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1.
Vaccines (Basel) ; 10(12)2022 Dec 01.
Article in English | MEDLINE | ID: mdl-36560474

ABSTRACT

The host immune response to SARS-CoV-2 appears to play a critical role in disease pathogenesis and clinical manifestations in severe COVID-19 cases. Until now, the importance of developing a neutralizing antibody response in the acute phase and its relationship with progression to severe disease or fatal outcome among hospitalized patients remains unclear. In this study, we aim to characterize and compare longitudinally the primary humoral immune host response in the early stages of the disease, looking for an association between neutralization, antibody titers, infective viral lineage, and the clinical outcome in hospitalized and non-hospitalized patients. A total of 111 patients admitted at INER from November 2021 to June 2022 were included. We found that patients with negative or low neutralization showed a significant reduction in survival probability compared to patients with medium or high neutralization. We observed a significant decrease in the median of neutralization in patients infected with viral variants with changes in RBD of the spike protein. Our results suggest that developing an early and robust neutralizing response against SARS-CoV-2 may increase survival probability in critical patients.

2.
Int J Infect Dis ; 125: 114-119, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36283676

ABSTRACT

OBJECTIVES: We evaluated the VE and the mutations of the viruses present in the Mexican population at the beginning of 2018. METHODS: We diagnosed influenza in outpatients with a high-performance Rapid Influenza Diagnostic Test (RIDT) qRT-PCR. Descriptive statistics were used to describe the study population, while the chi-square test was used to determine clinical variables. VE was analyzed through a negative test design. We sequenced the hemagglutinin (HA) gene, performed a phylogenetic analysis, and analyzed the nonsynonymous substitutions both in and outside antigenic sites. RESULTS: Of the 240 patients analyzed, 42.5% received the trivalent vaccine, and 37.5% were positive for influenza. The VE for the general population for any influenza virus type or subtype was 37.0%, while the VE for the predominant influenza A(H3N2) subtype was the lowest (19.7%). The phylogenetic analysis of HA showed the co-circulation of clades and subclades 3C.2a1, 3C.2a1b, 3C.2a2, 3C.2a2re, 3C.2a3, and 3C.3a with identities approximately 97-98% similar to the vaccine composition. CONCLUSION: Low VE was related to the co-circulation of multiple clades and subclades of influenza A(H3N2), with sufficient genetic and phenotypic distance to allow for the infection of vaccinated individuals.


Subject(s)
Influenza Vaccines , Influenza, Human , Humans , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Influenza A Virus, H3N2 Subtype/genetics , Phylogeny , Seasons , Mexico/epidemiology , Vaccine Efficacy , Hemagglutinin Glycoproteins, Influenza Virus/genetics , RNA, Viral/genetics , Antigenic Variation , Hemagglutinins/genetics
3.
Viruses ; 14(9)2022 08 23.
Article in English | MEDLINE | ID: mdl-36146648

ABSTRACT

Background: Infection by SARS-CoV-2 has been associated with multiple symptoms; however, still, little is known about persistent symptoms and their probable association with the risk of developing pulmonary fibrosis in patients post-COVID-19. Methods: A longitudinal prospective study on health workers infected by SARS-CoV-2 was conducted. In this work, signs and symptoms were recorded of 149 health workers with a positive PCR test for SARS-CoV-2 at the beginning of the diagnosis, during the active infection, and during post-COVID-19 follow-up. The McNemar chi-square test was used to compare the proportions and percentages of symptoms between the baseline and each follow-up period. Results: The signs and symptoms after follow-up were cardiorespiratory, neurological, and inflammatory. Gastrointestinal symptoms were unusual at the disease onset, but unexpectedly, their frequency was higher in the post-infection stage. The multivariate analysis showed that pneumonia (HR 2.4, IC95%: 1.5−3.8, p < 0.001) and positive PCR tests still after four weeks (HR 5.3, IC95%: 2.3-12.3, p < 0.001) were factors associated with the diagnosis of post-COVID-19 pulmonary fibrosis in this study group. Conclusions: Our results showed that pneumonia and virus infection persistence were risk factors for developing pulmonary fibrosis post-COVID-19, after months of initial infection.


Subject(s)
COVID-19 , Pulmonary Fibrosis , COVID-19/complications , Humans , Outpatients , Prospective Studies , Pulmonary Fibrosis/epidemiology , SARS-CoV-2
5.
PLoS One ; 7(7): e40529, 2012.
Article in English | MEDLINE | ID: mdl-22808184

ABSTRACT

BACKGROUND: In addition to clinical aspects and pathogen characteristics, people's health-related behavior and socioeconomic conditions can affect the occurrence and severity of diseases including influenza A(H1N1)pdm09. METHODOLOGY AND PRINCIPAL FINDINGS: A face-to-face interview survey was conducted in a hospital in Mexico City at the time of follow-up consultation for hospitalized patients with pneumonia due to influenza virus infection. In all, 302 subjects were enrolled and divided into two groups based on the period of hospitalization. Among them, 211 tested positive for influenza A(H1N1)pdm09 virus by real-time reverse-transcriptase-polymerase-chain-reaction during the pandemic period (Group-pdm) and 91 tested positive for influenza A virus in the post-pandemic period (Group-post). All subjects were treated with oseltamivir. Data on the demographic characteristics, socioeconomic status, living environment, and information relating to A(H1N1)pdm09, and related clinical data were compared between subjects in Group-pdm and those in Group-post. The ability of household income to pay for utilities, food, and health care services as well as housing quality in terms of construction materials and number of rooms revealed a significant difference: Group-post had lower socioeconomic status than Group-pdm. Group-post had lower availability of information regarding H1N1 influenza than Group-pdm. These results indicate that subjects in Group-post had difficulty receiving necessary information relating to influenza and were more likely to be impoverished than those in Group-pdm. Possible factors influencing time to seeking health care were number of household rooms, having received information on the necessity of quick access to health care, and house construction materials. CONCLUSIONS: Health-care-seeking behavior, poverty level, and the distribution of information affect the occurrence and severity of pneumonia due to H1N1 virus from a socioeconomic point of view. These socioeconomic factors may explain the different patterns of morbidity and mortality for H1N1 influenza observed among different countries and regions.


