How has the COVID-19 pandemic impacted wastewater-based epidemiology?

Wastewater-based epidemiology (WBE) was one of the areas of scientific knowledge that developed significantly with the COVID-19 pandemic, with robust worldwide application to monitor the circulation of the SARS-CoV-2 virus in urban communities at different scales and levels. This mini-review assesses how the COVID-19 pandemic may have influenced the WBE based on the investigation of 1305 scientific reports published (research, review, and conference papers) up to the end of 2022, considering the research objects, funding sources, actors, and countries involved. As a result, 71 % of all WBE-based publications occurred since the beginning of the pandemic, with 62 % addressing SARS-CoV-2, demonstrating the migration of WBE's relative importance in studies on drug abuse, pharmaceuticals consumption, and other disease-causing organisms to the constitution of a tool to support the monitoring of the coronavirus. Before the pandemic, WBE was a tool used for epidemiological surveillance of several diseases (54 % of studies), drug abuse (30 %), and pharmaceutical consumption (9 %). With the pandemic, these research topics lost to space, constituting only 37 % of the area's studies, and SARS-CoV-2 became the central object of studies. In addition, there has been a 4.7 % expansion of developing country participation in sewage surveillance publications and greater diversification of collaborators and funders, especially from government, businesses, and the water industry. International research partnerships had a reduction of 8 %, consequently, there was an increase in local and regional partnerships. With the COVID-19 pandemic, funding for research in WBE became approximately 6.5 % less dependent on traditional research funds. The future of WBE involves different approaches, including different focuses of research and technological advancements to improve the sensitivity, precision, and applicability of these investigations. The new WBE research arrangements are promising, although the post-pandemic challenges are likely to be in maintaining them and overcoming the trend toward a lack of diversity in study subjects.

Assessing the Extent of Covid-19 Transmission in French Guiana

Intro: The emergence of SARS-CoV-2 was accompanied by great uncertainty regarding the main epidemiological characteristics of the transmission. In a context where epidemiological surveillance was mainly targeted on symptomatic patients, we assessed the extent of SARS-CoV-2 transmission in French Guiana conducting an intra-household transmission study and population-based seroprevalence surveys repeated over time. Method(s): Household monitoring included virological and clinical follow-up for all household members for the first 28 days after the date of confirmation of the index case and serological follow-up over a 12-month period. Three seroprevalence surveys were conducted in July and September 2020 and in September 2021. Finding(s): A total of 57 dwellings including 245 individuals were included in the intra-household study. The average time between the date of onset of symptoms and the date of confirmation of diagnosis and inclusion in the study was 4.2 days and 7.2 days respectively. Secondary transmission was found in three quarters of households with a secondary infection rate of 35%. The highest transmission rate were observed in the most disadvantaged populations, within couples and from adults to children. Population-based seroprevalence studies have made it possible to monitor seroprevalence rates, which have varied from 15% at the time of the epidemic peak of the first epidemic wave to 65% of the population at the beginning of the fourth wave, despite the low impact of vaccination in French Guiana. Conclusion(s): The results obtained highlighted a high transmission of the virus in French Guiana associated with a low severity rate linked to the structure of the particularly young population. The project has provided health authorities with useful data to support prevention and control strategies and has allowed to evaluate the impact of interventions implemented during the pandemic.Copyright © 2023

Features of the course and medical and social aspects of a new coronavirus infection in the Republic of Tajikistan

