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1.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617060

ABSTRACT

Background: Respiratory syncytial virus (RSV) is the main cause of acute bronchiolitis. The peak of the infection is historically described in the autumn/winter season. The 2020 COVID-19 pandemic seems to have modified the seasonality of some respiratory viruses. The first case of SARS-CoV-2 infection diagnosed in Portugal was in March 2020. School closure and the use of masks are some of the pointed reasons for a decreased number of RSV infections observed in the autumn/winter season post the beginning of the pandemic. Interestingly, there are now a few studies from around the globe showing the resurgence of RSV infections in the spring/summer season that followed. Aim: To characterize the population of RSV infected infants admitted to a tertiary hospital before and after the beginning of the COVID-19 pandemic. Methods: A retrospective, descriptive, study was performed. All the RSV infected infants who were admitted to a Portuguese tertiary hospital from January 2017 to August 2021 were evaluated. The diagnosis of RSV infection was made through polymerase chain reaction of nasal secretions. Data such as age, gender, reason for admission, comorbidities, viral coinfection, bacterial superinfection, oxygen therapy, admission at Intensive Care Unit, ventilatory support and length of hospital stay were analyzed. Results: The data of a total of 354 patients was analyzed. The median age was 4 months (min 9 days, max 4 years), 50% were male. Before the COVID-19 pandemics (between 2017 and 2019), the peak of RSV infections used to occur in the months of December and January (medium of 25 and 28 cases per month, respectively). However, in December 2020 and January 2021 there was no detection of RSV. Nonetheless, a peak of RSV infection was verified in July and August 2021 (18 and 15 cases per month, respectively). The number of patients admitted for non-respiratory motifs, but in whom RSV was detected during the course of hospital stay, increased in 2021 (39%), comparing to 2017 (0%), 2018 (3%), 2019 (8%) or 2020 (3%), p<0,05. The number of viral coinfections was higher in 2021 (50%) comparing to 2017 (29%), 2019 (19%) or 2020 (18%), p<0,05. The patients admitted in 2021 were older (12 months average) than patients admitted in 2017 (5 months average) or 2018 (6 months average), p<0,05. Conclusions: RSV seasonality was modified by the COVID-19 pandemic, with an increase of the hospital admissions being registered in the summer of 2021. Our tertiary hospital's numbers reproduce what is being described in other places of the world. Subsequent studies are needed to verify the behavior of RSV infections in the next seasons, to understand if RSV infections are becoming more or less severe and to analyze the impact of SARS-CoV-2 virus on the virulence of RSV.

2.
Revista Brasileira de Parasitologia Veterinaria ; 30(4), 2021.
Article in English | Scopus | ID: covidwho-1598125

ABSTRACT

The article presents an exploratory, descriptive study on Bad News Communication skills (CMN) of medical interns. The student’s perception was on learning for the CMN was investigated with a cross-sectional design and a mixed approach. A questionnaire was applied, 176 participants were obtained, and a focus group was held with 12 students. The data were analyzed through the calculation of means and standard deviations for quantitative variables and the focus group reports were subjected to Content Analysis. It was observed that in the group that had training, compared to the one who did not, ocurred twice frequency with more skill for CMN. In the CMN’s management, it was considered harder to be “honest without taking away hope” (69%) and “to deal with the patient’s emotion” (59%). 99.4% knew the SPIKES protocol, of which 41.5% considered the expression of emotions as its most difficult stage. Communication and handling of emotions were pointed out as the main difficulties in the doctorpatient relationship, with deficits in the teaching of CMN. It was found that CMN is not limited to the technical issue, but it involves attitudes that need to be addressed with different methodologies, as well as the implementation of educational policies in the medical field, especially given the demands that emerges with the covid-19 pandemic. © 2021, Brazilain Coll Veterinary Parasitology. All rights reserved.

