Association between religion, mental health and social distancing during the Covid-19 pandemic / Associação entre religião, saúde mental e distanciamento social na pandemia de Covid-19 / Asociación entre religión, salud mental y distanciamiento social en la pandemia Covid-19

This cross-sectional study aimed to analyze the association of religiosity with behaviors and perceptions in the context of social distancing measures during the COVID-19 pandemic, as well as mental health outcomes, in a university community in Central-West Brazil. A sample of 1,796 subjects responded to an online form with socio-demographic questions and the DASS-21 and PWBS scales. Religion was associated with the frequency of interactions, perceptions of the duration of the social distancing measures, changes in emotional state and history of psychological illness. The prevalence of symptoms of depression, anxiety and stress was lower among people with religion and their scores in psychological well-being were higher. (AU)

Trata-se de um estudo transversal com o objetivo de analisar a associação entre religiosidade e comportamentos e percepções frente ao distanciamento social decorrente da pandemia de Covid-19 e estado de saúde mental em uma comunidade universitária do Centro-Oeste brasileiro. Participaram do estudo 1796 sujeitos, os quais responderam a um formulário online com questões sociodemográficas e às escalas DASS-21 e EBEP. Observou-se associação entre religião e frequência de interações, percepção sobre a duração do distanciamento social e mudanças no estado emocional e histórico de alterações psicológicas. Constatou-se menor prevalência de sintomas relacionados à depressão, à ansiedade e ao estresse e maiores escores de bem-estar psicológico entre aqueles com religião. (AU)

Se trata de un estudio transversal con el objetivo de analizar la asociación entre religiosidad, comportamientos y percepciones frente al distanciamiento social resultante de la pandemia Covid-19 y el estado de salud mental en una comunidad universitaria de la región Centro-Oeste de Brasil. Participaron en el estudio 1796 sujetos, que respondieron un formulario en línea con preguntas sociodemográficas y las escalas DASS-21 y EBEP. Se observó asociación entre religión y frecuencia de interacciones, la percepción de la duración del aislamiento social y los cambios en el estado emocional y el historial de cambios psicológicos. Se observó una menor prevalencia de síntomas relacionados con la depresión, la ansiedad y el estrés, y puntuaciones más altas de bienestar psicológico entre quienes profesaban una religión. (AU)

Overview of the SARS-CoV-2 genotypes circulating in Latin America during 2021 (preprint)

Latin America is one of the regions in which the COVID-19 pandemic has had a stronger impact, with more than 72 million reported infections and 1.6 million deaths until June 2022. Since this region is ecologically diverse and is affected by enormous social inequalities, efforts to identify genomic patterns of the circulating SARS-CoV-2 genotypes are necessary for the suitable management of the pandemic. To contribute to the genomic surveillance of the SARS-CoV-2 in Latin America, we extended the number of SARS-CoV-2 genomes available from the region by sequencing and analyzing the viral genome from COVID-19 patients from seven countries (Argentina, Brazil, Costa Rica, Colombia, Mexico, Bolivia and Peru). Subsequently, we analyzed the genomes circulating mainly during 2021 including records from GISAID database from Latin America. A total of 1534 genome sequences were generated from seven countries, demonstrating the laboratory and bioinformatics capabilities for genomic surveillance of pathogens that have been developed locally. For Latin America, patterns regarding several variants associated with multiple re-introductions, a relatively low percentage of sequenced samples, as well as an increment in the mutation frequency since the beginning of the pandemic, are in line with worldwide data. Besides, some variants of concern (VOC) and variants of interest (VOI) such as Gamma, Mu and Lambda, and at least 83 other lineages have predominated locally with a country-specific enrichments. This work has contributed to the understanding of the dynamics of the pandemic in Latin America as part of the local and international efforts to achieve timely genomic surveillance of SARS-CoV-2.

Evaluation of Clinical Course of Gamma (P.1) Variant of Concern versus Lineages in Hospitalized Patients with COVID-19 in a Reference Center in Brazil.

