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  1. Article ; Online: Prevalence of anti-SARS-CoV-2 antibodies in outpatients of a large public university hospital in Sao Paulo, Brazil.

    Oliveira, Luanda Mara da Silva / Tiyo, Bruna Tiaki / Silva, Lais Teodoro da / Fonseca, Luiz Augusto Marcondes / Rocha, Rosana Coura / Santos, Vera Aparecida Dos / Ceneviva, Carina / Bedin, Anderson Aparecido / Almeida, Alexandre de / Duarte, Alberto José da Silva / Oshiro, Telma Miyuki

    Revista do Instituto de Medicina Tropical de Sao Paulo

    2020  Volume 62, Page(s) e91

    Abstract: Coronavirus disease 19 (COVID-19) is caused by SARS-Cov-2 and the manifestations of this infection range from an absence of symptoms all the way up to severe disease leading to death. To estimate the prevalence of past infection in a population, the most ...

    Abstract Coronavirus disease 19 (COVID-19) is caused by SARS-Cov-2 and the manifestations of this infection range from an absence of symptoms all the way up to severe disease leading to death. To estimate the prevalence of past infection in a population, the most readily available method is the detection of antibodies against the virus. This study has investigated the prevalence of anti-SARS-CoV-2 antibodies in outpatients of the Hospital das Clinicas, in Sao Paulo city (Brazil), which is a large university hospital belonging to the public health system that cares for patients with complex diseases who need tertiary or quaternary medical care. Our serological inquiry was carried out for 6 weeks, with once-a-week blood sampling and included 439 patients from several outpatient services. Overall, 61 patients tested positive for anti-SARS-CoV-2 IgG (13.9%); 56.1 % of the patients live in Sao Paulo city, with the remaining living in other towns of the metropolitan area; 32.8% of the patients testing positive for IgG antibodies to SARS-CoV-2 were asymptomatic, 55.7% developed mild or moderate disease and 11.5% had to be hospitalized. The prevalence of SARS-CoV-2 positive serology was lower among patients who had received the seasonal influenza vaccine compared to the ones who did not. These findings may indicate that those individuals care more about health issues, and/or that they have a better access to health care and/or a better quality of health care service. The large proportion of patients who were unaware of having had contact with SARS-CoV-2 deserves attention, reflecting the scarcity of tests performed in the population.
    MeSH term(s) Antibodies, Viral/blood ; Betacoronavirus ; Brazil/epidemiology ; COVID-19 ; Coronavirus Infections/diagnosis ; Humans ; Outpatients ; Pandemics ; Pneumonia, Viral/diagnosis ; Prevalence ; SARS-CoV-2 ; Seroepidemiologic Studies
    Chemical Substances Antibodies, Viral
    Keywords covid19
    Language English
    Publishing date 2020-11-13
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 128928-7
    ISSN 1678-9946 ; 0036-4665
    ISSN (online) 1678-9946
    ISSN 0036-4665
    DOI 10.1590/S1678-9946202062091
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Safety and immunogenicity of CoronaVac in people living with HIV: a prospective cohort study.

    Netto, Lucas C / Ibrahim, Karim Y / Picone, Camila M / Alves, Ana Paula P S / Aniceto, Eliane V / Santiago, Mariana R / Parmejani, Patrícia S S / Aikawa, Nadia E / Medeiros-Ribeiro, Ana C / Pasoto, Sandra G / Yuki, Emily F N / Saad, Carla G S / Pedrosa, Tatiana / Lara, Amanda N / Ceneviva, Carina / Bonfa, Eloisa / Kallas, Esper G / Avelino-Silva, Vivian I

    The lancet. HIV

    2022  Volume 9, Issue 5, Page(s) e323–e331

    Abstract: Background: People living with HIV might have a poor or delayed response to vaccines, mainly when CD4 cell counts are low, and data concerning COVID-19 vaccines in this population are scarce. This prospective cohort study assessed the safety and ... ...