3.
Brazilian Journal of International Law ; 18(2):91-106, 2021.
Article in Portuguese | Scopus | ID: covidwho-1551764

ABSTRACT

The Covid-19 pandemic has had numerous social, political, economic and legal consequences around the world. Among the measures recommended by health authorities is social distancing, a recommendation that significantly affected Brazilian society and economy, with a high rate of informality. The President of the Republic of Brazil, after a period of inertia marked by denial of the seriousness of the disease, issued Provisional Measure 936/2020 containing changes in the scope of Labor Law in order to protect the economy and also the jobs of Brazilians. However, even in the case of an atypical pandemic context that requires exceptional actions, the legal measures adopted must be compatible with the Federal Constitution and with international conventions, especially those ratified by the Brazilian State within the scope of the International Labor Organization. Therefore, all public authorities involved in the elaboration of the necessary measures to face the consequences of the pandemic must carry out the constitutionality and conventionality controls. Thus, the present work discussed the conventionality control through a bibliographical review and through the analysis of the opinion of the Mixed Commission of the National Congress on the Provisional Measure 936/2020. It was verified that such control did not exist in relation to Provisional Measure 936/2020, despite its incompatibility with International Labor Organization conventions ratified by the Brazilian State, a fact capable of giving rise to the international responsibility of Brazil. © 2021 Centro Universitario de Brasilia. All rights reserved.

4.
Angiologia e Cirurgia Vascular ; 17(1):13-19, 2021.
Article in English | EMBASE | ID: covidwho-1525191

ABSTRACT

Background: The surge of the COVID-19 pandemic in Portugal and the implemented public health measures were accompanied with a noticeable decrease in patients' attendance to the Emergency Department (ED). Objectives: This study aims to evaluate the impact of COVID-19 pandemic on Vascular Surgery ED admissions, by comparing clinical and demographic characteristics of patients visiting the ED during the pandemic and the homologous period of 2019. Methods: We retrospectively collected data from patients admitted to the ED of a Portuguese tertiary hospital centre between March 4th and April 1st, 2020 - two weeks before and two weeks after the governmental implementation of the state of emergency in our country due to the COVID-19 pandemic - and the homologous period of 2019. Individual medical records were revised to obtain patients demographics and characteristics, clinical severity under the Manchester Triage System (MTS), final diagnosis, need for hospitalization or emergent/urgent surgery, in-hospital length of stay and mortality within 30 days of hospital discharge. Results: A total of 119 and 210 patients visited the Vascular Surgery ED during the pandemic and the homologous period of 2019, respectively. Males comprised the majority of patients in both years and the proportion of women visiting the ED was lower in 2020 compared to 2019 (P=0.015). The MTS attributed a lower number of high-priority levels (yellow and orange) to patients visiting the ED in 2020 (P=0.048). A higher proportion of patients required in-hospital treatment or emergent/urgent surgery (P<0.001 and P=0.002, respectively) during the pandemic. No differences were observed in in-hospital length of stay and early mortality. The most prevalent diagnosis during this critical period were chronic limb threatening ischemia (CLTI), deep vein thrombosis, and acute limb ischemia;in 2019, CLTI, non-vascular limb pain and post-operative pain were the dominating diagnosis. Conclusion: We found a 43.3% decrease in the number of visits to the Vascular Surgery ED in the first month after the inaugural diagnosis of COVID-19 in Portugal. There was a significant reduction of patients with high-priority complaints, but those who presented to the ED had more severe and advanced disease, refiected by the increased proportion on hospitalization and emergent/urgent surgery requirements. Fear of infection and mobility limitations imposed by the quarantine may deter patients from attending the ED and delay proper healthcare. Mid to long-term impact of such behaviour on morbimortality should be determined to evaluate the quality of response of healthcare services to the pandemic.

5.
Pesquisa Brasileira Em Odontopediatria E Clinica Integrada ; 21:7, 2021.
Article in English | Web of Science | ID: covidwho-1511868

ABSTRACT

Objective: To evaluate the effect of the COVID-19 impacts on the activities of researchers in the field of Oral Medicine (OM) and Oral Pathology (OP). To assess the research activities and training of human resources by Brazilian productivity fellows in research (BPFR) in OM and OP in the COVID-19 Era. Material and Methods: Thirty-six BPFR in OM and OP areas, funded by National Council for Scientific and Technological Development (CNPq), received a virtual structured questionnaire by e-mail, on the Google Forms (Google (R)) platform, with questions regarding research activities and training of human resources (supervision of undergraduate and postgraduate students), during the COVID-19 pandemic. From the thirty-six BPFR in OM and OP, twenty-seven (75.0%) answered the questionnaire. Results: Most of them were males (n=20;74.1%) and were distributed in four Brazilian regions and ten states of the federation, including the Federal District. Twenty-four (88.9%) BPFR reported having suspended clinical activities, while sixteen (59.3%) answered that histopathology practices are suspended. Twenty-five (92.6%) BPFR mentioned difficulties in conducting research projects and 55.5% stated having no difficulties in the supervision of undergraduates, master's and PhD students. Conclusion: The current scenario may significantly impact the diagnosis of oral diseases in Brazil. Moreover, a decrease in the scientific production of BPFR in OM and OP in the coming years is also considered.

