Impact of viral detection in patients with community-acquired pneumonia: An observational cohort study.

PURPOSE: The presence of a respiratory virus in patients with community-acquired pneumonia (CAP) may have an impact on the bacterial etiology and clinical presentation. In this study we aimed to assess the role of viral infection in the bacterial etiology and outcomes of patients with CAP. METHODS: We performed a retrospective study of all adults hospitalized with CAP between November 2017 and October 2018. Patients were classified according to the presence of viral infection. An unvaried and a multivaried analysis were performed to identify variables associated with viral infection and clinical outcomes. RESULTS: Overall 590 patients were included. A microorganism was documented in 375 cases (63.5%). A viral infection was demonstrated in 118 (20%). The main pathogens were Streptococcus pneumoniae (35.8%), Staphylococcus aureus (2.9%) and influenza virus (10.8%). A trend to a higher rate of S. aureus (p=0.06) in patients with viral infection was observed. Patients with viral infection had more often bilateral consolidation patterns (17.8% vs 10.8%, p=0.04), respiratory failure (59.3% vs 42.8%, p=0.001), ICU admission (17.8% vs 7%, p=0.001) and invasive mechanical ventilation (9.3% vs 2.8%, p=0.003). Risk factors for respiratory failure were chronic lung disease, age >65 years, positive blood cultures and viral infection. Influenza, virus but no other respiratory viruses, was associated with respiratory failure (OR, 3.72; 95% CI, 2.06-6.73). CONCLUSIONS: Our study reinforces the idea that co-viral infection has an impact in the clinical presentation of CAP causing a more severe clinical picture. This impact seems to be mainly due to influenza virus infection.

¿Qué sabemos del origen del COVID-19 tres años después? / What do we know about the origin of COVID-19 three years later?

More than three years have passed since the first case of a new coronavirus infection (SARS-CoV-2) in the city of Wuhan (Hubei, China). The Wuhan Institute of Virology was founded in that city in 1956 and the country’s first biosafety level 4 laboratory opened within that center in 2015. The coincidence that the first cases of infection emerged in the city where the virology institute’s headquarters is located, the failure to 100% identify the virus’ RNA in any of the coronaviruses isolated in bats, and the lack of evidence on a possible intermediate animal host in the contagion’s transmission make it so that at present, there are doubts about the real origin of SARS-CoV-2. This article will review two theories: SARS-CoV-2 as a virus of zoonotic origin or as a leak from the high-level biosafety laboratory in Wuhan (AU)

Han pasado más de tres años desde el primer caso de infección por un nuevo coronavirus (SARS-CoV-2) en la ciudad de Wuhan (Hubei, China). En esta misma ciudad se fundó en 1956 el Instituto de Virología de Wuhan y en 2015 abrieron en este centro el primer laboratorio de bioseguridad de nivel 4 del país. La coincidencia de ciudad entre los primeros casos de infección y la sede del instituto de virología, sumados a la fallida identificación del RNA del virus al 100% en ninguno de los coronavirus aislados en murciélagos, junto con la falta de evidencia sobre el posible animal intermediario en la transmisión de contagio, hacen que a fecha de hoy surjan dudas sobre el origen real del SARS-CoV-2. En este artículo revisaremos dos teorías, el SARS-CoV-2 como origen zoonótico o como escape del laboratorio de alta bioseguridad en Wuhan (AU)

What do we know about the origin of COVID-19 three years later?

More than three years have passed since the first case of a new coronavirus infection (SARS-CoV-2) in the city of Wuhan (Hubei, China). The Wuhan Institute of Virology was founded in that city in 1956 and the country's first biosafety level 4 laboratory opened within that center in 2015. The coincidence that the first cases of infection emerged in the city where the virology institute's headquarters is located, the failure to 100% identify the virus' RNA in any of the coronaviruses isolated in bats, and the lack of evidence on a possible intermediate animal host in the contagion's transmission make it so that at present, there are doubts about the real origin of SARS-CoV-2. This article will review two theories: SARS-CoV-2 as a virus of zoonotic origin or as a leak from the high-level biosafety laboratory in Wuhan.

