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Article ; Online: Trends of Infective Endocarditis at Two Teaching Hospitals: A 12-Year Retrospective Cohort Study in Rio de Janeiro, Brazil.

Damasco, Paulo Vieira / Solórzano, Victor Edgar Fiestas / Fortes, Natália Rodrigues Querido / Setta, Daniel Xavier de Brito / Fonseca, Aloysio Guimaraes da / Perez, Mario Castro Alvarez / Jazbick, João Carlos / Gonçalves-Oliveira, Jonathan / Horta, Marco Aurélio Pereira / de Lemos, Elba Regina Sampaio / Fortes, Claudio Querido

Tropical medicine and infectious disease

2023 Volume 8, Issue 12

Abstract: Background: Despite advances in diagnosis and treatment, the incidence and mortality of infective endocarditis (IE) have increased in recent decades. Studies on the risk factors for mortality in endocarditis in Latin America are scarce.: Methods: ... ...

Abstract	Background: Despite advances in diagnosis and treatment, the incidence and mortality of infective endocarditis (IE) have increased in recent decades. Studies on the risk factors for mortality in endocarditis in Latin America are scarce. Methods: This retrospective cohort study included 240 patients diagnosed with IE according to the modified Duke criteria who were admitted to two university hospitals in Rio de Janeiro, Brazil from January 2009 to June 2021. Poisson regression analysis was performed for trend tests. The multivariate Cox proportional hazards model was used to estimate the hazard ratio (HR) of predictors of in-hospital mortality. Findings: The median age was 55 years (IQR: 39-66 years), 57% were male, and 41% had a Charlson comorbidity index (CCI) score > 3. Healthcare-associated infective endocarditis (54%), left-sided native valve IE (77.5%), and staphylococcal IE (26%) predominated. Overall, in-hospital mortality was 45.8%, and mortality was significantly higher in the following patients: aged ≥ 60 years (53%), CCI score ≥ 3 (60%), healthcare-associated infective endocarditis (HAIE) (53%), left-sided IE (51%), and enterococcal IE (67%). Poisson regression analysis showed no trend in in-hospital mortality per year. The adjusted multivariate model determined that age ≥ 60 years was an independent risk factor for in-hospital mortality (HR = 1.9; 95% CI 1.2-3.1; Interpretation: In this 12-year retrospective cohort, there was no evidence of an improvement in survival in patients with IE. Since older age is a risk factor for mortality, consensus is needed for the management of IE in this group of patients.
Language	English
Publishing date	2023-12-12
Publishing country	Switzerland
Document type	Journal Article
ISSN	2414-6366
ISSN (online)	2414-6366
DOI	10.3390/tropicalmed8120516
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Article ; Online: Risk factors associated with mortality in patients hospitalized for coronavirus disease 2019 in Rio de Janeiro, Brazil.

Correal, Julio César Delgado / Solórzano, Victor Edgar Fiestas / Damasco, Paula Hesselberg / Martins, Maria de Lourdes / Oliveira, Adriana Guerreiro Soares de / Campos, Carla Salles / Fornasari, Marcos Fernando / Azeredo, Elzinandes Leal de / Damasco, Paulo Vieira

Revista da Sociedade Brasileira de Medicina Tropical

2021 Volume 54, Page(s) e0878–2020

Abstract: Introduction: Understanding the mortality-associated risk factors of coronavirus disease 2019 will impact clinical decisions.: Methods: This retrospective longitudinal study included patients hospitalized for coronavirus disease in Rio de Janeiro, ... ...