6.
Educacion Fisica Y Ciencia ; 23(3):13, 2021.
Article in Portuguese | Web of Science | ID: covidwho-1503045

ABSTRACT

The year 2020 was marked by the pandemic of Covid-19, a fact that impacted on different aspects of life. The social distancing was one of the ways to contain the pandemic, causing the cessation of face-to-face classes in Brazil, migrating to a remote teaching model. In this reality, this study, which considers remote teaching within the Brazilian social, political, and economic context, aimed to problematize the teaching of Physical Education in the context of remote classes in Brazil, focusing on the work with those considered students of inclusion. It is a qualitative exploratory study, in which interviews with Physical Education teachers were conducted. 116 interviews were carried out through a questionnaire elaborated on the Google platform. The analysis followed the contribution of post-structuralist researches to think about Education, supported by the concepts of governamentality and teaching. From the analysis, two points are brought up for discussion: the practices worked in Physical Education with students of inclusion in remote education, and the idea of teaching crisis in inclusive Physical Education. Thus, it is argued that the lack of contact with students at school and the inequalities in the Brazilian social and economic context can lead to exclusionary practices and contribute to teaching burnout.

8.
Journal of Human Sport and Exercise ; 16:S84-S91, 2021.
Article in English | Web of Science | ID: covidwho-1353408

ABSTRACT

Museums are important instruments for preserving a group's cultural memory and are responsible for its material or immaterial heritage. Furthermore, they participate in the tourism economy and in productive projects that contribute to the quality of life in the communities and regions in which they are located. Thus, in a period marked by the Coronavirus pandemic, with lockdowns going on in various parts of the world, online platforms for cultural consumption have been highlighted as a manner of guaranteeing entertainment and cultural access to the whole population. Thus, the present study aims to present the media impact results for the eMuseum of Sports in Brazilian digital and televised media. To fulfil this goal, the documental analysis technique was used to conduct a survey of the Sports eMuseum's impact through digital data. The internet data was obtained from the social networks Facebook and Instagram and the eMuseum's website, where all of its exhibits are concentrated. These digital communication media possess data analysis metrics that show how a certain post was followed by the public that uses these networks. Between April and October of 2020, the eMuseum of Sports launched 8 3D exhibits and 8 3D Galleries. On observing the gallery and exhibit contents in numbers, there are 184 collections (images or videos) in the exhibits and 560 in the galleries. At the end of this period, the total reach on the eMuseum's social networks arrived at the expressive number of almost 4 million and 300 thousand people impacted by the content that was created and organized by the eMuseum. The conclusion is that the eMuseum of Sports had a significant media coverage and allowed content to be accessed, strengthening the democratization of various sports content at a moment when other forms of in-person visitation would not be possible.

10.
Epidemiol Infect ; 149: e54, 2021 02 19.
Article in English | MEDLINE | ID: covidwho-1104397

ABSTRACT

COVID-19, although a respiratory illness, has been clinically associated with non-respiratory symptoms. We conducted a negative case-control study to identify the symptoms associated with SARS-CoV-2-positive results in Portugal. Twelve symptoms and signs included in the clinical notification of COVID-19 were selected as predictors, and the dependent variable was the RT-PCR test result. The χ2 tests were used to compare notified cases on sex, age group, health region and presence of comorbidities. The best-fit prediction model was selected using a backward stepwise method with an unconditional logistic regression. General and gastrointestinal symptoms were strongly associated with a positive test (P < 0.001). In this sense, the inclusion of general symptoms such as myalgia, headache and fatigue, as well as diarrhoea, together with actual clinical criteria for suspected cases, already updated and included in COVID-19 case definition, can lead to increased identification of cases and represent an effective strength for transmission control.


Subject(s)
COVID-19/virology , SARS-CoV-2/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Case-Control Studies , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Portugal/epidemiology , Young Adult
11.
IEEE Access ; 2021.
Article in English | Scopus | ID: covidwho-1096597

ABSTRACT

In the present work, we propose and validate a Common Criteria Standard Protection Profile (sPP) for videoconferencing equipment. The research presents the definition and analysis of the homologation system used to validate the standard protection profile, focusing on its application focused in a large Brazilian financial company. We address the main points to consider in the acquisition and current use of this product: reasonable information security assumptions, technical standards, recommendations, and international best cybersecurity practices. As a result, we have developed a Standard Protection Profile identifying the information security risks involved and the minimum parameters required in those systems acquired and used for Government environments. This paper also presents all tests performed to validate the proposed sPP. As the application is critical, involving sensitive data, our results can also foster less risky conditions in the myriad situations caused by the COVID pandemic. CCBY