The SARS-CoV-2 variant of concern (VOC) gamma (P.1) has increased transmissibility and resulted in elevated hospitalization and mortality rates in Brazil. We investigated the clinical course of COVID-19 caused by gamma and non-VOCs at a reference hospital in Brazil in a retrospective cohort study with nonelderly hospitalized patients from two periods, before and after the emergence of gamma. Cohort 1 included patients from both periods whose samples would be eligible for whole-genome sequencing (WGS). Cohort 2 was composed of randomly selected patients from Cohort 1 whose samples were submitted to WGS. A total of 433 patients: 259 from the first and 174 from the second period. Baseline characteristics were similar, except for a higher incidence of severe distress respiratory syndrome at admission in patients from the second period. Patients from the second period had significantly higher incidence rates of advanced respiratory support (adjusted hazard ratio [aHR]: 2.04; 95% confidence interval [CI], 1.60-2.59), invasive ventilatory support (aHR: 2.72; 95% CI: 2.05-3.62), and 28-day mortality from the onset of symptoms (aHR: 2.62; 95% CI: 1.46-4.72). A total of 86 (43 gamma and 43 nongamma) patients composed Cohort 2. Patients with confirmed gamma VOC infections had higher advanced ventilatory support and mortality rates than non-gamma-infected patients. Our study suggests that nonelderly patients hospitalized for COVID-19 in the second period (used as a proxy of gamma infection) had a more severe clinical course. This might have contributed to higher hospitalization and death rates observed in the second wave in Brazil.

Increased mTOR signaling, impaired autophagic flux and cell-to-cell viral transmission are hallmarks of SARS-CoV-2 infection. (preprint)

The COVID-19 disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has two characteristics that distinguish it from other viral infections. It affects more severely people with pre-existing comorbidities and viral load peaks prior to the onset of the symptoms. Investigating factors that could contribute to these characteristics, we found increased mTOR signaling and suppressed genes related to autophagy, lysosome, and vesicle fusion in Vero E6 cells infected with SARS-CoV-2. Transcriptomic data mining of bronchoalveolar epithelial cells from severe COVID-19 patients revealed that COVID-19 severity is associated with increased expression of genes related to mTOR signaling and decreased expression of genes related to au-tophagy, lysosome function, and vesicle fusion. SARS-CoV-2 infection in Vero E6 cells also re-sulted in virus retention inside the cells and trafficking of virus-bearing vesicles between neighboring cells. Our findings support a scenario where SARS-CoV-2 benefits from compromised autophagic flux and inhibited exocytosis in individuals with chronic hyperactivation of mTOR signaling, which might relate to undetectable proliferation and evasion of the immune system.

Advanced ventilatory support and mortality in hospitalized patients with COVID-19 caused by Gamma (P.1) variant of concern compared to other lineages: cohort study at a reference center in Brazil (preprint)

Background: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variant of concern (VOC) Gamma (P.1) has increased transmissibility and resulted in elevated hospitalization, intensive care unit occupancy and mortality rates in Brazil. It is not known whether this VOC is also associated with more severe clinical course of disease. Methods This was a retrospective cohort study with non-elderly patients hospitalized for COVID-19 from June to December/2020 (first period) and February to May/2021 (second period) at a reference hospital in Brazil. Two cohorts were performed: the main cohort, composed by patients with SARS-CoV-2 lineages confirmed by whole genome sequencing; and the sensitivity cohort, composed by all eligible patients admitted before and after the emergence of Gamma. The primary outcome was the incidence rate of need of advanced ventilatory support. Results In the main cohort a total of 86 (43 Gamma and 43 non-Gamma) patients were included. Baseline characteristics were similar, except that Gamma patients had lower median Charlson’s comorbidity score. The crude and adjusted incidence rates of advanced respiratory support (adjusted Hazard Ratio [aHR], 1.78; 95% Confidence Interval [CI], 1.05–3.03), invasive respiratory support (aHR, 2.64; 95% CI, 1.34–5.19) and 28-day mortality from onset of symptoms (aHR, 4.73; 95% CI, 1.15–19.41) and adjusted 28-day mortality from hospital admission (aHR, 3.72; 95% CI, 1.19–11.65) were significantly higher in patients infected by Gamma. These patients had significantly lower days alive and free of supplemental oxygen support. The sensitivity cohort included 433 patients: 259 from the first and 174 from the second period (before and after the emergence of Gamma, respectively). Baseline characteristics were similar, except for a higher incidence of severe distress respiratory syndrome in patients from second group at admission. Patients from the second period had significantly higher incidence rates of advanced respiratory support (aHR, 2.04; 95% CI, 1.60–2.59), invasive ventilatory support (aHR, 2.72; 95%CI, 2.05–3.62), and 28-day mortality from the onset of symptoms (aHR, 2.62; 95%CI, 1.46–4.72). Conclusions Our study suggests that in non-elderly hospitalized patients, COVID-19 caused by Gamma VOC may present a more severe clinical course, with increased need of advanced respiratory support and higher 28-day mortality.