Pacientes con enfermedad injerto contra huésped e infecciones asociadas al rechazo de trasplante / Patients with graft-versus-host disease and infections associated with transplant rejection

Introducción: durante muchos años las células madre hematopoyéticas han sido el tratamiento para muchos trastornos hematológicos, pero su eficacia está limitada por la enfermedad injerto contra huésped (EICH); una de las principales complicaciones del trasplante alogénico se encuentra asociado con morbilidad y mortalidad, por lo tanto, la prevención es importante para el éxito del trasplante alogénico. Objetivo: realizar una revisión acerca del reconocimiento clínico de una EICH para brindar el tratamiento correcto y evitar ciertas complicaciones, como infecciones que llevan al rechazo del injerto y ponen en riesgo la calidad de vida del paciente. En la mayoría de los casos las pruebas de laboratorio como biomarcadores y biopsias, son buenos predictores para procesos biológicos o patológicos que confirmen el diagnóstico y establezcan el estadio de la enfermedad. Metodología: se realizó una revisión bibliográfica en bases de datos, tales como Pubmed y ClinicalKey, con base en los siguientes términos MeSH: cirugía, mortalidad, patología, complicaciones, virología. Conclusión: la prevención y tratamiento de esta enfermedad predispone a infecciones y diferentes complicaciones que ponen en riesgo la vida del paciente.

Introduction: For many years hematopoietic stem cells have been the treatment for many hematological disorders, but their efficacy is limited by graft-versus-host disease (GVHD), one of the main complications of allogeneic transplantation associated with morbidity and mortality; therefore, prevention is important for the success of allogeneic transplantation. Objective: To review the clinical recognition of GVHD in order to provide the correct treatment and avoid certain complications, such as infections that lead to graft rejection and jeopardize the patient's quality of life. In most cases laboratory tests such as biomarkers and biopsies are good predictors of biological or pathological processes that confirm the diagnosis and establish the stage of the disease. Methodology: A bibliographic review was carried out in databases such as Pubmed and ClinicalKey based on the following MeSH terms: surgery, mortality, pathology, complications, virology. Conclusion: The prevention and treatment of this disease predisposes to infections and different complications that put the patient's life at risk.

Utilização de ensaios moleculares na detecção de vírus em serpentes dos plantéis do Instituto Butantan

Viruses can infect and cause diseases in snakes, causing outbreaks in herds and hindering the production of venom. Reptarenavirus were identified in cases of Inclusion Body Disease, and substantial evidence was presented suggesting the causal relationship of the virus with the disease, including co-infection of different virus species in the same animal. Chuviridae is a recently discovered family of negative-sense, single-stranded RNA viruses of variable genomic structure that infect several species of arthropods, including mosquitoes. This work was carried out as part of the implementation of methodologies for detection and identification of viruses in snakes kept in captivity in the herds of Instituto Butantan, which aim to optimize and improve protocols for handling and conservation of animals, in addition to the possibility of identifying new virus species. Sample collections were performed in vivo and/or post-mortem, considering the clinical situation of each animal and at the discretion of the veterinarian responsible for the vivarium. After extracting the nucleic acids, virus research was performed using the amplification of viral genome fragments by polymerase chain reaction and nucleotide sequencing by the Sanger method. The methodologies developed in this work were effective in detecting reptarenavirus and chuvirus in snakes kept in captivity at Instituto Butantan, which demonstrates the importance of implementing the diagnosis of viral diseases in the quarantine and sanitary surveillance of these collections.

Vírus podem infectar e causar doenças em serpentes, ocasionando surtos em biotérios e consequente comprometimento na produção de veneno. Reptarenavírus foram identificados em casos de Doença do Corpúsculo de Inclusão, sendo apresentadas evidências substanciais sugerindo a relação causal do vírus com a doença, inclusive com a coinfecção de diferentes espécies de vírus em um mesmo animal. Chuviridae é uma família recentemente descoberta de vírus RNA de fita simples, de sentido negativo e de estrutura genômica variável, que infecta várias espécies de artrópodes, incluindo mosquitos. Este trabalho foi realizado como parte da implantação de metodologias de detecção e identificação de vírus em serpentes mantidas em cativeiro nos plantéis do Instituto Butantan, que visam a otimização e o aperfeiçoamento dos protocolos de manejo e conservação dos animais, além da possibilidade de identificação de novas espécies de vírus. As coletas de amostras foram realizadas in vivo e/ou post-mortem, considerando a situação clínica de cada animal e a critério do médico veterinário responsável pelo biotério. Após a extração dos ácidos nucleicos, a pesquisa de vírus foi realizada utilizando a amplificação de fragmentos do genoma viral por reação em cadeia da polimerase e sequenciamento de nucleotídeos pelo método de Sanger. As metodologias desenvolvidas neste trabalho foram eficazes na detecção de reptarenavírus e chuvírus em serpentes mantidas em cativeiro em plantéis do Instituto Butantan, o que demonstra a importância da implementação do diagnóstico de doenças virais na quarentena e no monitoramento sanitário dessas coleções.

