Saliva effect on RT-PCR performance

The use of saliva directly in RT-PCR reactions may be interesting, particularly in screenings for the detection of DNA/RNA of pathogens, due to the advantages of time and costs. However, its use faces some difficulties that essentially result from the saliva being a matrix with a variable composition and which contains inhibitors of the polymerization reaction. Saliva samples obtained from healthy donors were spiked with SARS-CoV-2 RNA and 3 viral targets were detected by RT-PCR. This work was considered exempt from review by an institutional ethical review board, because it comprises use of completely anonymized specimens obtained voluntarily and informed. The efficiency of RT-PCR reactions was calculated in the presence of variable amounts of saliva and the effect of saliva pre-treatment on the performance of each reaction was also analysed. It was found that saliva has no significant influence on the mean efficiency of each individual reaction, affecting mainly the beginning of the exponential phase of amplification, resulting in a significant increase in Ct values. This effect which is target dependent, presents a highly between-person variability (DELTACt = 0.93 to 11.36) and affects RNA/DNA detection and the limit-of-detection, but can be partly reversed by a treatment of saliva prior to the reaction. The work presented contributes to a better understanding of the advantages and limitations of using saliva directly in RT-PCR. This work was supported by ProjectNORTE-01-0145- FEDER-072545- SAICTCOVID/72545/2020 and was the result of the projects: UIDB/05937/2020 and UIDP/05937/2020- Centre for Research and Development in Agrifood Systems and Sustainability-funded by national funds, through FCT-Fundacao para a Ciencia e a Tecnologia.Copyright © 2023 The American Society for Biochemistry and Molecular Biology, Inc.

International Mobility Flows and COVID-19 Effects: Evidence from Instituto Politécnico de Bragança

Facing the difficulties and the new challenges that COVID-19 has created for Higher Education Institutions (HEIs), the future needs to analyse and reflect on this crisis. Considering the increasing value of international mobility in Portuguese HEIs in the last decades, this research aims to study the effect of the COVID-19 pandemic on the flow of student and faculty mobility. Since international students, as well as teaching staff mobility, are an asset for many HEIs, this study will be applied to the Instituto Politécnico de Bragança (IPB), an institution located in the interior of Portugal where the weight of international students is quite significant. The paper provides an overview of the mobility flows between the period 2004/2005 and the 2020/2021 academic year. According to the findings obtained, the restrictions on international physical mobility are observed as the biggest challenges that occurred in IPB during the COVID-19. From the results presented, a sharp growth in international mobility flows is evident until the 2018/2019 academic year, as a consequence of the investment made by the IPB's presidency, in which one of the pillars of the institution's growth is based on the internationalisation strategy. Afterwards, in the last two academic years, there has been a sharp decline;both in terms of student mobility, on average, there was a decrease of around 26.0%, and faculty mobility, on average, there was a decrease of approximately 55%. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

The Use of Intraoperative Ecmo in Lung Transplantation: A Retrospective Analysis from the Largest Lung Transplant Center in Brazil

The use of extracorporeal membrane oxygenation (ECMO) presents several advantages in the intraoperative scenario during lung transplantation (LTx) and its use has increased over the last decade. The aim of the this study is to evaluate the use of ECMO at our institution throughout the years. Retrospective analysis considering the period from January/2014 to September/2022 using the REDCap database of the Lung Transplantation Group at Heart Institute - University of São Paulo - Brazil. Of the 254 lung transplants performed in this period, 37 utilized intraoperative ECMO. The recipients were mostly female (56.8%), mean age of 34.51 years old (±13.64 years - 13-65);94.6% (35) received bilateral lung transplant. The most common preoperative diagnostics were primary pulmonary hypertension (24.3%), hypersensitivity pneumonitis (18.9%) and cystic fibrosis (16.2%). The main isolated or combined reasons for ECMO use were hemodynamic instability (45.9%), hypoxemia (35.1%) and pulmonary hypertension (35.1%). Twenty one patients (56.8%) had preoperative diagnostic of pulmonary hypertension (Pulmonary Artery Systolic Pressure: 66.0 ± 19.20 mmHg). Thirty two patients (86.5%) received VA-ECMO, and 28 (87.5%) of those received central cannulation (right atrium cannulation for venous drainage and aorta cannulation for perfusion), and 4 received hybrid cannulation (common femoral vein cannulation for venous drainage and aorta cannulation for perfusion). Thirty three (89.18%) patients were decannulated and the overall survival rate were 75.56% (30 days) and 48.38% (90 days). Most of cases of ECMO use (70.27%) occurred in the last 3 years (2020-2022), propelled by the dissemination of devices and techniques due to the COVID-19 pandemic. The use of ECMO in LTx has increased in the past years at our institution, configuring an additional intraoperative resource in selected recipients. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Influential Factors for Hospital Management Maturity Models in a post-Covid-19 scenario - Systematic Literature Review

