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1.
Epidemiol Infect ; 150: e187, 2022 Nov 03.
Article in English | MEDLINE | ID: covidwho-2150943

ABSTRACT

The SARS-CoV-2 Omicron variant has increased infectivity and immune escape compared with previous variants, and caused the surge of massive COVID-19 waves globally. Despite a vast majority (~90%) of the population of Santa Fe city, Argentina had been vaccinated and/or had been infected by SARS-CoV-2 when Omicron emerged, the epidemic wave that followed its arrival was by far the largest one experienced in the city. A serosurvey conducted prior to the arrival of Omicron allowed to assess the acquired humoral defences preceding the wave and to conduct a longitudinal study to provide individual-level real-world data linking antibody levels and protection against COVID-19 during the wave. A very large proportion of 1455 sampled individuals had immunological memory against COVID-19 at the arrival of Omicron (almost 90%), and about half (48.9%) had high anti-spike immunoglobulin G levels (>200 UI/ml). However, the antibody titres varied greatly among the participants, and such variability depended mainly on the vaccine platform received, on having had COVID-19 previously and on the number of days elapsed since last antigen exposure (vaccine shot or natural infection). A follow-up of 514 participants provided real-world evidence of antibody-mediated protection against COVID-19 during a period of high risk of exposure to an immune-escaping highly transmissible variant. Pre-wave antibody titres were strongly negatively associated with COVID-19 incidence and severity of symptoms during the wave. Also, receiving a vaccine shot during the follow-up period reduced the COVID-19 risk drastically (15-fold). These results highlight the importance of maintaining high defences through vaccination at times of high risk of exposure to immune-escaping variants.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Argentina/epidemiology , Longitudinal Studies , SARS-CoV-2 , Immunoglobulin G
2.
BMC Prim Care ; 23(1): 277, 2022 11 08.
Article in English | MEDLINE | ID: covidwho-2108744

ABSTRACT

BACKGROUND: Chagas is a public health problem, especially in Latin America, exacerbated by migratory movements and increasing urbanization. Argentina is among the countries with the highest estimated prevalence in the region, with 1,500,000 people infected, with mother to child as the main mode of transmission. Vertical transmission has been significantly reduced by treating women of childbearing age; several guidelines in the region recommend treatment as a primary prevention strategy for the child and a secondary prevention strategy for women and their families. Despite recommendations, women of childbearing age are not always treated, and children do not receive timely diagnosis and treatment. The objective of this research was to design an implementation strategy to improve using Chagas guidelines focused on attending women of childbearing age and children at the primary healthcare level and pilot it in three primary health care centers in Argentina. METHODS: We conducted a pilot feasibility study using the Consolidated Framework for Implementation Research. A qualitative process evaluation was conducted using semi-structured interviews with health care providers and observations in primary health care centers. RESULTS: We developed a multifaceted implementation strategy including training, flowcharts and reminders, a register of suspected and confirmed cases, and the selection of a management facilitator. The pilot study took place between September 2019 and May 2020. The implementation level was heterogeneous and varied depending on the components, being the facilitating factors, the simplicity of the intervention, professionals' willingness to expand the indication of serologic tests, and staff commitment to the adoption of intervention components. The main barriers found were the change of authorities at the local level, some professionals´ reluctance to administer etiological treatment, staff shortages, lack of diagnostic supplies, and the health emergency caused by the COVID-19 pandemic. CONCLUSIONS: Behavioral change strategies should be applied to improve implementation to address some of the main barriers, including support actions offered by opinion leaders, medical experts, and local health authorities. Rapid diagnostic tests should be readily available to maintain behavior changes. We suggest further refinement of the strategy and its implementation in more centers to assess outcomes prospectively with a hybrid implementation research design.


Subject(s)
COVID-19 , Pandemics , Child , Female , Humans , Pilot Projects , Feasibility Studies , COVID-19/epidemiology , Argentina/epidemiology , Infectious Disease Transmission, Vertical , Primary Health Care
4.
Rev Esp Geriatr Gerontol ; 57(5): 278-281, 2022.
Article in Spanish | MEDLINE | ID: covidwho-2061812

ABSTRACT

INTRODUCTION: Demographic trends indicate that population aging is not exclusive to developed countries. Argentina reaches 15.5% of the elderly population. The Covid-19 pandemic has brought to the forefront the public health situation of this population, challenging health systems, with disproportionate impacts on this group, which has suffered more than 80% of the deaths in the country, mainly in those with comorbidities. OBJECTIVE: To analyze the sociodemographic and environmental conditions involved in the process of development of health and nutrition profiles of the elderly people of Córdoba, Argentina 2020. METHODOLOGY: Epidemiological, cross-sectional, population-based study that included 221 elderly people (≥60 years old), through random sampling. Data on sociodemographic and environmental conditions, health and dietary profiles were collected through structured interviews. RESULTS: The average age of the participants was 68 years. Eighty-five percent recognized neighborhood contamination, 38% of them being garbage dumps close to their homes. Eighty-nine percent reported at least one non-communicable disease (NCD) or associated risk factor and 66% were overweight (BMI≥25kg/m2). The presence of obesity (BMI≥30kg/m2) was associated (OR=2.05; CI 1.007-3.922) with the development of NCDs. Only 4% of the population complied with the daily fruit and vegetable consumption recommendation. CONCLUSION: The predominant characteristics of the health and dietary profiles associated with NCDs identified suggest the need to study in depth the social determinants that condition the aging process.