Abstract	Introduction: Understanding the mortality-associated risk factors of coronavirus disease 2019 will impact clinical decisions. Methods: This retrospective longitudinal study included patients hospitalized for coronavirus disease in Rio de Janeiro, Brazil. The Kaplan-Meier method and multivariate Cox regression analysis were used. Results: Sequential Organ Failure Assessment score of ≥2 (hazard ratio 4.614; 95% confidence interval =2.210-9.634; p<0.001) and neutrophil/lymphocyte ratio of >5 (hazard ratio=2.616; 95% confidence interval=1.303-5.252; p=0.007) were independently associated with mortality. Conclusions: Sequential Organ Failure Assessment score and neutrophil/lymphocyte ratio on admission can identify coronavirus disease patients at increased risk of death and guide subsequent clinical decisions.
MeSH term(s)	Brazil/epidemiology ; COVID-19 ; Humans ; Longitudinal Studies ; Retrospective Studies ; Risk Factors ; SARS-CoV-2
Language	English
Publishing date	2021-03-22
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	1038126-0
ISSN	1678-9849 ; 0037-8682
ISSN (online)	1678-9849
ISSN	0037-8682
DOI	10.1590/0037-8682-0878-2020
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Article: Was It Chikungunya? Laboratorial and Clinical Investigations of Cases Occurred during a Triple Arboviruses' Outbreak in Rio de Janeiro, Brazil.

de Souza, Thiara Manuele Alves / de Lima, Raquel Curtinhas / Solórzano, Victor Edgar Fiestas / Damasco, Paulo Vieira / de Souza, Luiz José / Sanchez-Arcila, Juan Camilo / Guimarães, Gabriel Macedo Costa / Paiva, Iury Amâncio / da Rocha Queiroz Lima, Monique / de Bruycker-Nogueira, Fernanda / Tomé, Larissa Cristina Teixeira / Coelho, Mariana Rosa Inácio / da Silva, Sandro Patroca / de Oliveira-Pinto, Luzia Maria / de Azeredo, Elzinandes Leal / Dos Santos, Flavia Barreto

Pathogens (Basel, Switzerland)

2022 Volume 11, Issue 2

Abstract: The co-circulation of chikungunya virus (CHIKV), dengue virus (DENV) and Zika virus (ZIKV) in Rio de Janeiro (RJ), Brazil, caused a challenging triple epidemic, as they share similar clinical signs and symptoms and geographical distribution. Here, we ... ...

Abstract	The co-circulation of chikungunya virus (CHIKV), dengue virus (DENV) and Zika virus (ZIKV) in Rio de Janeiro (RJ), Brazil, caused a challenging triple epidemic, as they share similar clinical signs and symptoms and geographical distribution. Here, we aimed to investigate the clinical and laboratorial aspects of chikungunya suspected cases assisted in RJ during the 2018 outbreak, focusing on the differential diagnosis with dengue and zika. All suspected cases were submitted to molecular and/or serological differential diagnostic approaches to arboviruses. A total of 242 cases suspected of arbovirus infection were investigated and 73.6% (178/242) were molecular and/or serologically confirmed as chikungunya. In RT-qPCR confirmed cases, cycle threshold (Ct) values ranged from 15.46 to 35.13, with acute cases presenting lower values. Chikungunya cases were mainly in females (64%) and the most frequently affected age group was adults between 46 to 59 years old (27%). Polyarthralgia affected 89% of patients, especially in hands and feet. No dengue virus (DENV) and Zika virus (ZIKV) infections were confirmed by molecular diagnosis, but 9.5% (23/242) had serological evidence of DENV exposure by the detection of specific anti-DENV IgM or NS1, and 42.7% (76/178) of chikungunya positive cases also presented recent DENV exposure reflected by a positive anti-DENV IgM or NS1 result. A significantly higher frequency of arthritis (
Language	English
Publishing date	2022-02-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2695572-6
ISSN	2076-0817
ISSN	2076-0817
DOI	10.3390/pathogens11020245
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Article: Was It Chikungunya? Laboratorial and Clinical Investigations of Cases Occurred during a Triple Arboviruses’ Outbreak in Rio de Janeiro, Brazil