The importance of Maturity Models in healthcare is proven to support, monitor and direct healthcare organizations to better plan and execute their investments, developments and processes. In this work, two literature reviews were collected: one of them focuses on the identification of the main maturity models developed in the health area, the similarities and gaps between them, identifying what are the Influencing Factors for each model studied, and the other is the identification lessons learned for hospital management during the Covid-19 pandemic. Combining these two lines of investigation, it can be concluded that, in order to better prepare, adapt and make health systems more resilient, it is fundamental that future Maturity Models begin to map agility in diagnosing diseases, scale of exams, process of hospital disinfection and technological infrastructure, focusing on ICTs such as ML, LMS, DL, Robot Assistance, Actuators, Big Data, Blockchain, Smart Wearables, Delivery Drones, Artificial Intelligence, Internet of Things, Augmented Reality, Virtual Reality, Sensors and Cloud Technology. These IFs are identified as gaps for existing MMs in the sector. Allied to this, it is indicated that the future MMs consider expanding their focus in supply chain, services and applications, monitoring and, mainly, patient safety and care, given the importance that these IFs demonstrated in coping with the pandemic. Copyright © 2023 by Author/s and Licensed by IADiTI.

#FightingCOVID19 (mis)information-the relevance of a communication strategy

Background: Managing communication during a health crisis is essential to meet the population's needs. Therefore, regarding the COVID-19 outbreak, the National Association of Pharmacies (ANF) developed, since the beginning, a strategy of communication in order to support such needs. Purpose(s): To support the management and communication of a health crisis. Method(s): Several documents were developed: On January 24th 2020, while there weren't cases in Europe, ANF published a CEDIME Informa (Scientific and Technical Information, headed to the pharmacy team);On January 30th 2020, after the first cases were described in Europe, it was released an updated CEDIME Informa and an iSaude (leaflet addressed to the population), and, the following day, an action flowchart for pharmacies (adapted and translated by FIP into six languages). In February 2020, two new iSaude and Guidelines were published: 'Preventive Measures' and 'Pharmacy Intervention Towards a Suspected Case';-On March 4th 2020, after the first case was confirmed in Portugal, a Contingency Plan for pharmacies was released. Since then, six new CEDIME Informa and one iSaude were released, and it was constantly assured that the population was informed, through digital media. Result(s): The progressive delivery of accurate information allowed a reality-adjusted response to the pharmacies and population's needs. Conclusion(s): Crisis management and communication are essential in situations like this outbreak. With a 2,750 pharmacies' network and about 3,517 inhabitants per pharmacy, it is time we question: wouldn't the integration of pharmacies in the health system be a means to ensure timely credible and understandable communication between health authorities and the population?

