Associated factors for mortality in a COVID-19 colombian cohort: is the third wave relevant when Mu variant was predominant epidemiologically?

OBJECTIVES: To evaluate the association between Colombia's third wave when the Mu variant was predominant epidemiologically (until 75%) in Colombia and COVID-19 all-cause in-hospital mortality. METHODS: In this retrospective cohort, we included hospitalized patients ≥18 years with SARS-CoV-2 infection between March 2020 to September 2021 in ten hospitals from three cities in Colombia. Description analysis, survival, and multivariate Cox regression analyses were performed to evaluate the association between the third epidemic wave and in-hospital mortality. RESULTS: A total of 25,371 patients were included. The age-stratified time-to-mortality curves showed differences according to epidemic waves in patients ≥75 years (log-rank test p = 0.012). In the multivariate Cox analysis, the third wave was not associated with increased mortality relative to the first wave (aHR 0.95; 95%CI 0.84-1.08), but there was an interaction between age ≥75 years and the third wave finding a lower HR for mortality (aHR 0.56, 95%CI 0.36-0.86). CONCLUSIONS: We did not find an increase in in-hospital mortality during the third epidemic wave in which the Mu variant was predominant in Colombia. The reduced hazard in mortality in patients ≥75 years hospitalized in the third wave could be explained by the high coverage of SARS-CoV-2 vaccination in this population and patients with underlying conditions.

Seroprevalence of HTLV-1 and 2 in organ donors and kidney transplant recipients. Colombia 2010-2017

Abstract Since 2004, in Colombia, the detection of human T-cell lymphotropic virus type 1 and 2 (HTLV-1-2) has been recommended for organ donors and recipients. The prevention of HTLV-1 and 2 infection in recipients is important due to its relationship with lymphoproliferative and inflammatory diseases and opportunistic infections. The objective of this study was to describe the seroprevalence of HTLV-1 and 2 among organ donors and kidney transplant recipients between 2010 and 2017 in Colombia. Methods: this was a descriptive study which included 1979 organ donors and 3,311 kidney transplant recipients from the donation and transplant network from 2010 to 2017. The seroprevalence of HTLV-1 and 2 was calculated, and serological and demographic variables were described. Results: out of 1979 donors, detection of antibodies against HTLV-1 was performed in 92% (1820), with a seroprevalence of 0.2%; 50% of the cases were from the Pacific region (an endemic zone in Colombia). Ninety percent of the donors were examined for HTLV-2, with a seroprevalence of 0.2%. Of the 3311 kidney recipients between 2010 and 2017, only 44% were evaluated for HTLV-1 and 43% for HTLV-2. The seroprevalence for both viruses was 0.3%. Two of the HTLV-1 cases were positive for HLADRB1*01. Conclusions: the seroprevalence found in organ donors and kidney transplant recipients was similar to that previously reported in Colombia. Screening of all potential donors must be adhered to prevent transmission of this virus. (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.2001).

Parâmetros ecocardiográficos de deposição de gordura epicárdica e sua relação com doença arterial coronariana / Echocardiographic parameters of epicardial fat deposition and its relation to coronary artery disease / Parámetros ecocardiográficos de deposición de grasa epicárdica y su relación con la enfermedad arterial coronaria

FUNDAMENTO: Gordura epicárdica tem sido associada com a presença de doença arterial coronariana (DAC) significante. Entretanto, a associação entre infiltração lipomatosa do septo atrial e a infiltração de gordura do ventrículo direito (VD) permanece incerta. Nenhum desses parâmetros foi totalmente estudado em pacientes hispânicos. OBJETIVO: Determinar a associação entre a gordura epicárdica, infiltração lipomatosa do septo atrial e a infiltração de gordura do VD na presença de DAC. MÉTODOS: Duzentos e cinquenta pacientes hispânicos (86 mulheres e 164 homens, média da idade 61,5 ± 8 vs 62 ± 10 respectivamente), submetidos à sua primeira angiografia coronariana invasiva (ACI) foram estudados. No dia seguinte ao ACI, parâmetros de deposição de gordura epicárdica foram avaliados através de ecocardiografia modo 2D. Variáveis clínicas (idade, sexo, antecedentes pessoais do hábito de fumar, hipertensão e diabete melito, bem como a apresentação clínica da DAC) e antropométricas (circunferência da cintura e índice de massa corporal [IMC]) também foram coletadas. RESULTADOS: A gordura epicárdica (OR 1,27 p = 0,009), bem como a infiltração de gordura no VD (OR 2,94 p = 0,027), apresentaram uma associação significante e independente com a presença, mas não com a extensão (p = 0,516) e apresentação clínica (p = 0,153) da DAC. A extensão da deposição da gordura epicárdica mostrou uma associação proporcional e significante (p = 0,001) com a presença de DAC. CONCLUSÃO: A Gordura epicárdica e a infiltração de gordura do VD foram fatores significantes e independentes associados com a presença de DAC, a qual estava proporcionalmente aumentada de acordo com a extensão da deposição de gordura epicárdica.

