Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 15 de 15
Filter
1.
J Infect Dis ; 2021 Dec 28.
Article in English | MEDLINE | ID: covidwho-1595523

ABSTRACT

We have investigated the evolution of the neutralizing response against SARS-CoV-2 variants at 8 months after Pfizer-BNT162b2 vaccination in COVID-19 naïve (n=21) and COVID-19 convalescent (n=21) individuals. Neutralizing levels declined for all variants (range 2-3.7-fold). Eight months after vaccination a significant proportion (4/21) of naïve individuals lacked detectable neutralizing activity against the highly transmissible SARS-CoV-2 delta variant. In the "convalescent" group the impressive high initial humoral response resulted in detectable neutralizing antibody levels against all variants throughout this period.

2.
Open Forum Infect Dis ; 8(10): ofab468, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1526183

ABSTRACT

Background: The objective of this study was to investigate the neutralizing response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VoC) during coronavirus disease 2019 (COVID-19) convalescence and after vaccination. Methods: COVID-19-convalescent and -naïve individuals were tested for neutralizing activity against SARS-CoV-2 VoC Alpha, Beta, Gamma, and Delta at 1 and 7 months postinfection and 4-6 weeks after BNT162b2 vaccination. Results: Vaccination induced a high neutralizing response in naïve individuals. Interestingly, vaccination of convalescent patients induced a boosted response that was able to neutralize all VoC at high titers. Conclusions: Vaccination with BNT162b2 induced high levels of neutralization against SARS-CoV-2 VoC in most patients; this is especially beneficial in COVID-19-convalescent individuals.

3.
Prehosp Disaster Med ; 36(6): 774-781, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1526025

ABSTRACT

Coronavirus disease 2019 (COVID-19) temporary hospitals, also called "alternate care sites" (ACS), as support to the health network have had uneven use. The World Health Organization (WHO) has published different recommendations in this regard. World-wide, many health services have improved their surge capacity with the implementation of new temporary hospital structures, but there have been few experiences of use over time despite representing an important element as support to the hospital network in the management of COVID-19 patients. In this article, the experiences are explained in the design, execution, and use of the temporary COVID-19 Hospital H144 of the Health Service of the Principality of Asturias (Sespa), with 144 beds, which was in operation from April 1 through July 1, 2020 (without admitting patients) and from November 12, 2020 through March 5, 2121, admitting a total of 334 COVID-19 patients (66% women; 34% men) and generating 3,149 hospital stays. Maximum occupancy was 74 patients. Mean stay was 9.42 days (MD = 3.99; [1-34]). At discharge, 126 patients (38%) went to a nursing home, 112 (33%) to their home, 40 (12%) were transferred to another hospital, and 56 (17%) died. The mean age of the admitted patients was 82.79 years (MD = 8.68; [29-104]) and was higher in women (85.09; MD = 7.57; P = .000) than in men (78.28; MD = 9.22). Some aspects to consider for future experiences of use have been: teamwork from different fields of knowledge (ie, architecture, engineering, medicine, and nursing) is essential for success; integration in the health system must be fully developed from different perspectives (ie, information system, logistics, medical records, or clinical procedures, among others); clear procedures for patient admission from different structures (ie, home, hospitals, nursing homes, or primary health care network) must combine with flexibility of use to adapt to new and unknown circumstances; and they must not compromise specialized staff availability in other health facilities.


Subject(s)
COVID-19 , Aged, 80 and over , Female , Hospitalization , Hospitals , Humans , Male , SARS-CoV-2 , Spain
4.
J Med Chem ; 64(19): 14332-14343, 2021 10 14.
Article in English | MEDLINE | ID: covidwho-1483078

ABSTRACT

In addition to a variety of viral-glycoprotein receptors (e.g., heparan sulfate, Niemann-Pick C1, etc.), dendritic cell-specific intercellular adhesion molecule-3-grabbing nonintegrin (DC-SIGN), from the C-type lectin receptor family, plays one of the most important pathogenic functions for a wide range of viruses (e.g., Ebola, human cytomegalovirus (HCMV), HIV-1, severe acute respiratory syndrome coronavirus 2, etc.) that invade host cells before replication; thus, its inhibition represents a relevant extracellular antiviral therapy. We report two novel p-tBu-calixarene glycoclusters 1 and 2, bearing tetrahydroxamic acid groups, which exhibit micromolar inhibition of soluble DC-SIGN binding and provide nanomolar IC50 inhibition of both DC-SIGN-dependent Jurkat cis-cell infection by viral particle pseudotyped with Ebola virus glycoprotein and the HCMV-gB-recombinant glycoprotein interaction with monocyte-derived dendritic cells expressing DC-SIGN. A unique cooperative involvement of sugar, linker, and calixarene core is likely behind the strong avidity of DC-SIGN for these low-valent systems. We claim herein new promising candidates for the rational development of a large spectrum of antiviral therapeutics.


