Characteristics and outcomes of severe COVID-19 in hospitalized patients with cardiovascular diseases in the Amazonian region of Brazil: a retrospective cohort.

The northern region of Brazil is already vulnerable to other infectious diseases and it was no different in COVID-19. However, cardiovascular diseases still lead the causes of death. Thus, the objective of this study is to identify the clinical predictors and outcome of severe COVID-19 in hospitalized patients with and without CVD in this region of the Amazon. A retrospective cohort, referring to the notifications from January 1 to December 31, 2020, including cases confirmed by molecular testing. The study consisted of 9223 confirmed cases for COVID-19. Of these, 6011 (65.17%) did not have cardiovascular disease and 3212 (34.83%) had some cardiovascular disease. The significance of deaths was in the age group of < 1 to 59 CVD carriers (< 0.001). Predictor of mortality were invasive ventilation for patients with CVD, (OR 23,688 CI 18,180-30,866), followed by chronic kidney disease (OR 2442 CI 1568-3740), dyspnea (OR 2312 CI 1817-3941), respiratory distress (OR 1523 CI 1210-2919), cough (OR 1268 CI 1005-1599), Lower oxygen saturation 95% (OR 1281 CI 1039-1579), diabetes mellitus (OR 1267 CI 1050-1528) and age (OR 1051 CI 1044-1058). Carriers of CVD had a lower survival rate (< 0.0001). The order of the predictors of death differed among the non-carriers, as well as the high odds ratio in the predictors of CVD, only cough was an independent predictor. The age group under 59 years was associated with deaths. We also show the shorter survival in CVD carriers, as well as the higher cardiovascular morbidity rate than other studies in the literature.

Chromatic discrimination in fixed saturation levels from trichromats and subjects with congenital color vision deficiency.

Color vision tests use estimative of threshold color discrimination or number of correct responses to evaluate performance in chromatic discrimination tasks. Both approaches have advantages and disadvantages. In the present investigation, we compared the number of errors during color discrimination task in normal trichromats and participants with color vision deficiency (CVD) using pseudoisochromatic stimuli at fixed saturation levels. We recruited 28 normal trichromats and eight participants with CVD. Cambridge Color Test was used to categorize their color vision phenotype, and those with a phenotype suggestive of color vision deficiency had their L- and M-opsin genes genotyped. Pseudoisochromatic stimuli were shown with target chromaticity in 20 vectors radiating from the background chromaticity and saturation of 0.06, 0.04, 0.03, 0.02, 0.01, and 0.005 u'v' units. Each stimulus condition appeared in four trials. The number of errors for each stimulus condition was considered an indicator of the participant's performance. At high chromatic saturation, there were fewer errors from both phenotypes. The errors of the normal trichromats had no systematic variation for high saturated stimuli, but below 0.02 u'v' units, there was a discrete prevalence of tritan errors. For participants with CVD, the errors happened mainly in red-green chromatic vectors. A three-way ANOVA showed that all factors (color vision phenotype, stimulus saturation, and chromatic vector) had statistically significant effects on the number of errors and that stimulus saturation was the most important main effect. ROC analysis indicated that the performance of the fixed saturation levels to identify CVD was better between 0.02 and 0.06 u'v' units reaching 100%, while saturation of 0.01 and 0.005 u'v' units decreased the accuracy of the screening of the test. We concluded that the color discrimination task using high saturated stimuli separated normal trichromats and participants with red-green color vision deficiencies with high performance, which can be considered a promising method for new color vision tests based in frequency of errors.

Cross-sectional study to assess the association of color vision with mercury hair concentration in children from Brazilian Amazonian riverine communities.

BACKGROUND: Mercury exposure in the Brazilian Amazon region has been an important concern since the 1980s, when gold mining activities contaminated many Amazonian river basins and the fish therein. Mercury exposure in humans can lead to changes in neural function. The visual system has been used as a functional indicator of methylmercury (organic) and mercury vapour (inorganic) toxicity. Children are particularly vulnerable to this metal exposure. OBJECTIVE: To compare the color vision of children from riverine communities of mercury-exposed (Tapajós basin) and non-exposed Amazonian rivers (Tocantins basin). METHODS: The study sample was 176 children, aged 7-14 years old. Children from two locations in the mercury-exposed Tapajós river basin, Barreiras (n = 71) and São Luiz do Tapajos (n = 41), were compared to children from Limoeiro do Ajuru (n = 64), a non-exposed area in the Tocantins river basin. No caregiver reported that any children had contact with mercury vapour during their lifetime, and probably most of the mercury in their bodies was obtained by fish consumption. Because of this, we decided to evaluate the mercury exposure by total mercury levels in hair samples, a good marker for organic mercury, and not in the urine, a marker for inorganic mercury. Color vision was assessed by the Lanthony Desaturated D-15 test. We used the Vingrys and King-Smith method (1988) to quantify the hue ordering test. The primary visual outcomes from this analysis were C-index (magnitude of the hue ordering error) and angle of the hue ordering. RESULTS: The Tapajós children had a higher mean hair mercury level (mean: 4.5 µg/g; range: 0.26-22.38 µg/g) than that of Tocantins children (mean: 0.49 µg/g; range: 0.03-1.91 µg/g) (p < 0.05). Mean difference was approximately 4.01 µg/g with a 95% confidence interval of 2.79-5.23. The results of the Lanthony D-15d test showed no significant difference between the C-index mean values of the Tapajós and Tocantins groups (p > 0.05). There was a weak linear correlation in the average C-index obtained from both eyes and the total mercury concentration. Multiple logistic regression analysis indicated that the location of the community and the age had a greater influence on the visual outcomes than the sex of the children and within-locale variation in mercury concentration. CONCLUSION: Our results suggest a difference in one aspect of vision, that is, color vision, between children living in two different river basins in the Brazilian Amazon. The association may be related to Hg exposure but also appeared related to the location of the community and age.