BACKGROUND: Epicardial fat has been associated to the presence of significant coronary artery disease (CAD). However, the association of lipomatous infiltration of the atrial septum and fat infiltration of the right ventricle remains uncertain. None of these parameters has been thoroughly studied in Hispanic patients. OBJECTIVE: To determine the association between epicardial fat, lipomatous infiltration of the atrial septum and fat infiltration of the right ventricle with the presence of CAD. METHODS: Two hundred and fifty Hispanic patients (86 women and 164 men, mean age 61.5 ± 8 vs 62 ± 10 respectively), undergoing their first invasive coronary angiography (ICA) were studied. The day after the ICA, parameters of cardiac fat deposition were evaluated using 2D-echocardiography. Clinical (age, sex, personal antecedents of smoking habit, hypertension and diabetes mellitus, as well as clinical presentation of CAD) and anthropometric (waist circumference and body mass index [BMI]) variables were also collected. RESULTS: Epicardial fat (OR 1.27 p = 0.009), as well as fat infiltration of the right ventricle (OR 2.94 p = 0.027), had a significant and independent association with the presence, but not the extent (p = 0.516) and clinical presentation (p = 0.153) of CAD. The extent of epicardial fat deposition showed a proportional and significant association (p = 0.001) with the presence of CAD. CONCLUSION: Epicardial fat and fat infiltration of the right ventricle were both significant and independent factors associated to the presence of CAD, which was proportionally increased according to the extent of cardiac fat deposition.

FUNDAMENTO: La grasa epicárdica ha venido siendo asociada con la presencia de enfermedad arterial coronaria (EAC) significativa. Sin embargo, la asociación entre la infiltración lipomatosa del septo atrial y la infiltración de grasa del ventrículo derecho (VD) permanece como algo indeterminado. Ninguno de esos parámetros fue totalmente estudiado en pacientes hispánicos. OBJETIVO: Determinar la asociación entre la grasa epicárdica, la infiltración lipomatosa del septo atrial y la infiltración de grasa del VD en presencia de EAC. MÉTODOS: Doscientos cincuenta pacientes hispánicos (86 mujeres y 164 hombres, con un promedio de edad entre los 61,5 ± 8 vs y 62 ± 10 años respectivamente), fueron sometidos a su primera angiografía coronaria invasiva (ACI) y se estudiaron. El día posterior a la ACI, los parámetros de deposición de grasa epicárdica fueron evaluados a través de la ecocardiografía bidimensional. Las variables clínicas como la edad, el sexo, antecedentes personales como el hábito de fumar, la hipertensión y la diabetes mellitus, como también la presentación clínica de la EAC, y antropométricas (circunferencia de la cintura e índice de masa corporal [IMC]), también se recolectaron. RESULTADOS: La grasa epicárdica (OR 1,27 p = 0,009), y la infiltración de grasa en el VD (OR 2,94 p = 0,027), presentaron una asociación significativa e independiente con la presencia, pero no con la extensión (p = 0,516) y presentación clínica (p = 0,153) de la EAC. La extensión de la deposición de la grasa epicárdica mostró una asociación proporcional y significativa (p = 0,001) en presencia de EAC. CONCLUSIÓN: La grasa epicárdica y la infiltración de grasa del VD fueron factores significativos e independientes asociados a la presencia de EAC, que estaba proporcionalmente aumentada a tono con la extensión de la deposición de grasa epicárdica.

Echocardiographic parameters of epicardial fat deposition and its relation to coronary artery disease.

BACKGROUND: Epicardial fat has been associated to the presence of significant coronary artery disease (CAD). However, the association of lipomatous infiltration of the atrial septum and fat infiltration of the right ventricle remains uncertain. None of these parameters has been thoroughly studied in Hispanic patients. OBJECTIVE: To determine the association between epicardial fat, lipomatous infiltration of the atrial septum and fat infiltration of the right ventricle with the presence of CAD. METHODS: Two hundred and fifty Hispanic patients (86 women and 164 men, mean age 61.5 ± 8 vs 62 ± 10 respectively), undergoing their first invasive coronary angiography (ICA) were studied. The day after the ICA, parameters of cardiac fat deposition were evaluated using 2D-echocardiography. Clinical (age, sex, personal antecedents of smoking habit, hypertension and diabetes mellitus, as well as clinical presentation of CAD) and anthropometric (waist circumference and body mass index [BMI]) variables were also collected. RESULTS: Epicardial fat (OR 1.27 p = 0.009), as well as fat infiltration of the right ventricle (OR 2.94 p = 0.027), had a significant and independent association with the presence, but not the extent (p = 0.516) and clinical presentation (p = 0.153) of CAD. The extent of epicardial fat deposition showed a proportional and significant association (p = 0.001) with the presence of CAD. CONCLUSION: Epicardial fat and fat infiltration of the right ventricle were both significant and independent factors associated to the presence of CAD, which was proportionally increased according to the extent of cardiac fat deposition.