Subject(s)
Calixarenes/chemistry , Cell Adhesion Molecules/antagonists & inhibitors , Glycoconjugates/metabolism , Glycoproteins/antagonists & inhibitors , Hydroxamic Acids/chemistry , Lectins, C-Type/antagonists & inhibitors , Phenols/chemistry , Receptors, Cell Surface/antagonists & inhibitors , Viral Proteins/antagonists & inhibitors , Antiviral Agents/chemistry , Antiviral Agents/metabolism , Antiviral Agents/pharmacology , Cell Adhesion Molecules/metabolism , Cell Line , Cytomegalovirus/metabolism , Dendritic Cells/cytology , Dendritic Cells/metabolism , Ebolavirus/physiology , Glycoconjugates/chemistry , Glycoconjugates/pharmacology , Glycoproteins/genetics , Glycoproteins/metabolism , Humans , Jurkat Cells , Lectins, C-Type/metabolism , Models, Biological , Protein Binding , Receptors, Cell Surface/metabolism , Recombinant Proteins/biosynthesis , Recombinant Proteins/chemistry , Recombinant Proteins/isolation & purification , Viral Proteins/genetics , Viral Proteins/metabolism
5.
PLoS Pathog ; 17(5): e1009576, 2021 05.
Article in English | MEDLINE | ID: covidwho-1236599

ABSTRACT

The efficient spread of SARS-CoV-2 resulted in a unique pandemic in modern history. Despite early identification of ACE2 as the receptor for viral spike protein, much remains to be understood about the molecular events behind viral dissemination. We evaluated the contribution of C-type lectin receptors (CLRS) of antigen-presenting cells, widely present in respiratory mucosa and lung tissue. DC-SIGN, L-SIGN, Langerin and MGL bind to diverse glycans of the spike using multiple interaction areas. Using pseudovirus and cells derived from monocytes or T-lymphocytes, we demonstrate that while virus capture by the CLRs examined does not allow direct cell infection, DC/L-SIGN, among these receptors, promote virus transfer to permissive ACE2+ Vero E6 cells. A glycomimetic compound designed against DC-SIGN, enable inhibition of this process. These data have been then confirmed using authentic SARS-CoV-2 virus and human respiratory cell lines. Thus, we described a mechanism potentiating viral spreading of infection.


Subject(s)
COVID-19/transmission , Lectins, C-Type/metabolism , SARS-CoV-2/metabolism , Spike Glycoprotein, Coronavirus/metabolism , Animals , Antigens, CD/metabolism , COVID-19/prevention & control , Cell Adhesion Molecules/metabolism , Cell Line , Chlorocebus aethiops , Humans , Jurkat Cells , Lung/metabolism , Mannose-Binding Lectins/metabolism , Mannosides/pharmacology , Protein Binding/drug effects , Receptors, Cell Surface/metabolism , Respiratory Mucosa/metabolism , Vero Cells
6.
Enferm Infecc Microbiol Clin (Engl Ed) ; 2021 Feb 19.
Article in English, Spanish | MEDLINE | ID: covidwho-1122923

ABSTRACT

INTRODUCTION: A newly identified SARS-CoV-2 variant, VOC202012/01 originating lineage B.1.1.7, recently emerged in the United Kingdom. The rapid spread in the UK of this new variant has caused other countries to be vigilant. MATERIAL AND METHODS: We based our initial screening of B.1.1.7 on the dropout of the S gene signal in the TaqPath assay, caused by the 69/70 deletion. Subsequently, we confirmed the B.1.1.7 candidates by whole genome sequencing. RESULTS: We describe the first three imported cases of this variant from London to Madrid, subsequent post-arrival household transmission to three relatives, and the two first cases without epidemiological links to UK. One case required hospitalization. In all cases, drop-out of gene S was correctly associated to the B.1.1.7 variant, as all the corresponding sequences carried the 17 lineage-marker mutations. CONCLUSION: The first identifications of the SARS-CoV-2 B.1.1.7 variant in Spain indicate the role of independent introductions from the UK coexisting with post-arrival transmission in the community, since the early steps of this new variant in our country.

