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Neurosci Lett ; 748: 135694, 2021 03 23.
Article in English | MEDLINE | ID: covidwho-1188917


Patients with COVID-19 often complain of smell and taste disorders (STD). STD emerge early in the course of the disease, seem to be more common in SARS-CoV-2 infection than in other upper respiratory tract infections, and could in some cases persist for long after resolution of respiratory symptoms. Current evidence suggests that STD probably result from a loss of function of olfactory sensory neurons and taste buds, mainly caused by infection, inflammation, and subsequent dysfunction of supporting non-neuronal cells in the mucosa. However, the possible occurrence of other mechanisms leading to chemosensory dysfunction has also been hypothesized, and contrasting data have been reported regarding the direct infection of sensory neurons by SARS-CoV-2. In this mini-review, we summarize the currently available literature on pathogenesis, clinical manifestations, diagnosis, and outcomes of STD in COVID-19 and discuss possible future directions of research on this topic.

COVID-19/complications , Olfaction Disorders/etiology , SARS-CoV-2/pathogenicity , Taste Disorders/etiology , COVID-19/immunology , COVID-19/virology , Humans , Mouth Mucosa/immunology , Mouth Mucosa/pathology , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Olfaction Disorders/physiopathology , Olfactory Mucosa/immunology , Olfactory Mucosa/pathology , Olfactory Receptor Neurons/immunology , Olfactory Receptor Neurons/pathology , SARS-CoV-2/immunology , Smell/physiology , Taste/physiology , Taste Buds/immunology , Taste Buds/pathology , Taste Disorders/diagnosis , Taste Disorders/epidemiology , Taste Disorders/physiopathology
Clin Microbiol Infect ; 27(3): 451-457, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-938846


OBJECTIVES: The aim of our study was to describe the incidence and predictive factors of secondary infections in patients with coronavirus disease 2019 (COVID-19). METHODS: This was a cohort study of patients hospitalized with COVID-19 at IRCCS San Raffaele Hospital between 25th February and 6th April 2020 (NCT04318366). We considered secondary bloodstream infections (BSIs) or possible lower respiratory tract infections (pLRTIs) occurring 48 hours after hospital admission until death or discharge. We calculated multivariable Fine-Gray models to assess factors associated with risk of secondary infections. RESULTS: Among 731 patients, a secondary infection was diagnosed in 68 patients (9.3%); 58/731 patients (7.9%) had at least one BSI and 22/731 patients (3.0%) at least one pLRTI. The overall 28-day cumulative incidence was 16.4% (95%CI 12.4-21.0%). Most of the BSIs were due to Gram-positive pathogens (76/106 isolates, 71.7%), specifically coagulase-negative staphylococci (53/76, 69.7%), while among Gram-negatives (23/106, 21.7%) Acinetobacter baumanii (7/23, 30.4%) and Escherichia coli (5/23, 21.7%) predominated. pLRTIs were caused mainly by Gram-negative pathogens (14/26, 53.8%). Eleven patients were diagnosed with putative invasive aspergillosis. At multivariable analysis, factors associated with secondary infections were low baseline lymphocyte count (≤0.7 versus >0.7 per 109/L, subdistribution hazard ratios (sdHRs) 1.93, 95%CI 1.11-3.35), baseline PaO2/FiO2 (per 100 points lower: sdHRs 1.56, 95%CI 1.21-2.04), and intensive-care unit (ICU) admission in the first 48 hours (sdHR 2.51, 95%CI 1.04-6.05). CONCLUSIONS: Patients hospitalized with COVID-19 had a high incidence of secondary infections. At multivariable analysis, early need for ICU, respiratory failure, and severe lymphopenia were identified as risk factors for secondary infections.

COVID-19/epidemiology , Coinfection/epidemiology , Hospitalization/statistics & numerical data , Aged , Cohort Studies , Coinfection/microbiology , Female , Humans , Incidence , Italy/epidemiology , Male , Middle Aged , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/microbiology , Risk Factors , SARS-CoV-2 , Sepsis/epidemiology , Sepsis/etiology , Sepsis/microbiology
Horizontes Antropológicos ; 26(57):7-25, 2020.
Article in Portuguese | ProQuest Central | ID: covidwho-831198


Mas, à medida que seus produtos ganharam terreno fora dos ambientes controlados dos laboratórios, o seu escopo se expandiu em debates éticos, protocolos, processos e equipamentos laborais que passaram a ser empregados nos contextos hospitalares, na produção industrial, no comércio e demais segmentos que envolvem a manipulação genética e microbiológica (Neves et al., 2007). Sob sua rubrica, passou-se a vigiar e controlar a circulação de agentes patógenos, como vírus e bactérias, mas também a acelerada circulação de pessoas e produtos de origem animal e vegetal. Assim, o debate sobre a segurança nacional, a pesquisa em saúde e suas crises, mas também os alimentos transgênicos, os organismos geneticamente modificados (GMO - genectic modified organism) e organismos vivos modificados (LMO - living modified organism)1 e as novas tecnologias para agricultura e pecuária, incorporaram a semântica e a atuação da biossegurança nas práticas cotidianas (Bingham;Hinchliffe, 2008;Fidler;Gostin, 2008). O próprio desenvolvimento da medicina tropical responderia, sobremaneira, como um saber médico desenvolvido para a aclimatação do branco às terras quentes (Löwy, 2006).