4 research outputs found
Vírus sincicial respiratório em crianças com menos de 2 anos: tendências nas hospitalizações e fatores de risco para doença grave – dados preliminares da rede de vigilância sentinela Portuguesa
No full textVigRSV network: Filipa Bazenga, Joana Nunes, Lídia Carvalho, Carolina Constant, Rosário Barreto, Susana Castanhinha, Rita Corte-Real, Beatriz Sousa, Margarida Freitas, Luis Miguel Silva, Florbela Cunha, Leonor Cardoso, Bruno Esteves, Regina Abreu, Ana Foles, Joana Brandão Silva, Paulo Lopes, Rita Marques, Raquel Marques, Mariana Reis, Ana Loureiro, Teresa Nunes, Eurico Jorge Gaspar, Eliana Costa, Miguel Félix, Lucília Araújo, Jorge Rodrigues, José Alves, Lina Winckler, Maria Manuel Zarcos, Carla Cruz, José Lupi, Sidónia Nunes, José Alves, Luísa Preto, Teresa Magalhães, Alberto Caldas Afonso, Manuel Magalhães, Alexandra Estrada, and Almerinda Pereira.Introduction and Objectives: Respiratory Syncytial Virus (RSV) infection is an important cause of hospitalization in children under five years. A national RSV sentinel network was set up in Portugal in April 2021. We describe the trends in RSV hospitalizations until September 2022 and identify risk factors for severe disease.
Methods: Acute respiratory infections in hospitalized children under two years were reported and tested for RSV. RSV disease severity was defined by the need for ventilation or admission to an intensive care unit. Risk ratios were used to assess the association between gender, age group, gestational age, birthweight, chronic conditions, RSV subtype and severity of disease.
Results: We detected two RSV off-season epidemics in June 2021 to February 2022 and May to September 2022. 63.3% of RSV-related hospitalizations occurred in children under six months old and 8.0% had chronic conditions. 11.0% had severe disease. Children under six months and with chronic conditions had, respectively, an 18-fold risk and a 2-fold risk of developing severe illness.
Discussion: The off-season RSV epidemics were probably triggered by the relaxation of COVID-19 physical distancing measures and immunity debt. In the first epidemic, the proportion of children with severe disease was higher than reported by previous studies, however, this result is probably overestimated due to the high proportion of cases notified by central hospitals. Age < 6 months and chronic conditions predispose to severe disease. As several factors may change the pattern of RSV activity, causing more severe outbreaks at different times, countries should implement year-round RSV surveillance systems.Introdução e Objetivos: O vírus sincicial respiratório (VSR) é uma importante causa de hospitalização em crianças com menos de cinco anos de idade. Em abril de 2021, foi implementado um sistema de vigilância sentinela de VSR em Portugal. Neste trabalho, descrevem-se tendências nas hospitalizações de VSR até setembro de 2022 e identificam-se fatores de risco para doença grave.
Métodos: Foram reportados, e testados para VSR, casos de Infeção respiratória aguda em crianças hospitalizadas com menos de 2 anos de idade. Definiu-se doença grave pela necessidade de ventilação ou de internamento em Unidade de Cuidados Intensivos. Utilizaram-se riscos relativos para avaliar a associação entre sexo, grupo etário, idade gestacional, peso à nascença, comorbilidades, subtipo de VSR e gravidade da doença.
Resultados: Detetaram-se duas epidemias de RSV fora de época, em junho 2021-fevereiro 2022 e maio-setembro de 2022. 63,3% das hospitalizações por VSR ocorreram em crianças com menos de 6 meses e 8,0% tinha comorbilidades. 11,0% desenvolveu doença grave. Crianças com menos de seis meses e com comorbilidades tiveram, respetivamente, um risco 18 e 2 vezes superior de desenvolver doença grave.