7.
Clin Microbiol Infect ; 27(6): 886-891, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1101160

ABSTRACT

OBJECTIVES: This study compares the infectivity of SARS-CoV-2 in respiratory samples from patients with mild COVID-19 with those from hospitalized patients with severe bilateral pneumonia. In severe COVID-19, we also analysed the presence of neutralizing activity in paired sera. METHODS: We performed cell cultures on 193 real-time reverse transcription polymerase chain reaction respiratory samples, positive for SARS-CoV-2, obtained from 189 patients at various times, from clinical diagnosis to follow-up. Eleven samples were obtained from asymptomatic individuals, 91 samples from 91 outpatients with mild forms of COVID-19 and 91 samples from 87 inpatients with severe pneumonia. In these patients, neutralizing activity was analysed in 30 paired sera collected after symptom onset >10 days. RESULTS: We detected a cytopathic effect (CPE) in 91/193 (47%) samples. Viral viability was maintained for up to 10 days in patients with mild COVID-19. In patients with severe COVID-19, the virus remained viable for up to 32 days after the onset of symptoms. Patients with severe COVID-19 presented infectious virus at a significantly higher rate in the samples with moderate to low viral load (cycle threshold value ≥ 26): 32/75 (43%) versus 14/63 (22%) for mild cases (p < 0.01). We observed a positive CPE despite the presence of clear neutralizing activity (NT50 > 1:1024 in 10% (3/30) of samples. DISCUSSION: Patients with severe COVID-19 might shed viable virus during prolonged periods of up to 4 weeks after symptom onset, even when presenting high cycle threshold values in their respiratory samples and despite having developed high neutralizing antibody titres.


Subject(s)
COVID-19/immunology , COVID-19/virology , SARS-CoV-2/growth & development , Virus Cultivation , Adult , Aged , Animals , Antibodies, Viral/blood , COVID-19 Nucleic Acid Testing , Cell Culture Techniques , Chlorocebus aethiops , Cytopathogenic Effect, Viral , Female , Hospitalization , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Microbial Viability , Middle Aged , Pneumonia, Viral , SARS-CoV-2/pathogenicity , Serologic Tests , Severity of Illness Index , Time Factors , Vero Cells , Viral Load , Virus Shedding , Young Adult
8.
Eur J Pediatr ; 180(7): 2099-2106, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1092067

ABSTRACT

Fever without source (FWS) in infants is a frequent cause of consultation at the emergency department, and the emergence of SARS-CoV-2 could affect the approach to those infants. The aim of this study is to define the clinical characteristics and rates of bacterial coinfections of infants < 90 days with FWS as the first manifestation of SARS-CoV-2 infection. This is a cross-sectional study of infants under 90 days of age with FWS and positive SARS-CoV2 PCR in nasopharyngeal swab/aspirate, attended at the emergency departments of 49 Spanish hospitals (EPICO-AEP cohort) from March 1 to June 26, 2020. Three hundred and thirty-three children with COVID-19 were included in EPICO-AEP. A total of 67/336 (20%) were infants less than 90 days old, and 27/67(40%) presented with FWS. Blood cultures were performed in 24/27(89%) and were negative in all but one (4%) who presented a Streptococcus mitis bacteremia. Urine culture was performed in 26/27(97%) children and was negative in all, except in two (7%) patients. Lumbar puncture was performed in 6/27(22%) cases, with no growth of bacteria. Two children had bacterial coinfections: 1 had UTI and bacteremia, and 1 had UTI. C-reactive was protein over 20 mg/L in two children (one with bacterial coinfection), and procalcitonin was normal in all. One child was admitted to the pediatric intensive care unit because of apnea episodes. No patients died.Conclusion: FWS was frequent in infants under 90 days of age with SARS-CoV-2 infection. Standardized markers to rule out bacterial infections remain useful in this population, and the outcome is generally good. What is Known: • Fever without source (FWS) in infants is a common cause of consultation at the emergency department, and young infants have a higher risk of serious bacterial infections (SBI). • The emergence of the new coronavirus SARS-CoV-2 could affect the approach to young infants with FWS in the emergency department. management of those children is a challenge because information about bacterial coinfection and prognosis is scarce. What is New: • SARS-CoV-2 infection should be ruled out in young infants (< 90 days of age) with FWS in areas with community transmission. • Bacterial coinfection rarely coexists in those infants. • Inflammatory markers were not increased in children without bacterial coinfection. • Outcome is good in most patients.