The aim - to assess some medical and social aspects of the epidemic process during the first wave of a new coronavirus infectious disease - COVID-19 in the Republic of Tajikistan. Material and methods. The retrospective study was conducted on the basis of an epidemiological analysis of official statistics as part of the epidemiological surveillance of COVID-19 from April 2020 to April 2021. Results and discussion. At the beginning of April 2021, a total of 13 308 cases of COVID-19 were registered, of which the proportion of recovered was 99.3% (13 218 cases), and the number of cases with a fatal outcome was 0.68% (90 cases;the average age of the deceased was 62.3+/-0.07 years). The peak of infection during the first wave occurred in May and June 2020, when the average daily increase was 97 people. For 2 months of the epidemic in the republic, 44.6% of the total number of patients with COVID-19 became infected, and the number of deaths reached 52 people or 57.7%. Among the patients, men prevailed (65%). The largest number of deaths (76.7%;n=69) was among older people with comorbidities (diabetes mellitus, cardiovascular disease, chronic lung disease, metabolic syndrome, etc.). An analysis of the age structure showed that the main proportion of cases fell on the age group of 40-60 years (42.6%). It was found that a significant proportion of patients with COVID-19 was detected in the Sughd region (33.0%) and Dushanbe (30.1%). Conclusion. The COVID-19 pandemic showed that the national healthcare system of the Republic of Tajikistan was not sufficiently prepared for such a development of the COVID-19 epidemic process. There was an acute shortage of medical and preventive specialists in the republic. Given the current situation in the Republic of Tajikistan, within the framework of epidemiological surveillance, the features of the course of the COVID-19 epidemic process were analyzed, adequate emergency measures were developed and proposed to limit the spread of the virus and reduce the negative impact of COVID-19 on public health. The number of beds has been reasonably expanded, the capacity of the laboratory service has been increased, mass vaccination of the population has been started according to epidemic indications.Copyright © 2022 Geotar Media Publishing Group

Analysis of case-based malaria surveillance and response during the period of COVID-19 outbreak in China

Objective To assess the case-based malaria surveillance and response during the period of COVID-19 outbreak in China, in order to provide reference for malaria elimination under the COVID-19 pandemic. Methods Information of malaria cases reported during the four months pre - and post-COVID -19 outbreak (December 1, 2019-March 31, 2020) and in the same time period of past two years in China (excluding Hong Kong, Macau and Taiwan regions) was obtained from the Parasitic Disease Control Information Management System. Cross-sectional survey and comparison were conducted for malaria surveillance and response data in 3 four-month time periods (December 1, 2019 to January 22, 2020;January 23 to March 17, 2020;and March 18-31, 2020). The number of malaria cases including deaths, the median and average time interval from disease onset to the first visit, the median and average of time interval from the first visit to the confirmed diagnosis, the completion status of the #1-3-7$ task and the source of infections in each period were analyzed and compared to the same times in the past two years. Results From December 1, 2019 to March 31, 2020, a total of 750 malaria cases, which were all imported cases, were reported in China, decreased by 9.2% from that reported during December 2018 and March 2019 (826 cases) and by 13.1% from that reported during December 2017 to March 2018 (863 cases). The decrease mainly occurred in February and March in 2020;there were no statistical differences in the time interval from onset to first visit (median 1 day, mean 2.0 days), time interval from first visit to confirmed diagnosis (median 1 day, mean 1.8 days), case reporting rate within 1 day (100%), case epidemiological investigation rate within 3 days (98.4%), epidemic site disposal rate within 7 days (100%) between the time period of COVID-19 outbreak and the same time in the past year (December 2018 to March 2019). In addition, no statistical difference (! > 0.05) was found in the time intervals from onset to first visit among the first period [median 1 d, average (1.9 +/- 0.2) d], the second period [median 1 d, average (2.1 +/- 0.3) d] and the third period [median 1 d, mean (1.5 +/- 0.3) d], while the time interval from the first visit to the confirmed diagnosis was statistically different (! X 0.05) among the first period [median 0 d, average (1.5 +/- 0.2) d], the second period [median 1 d, mean (2.3 +/- 0.3) d] and the third period [median 0.5 d, average (1.5 +/- 0.4) d], where the time interval in the second period was longer than that in the first period (! X 0.01). Conclusion China' s core measures to eliminate malaria have been carried out as planned, although the timely malaria diagnosis was slightly affected in the second time period (January 23 to March 17, 2020).Copyright © 2021, National Institute of Parasitic Diseases. All rights reserved.