Incidence and risk factors for moderate/severe COVID-19 in rheumatic diseases patients on hydroxychloroquine: a 24-week prospective cohort

Objective To evaluate the incidence of COVID-19 and its main outcomes in rheumatic disease (RD) patients on hydroxychloroquine (HCQ) compared to household cohabitants (HC).Methods This is a 24-week nationwide prospective multi-centre cohort with a control group without RD and not using HCQ. All participants were monitored through scheduled phone interviews performed by health professionals. Details regarding COVID-19 symptoms, and epidemiological, clinical, and demographic data were recorded on a specific web-based platform. COVID-19 was defined according to the Brazilian Ministry of Health criteria and classified as mild, moderate or severe.Results A total of 9,585 participants, 5,164 (53.9%) RD patients on HCQ and 4,421 (46.1%) HC were enrolled from March 29th, 2020 to September 30th, 2020, according to the eligibility criteria. COVID-19 confirmed cases were higher in RD patients than in cohabitants [728 (14.1%) vs. 427 (9.7%), p<0.001] in a 24-week follow-up. However, there was no significant difference regarding outcomes related to moderate/ severe COVID-19 (7.1% and 7.3%, respectively, p=0.896). After multiple adjustments, risk factors associated with hospitalisation were age over 65 (HR=4.5;95%CI 1.35-15.04, p=0.014) and cardiopathy (HR=2.57;95%CI 1.12-5.91, p=0.026). The final survival analysis demonstrated the probability of dying in 180 days after a COVID-19 diagnosis was significantly higher in patients over 65 years (HR=20.8;95%CI 4.5-96.1) and with 2 or more comorbidities (HR=10.8;95%CI 1.1-107.9 and HR=24.8;95%CI 2.5-249.3, p=0.006, respectively).Conclusion Although RD patients have had a higher COVID-19 incidence than individuals from the same epidemiological background, the COVID-19 severity was related to traditional risk factors, particularly multiple comorbidities and age, and not to underlying RD and HCQ.

Project-Based Learning Applied to Initial and Continuing Training Courses in the Maker Culture

This article presents the use of the Project-Based Learning (PBL) methodology as a practical method for the execution of two 40-hour Initial and Continuing Training (ICT) courses in the Maker Culture area for the hybrid class format with teams formed by undergraduate students in Control and Automation Engineering from the Federal Institute of Amazonas Campus Manaus Distrito Industrial (IFAM CMDI), developed over 14 weeks. Providing students with training in this area has become an even greater challenge because it took place during the Covid-19 pandemic period. At the end of the courses, all 36 participating students filled out a form presenting their perceptions of the courses. The results indicated a positive evaluation of the activities, highlighting the relevance of practical activities throughout the courses so that they did not become tiring, preventing students from dropping out. It is considered important to include remote research and guidance activities, together with face-to-face activities in a maker space using the PBL, which allowed the application of the contents in projects of interest to the students, fixing the contents taught.

Sustainable Tourism as a Driving Factor for Competitiveness in the Olive Sector

Tourism is facing serious difficulties worldwide due to the global pandemic COVID-19, translating considerably into an industry effort to compete in the marketplace. In effect, sustainable tourism is considered to have a symbiotic relationship with competitiveness that will allow organisations to make a difference. This means that the sustainability factors are positively related to the competitiveness indicators. In this context, as the oliviculture sector faces challenges in a changing market in terms of ecological, demographic, and consumption practices changes, it is considered that sustainable tourism will enable the sector to make a difference. For, the environmental and social changes of the stakeholders enhance the promotion of sustainability to meet their needs, which in turn increases the sector's competitive advantage. In this respect, the present study was based on a literature review consolidated in a bibliometric analysis to analyse sustainable tourism as a driver of competitiveness in the oliviculture industry. For this purpose, the Scopus database was used, in which 157 full articles published until September 2021 were obtained. Based on the results, using the Bibliometrix R, it was found that research in this field has emerged in the last 20 years and focuses particularly on the terms "competitiveness", "ecotourism" and "tourism development". In addition, the countries with the highest scientific production and citations, the main sources of publication in this field of research, the documents with the most citations as well as the co-citations between authors were analysed. Through bibliometric analysis, it is possible to provide researchers, policy-makers and managers with a current view of the undoubted role that sustainable tourism plays in the competitiveness of the olive sector. Considering the trends, it is therefore expected to contribute bases for future strategies aimed at overcoming obstacles, overcoming challenges, and seizing opportunities for a more competitive sector.