Pathogens. 2022 Feb. 14, v. 11, no. 2

2022

Abstract	The co-circulation of chikungunya virus (CHIKV), dengue virus (DENV) and Zika virus (ZIKV) in Rio de Janeiro (RJ), Brazil, caused a challenging triple epidemic, as they share similar clinical signs and symptoms and geographical distribution. Here, we aimed to investigate the clinical and laboratorial aspects of chikungunya suspected cases assisted in RJ during the 2018 outbreak, focusing on the differential diagnosis with dengue and zika. All suspected cases were submitted to molecular and/or serological differential diagnostic approaches to arboviruses. A total of 242 cases suspected of arbovirus infection were investigated and 73.6% (178/242) were molecular and/or serologically confirmed as chikungunya. In RT-qPCR confirmed cases, cycle threshold (Ct) values ranged from 15.46 to 35.13, with acute cases presenting lower values. Chikungunya cases were mainly in females (64%) and the most frequently affected age group was adults between 46 to 59 years old (27%). Polyarthralgia affected 89% of patients, especially in hands and feet. No dengue virus (DENV) and Zika virus (ZIKV) infections were confirmed by molecular diagnosis, but 9.5% (23/242) had serological evidence of DENV exposure by the detection of specific anti-DENV IgM or NS1, and 42.7% (76/178) of chikungunya positive cases also presented recent DENV exposure reflected by a positive anti-DENV IgM or NS1 result. A significantly higher frequency of arthritis (p = 0.023) and limb edema (p < 0.001) was found on patients with CHIKV monoinfection compared to dengue patients and patients exposed to both viruses. Lastly, phylogenetic analysis showed that the chikungunya cases were caused by the ECSA genotype. Despite the triple arboviruses’ epidemic in the state of RJ, most patients with fever and arthralgia investigated here were diagnosed as chikungunya cases, and the incidence of CHIKV/DENV co-detection was higher than that reported in other studies.
Keywords	Chikungunya virus ; Dengue virus ; Zika virus ; arboviruses ; arthritis ; dengue ; edema ; fever ; genotype ; geographical distribution ; phylogeny ; Brazil
Language	English
Dates of publication	2022-0214
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2695572-6
ISSN	2076-0817
ISSN	2076-0817
DOI	10.3390/pathogens11020245
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Increased circulating procoagulant and anticoagulant factors as TF and TFPI according to severity or infecting serotypes in human dengue infection.

Leal de Azeredo, Elzinandes / Solórzano, Victor Edgar Fiestas / de Oliveira, Débora Batista / Marinho, Cintia Ferreira / de Souza, Luiz José / da Cunha, Rivaldo Venâncio / Damasco, Paulo Vieira / Kubelka, Claire Fernandes / de-Oliveira-Pinto, Luzia Maria

Microbes and infection

2017 Volume 19, Issue 1, Page(s) 62–68

Abstract: Tissue Factor (TF) is the initiator of coagulation and Tissue Factor Inhibitor (TFPI) is the physiological inhibitor of the TF/FVIIa complex. Circulating levels of TF and TFPI were quantified in dengue patients and the relationships with disease severity ...

Abstract	Tissue Factor (TF) is the initiator of coagulation and Tissue Factor Inhibitor (TFPI) is the physiological inhibitor of the TF/FVIIa complex. Circulating levels of TF and TFPI were quantified in dengue patients and the relationships with disease severity and infecting serotype analysed. A significant decrease in TF and TPFI plasma levels was observed in mild DF patients compared with severe dengue. Furthermore, both factors were associated with haemorrhagic manifestations. Finally, TF levels were significantly increased in DENV-1/2 infected patients as compared with DENV-4. These findings suggest that activation of TF-pathway is an important component of DENV -related coagulation disorders.
MeSH term(s)	Adult ; Dengue/pathology ; Dengue Virus/classification ; Female ; Humans ; Lipoproteins/blood ; Male ; Middle Aged ; Serogroup ; Severity of Illness Index ; Thromboplastin/analysis ; Young Adult
Chemical Substances	Lipoproteins ; lipoprotein-associated coagulation inhibitor ; Thromboplastin (9035-58-9)
Language	English
Publishing date	2017-01
Publishing country	France
Document type	Journal Article
ZDB-ID	1465093-9
ISSN	1769-714X ; 1286-4579
ISSN (online)	1769-714X
ISSN	1286-4579
DOI	10.1016/j.micinf.2016.08.005
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Article ; Online: Analysis of Clinical and Laboratory Alterations Related to Dengue Case Severity: Comparison between Serotypes 2 and 4 in Brazil.

