ABSTRACT
BACKGROUND: Healthcare workers are at increased risk of infection due to occupational exposure to SARS-CoV-2-infected patients. The objective of this study was to determine the seroprevalence of SARS-CoV-2 in healthcare workers in Colombia. METHODS: This study is a cross-sectional study focused on estimating the seroprevalence of SARS-CoV-2 antibodies in healthcare workers from 65 hospitals in 10 cities in Colombia during the second semester of 2020. The seroprevalence was determined using an automated immunoassay (Abbott SARS-CoV-2 CLIA IgG). The study included a survey to establish the sociodemographic variables and the risk of infection. A multivariate model was used to evaluate the association between the results of seroprevalence and risk factors. RESULTS: The global seroprevalence of antibodies against SARS-CoV-2 was 35% (95% Bayesian CI 33% to 37%). All the personnel reported the use of protective equipment. General services personnel and nurses presented the highest ratios of seroprevalence among the healthcare workers. Low socioeconomic strata have shown a strong association with seropositivity. CONCLUSION: This study estimates the prevalence of SARS-CoV-2 infection among healthcare workers. Even though all the personnel reported the use of protective equipment, the seroprevalence in the general services personnel and nurses was high. Also, a significant difference by cities was observed.
Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , Bayes Theorem , COVID-19/epidemiology , Cities/epidemiology , Colombia/epidemiology , Cross-Sectional Studies , Health Personnel , Humans , Immunoglobulin G , Seroepidemiologic StudiesABSTRACT
Introduction Different factors are critical when assessing COVID-19 mortality, and can explain why severity differs so widely among populations. However, there is little information regarding prognostic factors and mortality in COVID-19 from Latin American countries. Objectives To determine prognostic factors in hospitalized COVID-19 patients and to evaluate the impact of tocilizumab use in patients with hyperinflammatory syndrome and severe disease defined by the National Early Warning Score 2 (NEWS2) with a value greater than or equal to seven points. Materials and methods This retrospective cohort study included hospitalized COVID-19 patients from May to July 2020. A multivariate logistic regression analysis was performed to determine independent factors associated with mortality. Results A total of 136 patients required hospital admission. In-hospital mortality was 39.7%. Mortality was observed to be potentiated by older age, LDH serum levels and the presence of type 2 diabetes mellitus. Lymphopenia and lower PaO2/FiO2 ratio were more common in these patients. Similarly, patients who died were classified more frequently with severe disease. The independent factors associated with in-hospital mortality were age greater than 65 years, type 2 diabetes mellitus, NEWS2 greater than or equal to seven points and LDH greater than 400U/L. The use of Tocilizumab alone was not related with decreased in-hospital mortality. Subgroup analysis performed in patients with hyperinflammation and severe disease showed similar results. Conclusions COVID-19 mortality in hospitalized patients was high and mainly related with older age, comorbidities, LDH and the severity of disease at hospital admission.
ABSTRACT
La infección por Entamoeba histolytica puede causar disentería y absceso hepático amebiano, enfermedades de alta morbi-mortalidad. Se presenta el seguimiento, durante 32 meses, mediante IgG de un paciente de 69 años, proveniente del Chocó en Colombia, con diagnóstico de absceso hepático amebiano, comprobado mediante ecografía, ELISA para IgG, e inmunodifusión y por la respuesta al tratamiento con metronidazol. Las pruebas inmunodiagnósticas han permanecido positivas durante el seguimiento
Subject(s)
Adult , Liver Abscess/metabolism , Immunoglobulin G/metabolism , Enzyme-Linked Immunosorbent Assay/methodsABSTRACT
La infección por el parásito Entamoeba histolytica es causa de disentería y absceso hepático amebianos, enfermedades asociadas con alta morbi-mortalidad. En el caso de la amebiosis hepática, el papel de la inmunidad humoral en la protección no ha sido del todo establecido pero tiene importancia en estudios seroepidemiológicos y métodos diagnósticos. La inmunidad celular es importante para el control de la infección y desarrollo de inmunidad protectora luego de amebiosis invasiva. Las técnicas de genética molecular y los nuevos modelos de experimentación han enseñado mucho acerca de la patogénesis de la amebiosis, su entendimiento adecuado junto con el conocimiento de la biología molecular y genética del parásito y los mecanismos inmunes del huésped permitirá no sólo el desarrollo de nuevas opciones diagnósticas y de tratamiento sino también de una vacuna efectiva y segura para eliminar la enfermedad.(AU)
Infection by the parasite Entamoeba histolytica causes amebic dysentery and amebic liver abscess, diseases associated with a high morbidity and mortality. In the case of amebic liver infection, the role of humoral immunity in protection has not been well established but it is important in seroidemiological studies and for diagnostic methods. Cellular immunity is important for the control of infection and the development of protective immunity after an invasive infection. Molecular genetic techniques and new experimental models have increased the knowledge on the pathogenesis of amebiasis. Its adequate understanding, together with the knowledge on the molecular biology and genetics of the parasite and of the host's immune mechanisms will allow the development of new diagnostic and therapeutic tools as well as the development of an effective and safe vaccine for eliminating the disease.(AU)