The relationship of rural tourism with sustainable tourism and outdoor activities: A bibliometric analysis

A bibliometric study is a method used to evaluate the productivity of scientific results in quantitative terms. Bibliometricians apply mathematical and statistical methods to quantify scholarly communications. Using the Bibliometrix program, a database compiled from SCOPUS and Web of science was studied to study the different scientific and literary behaviours of rural tourism development, tourism sustainability, and outdoor activities. In the main database steps, 161 articles were analysed, of which 61 were SCOPUS articles, and 100 were Web of Science articles. As per this database, the relationship between rural tourism with sustainable tourism and outdoor activities, through a bibliometric analysis, looks to study the annual scientific production, the research impact, the authors, and articles most relevant to the themes of research trends over the years. Several interesting and important conclusions were obtained from these results for developing the themes. The results of this study indicate that sustainable tourism and rural tourism have extreme relevance to the studies carried out. Hence, rural tourism and outdoor activities are increasingly sustaining a relationship of partnership, much due to the influences of COVID-19.

Impact of a home-based cardiac rehabilitation program in heart failure during the COVID-19 pandemic

Funding Acknowledgements Type of funding sources: Other. Main funding source(s): This work was financially supported by the project POCI-01-0145-FEDER-030011, funded by FEDER, through COMPETE2020-POCI, and by national funds, through FCT/MCTES (PTDC/MEC-CAR/30011/2017). CIAFEL, UnIC and UMIB are supported by national funds through Fundação para a Ciência e Tecnologia, I.P. [(UIDB/00617/2020), (UIDB/00051/2020 and UIDP/00051/2020), and (UIDB/00215/2020 and UIDP/00215/2020), respectively]. CS received an individual grant from CAPES [BEX 0554/14-6]. Introduction Cardiac rehabilitation (CR) is an evidence-based recommended treatment of heart failure (HF) patients. During the COVID-19 pandemic, the shutdown of CR centers was necessary to limit the infection risk among high-risk patients. The integration of a home-based CR (HBCR) program in CR units can help to improve the delivery of care and improve cardiovascular outcomes of HF patients. Purpose To assess the effectiveness of an HBCR program in HF patients. Methods This is a sub­study of the EXercise InTervention in Heart Failure trial (EXIT-HF), which include forty-nine HF patients (preserved and reduced ejection fraction). The HBCR program consisted in 12-week combined exercise program (60%-80% of peak oxygen consumption (VO2 peak)), 2 training sessions per week, for a total of 24 sessions. Patients performed 4 supervised training sessions and the remaining sessions at home. All patients performed a cardiopulmonary exercise test (VO2 peak), the 6-minute-walking test (6MWT), collected blood analysis (plasma NT-proBNP), and answered the Minnesota Living with Heart Failure Questionnaire. Results Forty-two patients (86%) complete at least 80% of prescribed training sessions (age: 61.1±12;FEVE: 37.1±10.8). The HBCR program improve VO2 peak from 18.3 to 20.1ml/kg/min (+1.8 ml/kg/min;95%IC:1.4 to 2.4;p<0.001) and the walked distance at the 6MWT from 462 to 512 meters (+49 meters;95%IC: 38 to 60;p<0.001). In addition, overall quality of life was improved (-13 points;95%IC:-7.8 to -18.5;p<0.001), as well physical (-6.3 points;95%IC:-3.5 to -9;p<0.001) and emotional dimension of quality of life (-2.8points ;95%IC: -0.9 to -4.7;p=0.06). No significant change was found in NT-proBNP levels (820±1220 vs 674±903;p=0.285). Conclusions Our results showed that HBCR is feasible and can improve functional capacity and quality of life in HF patients.