12.
Transfusion ; 60(SUPPL 5):286A, 2020.
Article in English | EMBASE | ID: covidwho-1044811

ABSTRACT

Background/Case Studies: In the past months, convalescent plasma (CP) has been used as an alternative therapy to treat COVID-19 patients. Previous studies highlighted the role of neutralizing antibody titers (NAbs) on clinical improvements. We analysed a series of cases of COVID patients treated with CP transfusion and associations between transfused NAbs and patient NAbs on respiratory outcomes. Study Design/Methods: Thirty patients diagnosed with SARS-CoV-2 by RT PCR and severe pneumonia were prospectively analysed at a single center in Brazil. Doses of 300-600ml of CP were transfused. To assess respiratory outcomes, PaO2/FiO2 ratios were determined at Day 0 (day of CP transfusion), Day 5 and by discharge and duration of ventilation support were analysed. Improvements were determined by variations of PaO2/ FiO2 ratios from Day 0 through day 5 (V0-5) and from Day 0 through discharge (V0-D). Neutralizing antibodies from patients prior to transfusion (NAbsP) and neutralizing antibodies of CP units transfused (NAbsCP) were analysed. NAbsCP considers the total amount of antibodies transfused to account for volume differences. We performed a generalized estimating equations (GEE) approach with logit link for binary data to model the effect of Nabs CP and variations on PaO2/FiO2 ratios between Day 0-Day 5 and Day 0-discharge. Regression models were performed to determine the predictive variables associated to improvements on PaO2/FiO2 ratios and duration of ventilation support. Results/Findings: Variations of PaO2/FiO2 ratios from day 0 through Day 5 and day 0 through discharge are displayed on Table 1. Significant improvements on PaO2/ FiO2 ratios were observed from Day 0 through discharge (p<0.001). NAbsP were associated to higher improvements on PaO2/FiO2 on V0-D (mean difference (MD)): 2.8 CI 95% -1.0-4.6 p 0.003), NAbsCP, however, were associated to minor variations in PaO2/FiO2 (MD -4.8 CI95% -7.9;-1.7 p 0.002) on the same interval. At each 100 unit increase in NAbs CP, variations on PaO2/FiO2 on V0-D were expected to be 4.8 units lower. When analysing V0-5, NAbsCP were again associated to minor improvements of PaO2/FiO2 ratios from D0 through D5 (MD -3.6 95%CI -7.2;-0.003 p 0.05). Other variables did not show statistical significance. When considering duration of ventilation support neither NabsP (Mean Ratio MR 0.985 CI 95% 0.962-1.007 p 0.185) nor NAbsCP (MR 0.967 CI95% 0.918 1.018 p 0.198) showed significant statistical differences. Conclusions: In our analysis, NAbs produced from the patient prior to CP transfusion are associated to better improvements on respiratory outcomes when compared to NAbs from transfused units. Regarding duration of mechanical ventilation, neither NAbsP nor Nabs CP had impact on outcomes.

13.
Transfusion ; 60(SUPPL 5):293A-294A, 2020.
Article in English | EMBASE | ID: covidwho-1044810

ABSTRACT

Background/Case Studies: Convalescent plasma (CP) has emerged in the past months as an alternative treatment for COVID-19. We prospectively analysed the outcomes of critically ill COVID-19 patients treated with CP in order to investigate predictive factors of intensive care unit (ICU) length of stay at a single center in Brazil. Study Design/Methods: Thirty COVID-19 patients laboratory-confirmed by RTPCR with severe pneumonia were recruited at a single center in Brazil. Doses of 300-600ml of CP were administered. Primary outcomes were ICU length of stay and duration of mechanical ventilation support.The following variables were analysed: Severity organ failure assessment score(SOFA) at day 0 (day of CP transfusion), patient ABO blood group, concomitant use of any other therapies (hydroxychloroquine, azythromicin, tocilizumab, immunoglobulin), neutralizing antibody titers of the patients prior to transfusion (NAbsP) and total titers of neutralizing antibody from CP units transfused (NAbsCP). NAbsCP considers the total amount of antibodies transfused to account for volume differences. Multivariate logistic regression was performed. Results/Findings: In our case series, SOFA at day 0, ABO group, and both NAbs P and NAbsCP were predictive factors of ICU length of stay. At each point increased in SOFA, ICU length of stay was 38.7% longer (MR: 1.387 CI 95% 1.254-1.534, p<0.001). Group A had36.1% longer ICU length of stay (MR: 0.639 CI 95% 0.417-0.980, p 0.04). Increases of 100 units in NAbsP resulted in 1% reduction of ICU lenght of stay (MR 0.990 CI 95% 0.982-0.998, p 0.017). Similar results were obtained with NAbs-CP, with 2% reduction in ICU length of stay (MR 0.980 CI95% 0.968-0.993, p 0.002) at each 100 unit increase. Use of other therapies did not influence ICU lenght of stay (p 0.373). We perform the same analysis for duration of mechanical ventilation support, and all the variables failed to demonstrate any association Conclusions: Our findings suggest that severity of disease prior to transfusion, ABO group, patient capacity to produce neutralizing antibodies and transfusion of CP with high titer NAbs are significant predictive factors for ICU length of stay. High titer NAbs CP may add benefit to these patients. No association was found between these same variables and duration of mechanical ventilation.