Tipos de modelos de análise para controle sanitário de animais de laboratório

The use of animals in research allowed gains in academic knowledge and in new therapeutic approaches, as they are models with characteristics common to humans. The quality of the animals used has a strong impact on the validity and reproducibility of research results, in addition to reducing the number of animals in the study. To achieve this type of quality standard, sanitary monitoring programs must be adopted in order to avoid biological contamination by animals, biological materials, insects, people and equipment. In addition to preventing the entry of pathogens into the colonies, the sanitary standard of the environment and of the animals already present in the vivarium must be known, preventing a collective outbreak of diseases. As laboratory animals can potentially be asymptomatic carriers of pathogens, sanitary control becomes even more challenging. According to what has been discussed, the objective of this study is to collect information on the sanitary control of animals used in research. This literature review includes information, recommendations and methodologies for parasitological, bacteriological and virological monitoring of the main species of animals intended for research, including mice, rats, guinea pigs and rabbits.

O uso de animais em pesquisas permitiram ganhos no conhecimento acadêmico e em novas abordagens terapêuticas pois são modelos com características comuns ao homem. A qualidade dos animais utilizados tem forte impacto na validade e reprodutibilidade dos resultados da pesquisa, além de reduzir o número de animais no estudo. Para se conseguir esse tipo de padrão de qualidade, devem ser adotados programas de monitoramento sanitário afim de evitar contaminação biológica por animais, materiais biológicos, insetos, pessoas e equipamentos. Além de evitar a entrada de patógenos nas colônias, deve-se conhecer o padrão sanitário do ambiente e dos animais já presentes no biotério, evitando que haja surto coletivo de doenças. Como animais de laboratório podem ser potencialmente portadores assintomáticos de patógenos, torna-se ainda mais desafiador o controle sanitário. De acordo com o abordado, tem-se como objetivo neste estudo o levantamento de informações sobre o controle sanitário de animais utilizados em pesquisas. Nesta revisão de literatura, inclui-se informações, recomendações e metodologias para o monitoramento parasitológico, bacteriológico e virológico das principais espécies de animais destinados a pesquisa, incluindo camundongos, ratos, cobaias e coelhos.

Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents / Glomerulonefrite membranoproliferativa relacionada à hepatite C na era dos agentes antivirais diretos

Abstract Membranoproliferative glomerulonephritis (MPGN) is the most typical Hepatitis C virus (HCV)-associated glomerulopathy, and the available data about the utilization of direct-acting antivirals (DAA) in HCV-associated glomerulonephritis is inadequate. We evaluated the renal and viral response in two cases of HCV-related MPGN; the first caused by cryoglobulinemia while the second was cryoglobulin-negative. Both patients received immunosuppression besides DAA in different regimens. They achieved partial remission but remained immunosuppression-dependent for more than 6 months after DAA despite sustained virological response, which enabled safer but incomplete immunosuppression withdrawal. Both patients were tested for occult HCV in peripheral blood mononuclear cells and found to be negative. Hence, the treatment of HCV-related MPGN ought to be according to the clinical condition and the effects of drug therapy. It is important to consider that renal response can lag behind the virological response.

Resumo A glomerulonefrite membranoproliferativa (GNMP) é a glomerulopatia associada ao vírus mais típico da hepatite C (HCV), e os dados disponíveis sobre a utilização de antivirais de ação direta (AAD) na glomerulonefrite associada ao HCV são inadequados. Avaliamos a resposta renal e viral em dois casos de GNMP relacionados ao HCV; o primeiro causado por crioglobulinemia, enquanto o segundo era negativo para crioglobulina. Ambos os pacientes receberam imunossupressão além de AAD em diferentes esquemas terapêuticos. Eles alcançaram remissão parcial, mas permaneceram dependentes da imunossupressão por mais de 6 meses após os AAD, apesar da resposta virológica sustentada, que permitiu a retirada da imunossupressão mais segura, mas incompleta. Ambos os pacientes foram testados para HCV oculto em células mononucleares do sangue periférico e deram resultados negativos. Portanto, o tratamento do GNMP relacionado ao VHC deve ser de acordo com a condição clínica e os efeitos da terapia medicamentosa. É importante considerar que a resposta renal pode ficar aquém da resposta virológica.