    Abstract Background: People living with HIV might have a poor or delayed response to vaccines, mainly when CD4 cell counts are low, and data concerning COVID-19 vaccines in this population are scarce. This prospective cohort study assessed the safety and immunogenicity of the inactivated SARS-CoV-2 vaccine CoronaVac in people with HIV compared with people with no known immunosuppression.
    Methods: In this prospective cohort study, adults (aged ≥18 years) living with HIV who were regularly followed up at the University of Sao Paulo HIV/AIDS outpatient clinic in Sao Paulo, Brazil, were included in the study. Eligibility for people with HIV was independent of antiretroviral use, HIV viral load, or CD4 cell count. Adults with no known immunosuppression with CoronaVac vaccination history were included as a control group. CoronaVac was given intramuscularly in a two-dose regimen, 28 days apart. Blood was collected before vaccine administration and 6 weeks after the second dose (day 69). Immunogenicity was assessed at baseline (day 0), before second vaccine (day 28), and 6 weeks after second vaccine dose (day 69) through SARS-CoV-2 IgG titre and seroconversion, neutralising antibody (NAb) positivity and percentage activity, and factor increase in IgG geometric mean titres (FI-GMT). We investigated whether HIV status and CD4 count (<500 or ≥500 cells per μL) were associated with CoronaVac immunogenicity by use of multivariable models adjusted for age and sex.
    Findings: Between Feb 9, 2021, and March 4, 2021, 776 participants were recruited. Of 511 participants included, 215 (42%) were people with HIV and 296 (58%) were people with no known immunosuppression. At 6 weeks after the second vaccine dose (day 69), 185 (91%) of 204 participants with HIV and 265 (97%) of 274 participants with no known immunosuppression had seroconversion (p=0·0055). 143 (71%) of 202 participants with HIV were NAb positive compared with 229 (84%) of 274 participants with no known immunosuppression (p=0·0008). Median IgG titres were 48·7 AU/mL (IQR 26·6-88·2) in people with HIV compared with 75·2 AU/mL (50·3-112·0) in people with no known immunosuppression (p<0·0001); and median NAb activity was 46·2% (26·9-69·7) compared with 60·8% (39·8-79·9; p<0·0001). In people with HIV who had CD4 counts less than 500 cells per μL seroconversion rates, NAb positivity, and NAb activity were lower than in those with CD4 counts of at least 500 cells per μL. In multivariable models for seroconversion, NAb positivity, IgG concentration, and NAb activity after a complete two-dose regimen, adjusted for age and sex, people with HIV who had CD4 counts of at least 500 cells per μL and people with no known immunosuppression had higher immunogenicity than did people with HIV with CD4 counts less than 500 cells per μL. No serious adverse reactions were reported during the study.
    Interpretation: Immunogenicity following CoronaVac in people with HIV seems strong but reduced compared with people with no known immunosuppression. Our findings highlight the need for strategies to improve vaccine immunogenicity in people with HIV.
    Funding: Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), and B3-Bolsa de Valores do Brasil.
    MeSH term(s) Adolescent ; Adult ; Antibodies, Neutralizing ; Brazil/epidemiology ; COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; HIV Infections/complications ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Humans ; Immunoglobulin G ; Prospective Studies ; SARS-CoV-2
    Chemical Substances Antibodies, Neutralizing ; COVID-19 Vaccines ; Immunoglobulin G
    Language English
    Publishing date 2022-03-23
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2352-3018
    ISSN (online) 2352-3018
    DOI 10.1016/S2352-3018(22)00033-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Systemic autoimmune myopathies: a prospective phase 4 controlled trial of an inactivated virus vaccine against SARS-CoV-2.