Subject(s)
COVID-19 , Pandemics , Aged , Humans , Cross-Sectional Studies , Argentina/epidemiology , COVID-19/epidemiology , Overweight , Risk Factors , Prevalence
5.
Emerg Infect Dis ; 28(11): 2294-2297, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2054896

ABSTRACT

We performed a descriptive study to characterize effects from COVID-19 among chronic dialysis patients compared with the general population in Argentina during March 2020-February 2021. COVID-19 case-fatality rate of chronic dialysis patients was 10 times the national rate; the age-standardized mortality ratio was 6.8 (95% CI 6.3-7.3).


Subject(s)
COVID-19 , Pandemics , Humans , COVID-19/epidemiology , SARS-CoV-2 , Argentina/epidemiology , Renal Dialysis
6.
Rev Chilena Infectol ; 39(3): 304-310, 2022 06.
Article in Spanish | MEDLINE | ID: covidwho-2044076

ABSTRACT

BACKGROUND: The spread of SARS-CoV-2 required widespread lockdown to mitigate the pandemic. Argentine authorities imposed preventive social isolation for 234 days (March 20th to November 9th 2020). This measure led to major changes in the population's lifestyle. AIM: To examine the influence of COVID-19 lockdown measures on the metabolic profile of HIV-infected patients in Argentina. METHODS: Retrospective cohort study of 10,239 HIV-infected patients under follow up in a private clinic for HIV care. Adult patients with ongoing antiretroviral therapy (ART) and a baseline determination of blood glucose, total cholesterol, HDL-cholesterol and triglycerides done before lockdown (BL: second semester of 2019) and a second determination during lockdown (DL: May 2020) were included. Patients with recent changes in ART that may have metabolic impact, those starting lipid/glucose lowering agents and pregnant women were excluded. Categorical variables were compared using the χ2 test or Fisher's exact test, and continuous variables using the t-test or the Mann-Whitney test. A two-tailed value of p < 0.05 was considered significant. RESULTS: 540 individuals were included, median of age was 47 years and 74.6% were male. Median body mass index was 26.1 and 94.6% had low cardiovascular risk. There was a significant increase in the percentage of patients that met criteria for hyperglycemia (BL 4.8% and DL 8.5%, p < 0.001). We also observed significant (p < 0.001) increase in median (IQR) BL vs DL values in LDL-cholesterol [109 (90-128) vs 118 (97-139) mg/dL]; and triglycerides [120 (87-172) vs. 132 mg/dL (96-184)]. The proportion of patients with hyper-LDL cholesterolemia according to individual cardiovascular risk increased from 12.6 to 17.2% (p = 0.04). CONCLUSION: Our results suggest that quarantine, at least in its initial phases, may have a negative impact on the metabolic profile of this population.


Subject(s)
COVID-19 , HIV Infections , Adult , Argentina/epidemiology , Blood Glucose , Cholesterol, HDL , Communicable Disease Control , Female , HIV Infections/epidemiology , Humans , Male , Metabolome , Middle Aged , Pregnancy , Retrospective Studies , SARS-CoV-2 , Triglycerides
7.
Math Biosci ; 346: 108664, 2022 04.
Article in English | MEDLINE | ID: covidwho-1959838

ABSTRACT

The COVID-19 pandemic has challenged authorities at different levels of government administration around the globe. When faced with diseases of this severity, it is useful for the authorities to have prediction tools to estimate in advance the impact on the health system as well as the human, material, and economic resources that will be necessary. In this paper, we construct an extended Susceptible-Exposed-Infected-Recovered model that incorporates the social structure of Mar del Plata, the 4°most inhabited city in Argentina and head of the Municipality of General Pueyrredón. Moreover, we consider detailed partitions of infected individuals according to the illness severity, as well as data of local health resources, to bring predictions closer to the local reality. Tuning the corresponding epidemic parameters for COVID-19, we study an alternating quarantine strategy: a part of the population can circulate without restrictions at any time, while the rest is equally divided into two groups and goes on successive periods of normal activity and lockdown, each one with a duration of τ days. We also implement a random testing strategy with a threshold over the population. We found that τ=7 is a good choice for the quarantine strategy since it reduces the infected population and, conveniently, it suits a weekly schedule. Focusing on the health system, projecting from the situation as of September 30, we foresee a difficulty to avoid saturation of the available ICU, given the extremely low levels of mobility that would be required. In the worst case, our model estimates that four thousand deaths would occur, of which 30% could be avoided with proper medical attention. Nonetheless, we found that aggressive testing would allow an increase in the percentage of people that can circulate without restrictions, and the medical facilities to deal with the additional critical patients would be relatively low.