A emergência da dengue como desafio virológico: de doença-fantasma à endemia "de estimação", 1986-1987 / The emergence of dengue as a virological challenge: from phantom disease to "pet" endemic, 1986-1987

Resumo O artigo analisa como a dengue se apresentou como desafio virológico na década de 1980. O objetivo é entender o papel dos estudos virológicos na compreensão da doença e a construção de uma expertise em arboviroses. Embora surtos da doença já tivessem sido relatados ao longo do século XX, a dengue era pouco conhecida nas Américas até a epidemia de dengue hemorrágica em Cuba, em 1981. Quando em 1986 a doença atingiu a cidade de Nova Iguaçu (RJ), a equipe de virologistas liderada por Hermann Schatzmayr tomaria a doença como objeto, mobilizando esforços a partir da criação do Laboratório de Flavivírus do Instituto Oswaldo Cruz.

Abstract This article analyzes how dengue presented a virological challenge during the 1980s in order to explore the role of virological studies in understanding this disease and constructing expertise in arboviral diseases. Although outbreaks were reported throughout the twentieth century, dengue was barely known in the Americas until the epidemic of dengue fever in Cuba in 1981. When the disease reached the Brazilian city of Nova Iguaçu (RJ) in 1986, it became the focus of attention for a team of virologists led by Hermann Schatzmayr, who mobilized efforts after the creation of the Flavivirus Laboratory at the Oswaldo Cruz Institute.

Retos actuales a la enseñanza de la virología para enfrentar enfermedades emergentes / Current challenges to the teaching of virology to face emerging diseases

En los últimos años los microorganismos han generado múltiples evoluciones, provocando enfermedades y problemas agudos de salud pública. Para poder controlar las virosis es necesario conocer su biología y epidemiología, establecer tratamiento y profilaxis adecuada para su control. Para ello, es indispensable comenzar con la formación de los profesionales de la salud, en particular, los estudiantes de medicina, es necesario potenciar el desarrollo de sus habilidades y competencias, no solo dominio del conocimiento científico, si no también pueda promoverlo, transferirlo y aplicarlo con impacto en la salud colectiva y que vaya a la par de los avances tecno-científicos. Es por ello, que surge la inquietud del fórum, discusión acerca del análisis de la enseñanza de la virología para enfrentar enfermedades emergentes en función de perfil del egresado. Se realizó encuesta a los estudiantes de los últimos diez años de la carrera de medicina de UNIANDES, sobre la biología, epidemiologia, respuesta inmunológica y diagnóstico, para mencionadas áreas de conocimiento se obtuvo, tanto en la evaluación objetiva estructurada y evaluación práctica, un nivel altamente satisfactorio. En la pirámide de Miller, se alcanzó nivel tres con conocimiento y desarrollo de habilidades, destrezas y actitudes del egresado satisfactorias. Sin embargo, los profesores de Virología están de acuerdo con innovar en la docencia integrando los contenidos transversalmente a las áreas de conocimiento: enfermedades infecciosas, clínicas, patologías, epidemiología y salud pública, lo que permitirá un aprendizaje integral para realizar abordaje adecuado de caso positivos de las virosis, además de tener capacidades para establecer vigilancia epidemiológica(AU)

In recent years, microorganisms have generated multiple evolutions, causing diseases and acute public health problems. In order to control virosis, it is necessary to know their biology and epidemiology, establish adequate treatment and prophylaxis for their control. For this, it is essential to start with the training of health professionals, in particular, medical students, it is necessary to promote the development of their skills and competencies, not only mastery of scientific knowledge, but also be able to promote it, transfer it and apply it with an impact on collective health and that goes hand in hand with techno-scientific advances. That is why the concern of the forum arises, a discussion about the analysis of the teaching of virology to face emerging diseases based on the profile of the graduate. A survey was conducted to the students of the last ten years of the UNIANDES medical career, on biology, epidemiology, immunological response and diagnosis, for mentioned areas of knowledge it was obtained, both in the objective structured evaluation and practical evaluation, a level highly satisfactory. In the Miller pyramid, level three was reached with satisfactory knowledge and development of abilities, skills and attitudes of the graduate. However, Virology professors agree with innovating in teaching by integrating the content transversally to the areas of knowledge: infectious diseases, clinics, pathologies, epidemiology and public health, which will allow comprehensive learning to carry out an adequate approach to positive cases of virosis, in addition to having the capacity to establish epidemiological surveillance(AU)

COVID-19: epidemiología, virología y transmisibilidad / COVID-19: epidemiology, virology, and transmissibility

Hasta diciembre del 2019, seis tipos de coronavirus ya estaban identificados como generadores de enfermedad en humanos, destacándose dos brotes epidemiológicos anteriores: SARS-CoV en 2002 y MERS-CoV en 2012. El nuevo agente infeccioso que causó la pandemia de 2019 se denominó SARS-CoV-2, el que se manifiesta como un síndrome respiratorio agudo severo (CO-VID-19). Al respecto, el 30 de enero del 2020, la Organización Mundial de la Salud (OMS) decretó la emergencia sanitaria. El propósito de esta revisión fue analizar el contexto epidemio-lógico alrededor del SARS-CoV-2, mediante una búsqueda bibliográfica en las bases de datos científicas como: PubMed Central, LILACS y Google académico. Se concluyó que el SARS-CoV-2 es altamente transmisible, con una tasa de letalidad en Ecuador del 8,59%.