Principles for evaluation of one health surveillance: The EVA book

This book outlines essential elements of the evaluation of health surveillance within the One Health concept. It provides an introduction to basic theoretical notions of evaluation and vividly discusses related challenges. Expert authors cover the entire spectrum of available, innovative methods, from those for system process evaluations to methods for the economic evaluation of the surveillance strategies. Each chapter provides a detailed description of the methodology required and the tools available as illustrated by practical examples of animal health or One Health surveillance evaluations in both developed and developing countries. Targeting not only scientists, including epidemiologists, but also technical advisers of decision-makers, the present work is suitable for the evaluation of any type of health surveillance system - animal, human or combined - regardless of the socio-economic context. The volume is richly equipped with practical tools and examples, which enables the reader to apply the methods described. Increasing importance of health surveillance, and threats from disease outbreaks such as the coronavirus pandemic, underline the practical relevance of this work, which will fill an important gap in the literature. © Springer Nature Switzerland AG 2022. All rights reserved.

Tick-borne encephalitis epidemiology and surveillance in Poland, and comparison with selected European countries before and during the COVID-19 pandemic, 2008 to 2020.

BackgroundTick-borne encephalitis (TBE) is the most common viral central nervous system (CNS) infection in Poland. Previous research suggests that its incidence was underestimated in the pre-pandemic period. The COVID-19 pandemic caused a considerable burden on surveillance systems, which could further impact reporting.AimWe aimed to assess the completeness of reporting of TBE in the years 2008 to 2020 and explore the potential impact of the COVID-19 pandemic on reporting to the epidemiological surveillance system, compared with hospitalisations for TBEV and other viral neuro-infections.MethodsWe compared the Polish epidemiology of TBE and other viral infections of the CNS from national surveillance reports with data on hospitalisations from 2008 to 2020 and data from selected European countries.ResultsBetween 2008 and 2020, 3,016 TBE cases were reported to surveillance compared with 3,620 hospitalisations. There was an increasing trend in hospitalisations, while surveillance data demonstrated the opposite, with the largest discrepancy observed in the first pandemic year (354 hospitalisations vs 159 cases reported to surveillance). Serological testing for TBE was used more in the known endemic region of north-eastern Poland and less in non-endemic areas. Other European countries reported higher TBE case numbers and an increase during the COVID-19 pandemic, whereas Poland observed an opposite trend.ConclusionThe sensitivity of TBE surveillance in Poland requires improvement. There are considerable regional differences. Regions that test for TBE intensively report most cases. Policymakers should be made aware of the value of quality epidemiological data for planning prophylactic measures in risk areas.

Use of MAIA (Medical Artificial Intelligence Aid) platform for adjustment of health services during the pandemy COVID-19 in the department of Magdalena, Colombia.

Background: Describe the experience and results of the use of a digital platform navigated by the MAIA artificial intelligence engine for epidemiological surveillance in the department of Magdalena, Colombia, during the public health emergency generated by the Covid-19 disease pandemic in the period July 30 to December 8, 2020. Method(s): The MAIA digital platform was adapted to extract data from Covid-19 cases from the different health institutions distributed in the municipalities of the department of Magdalena. This information is then transformed through the platform into dynamic digital dashboards with 24/7 functionality, which allowed the visualization of descriptive information, trend curves and geolocation to facilitate decision-making in public health during the operating time. Satisfaction and utility surveys of the use of the platform called "MAIA DATA CRUE CENTRO REGULACION DE URGENCIAS Y EMERGENCIAS" (MAIA DATA CRUE) designed by MEDZAIO were carried out to know the perception of users. Result(s): Currently 58 health institutions from 27 municipalities of Magdalena are using the MAIA digital platform, in more than 4 months of operation a daily use of 100% has been achieved, with information extraction every 12 hours and continuous display of information throughout the period of use. More than 1200 records have been received, which have served to consolidate live information, with which daily health decisions have been made by the Magdalena COVID-19 pandemic regulatory center, optimizing the installed hospital and ICU capacity. 100% of those surveyed agree that this type of tool should continue to be used as epidemiological surveillance in COVID-19. Conclusion(s): The adaptation and use of digital platforms such as MAIA DATA CRUE CENTRO DE REGULACIONES DE URGENCIAS Y EMERGENCIAS, is an application of digital epidemiology for the intelligent management of diseases. This article demonstrates the importance of using digital tools supported by artificial intelligence to optimize the capacities of health systems regarding the different dimensions, in this case epidemiological surveillance and public health.Copyright © 2022 Asociacion Colombiana de Infectologia. All rights reserved.

Population-based assessment of SARS-CoV-2 infection among people living with HIV and the general population of Catalonia (March-December, 2020).