14.
Transfusion ; 60(SUPPL 5):296A, 2020.
Article in English | EMBASE | ID: covidwho-1044684

ABSTRACT

Background/Case Studies: We describe the COVID- 19 Convalescent Plasma (CCP) program from two Brazilian hospitals for treatment of severe/critical patients Study Design/Methods: Mild/moderate COVID-19 convalescents were selected as CCP donors after RT-PCR confirmed SARS-CoV-2 infection and absence of symptoms for ≥14 days plus: 1) age (18-60yrs), body weight >55kg;2) immunohematological studies;3) no infectious markers of HBV, HCV, HIV, HTLV1-2, Chagas and syphilis infection;4) no HLA antibodies (multiparous);5) Second RT-PCR (nasopharyngeal swab and/or blood) negativity;6) virus neutralization test (CPE-based VNT nAb) and anti-nucleocapsid (NP) SARS-CoV-2 IgM, IgG and IgA ELISAs. Results/Findings: Among 271 donors (41 females, 230 males), 250 presented with nAb. Final RT-PCR was negative on swab (77.0%) or blood (88.4%;p= 0.46). Final definition of RT-PCR was only defined at>28days after full recovery in 59/174 (33.9%) RT-PCR-ve, and 25/69 RT-PCR+ve (36.2%;13 between 35-48 days). NAb titers ≥160 was found in 63.6%. Correlation between IgG signal/ cut-off ≥5.0 and nAb ≥160 was 82.4%. Combination of final RT-PCR-ve with nAb ≥160 was 41.3% (112/271). Serial plasma collection showed decline in nAb titers and IgA levels (p<0.05), probably denoting a “golden period” for CCP collection (≤ 28 days after joining the program);IgA might have an important role as nAb. Donor's weight, days between disease onset and serial plasma collection, IgG and IgM levels are important predictors for nAb titer. Conclusions: RT-PCR+ve cases are still detected in 36.2% within 28-48 days after recovery. High anti-NP IgG levels may be used as surrogate marker to nAb.

15.
Transfusion ; 60(SUPPL 5):290A, 2020.
Article in English | EMBASE | ID: covidwho-1044683

ABSTRACT

Background/Case Studies: COVID-19 convalescent plasma (CCP) has been used for therapy in severely affected COVID-19 patients. The rational relies on the presence of nAb in convalescent's bloodstream, which might suppress patient's viremia. Little is known about the nAb kinetics in CCP donors. Study Design/Methods: A cohort of previously RTPCR+ ve, male, volunteer, non-remunerated, mild convalescent donors has been studied, based on serial virus neutralization tests (CPE-based VNT, GenBank: MT MT350282, transformed in natural log) and specific IgM, IgG and IgA anti-nucleocapsid protein (NP) SARS-CoV-2 ELISA, depicted as signal/cutoff (S/CO). Results/Findings: A total of 63 donors were evaluated within a period ranging from 14-97 days after full recovery of symptoms (DARS). There was initially a decline in nAb and IgA anti-NP from the first to third collection (median = 45days), followed by an unexpected rise in two additional collections. No differences were seen for IgM and IgG anti-NP. Data are shown below, with statistical values between subsequent samples. Conclusions: There is a great variability in nAb titers, with a declining trend over time. Although this was clear during the first three collections, the sudden rise could be explained by biological nAb fluctuation or by viral re-exposure after recovery, due to contact with infected people (pandemic still active in our region). Although IgA anti-NP shows a wide range, its declining trend could be signaling a possible role of IgA as an important component of nAb. Further studies are required to better understand the kinetic behavior of these antibodies.

