Transmission cluster of COVID-19 cases from Uruguay: emergence and spreading of a novel SARS-CoV-2 ORF6 deletion.

BACKGROUND: Evolutionary changes in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) include indels in non-structural, structural, and accessory open reading frames (ORFs) or genes. OBJECTIVES: We track indels in accessory ORFs to infer evolutionary gene patterns and epidemiological links between outbreaks. METHODS: Genomes from Coronavirus disease 2019 (COVID-19) case-patients were Illumina sequenced using ARTIC_V3. The assembled genomes were analysed to detect substitutions and indels. FINDINGS: We reported the emergence and spread of a unique 4-nucleotide deletion in the accessory ORF6, an interesting gene with immune modulation activity. The deletion in ORF6 removes one repeat unit of a two 4-nucleotide repeat, which shows that directly repeated sequences in the SARS-CoV-2 genome are associated with indels, even outside the context of extended repeat regions. The 4-nucleotide deletion produces a frameshifting change that results in a protein with two inserted amino acids, increasing the coding information of this accessory ORF. Epidemiological and genomic data indicate that the deletion variant has a single common ancestor and was initially detected in a health care outbreak and later in other COVID-19 cases, establishing a transmission cluster in the Uruguayan population. MAIN CONCLUSIONS: Our findings provide evidence for the origin and spread of deletion variants and emphasise indels' importance in epidemiological studies, including differentiating consecutive outbreaks occurring in the same health facility.

Approach to the impact of the pandemic in addiction treatment centers in some Latin American countries

Introduction: Treatment centers for psychoactive substance users in Latin America were affected by the pandemic and had to reconvert treatment modalities incorporating virtual therapies, in many occasions for vulnerable populations living in neighborhoods with low connectivity and difficulty in accessing telephone or computer equipment. Questions arose regarding the demand, accessibility, modality, continuity of the treatments and the changes in the consumption profiles against which the study posed as a general objective to dimension the impact of the pandemic and the isolation measures in 55 addiction treatment centers identifying changes in the demand for treatment, in the consumption profiles and systematizing the main measures taken by the institutions to develop the treatments within this context. Results the study characterized the demand in times of pandemic in terms of an increase of dual patients, the facilitation of treatments for patients with remote residences, and with a decrease of the accessibility to the therapies for patients with scarce economic resources without advanced telephony or computer means. Conclusions: All residential centers implemented care protocols and both users and families showed a higher level of awareness of the problem of psychoactive substance use. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Abstract (Spanish) Introduccion: los centros de tratamiento de consumidores de sustancias psicoactivas en america Latina se vieron afectados por la pandemia y debieron reconvertir las modalidades de tratamiento incorporando terapias virtuales, inclusive para poblaciones vulnerables residentes en barrios con baja conectividad y con dificultad para acceder a equipos telefonicos o informaticos. surgieron interrogantes respecto a la demanda, accesibilidad, modalidad, continuidad de los tratamientos y a los cambios en los perfiles de consumo. Frente a estos ultimos el estudio se planteo como objetivo general dimensionar el impacto de la pandemia y las medidas de aislamiento en 55 centros de tratamiento de adicciones, identificando cambios en la demanda de tratamiento, en los perfiles de consumo y sistematizando las principales medidas tomadas por las instituciones para desarrollar los tratamientos en este contexto. Resultados: el estudio caracterizo la demanda en tiempos de pandemia, destacandose un aumento de pacientes duales, la facilitacion de los tratamientos a los usuarios con residencias alejadas de los centros y con disminucion a la accesibilidad a las terapias de usuarios carentes de telefonia de avanzada o medios informaticos. Conclusiones: todos los centros residenciales implementaron protocolos de cuidado, y tanto usuarios como familiares mostraron mayor nivel de concientizacion acerca del problema del consumo de sustancias psicoactivas. Palabras clave: demanda de trata (PsycInfo Database Record (c) 2021 APA, all rights reserved)