Six types of coronaviruses were already identified as generators of disease in humans as of 2019, with two previous epidemiological outbreaks standing out: SARS-CoV in 2002 and MERS-CoV in 2012. The new infectious agent that caused the 2019 pandemic was called SARS -CoV-2, which manifests as a severe acute respiratory syndrome (COVID-19). In this regard, on January 30, 2020, the World Health Organization decreed the health emergency. The purpose of this review was to analyze the epidemiological context around SARS-CoV-2 through a bibliographic review in scientific databases such as: PubMed Central, LILACS and Google Scholar. It was concluded that SARS-CoV-2 is highly transmissible, with a fatality rate in Ecuador of 8.59%.

Infection, treatment and virological features of SARS-CoV-2. A brief overview / Infección, tratamiento y características virológicas del SARS-CoV-2. Un breve resumen

Abstract A new coronavirus, the SARS-CoV-2, and its resulting disease, the COVID-19, originated in Wuhan, China, in December 2019, affecting human health by causing respiratory, digestive and systemic problems. In symptomatic patients, the clinical manifestations of the disease usually begin within a week after being infected with the virus, and consist of fever, dry cough, nasal congestion, fatigue and airway problems, which can lead to pneumonia. The virus is also present in patients who do not have symptoms, and therefore it is quite difficult to identify and quantify them. In this work, an overview of the virological features of SARS-CoV-2, its transmission and infection, as well as of the clinical signs and treatment of COVID-19 is carried out.

Resumen Un nuevo coronavirus, el SARS-CoV-2, y su enfermedad resultante, la COVID-19, se originó en Wuhan (China) en diciembre de 2019, afectando la salud humana al causar problemas respiratorios, digestivos y sistémicos. En los pacientes sintomáticos, las manifestaciones clínicas de la enfermedad suelen comenzar dentro de la semana siguiente a la infección por el virus y consisten en fiebre, tos seca, congestión nasal, fatiga y problemas de las vías respiratorias, que pueden provocar neumonía. El virus también está presente en pacientes asintomáticos, por lo que es bastante difícil identificarlos y cuantificarlos. En este trabajo se realiza una breve revisión de las características virológicas del SARS-CoV-2, su transmisión e infección, así como los signos clínicos y tratamiento de la COVID-19.

CO² filtration during pneumoperitoneum inflation and deflation in patients undergoing laparoscopy during the COVID-19 pandemic / Filtragem do CO² durante a insuflação e esvaziamento do pneumoperitônio em pacientes submetidos a videolaparoscopia durante pandemia de COVID-19

ABSTRACT The current Covid-19 pandemic has been the most discussed topic of the year, mostly about protection and ways to avoid dissemination of the virus. In the healthcare system, especially in the operating rooms, the viability of laparoscopic surgery was questioned, mostly because of the transmission through aerosol. This article tries to suggest a way to minimize risks of laparoscopic surgery, during this situation, by using electrostatic filters, a simple, effective and low cost alternative.

RESUMO A atual pandemia do Covid-19 tem sido o assunto mais discutido do ano de 2020, principalmente no que se refere a proteção e as formas de limitar a disseminação do vírus. No cenário hospitalar, mais especificamente no centro cirúrgico, a viabilidade da cirurgia laparoscópica foi questionada, em relação a transmissibilidade do vírus por aerossol. Este artigo sugere uma forma de minimizar os riscos em cirurgias laparoscópicas durante esse cenário, com o uso de filtros eletrostáticos de ventilação mecânica. Uma alternativa simples, eficaz e de baixo custo.