Subject(s)
COVID-19 , SARS-CoV-2 , Child , Cross-Sectional Studies , Fever/epidemiology , Fever/etiology , Humans , Infant , RNA, Viral
9.
Microorganisms ; 9(2)2021 Feb 22.
Article in English | MEDLINE | ID: covidwho-1090315

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in Madrid, Spain, on 25 February 2020. It increased in frequency very fast and by the end of May more than 70,000 cases had been confirmed by reverse transcription-polymerase chain reaction (RT-PCR). To study the lineages and the diversity of the viral population during this first epidemic wave in Madrid we sequenced 224 SARS-CoV-2 viral genomes collected from three hospitals from February to May 2020. All the known major lineages were found in this set of samples, though B.1 and B.1.5 were the most frequent ones, accounting for more than 60% of the sequences. In parallel with the B lineages and sublineages, the D614G mutation in the Spike protein sequence was detected soon after the detection of the first coronavirus disease 19 (COVID-19) case in Madrid and in two weeks became dominant, being found in 80% of the samples and remaining at this level during all the study periods. The lineage composition of the viral population found in Madrid was more similar to the European population than to the publicly available Spanish data, underlining the role of Madrid as a national and international transport hub. In agreement with this, phylodynamic analysis suggested multiple independent entries before the national lockdown and air transportation restrictions.

10.
Emergencias (Sant Vicenç dels Horts) ; 32(3):157-159, 2020.
Article in Spanish | IBECS | ID: covidwho-1016700

ABSTRACT

No disponible

11.
PLoS One ; 15(11): e0243029, 2020.
Article in English | MEDLINE | ID: covidwho-951198

ABSTRACT

OBJECTIVES: To evaluate the progression of the seroprevalence of SARS-CoV-2 in the pregnant population of the south of Madrid during the first wave of the COVID-19 pandemic. Secondarily we aimed to evaluate maternal and perinatal outcomes. STUDY DESIGN: Retrospective cohort study conducted at Hospital Universitario 12 de Octubre during weeks 10 to 19 of 2020, coinciding with the Spanish lockdown. We tested 769 serum samples obtained from routine serological testing during the first and third trimesters of pregnancy for specific IgG anti SARS-CoV-2 RBD and S proteins. RT-PCR tests were performed in suspected cases according to clinical practice. We compared maternal and perinatal outcomes in those with delivered pregnancies (n = 578) according to the presence or absence of specific IgG antibodies. Those with positive IgG were subdivided by the presence or absence of Covid-19 related symptoms at any time and the results of RT-PCR testing if performed. Therefore, we had 4 study groups: G1 (IgG negative), G2 (IgG positive, asymptomatic, RT-PCR testing negative or not done), G3 (IgG positive, symptomatic, RT-PCR testing negative or not done), and G4 (IgG positive, symptomatic, RT-PCR positive). RESULTS: Seropositivity increased from 0% to 21.4% (95% CI 11.8-31.0) during the study period, of which 27.9% had an asymptomatic course. Overall outcomes were favorable with a significant increased rate of preterm birth in G4 vs G1 (21.4% vs 6.7%) and cesarean/operative delivery (50% vs 26.9%). Asymptomatic and mild cases did not have differences regarding pregnancy course when compared to seronegative women. There were no documented cases of vertical or horizontal transmission. CONCLUSION: Seroprevalence in pregnant women in southern Madrid went up to 21.4% of which 27.9% had an asymptomatic course. Overall perinatal results were favorable, especially in those asymptomatic.