Subject(s)
COVID-19 , Argentina/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Humans , Pandemics/prevention & control , Quarantine , SARS-CoV-2
8.
Cad Saude Publica ; 38(4): ES219821, 2022.
Article in Spanish | MEDLINE | ID: covidwho-1951673

ABSTRACT

Seroepidemiological studies help identify the indirect distribution of diseases, detecting serological markers of immunity and demonstrating undiagnosed infections in the general population. The objectives were to estimate the seroprevalence of SARS-CoV-2 antibodies in Córdoba, Argentina, from December 2020 to January 2021 and to identify factors associated with the virus' contagiousness. A population-based cross-sectional observational study was performed in 3,225 individuals over two years of age living in Córdoba city, selected by multiple-stage random sampling proportional to distribution by gender, age group, and socioeconomic status in the city's population. Clinical characteristics, anthropometry, and comorbidities were collected by interview. Qualitative serological testing was performed for detection of SARS-CoV-2 nucleocapsid IgG antibodies (ARCHITECT, Abbott). SARS-CoV-2 seroprevalence was estimated for the total population and by age group, sex, socioeconomic status, and presence of target diseases. Prevalence ratios (PR) were estimated using a log-binomial regression model. SARS-CoV-2 seropositivity was 16.68% (95%CI: 15.41-18.01). Age 2 to 18 years, living in neighborhoods with low socioeconomic status, and obesity increased the odds of seropositivity (PR = 1.50; 95%CI: 1.10-2.04, PR = 1.91; 95%CI: 1.34-2.67 and PR = 1.39; 95%CI: 1.04-1.85). The results indicate that the city of Córdoba displays differential attributes that increase the likelihood of a positive SARS-CoV-2 antibody test. This allows targeting epidemiological surveillance strategies to reduce the spread of the virus.


Los estudios seroepidemiológicos permiten conocer la distribución indirecta de las enfermedades, detectando marcadores séricos de inmunidad y demostrando infecciones no diagnosticadas en la población general. El objetivo fue estimar la seroprevalencia de anticuerpos contra el SARS-CoV-2, en Córdoba, Argentina, entre diciembre de 2020 y enero de 2021, e identificar factores asociados a la contagiosidad del virus. Se realizó un estudio observacional transversal, de base poblacional, con 3.225 individuos mayores de 2 años, residentes en Córdoba Capital, que fueron seleccionados mediante un diseño de muestreo aleatorio en múltiples etapas, proporcional a la distribución por género, franja etaria y nivel socioeconómico de la población de Córdoba. Las características clínicas, antropometría y comorbilidades se recogieron mediante entrevistas. Se realizó un test serológico cualitativo para la detección de anticuerpos IgG antinucleocápside para SARS-CoV-2 (ARCHITECT, Abbott). La seroprevalencia del SARS-CoV-2 se estimó en la población y por franja de edad, sexo, nivel socioeconómico y presencia de las patologías estudiadas. Las razones de prevalencia (RP) se estimaron usando un modelo de regresión log-binomial. La seropositividad para SARS-CoV-2 fue de 16,68% (IC95%: 15,41-18,01). Tener entre 2 y 18 años, residir en barrios con nivel socioeconómico bajo y la presencia de obesidad, aumentaron la oportunidad de seropositividad (RP = 1,50; IC95%: 1,10-2,04, RP = 1,91; IC95%: 1,34-2,67 y RP = 1,39; IC95%: 1,04-1,85). Los resultados indican que en Córdoba Capital existen atributos diferenciales que aumentan la posibilidad de ser seropositivo para SARS-CoV-2. Esto permite dirigir estrategias de vigilancia epidemiológica para reducir la propagación del virus.


Os estudos soroepidemiológicos permitem conhecer a distribuição indireta das doenças, detectando marcadores séricos de imunidade e demonstrando infecções não diagnosticadas na população geral. O objetivo foi estimar a soroprevalência de anticorpos contra o SARS-CoV-2, em Córdoba, Argentina, entre dezembro de 2020 e janeiro de 2021, e identificar fatores associados à contagiosidade do vírus. Um estudo observacional transversal foi realizado, de base populacional, com 3.225 indivíduos maiores de 2 anos, residentes em Córdoba Capital, que foram selecionados por meio de um delineamento de amostragem aleatória em múltiplos estágios, proporcional à distribuição de gênero, a faixa etária e o nível socioeconômico da população de Córdoba. As características clínicas, antropometria e comorbidades foram coletadas por meio de entrevistas. Um teste sorológico qualitativo foi realizado para a detecção de anticorpos IgG anti-nucleocapsídeo para SARS-CoV-2 (ARCHITECT, Abbott). A soroprevalência do SARS-CoV-2 foi estimada na população e por faixa etária, sexo, nível socioeconômico e presença das patologias estudadas. Razões de prevalência (RP) foram estimadas usando um modelo de regressão log-binomial. A soropositividade para SARS-CoV-2 foi de 16,68% (IC95%: 15,41-18,01). Ter entre 2 e 18 años, residir em bairros com nível socioeconômico baixo e a presença de obesidade aumentaram a chance de soropositividade (RP = 1,50; IC95%: 1,10-2,04, RP = 1,91; IC95%: 1,34-2,67 e RP = 1,39; IC95%: 1,04-1,85). Os resultados indicam que em Córdoba Capital existem atributos diferenciais que aumentam a possibilidade de ser soropositivo para SARS-CoV-2. Isso permite direcionar estratégias de vigilância epidemiológica para reduzir a propagação do vírus.