Sustainable Tourism as a Driving Factor for Competitiveness in the Olive Sector

Tourism is facing serious difficulties worldwide due to the global pandemic COVID-19, translating considerably into an industry effort to compete in the marketplace. In effect, sustainable tourism is considered to have a symbiotic relationship with competitiveness that will allow organisations to make a difference. This means that the sustainability factors are positively related to the competitiveness indicators. In this context, as the oliviculture sector faces challenges in a changing market in terms of ecological, demographic, and consumption practices changes, it is considered that sustainable tourism will enable the sector to make a difference. For, the environmental and social changes of the stakeholders enhance the promotion of sustainability to meet their needs, which in turn increases the sector's competitive advantage. In this respect, the present study was based on a literature review consolidated in a bibliometric analysis to analyse sustainable tourism as a driver of competitiveness in the oliviculture industry. For this purpose, the Scopus database was used, in which 157 full articles published until September 2021 were obtained. Based on the results, using the Bibliometrix R, it was found that research in this field has emerged in the last 20 years and focuses particularly on the terms “competitiveness”, “ecotourism” and “tourism development”. In addition, the countries with the highest scientific production and citations, the main sources of publication in this field of research, the documents with the most citations as well as the co-citations between authors were analysed. Through bibliometric analysis, it is possible to provide researchers, policy-makers and managers with a current view of the undoubted role that sustainable tourism plays in the competitiveness of the olive sector. Considering the trends, it is therefore expected to contribute bases for future strategies aimed at overcoming obstacles, overcoming challenges, and seizing opportunities for a more competitive sector. © 2022 IEEE Computer Society. All rights reserved.

The relationship of rural tourism with sustainable tourism and outdoor activities: A bibliometric analysis

A bibliometric study is a method used to evaluate the productivity of scientific results in quantitative terms. Bibliometricians apply mathematical and statistical methods to quantify scholarly communications. Using the Bibliometrix program, a database compiled from SCOPUS and Web of science was studied to study the different scientific and literary behaviours of rural tourism development, tourism sustainability, and outdoor activities. In the main database steps, 161 articles were analysed, of which 61 were SCOPUS articles, and 100 were Web of Science articles. As per this database, the relationship between rural tourism with sustainable tourism and outdoor activities, through a bibliometric analysis, looks to study the annual scientific production, the research impact, the authors, and articles most relevant to the themes of research trends over the years. Several interesting and important conclusions were obtained from these results for developing the themes. The results of this study indicate that sustainable tourism and rural tourism have extreme relevance to the studies carried out. Hence, rural tourism and outdoor activities are increasingly sustaining a relationship of partnership, much due to the influences of COVID-19. © 2022 IEEE Computer Society. All rights reserved.

Home-based cardiac rehabilitation can reduce anxiety and depression in heart failure patients

Introduction: The current COVID-19 pandemic has led to significant changes in physical and mental health and has become a major challenge for cardiac rehabilitation (CR) programs. CR is an essential component in the treatment of heart failure (HF), as it improves cardiorespiratory fitness and quality of life, as well as reducing hospitalization rates. COVID-19 pandemic increased social isolation, and the CR centers were closed. Center-based CR requires the patient to travel to the hospital, which increases the risk of SARS-CoV-2 infection in this high-risk population. In this context, home-based CR can be an excellent strategy to reduce the physical and mental consequences of the social isolation imposed by the COVID-19 pandemic. Objective: To test the effectiveness of a home-based CR program on cardiorespiratory fitness and anxiety and depression levels in individuals with HF during covid-19 pandemic. Methods: Forty-two individuals with HF (age: 61.3±12.0;LVEF: 37.5±11.2) were included in this study. The exercise training program consisted in 12 weeks of combined exercise training (2x/week;60min/day, 60-80% VO2peak), with 4 supervised exercise sessions in the hospital context and the remaining at home. Patients were monitored using a heart rate monitor and weekly phone calls. The following parameters were evaluated: cardiorespiratory fitness through the 6-minute walk test (6MWT) and anxiety and depression levels through the Hospital Anxiety and Depression Scale (HADS). Results: After the home-based CR program, there was a significant increase in the 6MWT of 49 meters (95%IC: 38 to 60;p<0.001) and a significant decrease in anxiety levels of -1.12 points (95%CI: - 2.163 to -0.075 p=0.036). No significant changes were found in depression levels (p=0.954). Furthermore, the improvements in cardiorespiratory fitness were significantly associated with the reduction in the levels of anxiety (r= -0.281;p=0.028) and depression (r=: -0.278;p=0.030). Conclusions: The home-based CR program was able to improve cardiorespiratory fitness and this improvement was associated with a decrease in anxiety and depression levels in individuals with HF. The results suggest that home-based CR can be an important strategy to minimize the physical and mental impact induced by social isolation imposed by COVID-19 pandemic in HF patients.

