Impact of SARS-CoV-2 on HLA serological phenotyping level in southern Portuguese solid organ donors

HLA molecules play a key role in transplant medicine and disease pathogenesis, being a useful tool in predicting disease progression and identifying potential solid organ donors (SOD). The Coronavirus disease 2019 (SARS-CoV-2) pandemic had a huge worldwide impact, which strongly affected the activity of different transplant programs. So far, it has been shown that HLA type may be a crucial differentiator between individuals who have varying occurrence, morbidity, and mortality response to SARS-CoV-2. In this work, we investigated if differences in the frequency of SOD HLA alleles, were impacted during SARS-CoV-2 pandemic. We performed a retrospective file audit of all HLA-typings done in 2 subsets of SOD pre-pandemic period (ppp) (n = 379) and pandemic period (pp) (n = 351), collected in equivalent timeframes. We discuss data for the major HLA-A, HLA-B, HLA-C, and HLA-DRB1 allele groups at serological phenotyping level. Overall, there was a 7% SOD decrease in the pp. Considering both periods, the most common allele groups were HLA-A2, HLA-B35, HLA-Cw7, HLA-DR7 and HLA-DQ2. For the ppp group, the most common alleles were HLA-A2, HLA-B35, HLA-Cw7, HLADR13 and HLA-DQ2, while in the pp group the most common alleles were HLA-A2, HLA-B44, HLA-Cw7, HLA-DR4 and HLA-DQ2. When comparing both populations at the serological phenotyping level an increased in relative frequency was found for 10, 12, 8, 8 and 2, and a decreased was found for 10, 24, 8, 6 and 5 for HLA-A, -B, -C, -DR and -DQ, respectively. The significant variation within the HLA frequencies between the different pre-pandemic and pandemic groups highlights the value of population-specific HLA-typing. Furthermore, the identification of different frequencies among both populations will impact in patients HLA compatibility with SOD thus impacting their transplantability.

Subcutaneous immunotherapy with aeroallergens in a central hospital in portugal during the covid-19 pandemic

Background: Allergic disease, allergic rhinoconjunctivitis/bronchial asthma, are very prevalent worldwide, and the poten-tially modifying therapy is immunotherapy with aeroallergens. In December 2019 a new coronavirus (SARS-CoV-2) was iden-tified in China, causing a pandemic with devastating effects. For this reason, the State of Emergency (SE) was declared in Portugal for the first time in this pandemic, between 18 March and 2 May 2020, and all non-urgent activity was suspended in our hospital, including the administration of subcutaneous immunotherapy with aeroallergens (SCITA). Objective: Cha-racterize the dose adjustments according to the delay in SCITA administration, verify the safety of the dose administered when resuming SCITA and evaluate the worsening of symptoms of the allergic disease, in patients under SCITA program that inter-rupted it during the SE. Material and methods: An analysis of the SCITA clinical records of the 195 patients who interrupt-ed the maintenance dose during EE was performed. According to the symptoms and the delay interval, the dose was reduced or a new initiation protocol was performed, according to our Allergen Immunotherapy Functional Unit protocol, adapted from international guidelines for this specific time. Results: 7.7% of patients had worsening of allergic symptoms during the interruption period and 6.2% resorted to rescue therapy. 96.4% decreased the dose in SCITA resumption, with a decrease that was mostly greater than predicted, according to our protocol. Immediate local reactions were recorded in 9.2%, with no ana-phylactic reactions. After recovery, 9.7% worsened symptoms and 5.1% resorted to rescue therapy. Conclusions: The pandemic made it very difficult to monitor patients’ chronic pathologies, including allergic diseases. The majority of patients did not report worsening of symptoms and few had adverse reactions in the resumption of SCITA, demonstrating the safety of the dose adjustment protocol. © 2021 Sociedade Portuguesa de Alergologia e Imunologia Clínica. Published by Publicações Ciência & Vida.

Tourism 5.0: A contribution to the identification of specialized niches from context awareness

Tourism is a sector that employs a significant amount of labor, but thanks to the pandemic generated by COVID-19 it is a sector that is now among the most threatened. The consequences will affect the most vulnerable groups. This situation has invited to rethink about the best options for the reactivation of the activity. The fear of mass tourism has made people look towards community tourism, the contemplative and nature tourism, where the gathering of people is limited to small groups. It is necessary to mitigate the negative impact on the inhabitants of the destination, thus strengthening the development of a 5.0 tourism that takes care of society and its quality of life, through the identification of specialized niches, under a context awareness framework. This document presents the approaches to tourism planning, a comparison of different models that measure aspects of quality of life for populations and the proposal for the use of expert systems for tourism actors: the tourist, the host and the government. © 2020, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.