Subject(s)
COVID-19 , Adolescent , Antibodies, Viral , Argentina/epidemiology , Brazil , COVID-19/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Humans , Immunoglobulin G , SARS-CoV-2 , Seroepidemiologic Studies
9.
Health Place ; 77: 102870, 2022 09.
Article in English | MEDLINE | ID: covidwho-1936468

ABSTRACT

The Covid-19 pandemic has stimulated new appraisals of how social cohesion, including neighborhood-level social capital, fosters resilience in the face of crisis. Several studies suggest better health outcomes in neighborhoods with higher level of social capital, in general and during the pandemic. Building on a growing body of research which suggests that those who live in close-knit neighborhoods have fared better during the pandemic, this article analyzes how social capital influences individual and collective perceptions and attitudes about the experiences of the Covid-19 pandemic in Tucumán, Argentina. To assess this question, we used a mixed-methods approach, combining focus groups, semi-structured interviews, and an online survey (n = 701 respondents) conducted in September 2021. We find widespread experiences of resilience in response to the Covid-19 pandemic, in spite of difficult socioeconomic conditions and perceived poor government performance. Results from logistic regression analysis indicate that perceptions of high neighborhood social capital are associated with more positive outcomes in many dimensions, including personal resilience, ability to cope with uncertainty, perceptions of community solidarity, and reported compliance with public health measures. We further argue that conceptualizations of social cohesion need to be adjusted to local or national-level cultural norms to accurately capture the experience of countries of the Global South.


Subject(s)
COVID-19 , Social Capital , Argentina/epidemiology , COVID-19/epidemiology , Humans , Pandemics , Residence Characteristics
10.
PLoS One ; 17(2): e0263047, 2022.
Article in English | MEDLINE | ID: covidwho-1938413

ABSTRACT

Fitting Susceptible-Infected-Recovered (SIR) models to incidence data is problematic when not all infected individuals are reported. Assuming an underlying SIR model with general but known distribution for the time to recovery, this paper derives the implied differential-integral equations for observed incidence data when a fixed fraction of newly infected individuals are not observed. The parameters of the resulting system of differential equations are identifiable. Using these differential equations, we develop a stochastic model for the conditional distribution of current disease incidence given the entire past history of reported cases. We estimate the model parameters using Bayesian Markov Chain Monte-Carlo sampling of the posterior distribution. We use our model to estimate the transmission rate and fraction of asymptomatic individuals for the current Coronavirus 2019 outbreak in eight American Countries: the United States of America, Brazil, Mexico, Argentina, Chile, Colombia, Peru, and Panama, from January 2020 to May 2021. Our analysis reveals that the fraction of reported cases varies across all countries. For example, the reported incidence fraction for the United States of America varies from 0.3 to 0.6, while for Brazil it varies from 0.2 to 0.4.


Subject(s)
COVID-19/epidemiology , Argentina/epidemiology , Bayes Theorem , Brazil/epidemiology , Chile/epidemiology , Colombia/epidemiology , Humans , Incidence , Markov Chains , Mexico/epidemiology , Panama/epidemiology , Peru/epidemiology , Stochastic Processes , United States/epidemiology
11.
Stud Health Technol Inform ; 290: 377-379, 2022 Jun 06.
Article in English | MEDLINE | ID: covidwho-1933562

ABSTRACT

Since Argentina's government declared a national emergency to combat the COVID-19 pandemic with a lockdown status, it has produced consequences on the healthcare system. We aimed to quantify the effect on the Emergency Department (ED) visits at Hospital Italiano de Buenos Aires. Our electronic health data showed that ED in-person visits declined 46% during the COVID-19 pandemic, from an overall of 176,370 visits during 2019 to 95,421 visits during 2020. Simultaneously, there was a telehealth visits boom when mandatory quarantine began (March 20, 2020): from a median of 12 daily in February 2020 to a median of 338 daily in April 2020; reaching a maximum daily peak of 1,132 on March 26 2020. For a while, teleconsultations replaced ED visits. Then, when face-to-face visits began to increase, teleconsultations began to decrease slowly, as the phenomenon reversed.


