[PCR for COVID in the transplant protocol]. / PCR para COVID en el protocolo de trasplante.

Background: Since the beginning of the SARS-CoV-2 pandemic, identifying the COVID-19 pathophysiology not only has been addressed to applying diagnostic tests or preventing through vaccines, but also to the timely detection, especially of patients in risk groups such as those in transplants areas (renal, hematology, etcetera). In the case of these patients, using RT-PCR tests avoids putting them at risk by subjecting them to states of immunosuppression that could aggravate their situation if they were faced with an onset of a COVID-19 infection. Objective: To present the results of patients of a transplant unit tested for SARS-CoV-2. Material and methods: Descriptive, observational, cross-sectional, and retrolective study. Data of results of RT-PCR tests of patients who underwent transplantation from June 2021 to April 2022 in a third level hospital were collected. Results: 755 tests were done to patients who underwent transplantation. 384 (50.8%) were women. Out of all patients, only 73 (9.7%) were positive to SARS-CoV-2. Conclusions: Implementing RT-PCR tests as a transplant protocol to detect SARS-CoV-2 prevents fatal complications due to COVID infection to donors and receptors.

Introducción: desde que comenzó la pandemia por SARS-CoV-2, identificar la fisiopatología de la COVID-19 no solo se ha encaminado a aplicar pruebas diagnósticas o prevenir por medio de vacunas, sino también a la oportuna detección, sobre todo de pacientes de grupos de riesgo como los del área de trasplantes (renal, hematológico, etcétera). En el caso de estos pacientes, usar pruebas como la RT-PCR evita someterlos a estados de inmunosupresión que podrían agravar la situación en caso de que se encuentren ante un inicio de la infección por COVID-19. Objetivo: exponer los resultados de las pruebas de SARS-CoV-2 aplicadas a pacientes de una unidad de trasplantes. Material y métodos: estudio descriptivo, observacional, transversal y retrolectivo. Se recolectaron los datos de los resultados de las pruebas de RT-PCR para SARS-CoV-2 de pacientes sometidos a trasplante de junio de 2021 a abril de 2022 en un hospital de tercer nivel. Resultados: se hicieron 755 pruebas a los pacientes sometidos a trasplante; 384 (50.8%) fueron mujeres. De todos los pacientes, solo 73 (9.7%) fueron positivos a SARS-CoV-2. Conclusiones: implementar pruebas RT-PCR para detectar el SARS-CoV-2 como protocolo de trasplante previene complicaciones fatales derivadas de la infección por COVID a los donadores y a los receptores.

The immunogenetic diversity of the HLA system in Mexico correlates with underlying population genetic structure.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) allele groups and alleles by PCR-SSP based typing in a total of 15,318 mixed ancestry Mexicans from all the states of the country divided into 78 sample sets, providing information regarding allelic and haplotypic frequencies and their linkage disequilibrium, as well as admixture estimates and genetic substructure. We identified the presence of 4268 unique HLA extended haplotypes across Mexico and find that the ten most frequent (HF > 1%) HLA haplotypes with significant linkage disequilibrium (Δ'≥0.1) in Mexico (accounting for 20% of the haplotypic diversity of the country) are of primarily Native American ancestry (A*02~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*08~DQB1*04, A*68~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*14~DQB1*03:01, A*24~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*04~DQB1*03:02, A*02~B*40:02~DRB1*04~DQB1*03:02, A*68~B*35~DRB1*04~DQB1*03:02, A*02~B*15:01~DRB1*04~DQB1*03:02). Admixture estimates obtained by a maximum likelihood method using HLA-A/-B/-DRB1 as genetic estimators revealed that the main genetic components in Mexico as a whole are Native American (ranging from 37.8% in the northern part of the country to 81.5% in the southeastern region) and European (ranging from 11.5% in the southeast to 62.6% in northern Mexico). African admixture ranged from 0.0 to 12.7% not following any specific pattern. We were able to detect three major immunogenetic clusters correlating with genetic diversity and differential admixture within Mexico: North, Central and Southeast, which is in accordance with previous reports using genome-wide data. Our findings provide insights into the population immunogenetic substructure of the whole country and add to the knowledge of mixed ancestry Latin American population genetics, important for disease association studies, detection of demographic signatures on population variation and improved allocation of public health resources.

Genetic diversity of HLA system in two populations from Chiapas, Mexico: Tuxtla Gutiérrez and rural Chiapas.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 173 Mexicans from the state of Chiapas living in the city of Tuxtla Gutiérrez (N = 52) and rural communities (N = 121), to obtain information regarding allelic and haplotypic frequencies. We found that the most frequent haplotypes in Chiapas include 12 Native American and one European haplotype. Admixture estimates revealed that the main genetic components in Chiapas are Native American (71.61 ±â€¯0.58% by ML; 53.16% of Native American haplotypes) and European (26.39 ±â€¯5.05% by ML; 25.86% of European haplotypes), and a less prominent African genetic component (2.00 ±â€¯5.20% by ML; 9.77% of African haplotypes).

Genetic diversity of HLA system in two populations from Hidalgo, Mexico: Pachuca and rural Hidalgo.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 122 Mexicans from the state of Hidalgo living in the city of Pachuca (N = 41) and rural communities (N = 81), to obtain information regarding allelic and haplotypic frequencies. We find that the most frequent haplotypes in Hidalgo include eight Native American and one European haplotypes. Admixture estimates revealed that the main genetic components in Hidalgo are Native American (58.93 ±â€¯2.16% by ML; 54.51% of Native American haplotypes) and European (32.49 ±â€¯2.88% by ML; 28.69% of European haplotypes), and a relatively high African genetic component (8.58 ±â€¯0.93% by ML; 6.97% of African haplotypes).