    Shinjo, Samuel K / de Souza, Fernando H C / Borges, Isabela B P / Dos Santos, Alexandre M / Miossi, Renata / Misse, Rafael G / Medeiros-Ribeiro, Ana C / Saad, Carla G S / Yuki, Emily F N / Pasoto, Sandra G / Kupa, Léonard V K / Ceneviva, Carina / Seraphim, Júlia C / Pedrosa, Tatiana N / Vendramini, Margarete B G / Silva, Clóvis A / Aikawa, Nádia E / Bonfá, Eloisa

    Rheumatology (Oxford, England)

    2021  Volume 61, Issue 8, Page(s) 3351–3361

    Abstract: Objectives: To evaluate immunogenicity and safety of an inactivated SARS-CoV-2 vaccine in systemic autoimmune myopathies (SAMs) and the possible influence of baseline disease parameters, comorbidities and therapy on immune response.: Methods: This ... ...

    Abstract Objectives: To evaluate immunogenicity and safety of an inactivated SARS-CoV-2 vaccine in systemic autoimmune myopathies (SAMs) and the possible influence of baseline disease parameters, comorbidities and therapy on immune response.
    Methods: This prospective controlled study included 53 patients with SAMs and 106 non-immunocompromised control group (CTRL). All participants received two doses of the Sinovac-CoronaVac vaccine (28-day interval). Immunogenicity was assessed by anti-SARS-CoV-2 S1/S2 IgG seroconversion (SC), anti-S1/S2 IgG geometric mean titre (GMT), factor increase GMT (FI-GMT), neutralizing antibodies (NAb) positivity, and median neutralizing activity after each vaccine dose (D0 and D28) and six weeks after the second dose (D69). Participants with pre-vaccination positive IgG serology and/or NAb and those with RT-PCR confirmed COVID-19 during the protocol were excluded from immunogenicity analysis.
    Results: Patients and CTRL had comparable sex (P>0.99) and age (P=0.90). Immunogenicity of 37 patients and 79 CTRL-naïve participants revealed at D69, a moderate but significantly lower SC (64.9% vs 91.1%, P<0.001), GMT [7.9 (95%CI 4.7-13.2) vs 24.7 (95%CI 30.0-30.5) UA/ml, P<0.001] and frequency of NAb (51.4% vs 77.2%, P<0.001) in SAMs compared with CTRL. Median neutralizing activity was comparable in both groups [57.2% (interquartile range (IQR) 43.4-83.4) vs 63.0% (IQR 40.3-80.7), P=0.808]. Immunosuppressives were less frequently used among NAb+ patients vs NAb- patients (73.7% vs 100%, P=0.046). Type of SAMs, disease status, other drugs or comorbidities did not influence immunogenicity. Vaccine-related adverse events were mild with similar frequencies in patients and CTRL (P>0.05).
    Conclusion: Sinovac-CoronaVac is safe and has a moderate short-term immunogenicity in SAMs, but reduced compared with CTRL. We further identified that immunosuppression is associated with diminished NAb positivity.
    Trial registration: COVID-19 CoronaVac in Patients With Autoimmune Rheumatic Diseases and HIV/AIDS (CoronavRheum), http://clinicaltrials.gov/ct2/show/NCT04754698.
    MeSH term(s) Antibodies, Neutralizing ; Antibodies, Viral ; Autoimmune Diseases/drug therapy ; COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; Humans ; Immunogenicity, Vaccine ; Immunoglobulin G ; Muscular Diseases ; Prospective Studies ; SARS-CoV-2
    Chemical Substances Antibodies, Neutralizing ; Antibodies, Viral ; COVID-19 Vaccines ; Immunoglobulin G
    Language English
    Publishing date 2021-10-18
    Publishing country England
    Document type Clinical Trial, Phase IV ; Controlled Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/keab773
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Salivary, serological, and cellular immune response to the CoronaVac vaccine in health care workers with or without previous COVID-19.