Subject(s)
COVID-19 , Telemedicine , Argentina/epidemiology , COVID-19/epidemiology , Communicable Disease Control , Emergency Service, Hospital , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
12.
Stud Health Technol Inform ; 290: 219-221, 2022 Jun 06.
Article in English | MEDLINE | ID: covidwho-1933555

ABSTRACT

WHO and UNICEF highlight vaccination as the most cost-effective method of prevention of infectious diseases. An effective public health strategy requires efficient tracking of vaccination to assess coverage, safety, and efficacy of these vaccines. Paper-based immunization records are still being used in most low and middle-income countries. Adequate Electronic Logistic Management Information Systems, Immunization Registries and Records are crucial for proper data collection and analysis, and for making better decisions at an individual and at a population level. In this paper we share our experience in the redesign of an interoperable immunization record to track vaccination, including the recently developed vaccines for the novel coronavirus SARS-CoV-2 (COVID-19).


Subject(s)
COVID-19 , Vaccines , Argentina/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Hospitals , Humans , Immunization , Immunization Programs , Pandemics/prevention & control , SARS-CoV-2 , Vaccination
13.
BMC Genomics ; 23(1): 510, 2022 Jul 14.
Article in English | MEDLINE | ID: covidwho-1933076

ABSTRACT

BACKGROUND: The SARS-CoV-2 virus is responsible for the COVID-19 pandemic. To better understand the evolution of SARS-CoV-2 early in the pandemic in the Province of Cordoba, Argentina, we performed a comparative genomic analysis of SARS-CoV-2 strains detected in survivors and non-survivors of COVID-19. We also carried out an epidemiological study to find a possible association between the symptoms and comorbidities of these patients with their clinical outcomes. RESULTS: A representative sampling was performed in different cities in the Province of Cordoba. Ten and nine complete SARS-CoV-2 genomes were obtained by next-generation sequencing of nasopharyngeal specimens from non-survivors and survivors, respectively. Phylogenetic and phylodynamic analyses revealed multiple introductions of the most common lineages in South America, including B.1, B.1.1.1, B.1.499, and N.3. Fifty-six mutations were identified, with 14% of those in common between the non-survivor and survivor groups. Specific SARS-CoV-2 mutations for survivors constituted 25% whereas for non-survivors they were 41% of the repertoire, indicating partial selectivity. The non-survivors' variants showed higher diversity in 9 genes, with a majority in Nsp3, while the survivors' variants were detected in 5 genes, with a higher incidence in the Spike protein. At least one comorbidity was present in 60% of non-survivor patients and 33% of survivors. Age 75-85 years (p = 0.018) and hospitalization (p = 0.019) were associated with non-survivor patients. Related to the most common symptoms, the prevalence of fever was similar in both groups, while dyspnea was more frequent among non-survivors and cough among survivors. CONCLUSIONS: This study describes the association of clinical characteristics with the clinical outcomes of survivors and non-survivors of COVID-19 patients, and the specific mutations found in the genome sequences of SARS-CoV-2 in each patient group. Future research on the functional characterization of novel mutations should be performed to understand the role of these variations in SARS-CoV-2 pathogenesis and COVID-19 disease outcomes. These results add new genomic data to better understand the evolution of the SARS-CoV-2 variants that spread in Argentina during the first wave of the COVID-19 pandemic.


Subject(s)
COVID-19 , SARS-CoV-2 , Aged , Aged, 80 and over , Argentina/epidemiology , COVID-19/epidemiology , Genome, Viral , Genomics , Humans , Pandemics , Phylogeny , SARS-CoV-2/genetics
14.
Rev Bras Epidemiol ; 25: e220018, 2022.
Article in English | MEDLINE | ID: covidwho-1923764

ABSTRACT

OBJECTIVE: To assess the impact of the COVID-19 pandemic on mortality in Argentina, considering temporal trends in life expectancy at birth and premature mortality rate during 2010-2020. METHODS: Based on demographic projections, this ecological time-series study compares a "normal" versus a "COVID-19" mortality scenario for 2020 over a set of 11 Argentine provinces. Annual life expectancy at birth and age-standardized rates of premature mortality were estimated from 2010 to 2020. Joinpoint regression and multilevel models were used. RESULTS: A potential reduction in life expectancy at birth (a gap between scenarios >1 year) was observed. A significant (negative) point of inflection in temporal trends was identified for the country and most of the provinces, under the COVID-19 mortality scenario. However, our findings reveal disparities between provinces in the estimated life expectancy reduction toward 2020 (values range from -0.63 to -1.85 year in females and up to -2.55 years in males). While men showed more accentuated declines in life expectancy at birth in 2020 (a national gap between scenarios of -1.47 year in men vs. -1.35 year in women), women experienced more unfavorable temporal trends of premature mortality. In the absence of COVID-19, an improvement in both indicators was estimated toward 2020 in both sexes, while a return to levels reported in the past was observed under the COVID-19 scenario. CONCLUSION: The COVID-19 pandemic might seriously affect the trends of mortality and exacerbate health disadvantages in Argentina. A temporal and contextual perspective of health inequities merits special attention in the COVID-19 research.