16.
Transfusion ; 60(SUPPL 5):294A-295A, 2020.
Article in English | EMBASE | ID: covidwho-1044682

ABSTRACT

Background/Case Studies: COVID-19 Convalescent plasma (CCP) has been used for therapy in severely symptomatic COVID-19 patients. Pathogen reduction (PR) has been proposed to mitigate the risk of transfusion-transmitted infectious agents. We investigate the impact of A/UVA on nAbs and anti-NP (IgM, IgG and IgA) PR treatment of CCP units. Study Design/Methods: Plasmapheresis CCP units (600 mL) were collected from a cohort of previously confirmed male RT-PCR positive [+ve] COVID-19 mild/ moderate convalescent patients, all first-time and nonremunerated volunteers, with >14 days after full recovery of symptoms. CCP units were treated with INTERCEPT Blood System (Cerus Corporation, Concord, USA) according to manufacturer's instructions, either individually or pooled two by two. After treatment, units were separated into 200 mL doses. Pre- and post-PR treatment samples were harvested and kept at 4oC for 3-5 days prior to testing for nAb titers using a CPE-based virus neutralization assay (GenBank: MT MT350282), and specific IgM, IgG and IgA anti-NP antibodies by ELISA. Results/Findings: A total of 16 individual and 94 pooled units were treated (n =110 CCP donations), rendering 330 x 200 mL treated CCP therapeutic doses. There were no statistical differences in samples harvested before versus after A/UVA treatment (all p>0.05, Wilcoxon test) for nAb titers or IgM, IgG and IgA anti-NP absorbance levels, as shown in the table. Conclusions: Anti-NP IgM, IgG, IgA, and nAbs are not adversely impacted by A/UVA treatment, suggesting this PR technology can be employed to mitigate the risk of transfusion-transmitted infections after collection of CCP donors, who are often first time blood donors. With most CCP units destined to treat older, immunosuppressed patients with several comorbidities, the use of A/UVA PR treatment is not only safe and recommended, while preserving anti-SARSCoV- 2 antibodies in CCP units.

17.
Hematology, Transfusion and Cell Therapy ; 42:365, 2020.
Article in English | EMBASE | ID: covidwho-987810

ABSTRACT

Objetivos: O plasma convalescente COVID-19 (CCP) tem sido usado como terapia em pacientes graves desta infecção. O príncipio racional baseia-se na presença de anticorpos neutralizantes (nAb) na circulação de pacientes convalescentes, podendo assim, suprimir a viremia em receptores. A cinética destes nAb ainda é pouco conhecida até o momento. Materiais e métodos: Uma coorte de doadores convalescentes, todos RT-PCR+vo, masculinos e voluntários tem sido acompanhada por meio de coletas seriadas para testes de nAb (teste de neutralização viral – CPE-based VNT, GenBank: MT MT350282, cujos títulos foram transformados em logaritmo natural) e por anticorpos de ligação IgM, IgG e IgA específicos contra proteínas do nucleocapsídeo (NP) – SARS-CoV-2 ELISA – apresentados sob a forma de relação absorbância/cut-off, (S/CO). Resultados: Até o momento, 78 indivíduos foram avaliados, dentro de um período entre 14–97 dias após o término completo de sintomas (TCS). Observou-se inicialmente um declínio nos títulos de nAb (403±3 × 221±3, p=0.004) e IgA anti-NP (S/CO = 2.9±4.2 × 2.4 ±3.5, p=0.04) da primeira à terceira coleta sérica (mediana = 45 dias), seguida por uma súbita e inesperada elevação após duas coletas adicionais. Não foram observadas alterações estatisticamente significativas para os níveis de IgM e IgG anti-NP. Conclusão: Existe uma grande variabilidade nos títulos de nAb, com uma tendência de declínio ao longo do tempo. Embora este fenômeno seja evidente durante as três primeiras coletas, a súbita elevação pode ser talvez explicada por flutuações biológicas dos títulos, ou por reexposição viral após a recuperação destes indivíduos, devido ao contato ativo com outras pessoas infectadas, posto que ainda estão vivendo em ambientes acometidos pela pandemia atual. Embora a IgA anti-NP demonstre uma ampla variação, sua tendência ao declínio pode sinalizar um possível papel da IgA como importante componente de nAb. Mais estudos são necessários para o entendimento do comportamento cinético destes anticorpos.

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