    Ortega, Marina Mazzilli / da Silva, Laís Teodoro / Candido, Érika Donizetti / Zheng, Yingying / Tiyo, Bruna Tiaki / Ferreira, Arthur Eduardo Fernandes / Corrêa-Silva, Simone / Scagion, Guilherme Pereira / Leal, Fabyano Bruno / Chalup, Vanessa Nascimento / Valério, Camila Araújo / Schmitz, Gabriela Justamante Händel / Ceneviva, Carina / Corá, Aline Pivetta / de Almeida, Alexandre / Durigon, Edison Luiz / Oliveira, Danielle Bruna Leal / Palmeira, Patricia / da Silva Duarte, Alberto José /
    Carneiro-Sampaio, Magda / Oshiro, Telma Miyuki

    Scientific reports

    2022  Volume 12, Issue 1, Page(s) 10125

    Abstract: We investigated the anti-SARS-CoV-2 post-vaccine response through serum and salivary antibodies, serum antibody neutralizing activity and cellular immune response in samples from health care workers who were immunized with two doses of an inactivated ... ...

    Abstract We investigated the anti-SARS-CoV-2 post-vaccine response through serum and salivary antibodies, serum antibody neutralizing activity and cellular immune response in samples from health care workers who were immunized with two doses of an inactivated virus-based vaccine (CoronaVac) who had or did not have COVID-19 previously. IgA and IgG antibodies directed at the spike protein were analysed in samples of saliva and/or serum by ELISA and/or chemiluminescence assays; the neutralizing activity of serum antibodies against reference strain B, Gamma and Delta SARS-CoV-2 variants were evaluated using a virus neutralization test and SARS-CoV-2 reactive interferon-gamma T-cell were analysed by flow cytometry. CoronaVac was able to induce serum and salivary IgG anti-spike antibodies and IFN-γ producing T cells in most individuals who had recovered from COVID-19 and/or were vaccinated. Virus neutralizing activity was observed against the ancestral strain, with a reduced response against the variants. Vaccinated individuals who had previous COVID-19 presented higher responses than vaccinated individuals for all variables analysed. Our study provides evidence that the CoronaVac vaccine was able to induce the production of specific serum and saliva antibodies, serum virus neutralizing activity and cellular immune response, which were increased in previously COVID-19-infected individuals compared to uninfected individuals.
    MeSH term(s) Antibodies, Neutralizing ; Antibodies, Viral ; COVID-19/prevention & control ; COVID-19 Vaccines ; Health Personnel ; Humans ; Immunity, Cellular ; SARS-CoV-2 ; Vaccines, Inactivated ; Viral Vaccines
    Chemical Substances Antibodies, Neutralizing ; Antibodies, Viral ; COVID-19 Vaccines ; Vaccines, Inactivated ; Viral Vaccines
    Language English
    Publishing date 2022-06-16
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-022-14283-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Technical performance of a lateral flow immunoassay for detection of anti-SARS-CoV-2 IgG in the outpatient follow-up of non-severe cases and at different times after vaccination: comparison with enzyme and chemiluminescent immunoassays.

    Barreira, Gabriel Acca / Santos, Emilly Henrique Dos / Pereira, Maria Fernanda Bádue / Rodrigues, Karen Alessandra / Rocha, Mussya Cisotto / Kanunfre, Kelly Aparecida / Marques, Heloisa Helena de Sousa / Okay, Thelma Suely / Eisencraft, Adriana Pasmanik / Rossi Junior, Alfio / Fante, Alice Lima / Cora, Aline Pivetta / Costa Reis, Amelia Gorete A de / Ferrer, Ana Paula Scoleze / Andrade, Anarella Penha Meirelles de / Watanabe, Andreia / Gonçalves, Angelina Maria Freire / Waetge, Aurora Rosaria Pagliara / Silva, Camila Altenfelder /
    Ceneviva, Carina / Lazari, Carolina Dos Santos / Abellan, Deipara Monteiro / Sabino, Ester Cerdeira / Bianchini, Fabíola Roberta Marim / Alcantara, Flávio Ferraz de Paes / Ramos, Gabriel Frizzo / Leal, Gabriela Nunes / Rodriguez, Isadora Souza / Pinho, João Renato Rebello / Carneiro, Jorge David Avaizoglou / Paz, Jose Albino / Ferreira, Juliana Carvalho / Ferranti, Juliana Ferreira / Ferreira, Juliana de Oliveira Achili / Framil, Juliana Valéria de Souza / Silva, Katia Regina da / Bastos, Karina Lucio de Medeiros / Galleti, Karine Vusberg / Cristofani, Lilian Maria / Suzuki, Lisa / Campos, Lucia Maria Arruda / Perondi, Maria Beatriz de Moliterno / Diniz, Maria de Fatima Rodrigues / Fonseca, Maria Fernanda Mota / Cordon, Mariana Nutti de Almeida / Pissolato, Mariana / Peres, Marina Silva / Garanito, Marlene Pereira / Imamura, Marta / Dorna, Mayra de Barros / Luglio, Michele / Aikawa, Nadia Emi / Degaspare, Natalia Viu / Sakita, Neusa Keico / Udsen, Nicole Lee / Scudeller, Paula Gobi / Gaiolla, Paula Vieira de Vincenzi / Severini, Rafael da Silva Giannasi / Rodrigues, Regina Maria / Toma, Ricardo Katsuya / Paula, Ricardo Iunis Citrangulo de / Palmeira, Patricia / Forsait, Silvana / Farhat, Sylvia Costa Lima / Sakano, Tânia Miyuki Shimoda / Koch, Vera Hermina Kalika / Cobello Junior, Vilson