Genetic diversity of HLA system in seven populations from Veracruz, Mexico: Veracruz city, Coatzacoalcos, Córdoba, Orizaba, Poza Rica, Xalapa and rural Veracruz.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 1113 Mexicans from the state of Veracruz living in the cities of Coatzacoalcos (N = 55), Orizaba (N = 60), Córdoba (N = 56), Poza Rica (N = 45), Veracruz (N = 171), Xalapa (N = 187) and rural communities (N = 539) to obtain information regarding allelic and haplotypic frequencies. We found that the most frequent haplotypes include 12 Native American haplotypes. Admixture estimates revealed that the main genetic components are Native American (64.93 ±â€¯1.27% by ML; 55.10% of Native American haplotypes) and European (26.56 ±â€¯0.89% by ML; 28.38% of European haplotypes), and a relatively high African genetic component (8.52 ±â€¯1.82% by ML; 8.78% of African haplotypes).

Genetic diversity of HLA system in two populations from Morelos, Mexico: Cuernavaca and rural Morelos.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 112 Mexicans from the state of Morelos living in the city of Cuernavaca (N = 82) and rural communities (N = 30), to obtain information regarding allelic and haplotypic frequencies. The most frequent haplotypes in Morelos include seven Native American, one European, one African and one Asian haplotype. Admixture estimates revealed that the main genetic components in Morelos are Native American (60.43 ±â€¯2.22% by ML; 53.57% of Native American haplotypes) and European (39.58 ±â€¯3.70% by ML; 27.68% of European haplotypes), and a virtually absent African genetic component (0.00 ±â€¯4.93% by ML; but 11.16% of African haplotypes).

Genetic diversity of HLA system in two populations from Querétaro, Mexico: Querétaro city and rural Querétaro.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 88 Mexicans from the state of Querétaro living in the city of Querétaro (N = 45) and rural communities (N = 43), to obtain information regarding allelic and haplotypic frequencies. We find that the most frequent haplotypes in the state of Querétaro include seven Native American, two European and one Asian haplotype. Admixture estimates revealed that the main genetic components in the state of Querétaro are Native American (51.82 ±â€¯4.42% by ML; 42.61% of Native American haplotypes) and European (48.18 ±â€¯3.55% by ML; 46.02% of European haplotypes), with a virtually absent African genetic component (0.00 ±â€¯4.25% by ML; 4.55% of African haplotypes).

Genetic diversity of HLA system in six populations from Mexico City Metropolitan Area, Mexico: Mexico City North, Mexico City South, Mexico City East, Mexico City West, Mexico City Center and rural Mexico City.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 1217 Mexicans from the Mexico City Metropolitan Area living in the northern (N = 751), southern (N = 52), eastern (N = 79), western (N = 33), and central (N = 152) Mexico City, and rural communities (N = 150), to obtain information regarding allelic and haplotypic frequencies. We found that the most frequent haplotypes include 11 Native American haplotypes. Admixture estimates revealed that the main genetic components are Native American (63.85 ±â€¯1.55% by ML; 57.19% of Native American haplotypes) and European (28.53 ±â€¯3.13% by ML; 28.40% of European haplotypes), and a less apparent African genetic component (7.61 ±â€¯1.96% by ML; 7.17% of African haplotypes).

Genetic diversity of HLA system in a population from Guerrero, Mexico.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 144 Mexicans from the state of Guerrero to obtain information regarding allelic and haplotypic frequencies. We find that the ten most frequent haplotypes in the state of Guerrero include eight Native American and two European haplotypes. Admixture estimates revealed that the main genetic components in the state of Guerrero are Native American (61.36 ±â€¯2.69% by ML; 54.17% of Native American haplotypes) and European (35.01 ±â€¯4.59% by ML; 32.29% of European haplotypes), and a relatively low African genetic component (3.63 ±â€¯2.38% by ML; 5.90% of African haplotypes).

Genetic diversity of HLA system in a population sample from Aguascalientes, Mexico.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 95 Mexicans from the state of Aguascalientes to obtain information regarding allelic and haplotypic frequencies and their linkage disequilibrium. We find that the most frequent haplotypes in the state of Aguascalientes include four Native American, three European and one Asian haplotypes. Admixture estimates revealed that the main genetic components in the state of Aguascalientes are Native American (54.53 ±â€¯3.22% by ML; 44.21% of Native American haplotypes) and European (44.34 ±â€¯0.45% by ML; 40.53% of European haplotypes), and a relatively low African genetic component (1.13 ±â€¯2.33% by ML; 5.26% of African haplotypes).

Genetic diversity of HLA system in two populations from Nuevo León, Mexico: Monterrey and rural Nuevo León.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 665 Mexicans from the state of Nuevo León living in the city of Monterrey (N = 226) and rural communities (N = 439), to obtain information regarding allelic and haplotypic frequencies. We find that the most frequent haplotypes in the state of Nuevo León include 12 Native American and three European haplotypes. Admixture estimates revealed that the main genetic components in the state of Nuevo León are Native American (54.53 ±â€¯0.87% by ML; 48.88% of Native American haplotypes) and European (38.67 ±â€¯4.06% by ML; 32.59% of European haplotypes), and a less prominent African genetic component (6.80 ±â€¯4.30% by ML; 8.26% of African haplotypes).