Subject(s)
COVID-19 , Argentina/epidemiology , Brazil , Female , Humans , Infant, Newborn , Life Expectancy , Male , Pandemics
15.
Travel Med Infect Dis ; 49: 102390, 2022.
Article in English | MEDLINE | ID: covidwho-1907826

ABSTRACT

BACKGROUND: SARS-CoV-2, the virus that causes COVID-19, is constantly mutating, leading to new variants that culminate in a temporal lineages fluctuation. B.1.1.28 lineage has been evolving in Brazil since February 2020 and originated P.1 (VOC), P.2 (VOI) and other P.Xs proposed as new variants. METHODS AND RESULTS: In this study, through the Illumina platform, we performed the whole-genome sequencing of 26 positive samples of SARS-CoV-2. Employing variant calling analysis on FASTQ reads and phylogenetic inference, we report a brief dispersion of a potentially new B.1.1.28-derived variant detected between 2021 May and June in individuals crossing the border between Brazil and Argentina, and local spread to inpatients from hospitals at the Rio Grande do Sul state capital (Porto Alegre). Besides, the Rio Grande do Sul State SARS-CoV-2 genomic epidemiological data was analyzed and showed an important B.1.1.28 peak in RS at the same period (May-June), even in the presence of a major Gamma wave. CONCLUSIONS: The emergence of a putative B.1.1.28-derived lineage was identified in travelers crossing Brazil-Argentina border representing an important peak of B.1.1.28 in RS State with a decreased in Gamma variant frequency in the same period of time.


Subject(s)
COVID-19 , SARS-CoV-2 , Argentina/epidemiology , Brazil/epidemiology , COVID-19/epidemiology , Humans , Mutation , Phylogeny , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics
16.
Clin Rheumatol ; 41(10): 3199-3209, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1906098

ABSTRACT

BACKGROUND/OBJECTIVE: To evaluate the efficacy and safety of SARS-CoV-2 vaccine in patients with rheumatic and immune-mediated inflammatory diseases (IMIDs) in Argentina: the SAR-CoVAC registry. METHODS: SAR-CoVAC is a national, multicenter, and observational registry. Adult patients with rheumatic or IMIDs vaccinated for SARS-CoV-2 were consecutively included between June 1 and September 17, 2021. Sociodemographic data, comorbidities, underlying rheumatic or IMIDs, treatments received, their modification prior to vaccination, and history of SARS-CoV-2 infection were recorded. In addition, date and place of vaccination, type of vaccine applied, scheme, adverse events (AE), disease flares, and new immune-mediated manifestations related to the vaccine were analyzed. RESULTS: A total of 1234 patients were included, 79% were female, with a mean age of 57.8 (SD 14.1) years. The most frequent diseases were rheumatoid arthritis (41.2%), osteoarthritis (14.5%), psoriasis (12.7%), and spondyloarthritis (12.3%). Most of them were in remission (28.5%) or low disease activity (41.4%). At the time of vaccination, 21% were receiving glucocorticoid treatment, 35.7% methotrexate, 29.7% biological (b) disease modifying anti-rheumatic drugs (DMARD), and 5.4% JAK inhibitors. In total, 16.9% had SARS-CoV-2 infection before the first vaccine dose. Most patients (51.1%) received Gam-COVID-Vac as the first vaccine dose, followed by ChAdOx1 nCoV-19 (32.8%) and BBIBP-CorV (14.5%). Half of them (48.8%) were fully vaccinated with 2 doses; 12.5% received combined schemes, being the most frequent Gam-COVID-Vac/mRAN-1273. The median time between doses was 51 days (IQR 53). After the first dose, 25.9% of the patients reported at least one AE and 15.9% after the second, being flu-like syndrome and local hypersensitivity the most frequent manifestations. There was one case of anaphylaxis. Regarding efficacy, 63 events of SARS-CoV-2 infection were reported after vaccination, 19% occurred during the first 14 days post-vaccination, 57.1% after the first dose, and 23.8% after the second. Most cases (85.9%) were asymptomatic or mild and 2 died due to COVID-19. CONCLUSIONS: In this national cohort of patients, the most common vaccines used were Gam-COVID-Vac and ChAdOx1 nCoV-19. A quarter of the patients presented an AE and 5.1% presented SARS-CoV-2 infection after vaccination, in most cases mild. STUDY REGISTRATION: This study has been registered in ClinicalTrials.gov under the number: NCT04845997. Key Points • This study shows real-world data about efficacy and safety of SARS-CoV-2 vaccination in patients with rheumatic and immune-mediated inflammatory diseases. Interestingly, different types of vaccines were used including vector-based, mRNA, and inactivated vaccines, and mixed regimens were enabled. • A quarter of the patients presented an adverse event. The incidence of adverse events was significantly higher in those receiving mRAN-1273 and ChAdOx1 nCoV-19. • In this cohort, 5.1% presented SARS-CoV-2 infection after vaccination, in most cases mild.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Aged , Antirheumatic Agents/therapeutic use , Argentina/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , ChAdOx1 nCoV-19 , Female , Glucocorticoids , Humans , Janus Kinase Inhibitors , Male , Methotrexate , Middle Aged , Preliminary Data , RNA, Messenger , Registries , SARS-CoV-2 , Vaccination , Vaccines, Inactivated
17.
Int J Environ Res Public Health ; 19(10)2022 05 13.
Article in English | MEDLINE | ID: covidwho-1903303