    Revista do Instituto de Medicina Tropical de Sao Paulo

    2022  Volume 64, Page(s) e49

    Abstract: This study assessed the technical performance of a rapid lateral flow immunochromatographic assay (LFIA) for the detection of anti-SARS-CoV-2 IgG and compared LFIA results with chemiluminescent immunoassay (CLIA) results and an in-house enzyme ... ...

    Abstract This study assessed the technical performance of a rapid lateral flow immunochromatographic assay (LFIA) for the detection of anti-SARS-CoV-2 IgG and compared LFIA results with chemiluminescent immunoassay (CLIA) results and an in-house enzyme immunoassay (EIA). To this end, a total of 216 whole blood or serum samples from three groups were analyzed: the first group was composed of 68 true negative cases corresponding to blood bank donors, healthy young volunteers, and eight pediatric patients diagnosed with other coronavirus infections. The serum samples from these participants were obtained and stored in a pre-COVID-19 period, thus they were not expected to have COVID-19. In the second group of true positive cases, we chose to replace natural cases of COVID-19 by 96 participants who were expected to have produced anti-SARS-CoV-2 IgG antibodies 30-60 days after the vaccine booster dose. The serum samples were collected on the same day that LFIA were tested either by EIA or CLIA. The third study group was composed of 52 participants (12 adults and 40 children) who did or did not have anti-SARS-CoV-2 IgG antibodies due to specific clinical scenarios. The 12 adults had been vaccinated more than seven months before LFIA testing, and the 40 children had non-severe COVID-19 diagnosed using RT-PCR during the acute phase of infection. They were referred for outpatient follow-up and during this period the serum samples were collected and tested by CLIA and LFIA. All tests were performed by the same healthcare operator and there was no variation of LFIA results when tests were performed on finger prick whole blood or serum samples, so that results were grouped for analysis. LFIA's sensitivity in detecting anti-SARS-CoV-2 IgG antibodies was 90%, specificity 97.6%, efficiency 93%, PPV 98.3%, NPV 86.6%, and likelihood ratio for a positive or a negative result were 37.5 and 0.01 respectively. There was a good agreement (Kappa index of 0.677) between LFIA results and serological (EIA or CLIA) results. In conclusion, LFIA analyzed in this study showed a good technical performance and agreement with reference serological assays (EIA or CLIA), therefore it can be recommended for use in the outpatient follow-up of non-severe cases of COVID-19 and to assess anti-SARS-CoV-2 IgG antibody production induced by vaccination and the antibodies decrease over time. However, LFIAs should be confirmed by using reference serological assays whenever possible.
    MeSH term(s) Adult ; Antibodies, Viral ; COVID-19/diagnosis ; COVID-19/prevention & control ; Child ; Follow-Up Studies ; Humans ; Immunoassay/methods ; Immunoglobulin G ; Immunoglobulin M ; Outpatients ; Sensitivity and Specificity ; Vaccination
    Chemical Substances Antibodies, Viral ; Immunoglobulin G ; Immunoglobulin M
    Language English
    Publishing date 2022-07-13
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 128928-7
    ISSN 1678-9946 ; 0036-4665
    ISSN (online) 1678-9946
    ISSN 0036-4665
    DOI 10.1590/S1678-9946202264049
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital.

