Persistence of SARS-CoV-2 RNA shedding and infectivity in immunized population: Prospective study along different epidemiological periods in Argentina.

During the pandemic of COVID-19, numerous waves of infections affected the two hemispheres with different impacts on each country. Throughout these waves, and with the emergence of new variants, health systems and scientists have tried to provide real-time responses to the complex biology of SARS-CoV-2, dealing with different clinical presentations, biological characteristics, and clinical impact of these variants. In this context, knowing the extent period in which an infected individual releases infectious viral particles has important implications for public health. This work aimed to investigate viral RNA shedding and infectivity of SARS-CoV-2 beyond 10 days after symptom onset (SO). A prospective multicenter study was performed between July/2021 and February/2022 on 116 immunized strategic personnel with COVID-19 diagnosed by RT-qPCR, with asymptomatic (7%), mild (91%) or moderate disease (2%). At the time of diagnosis, 70% had 2 doses of vaccines, 26% had 2 plus a booster, and 4% had one dose. After day 10 from SO, sequential nasopharyngeal swabs were taken to perform RT-qPCR, viral isolation, and S gene sequencing when possible. Viral sequences were obtained in 98 samples: 43% were Delta, 16% Lambda, 15% Gamma, 25% Omicron (BA.1) and 1% Non-VOC/VOI, in accordance with the main circulating variants at each moment. SARS-CoV-2 RNA was detected 10 days post SO in 57% of the subjects. Omicron was significantly less persistent. Noteworthy, infective viruses could not be isolated in any of the samples. In conclusion, a 10-days isolation period was useful to prevent further infections, and proved valid for the variants studied. Recently, even shorter periods have been applied, as the Omicron variant is prevalent, and worldwide population is largely vaccinated. In the future, facing the possible emergence of new variants and considering immunological status, a return to 10 days may be necessary.

Consideraciones éticas en épocas de epidemias y pandemias. Una mirada de asombro en tiempos de COVID-19

On March 11, 2020, the World Health Organization declared that the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that causes the coronavirus disease 2019 (COVID-19), is a pandemic. The severity of this disease has alerted everyone and poses ethical and moral dilemmas. However, it is important to highlight that even in times of crisis, central ethical principles such as respect for autonomy, beneficence, non-maleficence and justice remain the same (even if some become more significant than others as new contexts emerge), since ethics is subject to the social reality in which people find themselves and the unforeseeable events that may arise in it, as in this case, COVID-19. We will address these ethical aspects in this review;we will also recall a little bit of the history of humanity in times of epidemics and pandemics and the ethical challenges they faced. A pandemic likes the one we are living in can be an area of opportunity to reflect and progress towards fairer and more equitable health, in addition to a society and people more committed to their health and respectful of the common good. El 11 de marzo del 2020, la Organización Mundial de la Salud declaró que el brote del coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2), causante de la enfermedad por coronavirus 2019 (COVID-19), es una pandemia. La gravedad de esta enfermedad ha puesto en alerta a todo el mundo y plantea dilemas éticos y morales. Sin embargo, es importante resaltar que incluso en épocas de crisis los principios éticos centrales como el respeto a la autonomía, la beneficencia, la no maleficencia y la justicia siguen siendo los mismos (incluso si algunos se vuelven más significativos que otros a medida que surgen nuevos contextos), ya que la ética está supeditada a la realidad social en la que se encuentran las personas y los sucesos imprevisibles que se pueden suscitar en esta, como en este caso la COVID-19. Estos aspectos éticos los abordaremos en la presente revisión;además recordaremos un poco de la historia de la humanidad en épocas de epidemias y pandemias y los retos éticos a los que se enfrentaron. Una pandemia como la que nos está tocando vivir puede ser un área de oportunidad para reflexionar y progresar hacia una salud más justa y equitativa, con una sociedad y personas más comprometidas con su salud y respetuosas del bien común.