Profile of Brazilian inpatients with COVID-19 vaccine breakthrough infection and risk factors for unfavorable outcome.

Objective: To characterize the epidemiological and clinical profile of individuals more likely to become infected with SARS-CoV-2 after the fully vaccination schedule in order to profile priority groups to receive a booster dose in situations of vaccine doses shortage as well as for maintenance of personal protective care. Methods: This cross-sectional study used data from hospitalized COVID-19 patients aged ≥18 years, who had been fully vaccinated and had a SARS-CoV-2 infection positive diagnosis collected from the SIVEP-Gripe database (Influenza Epidemiological Surveillance Information System) from January 18, 2021 to September 15, 2021. Demographic data, clinical symptoms and preexisting medical conditions (comorbidities) were analyzed. The primary outcome was in-hospital death. Results: The majority of hospitalized patients with vaccine breakthrough infection were ≥60 years old, male, with critical or severe COVID-19. The fatality rate was extremely high (50.27%) and more pronounced in elderly groups. The most prevalent symptoms were cough, dyspnea, respiratory distress, and low blood oxygen saturation. The most frequent comorbidities were heart disease and diabetes. High fatality rates were observed among patients admitted to the intensive care units (72.88%) and those who required invasive mechanical ventilation (87.82%). The main risk factors for an unfavorable outcome were older age, respiratory compromise, inactivated virus vaccine immunization, and preexisting medical conditions. Conclusions: We characterized the profile of hospitalized Brazilian patients with COVID-19 vaccine breakthrough infection and the risk factors for an unfavorable outcome. These data allow to identify priority groups to receive a booster dose and to continue using personal protection.

A temporal study of Brazilian pregnant and postpartum women vulnerability for COVID-19: Characteristics, risk factors and outcomes.

BACKGROUND: During the COVID-19 second wave in Brazil, there has been a significant increase in the number of daily cases and deaths, including pregnant and postpartum women. We assess risk factors and outcomes for this priority group compared to the COVID-19 non-pregnant cohort in two epidemic waves. METHODS: In this retrospective cohort study we evaluated data of hospitalized pregnant, postpartum, and nonpregnant women aged 15-44 years, between epidemiological weeks 2020-8 and 2021-15, who tested positive for SARS-CoV-2, retrieved from the Influenza Epidemiological Surveillance Information System maintained by Ministry of Health of Brazil. We analysed in-hospital case fatality rate, crude and adjusted risk ratios on different outcomes aiming to compare data in two waves. FINDINGS: The study included pregnant women (n = 7,132), postpartum women (n = 2,405) and nonpregnant women (n = 76,278) hospitalized with COVID-19. Case fatality rates of pregnant women were lower in both waves compared to nonpregnant women, but higher among postpartum women. The risk for admission to the intensive care unit and invasive mechanical ventilation requirement in both waves was significantly higher among postpartum women compared to nonpregnant women. Cardiac disease, diabetes, obesity, and asthma were the most frequent underlying medical conditions in all patient groups. These comorbidities were significantly less frequent among pregnant women. INTERPRETATION: Pregnant women with COVID-19 are at lower risk of poor outcome compared to nonpregnant women. On the other hand, postpartum women are at higher risk of adverse outcomes compared to pregnant and nonpregnant women, especially during the second wave. There was a significant increase in the in-hospital case fatality rate for all patient groups during the second wave of COVID-19. FUNDING: This study was financed in part by CAPES, CNPq, FAPEMIG and UFSJ.

Profile of Brazilian inpatients with COVID-19 vaccine breakthrough infection and risk factors for unfavorable outcome / Perfil de los pacientes brasileños vacunados hospitalizados por COVID-19 y factores de riesgo de un resultado desfavorable / Perfil de pacientes brasileiros internados com infecção por COVID-19 devido a escape vacinal e fatores de risco para desfecho desfavorável

ABSTRACT Objective. To characterize the epidemiological and clinical profile of individuals more likely to become infected with SARS-CoV-2 after the fully vaccination schedule in order to profile priority groups to receive a booster dose in situations of vaccine doses shortage as well as for maintenance of personal protective care. Methods. This cross-sectional study used data from hospitalized COVID-19 patients aged ≥18 years, who had been fully vaccinated and had a SARS-CoV-2 infection positive diagnosis collected from the SIVEP-Gripe database (Influenza Epidemiological Surveillance Information System) from January 18, 2021 to September 15, 2021. Demographic data, clinical symptoms and preexisting medical conditions (comorbidities) were analyzed. The primary outcome was in-hospital death. Results. The majority of hospitalized patients with vaccine breakthrough infection were ≥60 years old, male, with critical or severe COVID-19. The fatality rate was extremely high (50.27%) and more pronounced in elderly groups. The most prevalent symptoms were cough, dyspnea, respiratory distress, and low blood oxygen saturation. The most frequent comorbidities were heart disease and diabetes. High fatality rates were observed among patients admitted to the intensive care units (72.88%) and those who required invasive mechanical ventilation (87.82%). The main risk factors for an unfavorable outcome were older age, respiratory compromise, inactivated virus vaccine immunization, and preexisting medical conditions. Conclusions. We characterized the profile of hospitalized Brazilian patients with COVID-19 vaccine breakthrough infection and the risk factors for an unfavorable outcome. These data allow to identify priority groups to receive a booster dose and to continue using personal protection.