    Fink, Thais T / Marques, Heloisa H S / Gualano, Bruno / Lindoso, Livia / Bain, Vera / Astley, Camilla / Martins, Fernanda / Matheus, Denise / Matsuo, Olivia M / Suguita, Priscila / Trindade, Vitor / Paula, Camila S Y / Farhat, Sylvia C L / Palmeira, Patricia / Leal, Gabriela N / Suzuki, Lisa / Odone Filho, Vicente / Carneiro-Sampaio, Magda / Duarte, Alberto José S /
    Antonangelo, Leila / Batisttella, Linamara R / Polanczyk, Guilherme V / Pereira, Rosa Maria R / Carvalho, Carlos Roberto R / Buchpiguel, Carlos A / Xavier, Ana Claudia L / Seelaender, Marilia / Silva, Clovis Artur / Pereira, Maria Fernanda B / Sallum, Adriana M E / Brentani, Alexandra V M / Neto, Álvaro José S / Ihara, Amanda / Santos, Andrea R / Canton, Ana Pinheiro M / Watanabe, Andreia / Santos, Angélica C Dos / Pastorino, Antonio C / Franco, Bernadette D G M / Caruzo, Bruna / Ceneviva, Carina / Martins, Carolina C M F / Prado, Danilo / Abellan, Deipara M / Benatti, Fabiana B / Smaria, Fabiana / Gonçalves, Fernanda T / Penteado, Fernando D / Castro, Gabriela S F de / Gonçalves, Guilherme S / Roschel, Hamilton / Disi, Ilana R / Marques, Isabela G / Castro, Inar A / Buscatti, Izabel M / Faiad, Jaline Z / Fiamoncini, Jarlei / Rodrigues, Joaquim C / Carneiro, Jorge D A / Paz, Jose A / Ferreira, Juliana C / Ferreira, Juliana C O / Silva, Katia R / Bastos, Karina L M / Kozu, Katia / Cristofani, Lilian M / Souza, Lucas V B / Campos, Lucia M A / Silva Filho, Luiz Vicente R F / Sapienza, Marcelo T / Lima, Marcos S / Garanito, Marlene P / Santos, Márcia F A / Dorna, Mayra B / Aikawa, Nadia E / Litvinov, Nadia / Sakita, Neusa K / Gaiolla, Paula V V / Pasqualucci, Paula / Toma, Ricardo K / Correa-Silva, Simone / Sieczkowska, Sofia M / Imamura, Marta / Forsait, Silvana / Santos, Vera A / Zheng, Yingying

    Clinics (Sao Paulo, Brazil)

    2021  Volume 76, Page(s) e3511

    Abstract: Objectives: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19).: Methods: This was a longitudinal observational study of ...

    Abstract Objectives: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19).
    Methods: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed.
    Results: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls.
    Conclusions: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.
    MeSH term(s) Adolescent ; COVID-19/complications ; COVID-19 Testing ; Child ; Humans ; Latin America ; Male ; Prospective Studies ; Quality of Life ; SARS-CoV-2 ; Tertiary Care Centers ; Post-Acute COVID-19 Syndrome
    Language English
    Publishing date 2021-11-26
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 2182801-5
    ISSN 1980-5322 ; 1807-5932
    ISSN (online) 1980-5322
    ISSN 1807-5932
    DOI 10.6061/clinics/2021/e3511
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital.