INTRODUCTION: It is unclear if SARS-CoV-2 has affected people living with HIV (PLWH) more. METHODS: We compared SARS-CoV-2 testing, test positivity, hospitalisation, intensive care unit (ICU) admission, and mortality between PLWH and the general HIV-negative population of Catalonia, Spain from March 1 to December 15, 2020. RESULTS: SARS-CoV-2 testing was lower among PLWH 3556/13,142 (27.06%) compared to the general HIV-negative population 1,954,902/6,446,672 (30.32%) (p<0.001) but test positivity was higher among PLWH (21.06% vs. 15.82%, p<0.001). We observed no significant differences between PLWH and the general population in terms of hospitalisation (13.75% vs. 14.97%, p=0.174) and ICU admission (0.93% vs. 1.66%, p=0.059). Among positive cases, we found a lower mortality rate among PLWH compared to the general population (1.74% vs 3.64%, p=0.002). CONCLUSION: PLWH tested less frequently for SARS-CoV-2, had a higher test positivity, similar ICU admission and hospitalisation rates, and lower SARS-CoV-2-associated mortality compared to the general HIV-negative population.

A Computational Platform to Support the Detection, Follow-up, and Epidemiological Surveillance of Mental Health and Substance Use Disorders: Protocol for a Development and Evaluation Study.

BACKGROUND: According to the World Health Organization, approximately 15% of the global population is affected by mental health or substance use disorders. These conditions contribute significantly to the global disease burden, which has worsened because of the direct and indirect effects of COVID-19. In Mexico, a quarter of the population between the ages of 18 and 65 years who reside in urban areas present a mental health condition. The presence of a mental or substance abuse disorder is behind a significant percentage of suicidal behaviors in Mexico, where only 1 in 5 of those who have these disorders receive any treatment. OBJECTIVE: This study aims to develop, deploy, and evaluate a computational platform to support the early detection and intervention of mental and substance use disorders in secondary and high schools as well as primary care units. The platform also aims to facilitate monitoring, treatment, and epidemiological surveillance ultimately helping specialized health units at the secondary level of care. METHODS: The development and evaluation of the proposed computational platform will run during 3 stages. In stage 1, the identification of the functional and user requirements and the implementation of the modules to support the screening, follow-up, treatment, and epidemiological surveillance will be performed. In stage 2, the initial deployment of the screening module will be carried out in a set of secondary and high schools, as well as the deployment of the modules to support the follow-up, treatment, and epidemiological surveillance processes in primary and secondary care health units. In parallel, during stage 2, patient applications to support early interventions and continuous monitoring will also be developed. Finally, during stage 3, the deployment of the complete platform will be performed jointly with a quantitative and qualitative evaluation. RESULTS: The screening process has started, and 6 schools have been currently enrolled. As of February 2023, a total of 1501 students have undergone screening, and the referral of those students presenting a risk in mental health or substance use to primary care units has also started. The development, deployment, and evaluation of all the modules of the proposed platform are expected to be completed by late 2024. CONCLUSIONS: The expected results of this study are to impact a better integration between the different levels of health care, from early detection to follow-up and epidemiological surveillance of mental and substance use disorders contributing to reducing the gap in the attention to these problems in the community. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44607.

SARS-CoV-2 surveillance-based on municipal solid waste leachate in Brazil.

Municipal solid waste leachate-based epidemiology is an alternative viral tracking tool that applies fresh truck leachate as an early warning of public health emergencies. This study aimed to investigate the potential of SARS-CoV-2 surveillance based on solid waste fresh truck leachate. Twenty truck leachate samples were ultracentrifugated, nucleic acid extracted, and real-time RT-qPCR SARS-CoV-2 N1/N2 applied. Viral isolation, variant of concern (N1/N2) inference, and whole genome sequencing were also performed. SARS-CoV-2 was detected on 40% (8/20) of samples, with a concentration from 2.89 to 6.96 RNA Log10 100 mL-1. The attempt to isolate SARS-CoV-2 and recover the whole genome was not successful; however, positive samples were characterized as possible pre-variant of concern (pre-VOC), VOC Alpha (B.1.1.7) and variant of interest Zeta (P.2). This approach revealed an alternative tool to infer SARS-CoV-2 in the environment and may help the management of local surveillance, health, and social policies.