Subject(s)
Hospitalization/statistics & numerical data , Influenza A Virus, H1N1 Subtype , Influenza, Human/complications , Influenza, Human/epidemiology , Pandemics/economics , Pandemics/statistics & numerical data , Pneumonia/epidemiology , Pneumonia/etiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Delivery of Health Care , Female , Health , Hospitalization/economics , Humans , Infant , Infant, Newborn , Influenza A Virus, H1N1 Subtype/classification , Influenza, Human/economics , Influenza, Human/virology , Male , Mexico/epidemiology , Middle Aged , Multivariate Analysis , Pneumonia/economics , Socioeconomic Factors , Young Adult
6.
Gac Med Mex ; 147(5): 377-84, 2011.
Article in Spanish | MEDLINE | ID: mdl-22089667

ABSTRACT

OBJECTIVE: The aim of this study was to establish whether there was a histoplasmosis outbreak among a group of residents of Naucalpan (State of Mexico, a non-endemic area for histoplasmosis) and to ascertain the source through which they were infected. MATERIAL AND METHODS: Anyone associated with the Index Case in the same period with a flu-like infection was considered as a suspected case. Diagnosis was confirmed by clinical examination positive, cultures and positive immunological tests. Date and form of potential exposure were obtained through interviews. Material potentially contaminated with bird or bat droppings was sought and analyzed by PCR. RESULTS: The outbreak was associated with a trip to El Tamarindo (Veracruz, near the Gulf of Mexico). Patients got sick after digging a hole in the floor inside a house where a treasure had been supposedly buried by a death relative. The pathogen was detected in soil samples at 10 cm below the surface. CONCLUSIONS: The study showed that patients contracted histoplasmosis in El Tamarindo, a community where there had been no prior cases of this disease.


Subject(s)
Disease Outbreaks , Histoplasmosis/epidemiology , Adult , Female , Humans , Male , Mexico/epidemiology , Middle Aged
7.
PLoS One ; 6(7): e21838, 2011.
Article in English | MEDLINE | ID: mdl-21760915

ABSTRACT

BACKGROUND: Anti-viral treatment has been used to treat severe or progressive illness due to pandemic H1N1 2009. A main cause of severe illness in pandemic H1N1 2009 is viral pneumonia; however, it is unclear how effective antiviral treatment is against pneumonia when administered >48 hours after symptom onset. Therefore, we aimed to determine how time from symptom onset to antiviral administration affected the effectiveness of antiviral treatment against pneumonia due to pandemic (H1N1) 2009. METHODS/PRINCIPAL FINDINGS: A retrospective medical chart review of 442 patients was conducted in a hospital in Mexico. Subjects had tested positive for pandemic H1N1 2009 virus by real-time reverse-transcriptase-polymerase-chain-reaction and were administered oseltamivir. Median time from symptom onset to oseltamivir administration was 5.0 days (range, 0-43). 442 subjects, 71 (16.1%) had severe pneumonia which required mechanical ventilation, 191 (43.2%) had mild to moderate pneumonia, and 180 (40%) did not have pneumonia. Subjects were divided into four groups based on time to oseltamivir administration: ≤2, 3-7, 8-14, and >14 days. Severity of respiratory features was associated with time to treatment, and multivariate analysis indicated that time to oseltamivir administration was associated with severity of respiratory features. A proportional odds model indicated that 50% probability for occurrence of pneumonia of any severity and that of severe pneumonia in patients who would develop pneumonia reached at approximately 3.4 and 21 days, respectively, after symptom onset. Patients with a shorter time to oseltamivir administration were discharged earlier from the hospital. CONCLUSIONS: Earlier initiation of oseltamivir administration after symptom onset significantly reduced occurrence and severity of pneumonia and shortened hospitalization due to pandemic H1N1 2009. Even when administered >48 hours after symptom onset, oseltamivir showed considerable potential for reducing pneumonia. Application of these results would benefit patients affected by future influenza pandemics.


Subject(s)
Influenza A Virus, H1N1 Subtype/physiology , Influenza, Human/virology , Oseltamivir/administration & dosage , Oseltamivir/therapeutic use , Pandemics , Pneumonia, Viral/drug therapy , Severity of Illness Index , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Hospitalization , Humans , Infant , Infant, Newborn , Influenza A Virus, H1N1 Subtype/drug effects , Influenza, Human/complications , Influenza, Human/drug therapy , Influenza, Human/epidemiology , Male , Mexico/epidemiology , Middle Aged , Multivariate Analysis , Oseltamivir/pharmacology , Patient Admission , Patient Discharge , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/virology , Probability , Retrospective Studies , Young Adult
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