A Virus, H1N1 Subtype , Europe/epidemiology , Mexico/epidemiology
Rev. chil. infectol ; 37(2): 138-146, abr. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1126100


Resumen Introducción: Los pacientes con leucemia linfoblástica aguda (LLA) tienen alto riesgo de influenza grave y la vacunación es altamente recomendada. La inmunogenicidad y efectividad de la vacuna es menor comparada a los sujetos sanos. Objetivo: Evaluar la respuesta inmune inducida por vacuna anti-influenza en niños con LLA y observar su efectividad. Métodos: Se reclutaron niños con LLA en terapia de mantención y niños sanos. Se tomaron muestras de sangre el día de la vacuna (D0) y al día 28 (D28), y se realizó test de inhibición de hemaglutinación (IHA) contra H1N1. Los pacientes fueron seguidos por un año, registrando datos clínicos y episodios de influenza. Resultados: Se incluyeron 34 niños con LLA y 9 niños sanos. Respecto al IHA en D28, 12/34 pacientes y 5/8 niños sanos presentaron títulos ≥ 1/40, resultando una tasa de seroprotección de 35 y 63%, respectivamente. Los niños seroprotegidos eran significativamente mayores. Durante el seguimiento, sólo tres pacientes, no seroprotegidos, presentaron infección por influenza, ninguno requirió oxigeno o cuidados intensivos. Discusión: Los niños con LLA alcanzaron una tasa seroprotección más baja que la observada en niños sanos. Sin embargo, ninguno de los niños seroprotegidos presentó infección por influenza, reforzando la recomendación de vacunación anual.

Abstract Background: Patients with acute lymphoblastic leukemia (ALL) have high risk of severe influenza infection and vaccination is highly recommended. The immunogenicity and effectiveness of vaccination are lower than in healthy people. Aim: To evaluate the immune response induced by influenza vaccine in children with ALL and observe effectiveness. Method: Children with ALL in maintenance phase and healthy children were recruited. Blood samples were taken at vaccination day (D0) and at day 28 (D28). Humoral response was evaluated by hemaglutination inhibition test (HAI) against H1N1. Patients were followed up for one year, clinical data and influenza episodes were recorded. Results: 34 children with ALL and 9 healthy children were included. Concerning HAI on D28, 12/34 patients and 5/8 healthy children had titers ≥ 1/40, with seroprotection rates of 35 and 63% respectively. Seroprotected children were older than non-seroprotected ones. During follow-up, only 3 patients non seroprotected, presented influenza infection, without oxygen supplementation or critical care support. Discussion: Children with ALL had a lower seroprotection rate than healthy children. Nevertheless, none of the seroprotected children presented influenza infection, reinforcing the annual vaccination recommendation.

Humans , Child , Influenza Vaccines , Influenza, Human , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Vaccination , Influenza A Virus, H1N1 Subtype , Immunity, Humoral , Antibodies, Viral
Chinese Medical Journal ; (24): 2429-2436, 2020.
Article in English | WPRIM | ID: wpr-877825


BACKGROUND@#Endothelial cells play a key role in the cytokine storm caused by influenza A virus. MicroRNA-155 (miR-155) is an important regulator in inflammation. Its role in the inflammatory response to influenza A infection, however, has yet to be elucidated. In this study, we explored the role as well as the underlying mechanism of miR-155 in the cytokine production in influenza A-infected endothelial cells.@*METHODS@#Human pulmonary microvascular endothelial cells (HPMECs) were infected with the influenza A virus strain H1N1. The efficiency of H1N1 infection was confirmed by immunofluorescence. The expression levels of proinflammatory cytokines and miR-155 were determined using real-time polymerase chain reaction. A dual-luciferase reporter assay characterized the interaction between miR-155 and sphingosine-1-phosphate receptor 1 (S1PR1). Changes in the target protein levels were determined using Western blot analysis.@*RESULTS@#MiR-155 was elevated in response to the H1N1 infection in HPMECs (24 h post-infection vs. 0 h post-infection, 3.875 ± 0.062 vs. 1.043 ± 0.013, P = 0.001). Over-expression of miR-155 enhanced inflammatory cytokine production (miR-155 mimic vs. negative control, all P < 0.05 in regard of cytokine levels) and activation of nuclear factor kappa B in infected HPMECs (miR-155 mimic vs. negative control, P = 0.004), and down-regulation of miR-155 had the opposite effect. In addition, S1PR1 was a direct target of miR-155 in the HPMECs. Inhibition of miR-155 enhanced the expression of the S1PR1 protein. Down-regulation of S1PR1 decreased the inhibitory effect of the miR-155 blockade on H1N1-induced cytokine production and nuclear factor kappa B activation in HPMECs.@*CONCLUSION@#MiR-155 maybe modulate influenza A-induced inflammatory response by targeting S1PR1.