ABSTRACT

Copahue Thermal Center is characterized by the presence of mineromedicinal acidic waters with high temperatures, therapeutic peloids, and relevant consortia of extremophiles species, distributed in small natural pools which cannot be disinfected. The objective of this research was to investigate the survival of SARS-CoV-2 in Copahue's waters and its remaining infective capacity. In a first assay, a decrease of more than 50% of the initially viral load compared to the initially inoculated positive sample was detected for all the water samples analyzed. After that, two of the Copahue springs, which are used as an immersion bath in closed environments without going through any disinfection treatment, was selected to determine the viral viability. VERO cell infections were performed, with no cytopathic effect detected, but a strikingly high resistance of the virus, detecting its genome by real time PCR, during the seven days of study under laboratory conditions. SARS-CoV-2 survival in acid media was reaffirmed, which is a peculiarity for a covered virus. A decrease in the detectable viral load of the positive sample was found as the infection time passed, becoming completely negative in the subsequent blind passages. More research is needed to further study the feasibility of SARS-CoV-2 in mineromedicinal waters, especially natural acidic waters that cannot disinfected, in order to expand information about the risk to populations that are exposed to them.


Subject(s)
COVID-19 , SARS-CoV-2 , Argentina/epidemiology , COVID-19/epidemiology , Humans
18.
Sci Rep ; 12(1): 8496, 2022 05 19.
Article in English | MEDLINE | ID: covidwho-1900647

ABSTRACT

This study analyzed the frequency and intensity of acute stress among health professionals caring for COVID-19 patients in four Latin American Spanish-speaking countries during the outbreak. A cross-sectional study involved a non-probability sample of healthcare professionals in four Latin American countries. Participants from each country were invited using a platform and mobile application designed for this study. Hospital and primary care workers from different services caring for COVID-19 patients were included. The EASE Scale (SARS-CoV-2 Emotional Overload Scale, in Spanish named Escala Auto-aplicada de Sobrecarga Emocional) was a previously validated measure of acute stress. EASE scores were described overall by age, sex, work area, and experience of being ill with COVID-19. Using the Mann-Whitney U test, the EASE scores were compared according to the most critical moments of the pandemic. Univariate and multivariate analysis was performed to investigate associations between these factors and the outcome 'acute stress'. Finally, the Kruskal-Wallis was used to compare EASE scores and the experience of being ill. A total of 1372 professionals responded to all the items in the EASE scale: 375 (27.3%) Argentines, 365 (26.6%) Colombians, 345 (25.1%) Chileans, 209 (15.2%) Ecuadorians, and 78 (5.7%) from other countries. 27% of providers suffered middle-higher acute stress due to the outbreak. Worse results were observed in moments of peak incidence of cases (14.3 ± 5.3 vs. 6.9 ± 1.7, p < 0.05). Higher scores were found in professionals in COVID-19 critical care (13 ± 1.2) than those in non-COVID-19 areas (10.7 ± 1.9) (p = 0.03). Distress was higher among professionals who were COVID-19 patients (11.7 ± 1) or had doubts about their potential infection (12 ± 1.2) compared to those not infected (9.5 ± 0.7) (p = 0.001). Around one-third of the professionals experienced acute stress, increasing in intensity as the incidence of COVID-19 increased and as they became infected or in doubt whether they were infected. EASE scale could be a valuable asset for monitoring acute stress levels among health professionals in Latin America.ClinicalTrials: NCT04486404.


Subject(s)
COVID-19 , Health Personnel , Occupational Stress , Argentina/epidemiology , COVID-19/epidemiology , COVID-19/therapy , Chile , Colombia/epidemiology , Cross-Sectional Studies , Ecuador/epidemiology , Health Personnel/psychology , Humans , Occupational Stress/epidemiology , Risk Factors
19.
Cad Saude Publica ; 38(5): e00163921, 2022.
Article in Spanish | MEDLINE | ID: covidwho-1875195

ABSTRACT

The study aimed to analyze the socio-spatial differences in COVID-19 mortality in the pandemic's three waves in the city of Buenos Aires, Argentina. COVID-19 mortality data were obtained from the COVID-19 Database and reported by the Buenos Aires Autonomous Government from March 7, 2020, to September 30, 2021. Three waves were identified: the first from March to December 2020, the second from December 2020 to March 2021, and the third from March to September 2021. Multivariate regressions were calculated for each wave to analyze the association between risk of COVID-19 mortality in two age groups (0-59 years and 60 years or older) and the percentage of households with unmet basic needs as indicator of neighborhood poverty level, and population density. During the first wave and in both age groups, the neighborhood in the tertile with the highest percentages of households with unmet basic needs showed higher risk of COVID-19 mortality when compared to neighborhoods in the tertile with the lowest percentages of households with unmet basic needs. These inequalities disappeared in the second wave in both age groups, while the third wave saw a similar geographic pattern to the first wave. Higher levels of immunity in neighborhoods with high poverty levels might partially explain the absence of socio-spatial inequalities in the second wave, while the emergence of the gamma and lambda variants could partially explain the return to inequalities observed in the first wave.