A live measles-vectored COVID-19 vaccine induces strong immunity and protection from SARS-CoV-2 challenge in mice and hamsters

Several COVID-19 vaccines have now been deployed to tackle the SARSCoV- 2 pandemic, most of them based on messenger RNA or adenovirus vectors. The duration of protection afforded by these vaccines is unknown, as well as their capacity to protect from emerging new variants. To provide sufficient coverage for the world population, additional strategies need to be tested. The live pediatric measles vaccine (MeV) is an attractive approach, given its extensive safety and efficacy history, along with its established large-scale manufacturing capacity. We develop an MeVbased SARS-CoV-2 vaccine expressing the prefusion-stabilized, membrane-anchored full-length S antigen, which proves to be efficient at eliciting strong Th1-dominant T-cell responses and high neutralizing antibody titers. In both mouse and golden Syrian hamster models, these responses protect the animals from intranasal infectious challenge. Additionally, the elicited antibodies efficiently neutralize in vitro the three currently circulating variants of SARS-CoV-2.

Seasonal Autoregressive Integrated Moving Average Time Series Model for Tourism Demand: The Case of Sal Island, Cape Verde

This article appears as an essential contribution for decision-makers in the Cape Verdean tourism sector given the impact that the number of overnight stays has on the economy of the country and the Sal Island, which until 2018 had been increasing every year. Since seasonality is a strong feature of the island’s tourism, decision-makers are interested in knowing the seasonal variation in tourism demand. Thus, this study focussed on the application of the Box-Jenkins method to the time series of the monthly number of nights stays in tourist establishments on the Sal Island, Cape Verde, over the period from January 2000 to December 2018, to find a model that better describes the series and with good forecast results for the year 2019. Several SARIMA models were studied using the Box-Jenkins method, with the SARIMA (1, 1, 1 ) (0, 1, 1 ) 12 and the SARIMA (2, 1, 0 ) (0, 1, 1 ) 12 demonstrating the best predictive performance in the test phase. However, in forecasting the series for the year 2019, the SARIMA (2, 1, 0 ) (0, 1, 1 ) 12 achieved the best results with a MAPE = 6.77%. This model can be used to simulate and analyze the number of overnight stays that be expected on the Island, if the tourism sector was not affected by the pandemic caused by COVID-19. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