Analysis of a Typical COVID-19 Outbreak Spread by Tourist Groups

Background: Novel coronavirus disease (SARS-COV-2 infection or COVID-19) is a respiratory tract infection that has been linked to severe acute respiratory syndrome transmitted particularly through touching and respiration. The purpose of this study is to understand the epidemiological characteristics of COVID-19 cases in a typical tourist-related outbreak and explore the possible route for its transmission. Method(s): All data and epidemiological survey reports of COVID-19 cases in the outbreak were reported by provincial and urban (county) Centers for Disease Control and Prevention and Health Commissions nationwide from October 16th to November 5th, 2021. The epidemiological survey reports included information on gender, age, source of infection (imported from other provinces or locally acquired), daily life track and itinerary, date of symptom onset, and date of diagnosis. The data were analyzed using descriptive statistical methods, one-way analysis of variance, independent t-test, and Chi-square tests. Histograms and percentage stacked area plots were used to describe the epidemiological characteristics of the outbreaks. Result(s): The COVID-19 outbreak associated with the tourist groups has involved 551 COVID-19 cases, with a median age of 44 years (interquartile range: 30-59 years), gradually spreading from the northwestern region to the national level across 15 provinces of China. One-fifth of the cases (16.0%) had traveled to Ejin Banner, resulting in 68 second-generation cases. We estimated an outbreak on 11 flights and 19 trains, accounting for a total of 27 confirmed cases. In addition, 42 clusters of outbreak cases were also reported to occur, 21 (50.0%) in households and 10 (23.81%) in restaurants. About 106 confirmed cases were related to the gatherings in restaurants. The median incubation period for this COVID-19 outbreak was 7 days (inter-quartile range: 5-10 days). Conclusion(s): The survey results indicated that this COVID-19 outbreak originated in Ejin Banner and was spread by tourist groups, which was a typical infection outbreak promoted by travel. Our results further confirmed that travel needs to be more strictly weighed in pandemics like COVID-19, and people need to pay more attention to the prevention against infectious diseases, particularly when traveling in a tourist group.Copyright © 2022 Zheng et al.

Guidelines on epidemics in Mexico. Historical perspective.

A perspective of epidemics and pandemics in Mexico is offered, focusing on three time periods, namely, end of the 18th century, the 20th century, and the 21st century, in order to analyze how they were approached by health and government authorities, as well as the challenges they have represented. Historical documentary sources were consulted and, in current cases, participation in them was analyzed. Epidemiological and social historical methodologies were combined. The presence of epidemics in Mexico is a constant on its evolution, which highlights the need for the epidemiological surveillance system to be updated, the importance of being prepared to face an epidemic and to develop a contingency plan.Copyright © 2022 Academia Nacional de Medicina de Mexico, A.C. Publicado por Permanyer.

[Clinical and epidemiological features of COVID-19-related deaths in Tunisia before the emergence of VOCs (March 2020-February 2021)]. / Caractéristiques cliniques et épidémiologiques des décès COVID-19 en Tunisie avant l'émergence des VOCs (mars 2020-février 2021).

Introduction: the purpose of this study was to describe the clinical and epidemiological features of COVID-19-related deaths in Tunisia notified at the ONMNE (National Observatory of New and emerging Diseases) between 2nd March 2020 and 28th February 2021 and to compare COVID-19-related deaths recorded in Tunisia with the international data. Methods: we conducted a national prospective longitudinal descriptive study of data collected from the National Surveillance System of SARS-CoV-2 infection of the ONMNE, Ministry of Health. All COVID-19-related deaths that occurred in Tunisia between March 2020 and February 2021 were included in this study. Data were collected from hospitals, municipalities and regional health departments. Death notifications were collected from multiple data sources (triangulation): The Regional Directorate of Basic Health Care, the ShocRoom (Strategic Health Operations Center), public and private health facilities, the Crisis Unit of the Presidency of the Government, the Directorate for Hygiene and Environmental Protection, the Ministry of Local Affairs and the Environment, as part of the follow-up of confirmed cases by the ONMNE team, positive RT-PCR / TDR post mortem results. Results: during this study, 8051 deaths were recorded, corresponding to a proportional mortality of 10.4%. The median age was 73 years, with an interquartile range of 17 years. Sex-ratio (M/F) was 1.8. The crude death rate was 69.1/100 000 inhabitants and fatality rate was 3.5%. The analysis of the epidemic curve showed 2 peaks of deaths on 29th October 2020 and 22nd January 2021, with 70 and 86 deaths notified respectively. The spatial distribution of mortality showed that the southern Tunisian region had the highest mortality rate. Patients aged 65 and over were most affected (73.7% of cases) with a crude mortality rate of 570.9/100,000 inhabitants and a fatality rate of 13.7%. Conclusion: prevention strategy based on public health measures must be reinforced by the rapid deployment of anti-COVID-19 vaccination, especially for people at risk of death.