Down-Regulation , Endothelial Cells , Humans , Influenza A Virus, H1N1 Subtype/genetics , Influenza A virus , Influenza, Human/genetics , MicroRNAs/genetics , Sphingosine-1-Phosphate Receptors
Protein & Cell ; (12): 894-914, 2020.
Article in English | WPRIM | ID: wpr-880885


Tripartite motif (TRIM) family proteins are important effectors of innate immunity against viral infections. Here we identified TRIM35 as a regulator of TRAF3 activation. Deficiency in or inhibition of TRIM35 suppressed the production of type I interferon (IFN) in response to viral infection. Trim35-deficient mice were more susceptible to influenza A virus (IAV) infection than were wild-type mice. TRIM35 promoted the RIG-I-mediated signaling by catalyzing Lys63-linked polyubiquitination of TRAF3 and the subsequent formation of a signaling complex with VISA and TBK1. IAV PB2 polymerase countered the innate antiviral immune response by impeding the Lys63-linked polyubiquitination and activation of TRAF3. TRIM35 mediated Lys48-linked polyubiquitination and proteasomal degradation of IAV PB2, thereby antagonizing its suppression of TRAF3 activation. Our in vitro and in vivo findings thus reveal novel roles of TRIM35, through catalyzing Lys63- or Lys48-linked polyubiquitination, in RIG-I antiviral immunity and mechanism of defense against IAV infection.

A549 Cells , Animals , Apoptosis Regulatory Proteins/immunology , DEAD Box Protein 58/immunology , Dogs , HEK293 Cells , Humans , Influenza A Virus, H1N1 Subtype/immunology , Madin Darby Canine Kidney Cells , Mice , Mice, Knockout , Orthomyxoviridae Infections/pathology , Proteolysis , Signal Transduction/immunology , THP-1 Cells , TNF Receptor-Associated Factor 3/immunology , Ubiquitination/immunology , Viral Proteins/immunology
Chinese Journal of Traumatology ; (6): 187-189, 2020.
Article in English | WPRIM | ID: wpr-827829


The COVID-19 pandemic is still raging across the world. Everyday thousands of infected people lost their lives. What is worse, there is no specific medicine and we do not know when the end of the pandemic will come. The nearest global pandemic is the 1918 influenza, which caused about 50 million deaths and partly terminate the World War Ⅰ. We believe that no matter the virus H1N1 for the 1918 influenza or 2019-nCoV for COVID-19, they are essentially the same and the final cause of death is sepsis. The definition and diagnostic/management criteria of sepsis have been modified several times but the mortality rate has not been improved until date. Over decades, researchers focus either on the immunosuppression or on the excessive inflammatory response following trauma or body exposure to harmful stimuli. But the immune response is very complex with various regulating factors involved in, such as neurotransmitter, endocrine hormone, etc. Sepsis is not a kind of disease, instead a misbalance of the body following infection, trauma or other harmful stimulation. Therefore we should re-think sepsis comprehensively with the concept of systemic biology, i.e. inflammationomics.

Betacoronavirus , Coronavirus Infections , Epidemiology , Allergy and Immunology , Humans , Immune Tolerance , Inflammation , Influenza A Virus, H1N1 Subtype , Influenza, Human , Epidemiology , Allergy and Immunology , Pandemics , Pneumonia, Viral , Epidemiology , Allergy and Immunology , Sepsis
Braz. j. med. biol. res ; 53(10): e9183, 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1132479


H1N1 virus-induced excessive inflammatory response contributes to severe disease and high mortality rates. There is currently no effective strategy against virus infection in lung. The present study evaluated the protective roles of a natural compound, lapiferin, in H1N1 virus-induced pulmonary inflammation in mice and in cultured human bronchial epithelial cells. Initially, Balb/C mice were grouped as Control, H1N1 infection (intranasally infected with 500 plaque-forming units of H1N1 virus), lapiferin (10 mg/kg), and H1N1+lapiferin (n=10/group). Lung histology, expression of inflammatory factors, and survival rates were assessed after 14 days of exposure. Administration of lapiferin significantly alleviated the virus-induced inflammatory infiltrate in lung tissues. Major pro-inflammatory cytokines, such as interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, were decreased at both mRNA and protein levels by lapiferin administration in the lung homogenate. Lapiferin also reduced inflammatory cell numbers in bronchoalveolar fluid. Mechanistically, lapiferin suppressed the transcriptional activity and protein expression of NF-κB p65, causing inhibition on NF-κB signaling. Pre-incubation of human bronchial epithelial cells with an NF-κB signaling specific activator, ceruletide, significantly blunted lapiferin-mediated inhibition of pro-inflammatory cytokines secretion in an air-liquid-interface cell culture experiment. Activation of NF-κB signaling also blunted lapiferin-ameliorated inflammatory infiltrate in lungs. These results suggested that lapiferin was a potent natural compound that served as a therapeutic agent for virus infection in the lung.

Humans , Animals , Rabbits , Pneumonia , Sesquiterpenes/pharmacology , NF-kappa B/metabolism , Protective Agents/pharmacology , Influenza A Virus, H1N1 Subtype , Signal Transduction , Cytokines , Inflammation