Fundamentos moleculares de la exclusión competitiva durante la coinfección de virus respiratorios: a propósito del COVID-19 / Molecular foundations of competitive exclusion during coinfection of respiratory viruses: about COVID-19

Introducción: La idea de exclusión competitiva es indiscutible cuando se trata de animales y bacterias que intentan ocupar el mismo nicho ecológico, pero su aplicación a la coinfección viral no es tan sencilla de interpretar. La interferencia viral es un fenómeno en el que un virus suprime competitivamente la replicación de otros virus coinfectantes y es el resultado más común de las coinfecciones virales. Objetivo: Comprender mejor el comportamiento de las infecciones respiratorias concomitantes en escenarios de brotes comunitarios y de forma individual en entornos hospitalarios e individuos con comorbilidades. Métodos: Se realizó una búsqueda de información en las bases de datos MEDLINE / PubMed, SciELO y LILACS. También se consideraron artículos publicados en el repositorio de preimpresión medRxiv y los informes de los Centros para el Control y Prevención de enfermedades de los Estados Unidos de América. Mediante el gestor de referencias Mendeley, se eliminaron los duplicados y aquellos que no se ajustaban al objetivo del estudio, seleccionando 48 artículos para la revisión. Análisis y síntesis de la in formación: En la literatura científica se encontró evidencia que sustenta la exclusión competitiva viral entre virus relacionados que comparten células susceptibles y permisivas. Conclusión: La exclusión competitiva impide que dos virus que comparten rutas de transmisión similares y el mismo órgano diana, infecten no sólo al mismo tiempo, sino que también se propaguen con éxito. Por lo tanto, la sindemia producida por virus que comparten estas características podría ser un evento improbable(AU)

Introduction: The idea of competitive exclusion is undisputed when it comes to animals and bacteria trying to occupy the same ecological niche, but its application to viral coinfection is not so simple to interpret. Viral interference is a phenomenon in which one virus competitively suppresses the replication of other co-infecting viruses and is the most common outcome of viral co-infections. Objective: To better understand the behavior of concomitant respiratory infections in community outbreak settings and individually in hospital settings and individuals with comorbidities. Methods: A search for information was performed in the MEDLINE / PubMed, SciELO and LILACS databases. Articles published in the preprint repository medRxiv and reports from the US Centers for Disease Control and Prevention were also considered. Using the Mendeley reference manager, duplicates and those that did not fit the study objective were eliminated, selecting 48 articles for the review. Analysis and synthesis of information: Evidence supporting viral competitive exclusion between related viruses sharing susceptible and permissive cells was found in the scientific literature. Conclusion: Competitive exclusion prevents two viruses that share similar transmission routes and the same target organ from infecting not only at the same time, but also from spreading successfully. Therefore, syndemia produced by viruses sharing these characteristics could be an unlikely event(AU)

Three SARS-CoV-2 reinfection cases by the new Variant of Concern (VOC) P.1/501Y.V3

Neste relatório (pre-print), são apresentados três casos de reinfecção causados pela Variante de Preocupação (VOC) P.1, também conhecida como "cepa de Manaus". As três pacientes eram mulheres adultas, e tiveram a primeira infecção durante a primeira onda da pandemia na primeira metade de 2020. Nos três casos, a linhagem detectada no primeiro diagnóstico molecular era diferente da encontrada posteriormente, evidência da reinfecção. Dois dos casos de reinfecção tiveram apresentação de sintomas leves, enquanto o terceiro foi assintomático, apesar de a quantidade de material genético viral detectado sugerir cargas virais elevadas. As evidências aqui apresentadas sugerem que a imunidade após infecção primária por linhagens anteriores à circulação daquelas contendo a mutação E484K não impede uma nova infecção pela variante P.1, e nem mesmo que pessoas reinfectadas por esta variante espalhem o vírus, embora seja possível que tenha protegido estas três pacientes do desenvolvimento de sintomas graves.

La cavidad bucal como fuente de transmisión del SARSCoV-2 / Oral cavity as a transmission source for SARSCoV-2

RESUMEN Fundamento: debido a las características de la infección con SARSCoV-2, la cavidad bucal es un entorno que representa un alto riesgo para producir infección cruzada entre los pacientes y los odontólogos. Objetivo: recopilar la evidencia científica sobre si la cavidad bucal es una fuente de transmisión del SARSCoV-2. Métodos: se realizó una revisión en PubMed/Medline y Cochrane mediante términos de indización, para obtener información si la cavidad bucal es una fuente de transmisión del SARSCoV-2. Resultados: debido al contacto cercano con la boca y la nariz del paciente, las gotas y los aerosoles producidos en el tratamiento bucal exponen al odontólogo a infectarse con SARSCoV-2. Al analizar la información bibliográfica se encuentra evidencia de que el SARSCoV-2 se une de forma inicial a la enzima convertidora de angiotensina II que se encuentra en la mucosa oral, la lengua y las glándulas salivales, para después recién colonizar los tractos respiratorios; por lo que, se puede considerar a la cavidad bucal como una fuente de contagio y además la saliva puede usarse para realizar el análisis molecular del SARSCoV-2. Conclusiones: la evidencia científica recopilada, sugiere que la cavidad bucal puede actuar como una fuente de contagio del SARSCoV-2, gracias a la presencia en la boca de la enzima convertidora de angiotensina II que actúa como receptor del SARSCoV-2 y convierte a esta cavidad en una fuente de transmisión.