The epidemiological follow-up process for suspected and confirmed cases of COVID-19 in migrant shelters on the northern border of Mexico from July to December 2020: Between contagion underestimation and containment.

Background: Elements associated with an increased risk factor for the contagion of COVID-19 in shelters include the turnover and overcrowding of people, time spent in communal areas, daily supply needs, water availability, and sanitation levels. The "Report on the Effects of the COVID-19 Pandemic on Migrants and Refugees," shows that factors such as the shortage of food, supplies, water, sanitizing materials, spaces for healthy distancing, financial resources for rent and essential services, and the lack of medical or psychological care complicated providing care for migrants and applicants seeking international protection. Objective: We describe shelter operations regarding the detection and follow-up of suspected and confirmed COVID-19 cases showing mild symptoms among the migrant population housed in the border cities under study. Methods: We conducted semi-structured, in-depth interviews with study subjects (people in charge, managers, coordinators, shelter directors) from 22 migrant shelters, and 30 with key informants. We studied the cities of Tijuana (Baja California), Nogales (Sonora), Ciudad Juárez (Chihuahua), Piedras Negras (Coahuila), and Heroica Matamoros (Tamaulipas). The research was based on a qualitative methodological design with an ethnographic approach. The information collected was transcribed and systematized into two tables or analytical templates, one for interviews with study subjects, and another for interviews with key actors. Findings: Overall, seventy-eight registered shelters provided accommodation services for migrants in the five cities the study focused on: thirty-seven in Tijuana, five in Nogales, twenty-two in Ciudad Juárez, eight in Piedras Negras, and five plus a camp (six in total) in Matamoros. The major concentration of shelters was in Tijuana (47.4%) and Ciudad Juárez (28.2%). At the beginning of the pandemic, only a few shelter facilities met quarantine and isolation guidelines, such as having separate bathrooms and sufficient space to isolate the "asymptomatic" and "confirmed" from close "contacts". The lack of isolation space and the inability to support the monitoring of patients with COVID-19 posed a challenge for those housed in shelters, forcing many shelters to close or continue operating behind closed doors to avoid becoming a source of infection during the pandemic. Discussion and outlook: Contrary to speculation, during the onset of the pandemic northern border migrant shelters did not become sources of COVID-19 infection. According to the data analyzed from 78 shelters only seven had confirmed cases, and the classification of "outbreak" was applied only in two facilities. Contagion control or containment was successful as the result of following a preventive containment logic, including the isolation of all suspected but unconfirmed cases, without a clear understanding of the human and financial resources required to maintain isolation areas. However, shelters in the study implemented protocols for epidemiological surveillance, control, and prevention with elements that interfered with monitoring spaces, and processes that caused oversights that resulted in underestimating the number of cases. Limitations: Due to travel restrictions imposed to prevent and contain coronavirus infections it was impossible to stay on-site in the cities studied, except for Tijuana, or carry-out recordings of migrants' views in shelters.

Impact of COVID-19 Pandemic on Seroprevalence of HIV, HBV, HCV and HTLV I-II in a Blood Bank in Medellín, Colombia, 2019-2022.