    Marques, Heloisa Helena de Sousa / Pereira, Maria Fernanda Badue / Santos, Angélica Carreira Dos / Fink, Thais Toledo / Paula, Camila Sanson Yoshino de / Litvinov, Nadia / Schvartsman, Claudio / Delgado, Artur Figueiredo / Gibelli, Maria Augusta Bento Cicaroni / Carvalho, Werther Brunow de / Odone Filho, Vicente / Tannuri, Uenis / Carneiro-Sampaio, Magda / Grisi, Sandra / Duarte, Alberto José da Silva / Antonangelo, Leila / Francisco, Rossana Pucineli Vieira / Okay, Thelma Suely / Batisttella, Linamara Rizzo /
    Carvalho, Carlos Roberto Ribeiro de / Brentani, Alexandra Valéria Maria / Silva, Clovis Artur / Eisencraft, Adriana Pasmanik / Rossi Junior, Alfio / Fante, Alice Lima / Cora, Aline Pivetta / Reis, Amelia Gorete A de Costa / Ferrer, Ana Paula Scoleze / Andrade, Anarella Penha Meirelles de / Watanabe, Andreia / Gonçalves, Angelina Maria Freire / Waetge, Aurora Rosaria Pagliara / Silva, Camila Altenfelder / Ceneviva, Carina / Lazari, Carolina Dos Santos / Abellan, Deipara Monteiro / Santos, Emilly Henrique Dos / Sabino, Ester Cerdeira / Bianchini, Fabíola Roberta Marim / Alcantara, Flávio Ferraz de Paes / Ramos, Gabriel Frizzo / Leal, Gabriela Nunes / Rodriguez, Isadora Souza / Pinho, João Renato Rebello / Carneiro, Jorge David Avaizoglou / Paz, Jose Albino / Ferreira, Juliana Carvalho / Ferranti, Juliana Ferreira / Ferreira, Juliana de Oliveira Achili / Framil, Juliana Valéria de Souza / Silva, Katia Regina da / Kanunfre, Kelly Aparecida / Bastos, Karina Lucio de Medeiros / Galleti, Karine Vusberg / Cristofani, Lilian Maria / Suzuki, Lisa / Campos, Lucia Maria Arruda / Perondi, Maria Beatriz de Moliterno / Diniz, Maria de Fatima Rodrigues / Fonseca, Maria Fernanda Mota / Cordon, Mariana Nutti de Almeida / Pissolato, Mariana / Peres, Marina Silva / Garanito, Marlene Pereira / Imamura, Marta / Dorna, Mayra de Barros / Luglio, Michele / Rocha, Mussya Cisotto / Aikawa, Nadia Emi / Degaspare, Natalia Viu / Sakita, Neusa Keico / Udsen, Nicole Lee / Scudeller, Paula Gobi / Gaiolla, Paula Vieira de Vincenzi / Severini, Rafael da Silva Giannasi / Rodrigues, Regina Maria / Toma, Ricardo Katsuya / Paula, Ricardo Iunis Citrangulo de / Palmeira, Patricia / Forsait, Silvana / Farhat, Sylvia Costa Lima / Sakano, Tânia Miyuki Shimoda / Koch, Vera Hermina Kalika / Cobello Junior, Vilson

    Clinics (Sao Paulo, Brazil)

    2021  Volume 76, Page(s) e3488

    Abstract: Objectives: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19).: Methods: This was a cross-sectional study that included patients diagnosed ... ...

    Abstract Objectives: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19).
    Methods: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results.
    Results: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035).
    Conclusions: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.
    MeSH term(s) Adolescent ; COVID-19/complications ; Child ; Cohort Studies ; Cross-Sectional Studies ; Humans ; Infant, Newborn ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome ; Tertiary Care Centers
    Language English
    Publishing date 2021-11-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2182801-5
    ISSN 1980-5322 ; 1807-5932
    ISSN (online) 1980-5322
    ISSN 1807-5932
    DOI 10.6061/clinics/2021/e3488
    Database MEDical Literature Analysis and Retrieval System OnLINE

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