ABSTRACT Background: due to the characteristics of SARSCoV-2 infection, the oral cavity is a high risk environment for cross-infection between patients and dentists. Objective: to gather scientific evidence on whether the oral cavity is a source of SARSCoV-2 transmission. Methods: a review was performed in PubMed / Medline and Cochrane using indexing terms, to obtain information if the oral cavity is a source of SARSCoV-2 transmission. Results: due to close contact with the patient's mouth and nose, the drops and aerosols produced in the oral treatment expose the dentist to becoming infected with SARSCoV-2. Analyzing the bibliographic information, we find evidence that SARSCoV-2 binds initially to the angiotensin II converting enzyme found in the oral mucosa, tongue and salivary glands, and then only recently colonized the respiratory tracts; therefore, the oral cavity can be considered as a source of contagion and saliva can also be used to perform the molecular analysis of SARSCoV-2. Conclusions: the collected scientific evidence suggests that the oral cavity may act as a source of SARSCoV-2 transmission, thanks to the presence in the mouth of the angiotensin II converting enzyme that acts as a receptor for SARSCoV-2 and converts this cavity into a source of transmission.

Fighting COVID-19 / Combatendo a COVID-19

Abstract The current COVID-19 pandemic caused by the novel coronavirus (SARS-CoV2) poses a threat to global health owing to its high rate of spread and severe forms of respiratory infection. The lack of vaccines and antivirals prevents clinical strategies against the disease, creating an emerging need for the development of safe and effective treatments. Strategies for vaccine development include complete vaccines against viruses, subunits, and nucleic acids, but are still in their early stages. Studies carried out to date on possible SARS-CoV2 drug targets highlight glycoprotein S, Mpro (main protease or protease type 3C), and a member of the transmembrane serine protease II families (TMPRSS2). However, due to the pandemic state, priority is given to marketed drugs. These include chloroquine (CQ), hydroxychloroquine (HCQ), nitazoxanide, remdesivir, Lopinavir/ritonavir (LPV / r), in addition to treatment with convalescent plasma. But, therapeutic specific effects against SARS-CoV2 have not yet been verified. Most of the information obtained about treatment is based on preliminary and limited studies. We conclude that, at this time of emergency, the search for new therapies is more urgent due to the need to save lives. Thus, we point out as interesting targets for future more specific research: glycoprotein S, Mpro, and TMPRSS2.

Resumo A pandemia de COVID-19 causada pelo novo Coronavírus (SARS-CoV2) representa uma ameaça à saúde global devido à alta taxa de disseminação e formas graves de infecção respiratória. A falta de vacinas e antivirais específicos dificultam as estratégias clínicas de controle da doença, criando a necessidade urgente do desenvolvimento de tratamentos seguros e eficazes. Com relação as estratégias para o desenvolvimento de vacinas, incluem-se: aquelas com o vírus completo, subunidades e ácidos nucléicos, mas estas ainda estão em estágios iniciais. Já sobre os estudos realizados até o momento buscando novos alvos terapêuticos contra o SARS-CoV2, destacam a glicoproteína S; Mpro (principal protease ou protease tipo 3C) e um membro da família transmembrana serina protease II (TMPRSS2). No entanto, devido ao estado pandêmico, tem sido dada prioridade aos medicamentos comercializados. Estes incluem a cloroquina (CQ); hidroxicloroquina (HCQ); nitazoxanida; remdesivir; Lopinavir / ritonavir (LPV/r); além do tratamento com plasma de pacientes curados. Porém, ainda não há uma estratégia terapêutica contra o SARS-CoV2 totalmente eficaz, e a maioria das informações obtidas sobre o tratamento é baseada em estudos preliminares e limitados. Concluímos então que, neste momento de emergência, a busca por novas terapias é algo urgente devido à necessidade de salvar vidas. Assim finalizamos sugerindo como alvos interessantes para futuras pesquisas específicas: a glicoproteína S, Mpro e o TMPRSS2.