Nuestro propósito fue investigar las diferencias de las desigualdades socioespaciales de la mortalidad por COVID-19 entre tres olas de propagación del virus en la Ciudad Autónoma de Buenos Aires (CABA), Argentina. Los datos de mortalidad por COVID-19 se obtuvieron de la base de datos de casos de COVID-19, informados por el gobierno de la CABA, desde el 7 de marzo de 2020 hasta el 30 de septiembre de 2021. Se determinaron tres olas: la primera ola, entre los meses de marzo y diciembre de 2020, la segunda ola, entre diciembre y marzo de 2021, y la tercera ola, entre marzo y septiembre de 2021. En cada ola se calcularon regresiones multivariadas para analizar la asociación entre el riesgo de mortalidad por COVID-19, en dos grupos etarios (0-59 años y 60 o más años), y el porcentaje de hogares con necesidades básicas insatisfechas, como indicador del nivel de pobreza de los barrios, y la densidad poblacional. Durante la primera ola y en ambos grupos etarios, los barrios del tercil con mayores porcentajes de hogares con necesidades básicas insatisfechas tuvieron un riesgo mayor de mortalidad por COVID-19, en comparación a los barrios del tercil con menores porcentajes de hogares con necesidades básicas insatisfechas. Estas desigualdades desaparecieron durante la segunda ola en ambos grupos etarios, mientras que en la tercera ola pareció emerger un patrón geográfico similar al de la primera ola. Es posible que mayores niveles de inmunidad en barrios con niveles altos de pobreza pudieran explicar parcialmente la ausencia de desigualdades socioespaciales durante la segunda ola, mientras que la irrupción de las variantes gamma y lambda podría explicar parcialmente el retorno a las desigualdades observadas en la primera ola.


A proposta era investigar as diferenças nas desigualdades socioespaciais da mortalidade por COVID-19 entre três ondas de propagação do vírus na Cidade Autônoma de Buenos Aires, Argentina. Os dados de mortalidade por COVID-19 foram obtidos a partir da base de dados dos casos de COVID-19 informados pelo governo da Cidade Autônoma de Buenos Aires, do dia 7 de março de 2020, até 30 de setembro de 2021. Foram identificadas três ondas: a primeira, entre os meses de março e dezembro de 2020, a segunda, entre dezembro e março de 2021, e a terceira, entre março e setembro de 2021. Para cada uma delas, foram calculadas regressões multivariadas, visando analisar a associação entre o risco de mortalidade por COVID-19 em dois grupos etários (0-59 anos e 60 anos ou mais), e o percentual de domicílios com necessidades básicas não atendidas, como indicador do nível de pobreza dos bairros, e a densidade populacional. Durante a primeira onda e em ambos grupos etários, os bairros do tercil com maiores percentuais de domicílios com necessidades básicas não atendidas apresentaram um risco maior de mortalidade por COVID-19 na comparação com os bairros do tercil com menores taxas de domicílios com necessidades básicas não atendidas. Estas desigualdades desapareceram durante a segunda onda nos dois grupos etários, ao passo que, na terceira onda parece ter emergido um padrão geográfico similar ao da primeira onda. Maiores níveis de imunidade em bairros com altas taxas de pobreza poderiam explicar parcialmente a ausência de desigualdades socioespaciais durante a segunda onda, sendo que a irrupção das variantes gama e lambda poderia explicar parcialmente a volta para as desigualdades observadas na primeira onda.


Subject(s)
COVID-19 , Adolescent , Adult , Argentina/epidemiology , Brazil , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Middle Aged , SARS-CoV-2 , Young Adult
20.
Ecohealth ; 19(2): 159-163, 2022 06.
Article in English | MEDLINE | ID: covidwho-1872562

ABSTRACT

Swine coronaviruses affecting pigs have been studied sporadically in wildlife. In Argentina, epidemiological surveillance of TGEV/PRCV is conducted only in domestic pigs. The aim was to assess the prevalence of TGEV/PRCV in wild Suina. Antibodies against these diseases in wild boar and captive collared peccary were surveyed by ELISA. Antibodies against TGEV were found in three collared peccaries (n = 87). No TGEV/PRCV antibodies were detected in wild boar (n = 160). Preventive measures should be conducted in contact nodes where the transmission of agents may increase. Epidemiological surveillance in wildlife populations and in captive animals before their reintroduction should be attempted.


Subject(s)
Artiodactyla , Coronavirus Infections , Coronavirus , Gastroenteritis, Transmissible, of Swine , Swine Diseases , Transmissible gastroenteritis virus , Animals , Animals, Wild , Argentina/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/veterinary , Swine
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