RESUMEN Objetivo. Caracterizar el perfil clínico y epidemiológico de las personas con mayores probabilidades de contraer la infección por el SARS-CoV-2 luego de tener el esquema completo de vacunación, con el fin de definir los grupos de prioridad para la aplicación de la dosis de refuerzo en situaciones de escasez de dosis de vacunación, así como para el mantenimiento de los equipos de protección personal. Métodos. En este estudio transversal se emplearon datos de pacientes mayores de 18 años hospitalizados con COVID-19 que habían recibido la pauta completa de vacunación y tenían un diagnóstico positivo de infección por SARS-CoV-2, recabados de la base de datos SIVEP-Gripe (Sistema de Información de Vigilancia Epidemiológica de la Gripe) en el periodo comprendido entre el 18 de enero del 2021 y el 15 de septiembre del 2021. Se analizaron datos demográficos, síntomas clínicos y trastornos médicos preexistentes (comorbilidades). El resultado primario fue la muerte hospitalaria. Resultados. La mayoría de los pacientes vacunados hospitalizados fueron varones mayores de 60 años con infección crítica o grave por el virus de la COVID-19. La tasa de letalidad fue extremadamente elevada (50,27 %) y más pronunciada en los grupos de edad avanzada. Los síntomas más prevalentes fueron tos, disnea, dificultad respiratoria y baja saturación de oxígeno en sangre. Las comorbilidades más frecuentes fueron las cardiopatías y la diabetes. Se observaron altas tasas de letalidad entre los pacientes ingresados en las unidades de cuidados intensivos (72,88 %) y los que necesitaron ventilación mecánica invasiva (87,82 %). Los principales factores de riesgo para un resultado desfavorable fueron la edad avanzada, dificultades respiratorias, inmunización con vacunas de virus inactivados y trastornos médicos preexistentes. Conclusiones. Se caracterizaron el perfil de los pacientes brasileños vacunados hospitalizados con COVID-19 por infección irruptiva de vacuna y los factores de riesgo de un resultado desfavorable. Estos datos permiten identificar los grupos de prioridad para recibir la dosis de refuerzo y continuar utilizando protección personal.

RESUMO Objetivo. Caracterizar o perfil epidemiológico e clínico dos indivíduos mais propensos a se infectar com SARS-CoV-2 após o esquema vacinal completo, a fim de traçar o perfil dos grupos prioritários para receberem uma dose de reforço em situações de escassez de doses vacinais, bem como para manutenção dos cuidados de proteção individual. Métodos. Este estudo transversal utilizou dados de pacientes hospitalizados com COVID-19 com idade ≥18 anos, esquema vacinal completo e diagnóstico positivo de infecção por SARS-CoV-2, coletados do banco de dados SIVEP-Gripe (Sistema de Informação da Vigilância Epidemiológica da Gripe) de 18 de janeiro a 15 de setembro de 2021. Foram analisados dados demográficos, sintomas clínicos e problemas médicos preexistentes (comorbidades). O desfecho primário foi óbito intra-hospitalar. Resultados. A maioria dos pacientes hospitalizados com infecção devido a escape vacinal tinha ≥60 anos, era do sexo masculino e tinha um quadro de COVID-19 grave ou gravíssimo. A letalidade foi extremamente alta (50,27%) e mais pronunciada nos grupos de pessoas idosas. Os sintomas mais prevalentes foram tosse, dispneia, desconforto respiratório e baixa saturação de oxigênio no sangue. As comorbidades mais frequentes foram cardiopatia e diabetes. Altas taxas de letalidade foram observadas entre os pacientes internados em unidades de terapia intensiva (72,88%) e os que precisaram de ventilação mecânica invasiva (87,82%). Os principais fatores de risco para um desfecho desfavorável foram idade avançada, comprometimento respiratório, imunização com vacina de vírus inativado e problemas médicos preexistentes. Conclusões. Caracterizamos o perfil dos pacientes brasileiros hospitalizados com infecção por COVID-19 devido a escape vacinal e os fatores de risco para desfecho desfavorável. Esses dados permitem identificar grupos prioritários para receber dose de reforço e continuar os cuidados de proteção individual.

The interaction of eugenol with cell membrane models at the air-water interface is modulated by the lipid monolayer composition.

Eugenol, a natural phenylpropanoid derivative with possible action in biological surfaces as microbicide, anesthetic and antioxidant, was incorporated in lipid monolayers of selected lipids at the air-water interface, representing cell membrane models. Interaction of eugenol with the lipids dipalmitoylphosphatidylcholine (DPPC), dioctadecyldimethylammonium bromide (DODAB), and dipalmitoylphosphatidylserine (DPPS) could be inferred by means of surface pressure-area isotherms and Polarization-Modulation Reflection-Absorption Spectroscopy. The interaction showed different effects on the different lipids. A higher monolayer expansion was observed for DPPS and DODAB, while more significant effects on the polar groups of the lipids were observed for DPPS and DPPC. These results pointed to the fact that the interaction of eugenol with lipid monolayers at the air-water interface is modulated by the lipid composition, which may be important to comprehend at the molecular level the interaction of this drug with biological surfaces.