The objective of this research was to analyze the impact of the COVID-19 pandemic on seroprevalence of HIV, HBV, HCV and HTLV I-II in donors from a blood bank in Medellin, Colombia, 2019-2022. A cross-sectional analytical study was carried out with three groups: pre-pandemic with 14,879 donors; preventive isolation with 9035; and selective isolation + new normality with 26,647 subjects. Comparisons were made with Chi2 and Bonferroni adjustment, Kruskal-Wallis' H with Dunnett's post-hoc, prevalence ratios, and multivariate logistic regression. COVID-19 decreased donations of men, altruistic and repetitive donors, and increased the age of donors. HIV increased with the COVID-19 pandemic, while HBV, HCV, and HTLV I-II decreased. The pandemic had an independent effect on these viral infections. These findings constitute an alert about what may be happening in the general population and show the importance of improving epidemiological surveillance and the investigation of these infections.

Monitoring algorithm of hospitalized patients in a medical center with SARS-CoV-2 (Omicron variant) infection: clinical epidemiological surveillance and immunological assessment.

Purpose: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a major healthcare threat worldwide. Since it was first identified in November 2021, the Omicron (B.1.1.529) variant of SARS-CoV-2 has evolved into several lineages, including BA.1, BA.2-BA.4, and BA.5. SARS-CoV-2 variants might increase transmissibility, pathogenicity, and resistance to vaccine-induced immunity. Thus, the epidemiological surveillance of circulating lineages using variant phenotyping is essential. The aim of the current study was to characterize the clinical outcome of Omicron BA.2 infections among hospitalized COVID-19 patients and to perform an immunological assessment of such cases against SARS-CoV-2. Patients and Methods: We evaluated the analytical and clinical performance of the BioIC SARS-CoV-2 immunoglobulin (Ig)M/IgG detection kit, which was used for detecting antibodies against SARS-CoV-2 in 257 patients infected with the Omicron variant. Results: Poor prognosis was noted in 38 patients, including eight deaths in patients characterized by comorbidities predisposing them to severe COVID-19. The variant-of-concern (VOC) typing and serological analysis identified time-dependent epidemic trends of BA.2 variants emerging in the outbreak of the fourth wave in Taiwan. Of the 257 specimens analyzed, 108 (42%) and 24 (9.3%) were positive for anti-N IgM and IgG respectively. Conclusion: The VOC typing of these samples allowed for the identification of epidemic trends by time intervals, including the B.1.1.529 variant replacing the B.1.617.2 variant. Moreover, antibody testing might serve as a complementary method for COVID-19 diagnosis. The combination of serological testing results with the reverse transcription-polymerase chain reaction cycle threshold value has potential value in disease prognosis, thereby aiding in epidemic investigations conducted by clinicians or the healthcare department.

Viruses responsible for acute respiratory infections before (2016-2019) and during (2021) circulation of the SARS-CoV-2 virus in pediatric patients in a reference center at Barranquilla Colombia: A pattern analysis.

OBJECTIVE: To evaluate the behavior of the viruses responsible for acute respiratory infections before (2016-2019) and after (2020-2021) the start of the circulation of the SARS-CoV-2 virus in pediatric patients treated at a reference center from Barranquilla, Colombia. MATERIALS AND METHODS: A descriptive observational study was carried out, and data were obtained by reviewing the influenza-like illness and severe acute respiratory infection database in the pediatric population of the sentinel surveillance reference center in the district of Barranquilla during the years 2016-2021, applying inclusion and exclusion criteria. RESULTS: During 2016-2019, the average age of individuals was 1.3 (±1.7) years, during 2021, it was 2.3 (±3.5) years. The distribution by sex was similar, predominantly male. August and February were the months with the highest record of symptoms for 2016-2019 and 2021, respectively, the most frequent being cough, fever, shortness of breath, and diarrhea. By 2021 there was a higher use of antibiotics and antivirals reported than in 2016-2019. Most patients tested negative for viral detection. When comparing the percentage of viruses detected by age group and years of detection, positivity was lower in 2021 by every age group, and respiratory syncytial virus (RSV) was the most frequently detected. CONCLUSIONS: There was less virus positivity in viral detection tests in the pediatric population in 2021. RSV persists as the main etiology affecting this population, especially infants. The use of antibiotic therapy in viral infections continues to be a problematic practice in their management. Sentinel surveillance can be strengthened throughout the country.