The role of the World Health Organization country programs in the development of virology in Spain, 1951-1975 / El papel desempeñado por los programas país de la Organización Mundial de la Salud en el desarrollo de la virología en España, 1951-1975

Abstract Within the framework of recent historiography about the role of the World Health Organization (WHO) in modernizing public health and the multifaceted concept of global health, this study addresses the impact of the WHO's "country programs" in Spain from the time it was admitted to this organization in 1951 to 1975. This research adopts a transnational historical perspective and emphasizes attention to the circulation of health knowledge, practices, and people, and focuses on the Spain-0001 and Spain-0025programs, their role in the development of virology in Spain, and the transformation of public health. Sources include historical archives (WHO, the Spanish National Health School), various WHO publications, the contemporary medical press, and a selection of the Spanish general press.

Resumen En el marco de la reciente historiografía sobre el papel de la Organización Mundial de la Salud (OMS) en la modernización de la salud pública y el concepto multifacético de salud global, se estudia el papel de los llamados "programas país" de la OMS en España desde su admisión en 1951 hasta 1975. Adoptando perspectiva histórica transnacional y enfatizando el estudio de la circulación de personas, conocimientos y prácticas científico-sanitarias, nuestro análisis se centra en los programas España-0001 y España-0025, en evaluar su papel en el desarrollo de la virología en España y en la transformación de la salud pública. Nuestras fuentes vienen de archivos históricos (OMS, Escuela Nacional de Sanidad), publicaciones de la OMS, revistas médicas contemporáneas, y una selección de prensa general española.

Detección de virus de ARN en cultivos de tomate del Oriente Antioqueño mediante secuenciación de alto rendimiento y RT-qPCR / Detection of RNA viruses in tomato fields in eastern Antioquia using high-throughput sequencing (HTS) and RT-qPCR

RESUMEN En Antioquia, el cultivo de tomate (Solanum lycopersicum) se ve afectado por diversas enfermedades virales, que ocasionan la disminución en la calidad de los frutos y de los rendimientos; sin embargo, pocos estudios han identificado, a nivel de especie, los agentes causales de dichas enfermedades. En los últimos años, la secuenciación de alto rendimiento (HTS), se ha convertido en una herramienta eficiente de diagnóstico de fitopatógenos, permitiendo la detección y la caracterización genómica de un alto número de virus, en diferentes plantas. En este trabajo, se evaluó la presencia de virus de ARN infectando tomate var. Chonto del oriente Antioqueño, mediante HTS y RT-PCR, en tiempo real (RT-qPCR), en muestras de tejido foliar y en semillas. El análisis de HTS indicó la infección de los virus Potato virus S (PVS), Potato virus Y (PVY), Potato yellow vein virus (PYVV), Potato virus X (PVX), Southern tomato virus (STV) y Bell pepper endornavirus (BPEV), en los cultivos de tomate de esta región, obteniéndose los genomas completos de PYVV, STV y BPEV. Las pruebas de RT-qPCR indicaron la presencia de PYVV en el 100% de las muestras foliares analizadas, mientras que PVX, PVY, STV y PVS, se encontraron en niveles de 94,4, 77,8, 72,2 y 5,6%, respectivamente. La evaluación de estos virus en lotes de semilla sexual comercial y no comercial y en sus plantas derivadas evidenció la presencia de cinco virus en dicho material, con niveles de prevalencia del 13 al 93% e infecciones mixtas, que incluyeron combinaciones, desde dos a cinco virus.

ABSTRACT In Antioquia, the tomato crop (Solanum lycopersicum) is seriously affected by a wide range of viral diseases that affect yield and the quality of fruits. Despite of this, there are few studies aimed at identifying these viruses at the species level. With the advent of High-throughput sequencing (HTS) methods, it is now possible to achieve an efficient characterization of viruses infecting plant hosts. In this work, the presence of RNA viruses infecting tomato var. Chonto in eastern Antioquia was tested using HTS and Real-time RT-PCR (RT-qPCR) in leaf tissues and seeds. HTS revealed infection with Potato virus S (PVS), Potato virus Y (PVY), Potato yellow vein virus (PYVV), Potato virus X (PVX), Southern tomato virus (STV) and Bell pepper endornavirus (BPEV). Complete genome sequences were obtained for PYVV, STV and BPEV. RT-qPCR showed prevalence of 100%, 94.4%, 77.8%, 72.2% and 5.6% for PYVV, PVX, PVY, STV and PVS in leaf samples, respectively. These viruses were also found infecting commercial and informal seeds and in their seedlings with a prevalence between 13 and 93%. Mixed infections were found to combine a mixture of two to five viruses.