Subject(s)
Pandemics , Pregnancy Complications, Infectious/epidemiology , SARS-CoV-2/physiology , Adult , Cohort Studies , Female , Humans , Pregnancy , Retrospective Studies , Seroepidemiologic Studies
12.
Prog Disaster Sci ; 8: 100136, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-927444

ABSTRACT

The COVID-19 pandemic has shocked health systems worldwide, with visible impacts on intensive care units and emergency departments. The concept of "surge capacity" should be analyzed within this context as this crisis could be seen as an opportunity to improve the knowledge base of intensive care units and emergency departments. We reflected, based on our experience from work at the frontlines, on health service planning and with epidemiological data, about the importance of surging critical care capacity for COVID, now and as lessons for the future. We summarize and relate virus clinical characteristics, epidemiological patterns and critical care surge capacity as important factors to consider for effective health systems response. Some practical aspects are described, but also the role that mathematical models can play to improve intensive care units surge capacity by considering its importance as a predictor of needs according to epidemiological patterns. Also, in the transitional phase, we consider the importance of coexisting COVID-19 and non-covid-19 health care services, and the importance of a new surge capacity for postponed activities. In this new transitional phase, also emergency departments will have to adapt their surge capacity for a rebound effect due to delayed visits from non-COVID-19 health conditions during the pandemic. Health systems and society must remain vigilant for potential resurgence of cases as measures are relaxed to restart the economy and a new normal. Emergency departments and intensive care units have to develop surge strategies to deal together with COVID-19 and non-COVID-19 flow of patients.

14.
Eur J Haematol ; 105(5): 597-607, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-671499

ABSTRACT

BACKGROUND: The impact of coronavirus disease 2019 (COVID-19) in haematological patients (HP) has not been comprehensively reported. METHODS: We analysed 39 patients with SARS-CoV-2 infection and haematological malignancies. Clinical characteristics and outcomes were compared to a matched control group of 53 non-cancer patients with COVID-19. Univariate and multivariate analyses were carried out to assess the risk factors associated with poor outcome. RESULTS: The most frequent haematological diseases were lymphoma (30%) and multiple myeloma (30%). Eighty-seven % HP developed moderate or severe disease. Patients with haematological malignancies had a significantly higher mortality rate compared to non-cancer patients (35.9% vs 13.2%; P = .003 (odds ratio 6.652). The worst outcome was observed in chronic lymphocytic leukaemia patients. Only age >70 years and C reactive protein >10 mg/dl at admission were associated with higher risk of death (odds ratio 34.86, P = .003 and 13.56,P = .03). Persistent viral sheddind was detected in 5 HP. Active chemotherapy, viral load at diagnosis and COVID-19 therapy were not predictors of outcome. CONCLUSION: Mortality of COVID-19 is significantly higher in patients with haematological malignancies compared to non-cancer patients. The impact of persistent viral shedding must be considered in order to re-start therapies and maintain infectious control measures.


Subject(s)
COVID-19/complications , COVID-19/mortality , Hematologic Neoplasms/complications , Adult , Age Factors , Aged , Aged, 80 and over , COVID-19/blood , Case-Control Studies , Female , Hematologic Neoplasms/blood , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Lymphoma/complications , Male , Middle Aged , Multiple Myeloma/complications , Multivariate Analysis , Pandemics , Risk Factors , SARS-CoV-2 , Spain/epidemiology
15.
J Perinat Med ; 48(9): 981-984, 2020 Nov 26.
Article in English | MEDLINE | ID: covidwho-654794

ABSTRACT

Objectives Asymptomatic women admitted to labor may act as silent spreaders of COVID-19. Therefore, universal screening at admission has been proposed. The objective of the study was to evaluate the performance of universal screening for SARS-CoV-2 using quantitative reverse transcription polymerase-chain-reaction (qRT-PCR) tests in women admitted to labor. Methods Observational retrospective study of a cohort of pregnant women admitted to labor and delivery between April 8 and May 2, 2020 in a large maternity in Madrid. SARS-CoV-2 screening with qRT-PCR from combined nasopharyngeal and oropharyngeal swabs was carried out systematically. Screening performance was described. Results We attended 212 deliveries. Nine cases with COVID-19 diagnosis before admission were excluded. In the remaining 203 women, seven referred COVID-19-related symptoms but only one had a positive qRT-PCR. Among the 194 asymptomatic women, only one case (0.5%) was positive. Conclusions The percentage of positive tests in asymptomatic women admitted to delivery was only 0.5% during the post-peak period.


Subject(s)
Betacoronavirus , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Labor, Obstetric , Mass Screening , Pneumonia, Viral/diagnosis , Asymptomatic Infections/epidemiology , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , COVID-19 , COVID-19 Testing , Cohort Studies , Coronavirus Infections/epidemiology , Delivery, Obstetric , Female , Hospitalization , Humans , Infant, Newborn , Pandemics , Pneumonia, Viral/epidemiology , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Spain/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL
...