da Costa Faria, Nieli Rodrigues / Solorzano, Victor Edgar Fiestas / de Souza, Luiz José / Nogueira, Rita Maria Ribeiro / de Bruycker-Nogueira, Fernanda / Chouin-Carneiro, Thaís / Santos Simões, Jaqueline Bastos / da Rocha Queiroz Lima, Monique / de Oliveira Pinto, Luzia Maria / Kubelka, Claire Fernandes / Heringer, Manoela / de Azeredo, Elzinandes Leal / Barreto Dos Santos, Flavia

The American journal of tropical medicine and hygiene

2017 Volume 97, Issue 1, Page(s) 137–145

Abstract: The increase in severe dengue (SD) cases has caused great impact on public health and has concerned authorities of countries where the disease is endemic and epidemics reach high proportions. The recognition of progression signs of this severe disease ... ...

Abstract	The increase in severe dengue (SD) cases has caused great impact on public health and has concerned authorities of countries where the disease is endemic and epidemics reach high proportions. The recognition of progression signs of this severe disease during the initial febrile phase can be difficult, since the symptoms are often indistinguishable from other febrile diseases. The aim of this study was to evaluate the clinical manifestations and laboratory findings in patients from two dengue outbreaks and their association with the disease. The study was conducted in patients (
MeSH term(s)	Brazil/epidemiology ; Dengue/epidemiology ; Dengue/pathology ; Dengue/virology ; Dengue Virus/classification ; Dengue Virus/genetics ; Dengue Virus/pathogenicity ; Epidemics ; Humans ; Serogroup
Language	English
Publishing date	2017-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.16-0227
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Article ; Online: Association of rs1285933 single nucleotide polymorphism in CLEC5A gene with dengue severity and its functional effects.

Xavier-Carvalho, Caroline / Cezar, Renata Duarte da Silva / Freire, Naishe Matos / Vasconcelos, Carla Maria Mola de / Solorzano, Victor Edgar Fiestas / de Toledo-Pinto, Thiago Gomes / Fialho, Luciana Gomes / do Carmo, Rodrigo Feliciano / Vasconcelos, Luydson Richardson Silva / Cordeiro, Marli Tenório / Baptista, Paulo / de Azeredo, Elzinandes Leal / da Cunha, Rivaldo Venâncio / de Souza, Luiz José / Pacheco, Antonio Guilherme / Kubelka, Claire Fernandes / Moura, Patrícia Muniz Mendes Freire de / Moraes, Milton Ozorio

Human immunology

2017 Volume 78, Issue 10, Page(s) 649–656

Abstract: Outbreaks of the Zika, dengue, and chikungunya viruses, especially in the Americas, pose a global threat due to their rapid spread and difficulty controlling the vector. Extreme phenotypes are often observed, from asymptomatic to severe clinical ... ...

Abstract	Outbreaks of the Zika, dengue, and chikungunya viruses, especially in the Americas, pose a global threat due to their rapid spread and difficulty controlling the vector. Extreme phenotypes are often observed, from asymptomatic to severe clinical manifestations, which are well-studied in dengue. Host variations are also important contributors to disease outcomes, and many case-control studies have associated single nucleotide polymorphisms (SNPs) with severe dengue. Here, we found that the TC genotype and T-carriers for SNP rs1285933 in the C-type lectin superfamily member 5 (CLEC5A) gene was associated with severe dengue in a Northern Brazilian population (OR=2.75 and p-value=0.01, OR=2.11 and p-value=0.04, respectively). We also tested the functional effect of the CLEC5A protein and found that it is upregulated on the surface of human monocytes after in vitro dengue infection. CLEC5A was correlated with viral load inside the monocytes (Spearman r=0.55, p=0.008) and TNF production in culture supernatants (Spearman r=0.72, p=0.03). Analysis of mRNA in blood samples from DENV4-infected patients exhibiting mild symptoms showed that CLEC5A mRNA expression is correlated with TNF (r=0.67, p=0.0001) and other immune mediators. Monocytes from rs1285933 TT/TC individuals showed lower CLEC5A expression compared to CC genotypes. However, in these cells, CLEC5A was not correlated with TNF production. In summary, we confirmed that CLEC5A is genetically associated with dengue severity outcome, playing a central role during the immune response triggered by a dengue viral infection, and rs1285933 is a relevant SNP that is able to regulate signaling pathways after interactions between the dengue virus and CLEC5A receptors.
Language	English
Publishing date	2017-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	801524-7
ISSN	1879-1166 ; 0198-8859
ISSN (online)	1879-1166
ISSN	0198-8859
DOI	10.1016/j.humimm.2017.07.013
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Article ; Online: Dengue epidemics in two distinct periods reveal distinct epidemiological, laboratorial and clinical aspects in a same scenario: analysis of the 2010 and 2013 epidemics in Mato Grosso do Sul, Brazil.