ANÁLISE DE DADOS EPIDEMIOLÓGICOS DA INFLUENZA DURANTE A PANDEMIA DA COVID-19 NO BRASIL

Introdução/Objetivo: A pandemia da COVID-19 tem imposto grandes mudanças para o mundo, entre elas, o manejo e o diagnóstico de pacientes com essa enfermidade, que se tem mostrado um desafio ainda a ser superado, visto a alta transmissibilidade da COVID-19 e a similaridade dela com outras enfermidades como a Influenza. Dessa forma, o objetivo deste estudo é analisar variáveis como internações, mortalidade e gastos hospitalares referentes à Influenza no período da pandemia da COVID-19 e proporcionar medidas para se enfrentar essa e futuras pandemias. Métodos: Com base no sistema de dados da plataforma DATASUS realizou-se um estudo epidemiológico descritivo, em que foram coletadas informações sobre o número de internações, taxa de mortalidade, óbitos por faixa etária e gastos totais com hospitalizações, por influenza, no Brasil, de janeiro a setembro dos anos de 2017, 2018, 2019 e 2020. Procedeu-se à análise percentual e média dos dados, comparando a média dos últimos três anos ao ano de 2020, ano de pandemia. Resultados: Durante a pandemia da COVID-19, foram observadas 2147,11 internações, 6,59% de mortalidade nas internações e R$ 2.284.781,40 gastos com internações por gripe influenza. Esses números representam aumentos de 29,62%, 74,93% e 78,2%, respectivamente, nas médias de 1656,51 internações, de 3,77 % na taxa de mortalidade e do valor total de R$ 1.282.138,43 gastos com internações pela gripe influenza, os quais foram observados nos primeiros nove meses dos anos de 2017 a 2019. No ano de 2020, as faixas etárias de 80 anos ou mais, 70 a 79 anos e 60 a 69 anos obtiveram, 428, 329 e 258 óbitos, que representam, nessa ordem, aumentos de 72,85%, 179,6% e 268,57%, em comparação aos últimos três anos. Conclusão: O atual estudo cumpriu seus objetivos, com o foco na análise da situação do vírus influenza, no período da pandemia em 2020 e os três anos anteriores, verificando o aumento das internações, taxa de mortalidade e dos gastos hospitalares. Também, buscou analisar as dificuldades no diagnóstico e de coinfecções com a influenza, juntamente com a pandemia da COVID-19, o que causou atraso nas notificações e confirmações dos casos que, consequentemente, resultou em mortes e piores desfechos dos casos clínicos. Embora seja uma pandemia da atualidade, foi possível analisar a necessidade de maiores preparos para esse cenário, com investigações e monitoramento de cepas virais, para haver posteriormente medidas de prevenção e controle.

PRIMEIRO DIAGNÓSTICO DE FEBRE DO NILO OCIDENTAL EM HUMANO EM MINAS GERAIS: RELATO DE CASO

Introdução: O vírus do Nilo Ocidental, inicialmente isolado em Uganda em 1937, constitui uma das arbovirose de maior distribuição atual (1). No Brasil, há registros de casos humanos apenas no Piauí, onde dez pessoas foram diagnosticadas de 2014 a 2020 (1). A transmissão ocorre pela picada de mosquito Culex e aves migratórias são os principais hospedeiros (1). Apenas 20 a 40% dos pacientes infectados cursam com sintomas, geralmente leves, como náusea, vômito, cefaleia, mialgia, exantema, febre e adinamia (2). Com maior gravidade, a forma neuroinvasiva cursa com encefalite, meningite ou paralisia flácida (2). O diagnóstico pode ser obtido por sorologia ou PCR séricos, mas na doença neuroinvasiva os testes também devem ser realizados no líquor (2). Objetivo: Relatar o primeiro caso humano de febre do Nilo Ocidental (FNO) diagnosticado em Minas Gerais. Descrição do caso: Paciente de sexo feminino, 78 anos, covid-19 confirmado há 19 dias, procurou atendimento informando diplegia facial, disfagia e tetraparestesia, com tetraparesia há 2 dias. Informa que sintomas gripais iniciaram 10 dias após vacinação covid-19, sendo medicada com sintomáticos, sem sinais de gravidade. Após liberação de isolamento, permaneceu com dor e parestesia em MMII, ascendente e progressiva. Nega fenômenos isquêmicos ou hemorrágicos, alergias, viagens recentes, porém identificou ave morta em quintal da residência. Hipertensa, em uso de losartana e metoprolol. Durante internação, houve piora do quadro neurológico, disfonia, tetraplegia e insuficiência respiratória. Foi tratada com imunoglobulina, esteve 18 dias internada, com melhora paulatina do déficit motor, disfagia e fala. Como parte da investigação de síndrome febril inexplicada com quadro neurológico, foi realizado rastreio de arboviroses no líquor, confirmando-se o diagnóstico de febre do Nilo Ocidental por PCR. Comentários: Como apenas 1-2% dos casos de FNO são diagnosticados, a vigilância e o rastreio de doenças neuroinvasivas por arboviroses permitem compreender a dinâmica de transmissão do agravo no Brasil, com vistas à suspeita, notificação, investigação e manejo adequado.