Faria, Nieli Rodrigues da Costa / Solorzano, Victor Edgar Fiestas / Nogueira, Rita Maria Ribeiro / Chouin-Carneiro, Thaís / Nunes, Priscila Conrado Guerra / Simões, Jaqueline Bastos Santos / de Bruycker Nogueira, Fernanda / Lima, Monique da Rocha Queiroz / de Oliveira Pinto, Luzia Maria / Kubelka, Claire Fernandes / da Cunha, Rivaldo Venâncio / de Azeredo, Elzinandes Leal / dos Santos, Flavia Barreto

Transactions of the Royal Society of Tropical Medicine and Hygiene

2016 Volume 110, Issue 4, Page(s) 228–236

Abstract: Background: Dengue is a major problem in Brazil. Epidemiological and clinical aspects were characterized in patients from two epidemics which occurred in Mato Grosso do Sul, Brazil.: Methods: Dengue cases were classified according to the 2009 WHO ... ...

Abstract	Background: Dengue is a major problem in Brazil. Epidemiological and clinical aspects were characterized in patients from two epidemics which occurred in Mato Grosso do Sul, Brazil. Methods: Dengue cases were classified according to the 2009 WHO criteria, tested by serological and molecular biology tests and analysed for nonstructural protein 1 (NS1) antigenemia. Results: Dengue was confirmed in 78.7% (48/61) and 75.6% (118/156) of the cases studied in 2010 and 2013, respectively. DENV-1 and DENV-2 were the serotypes involved in the 2010 epidemic and DENV-4 in the 2013 one. Most of the cases were classified as dengue without warning; however, severe dengue was observed in 18.7% (9/48) of the cases in 2010 and less observed in DENV-4 cases. NS1 levels were higher in patients with dengue with warning signs and severe dengue in 2010. Circulating aspartate aminotransferase (AST) and alanine transferase (ALT) were altered in all groups, independently of the infecting serotype or epidemic. Patients with DENV-1 and DENV-2 presented significant lower monocyte counts when compared to patients with DENV-4. An inverse correlation was found between platelet count, leucocytes, monocytes and NS1 levels. Conclusions: Epidemics caused by the prevalence of distinct DENV serotypes had different impacts and clinical characteristics in a same scenario and, despite the occurrence of secondary infections, the DENV-4 emergence was not associated with severe cases.
MeSH term(s)	Adult ; Alanine Transaminase/blood ; Antigens/blood ; Aspartate Aminotransferases/blood ; Blood Cell Count ; Brazil/epidemiology ; Dengue/blood ; Dengue/epidemiology ; Dengue/virology ; Dengue Virus/genetics ; Enzyme-Linked Immunosorbent Assay ; Epidemics ; Female ; Humans ; Leukocytes/metabolism ; Male ; Prevalence ; Serogroup ; Serotyping ; Severe Dengue/blood ; Severe Dengue/virology ; Viral Nonstructural Proteins/blood
Chemical Substances	Antigens ; Viral Nonstructural Proteins ; Aspartate Aminotransferases (EC 2.6.1.1) ; Alanine Transaminase (EC 2.6.1.2)
Language	English
Publishing date	2016-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	441375-1
ISSN	1878-3503 ; 0035-9203
ISSN (online)	1878-3503
ISSN	0035-9203
DOI	10.1093/trstmh/trw013
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