Discussão: As epidemias de VSR fora de época foram provavelmente desencadeadas pelo relaxamento das medidas de distanciamento social, no âmbito de combate à pandemia de COVID-19, e pela falta de imunidade por ausência de exposição à doença. Na primeira epidemia, a proporção de crianças com doença grave foi superior ao reportado em outros estudos, contudo, este resultado está provavelmente sobrestimado pela proporção elevada de casos notificados por hospitais centrais. Idade inferior a seis meses e comorbilidades predispõem a doença grave. Uma vez que diversos fatores podem afetar a sazonalidade de VSR, causando epidemias mais severas e em diferentes alturas do ano, recomenda-se a implementação de sistemas de vigilância contínua de VSR.Keypoints: - What is known – Respiratory Syncytial Virus (RSV) infection is an important cause of hospitalization in children under five years. Seasonal data on RSV detections have been available in Portugal since 2013-2014, however, data on RSV disease burden is sparse.
- What is added – Two RSV off-season epidemics were identified in Portugal. The off-season RSV epidemics were probably triggered by the relaxation of COVID-19 physical distancing measures and immunity debt. In the first epidemic, the proportion of children with severe disease was higher than reported by previous national studies.info:eu-repo/semantics/publishedVersio
Complete blood count parameters as biomarkers of retinopathy of prematurity: a Portuguese multicenter study
No full text© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Purpose: To evaluate complete blood count (CBC) parameters in the first week of life as predictive biomarkers for the development of retinopathy of prematurity (ROP).
Methods: Multicenter, prospective, observational study of a cohort of preterm infants born with gestational age (GA) < 32 weeks or birth weight < 1500 g in eight Portuguese neonatal intensive care units. All demographic, clinical, and laboratory data from the first week of life were collected. Univariate logistic regression was used to assess risk factors for ROP and then multivariate regression was performed.
Results: A total of 455 infants were included in the study. The median GA was 29.6 weeks, and the median birth weight was 1295 g. One hundred and seventy-two infants (37.8%) developed ROP. Median values of erythrocytes (p < 0.001), hemoglobin (p < 0.001), hematocrit (p < 0.001), mean corpuscular hemoglobin concentration (p < 0.001), lymphocytes (p = 0.035), and platelets (p = 0.003) of the group of infants diagnosed with ROP any stage were lower than those without ROP. Mean corpuscular volume (MCV) (p = 0.044), red blood cell distribution width (RDW) (p < 0.001), erythroblasts (p < 0.001), neutrophils (p = 0.030), neutrophils-lymphocytes ratio (p = 0.028), and basophils (p = 0.003) were higher in the ROP group. Higher values of MCV, erythroblasts, and basophils remained significantly associated with ROP after multivariate regression.
Conclusion: In our cohort, the increase in erythroblasts, MCV, and basophils in the first week of life was significantly and independently associated with the development of ROP. These CBC parameters may be early predictive biomarkers for ROP.Open access funding provided by FCT|FCCN (b-on). This work was supported by the Laboratório de Genética and the Instituto de Saúde Ambiental (ISAMB) of the Faculdade de Medicina of Universidade de Lisboa and the Instituto de Investigação Científica Bento da Rocha Cabral. The writing of the manuscript was also supported by funds from Fundação para a Ciência e a Tecnologia to ISAMB (ref. UIDB/04295/2020 and UIDP/04295/2020). This work was also part of a doctoral project funding by the company CUF with a PhD grant in Medicine awarded in 2021 and by the Portuguese Society of Ophthalmology with a PhD grant awarded in 2019.info:eu-repo/semantics/publishedVersio
Vitamin D-related polymorphisms and vitamin D levels as risk biomarkers of COVID-19 disease severity
No full textFunding Information: We thank all the study participants, who donated blood and authorized the genetic analysis and the collection of the clinical and phenotypic personal data. This project was supported by the “Fundação para a Ciência e Tecnologia”, program “Research 4 Covid-19 Apoio especial a projetos de implementação rápida para soluções inovadoras de resposta à pandemia de COVID-19”. It was also partially supported by each institution. Publisher Copyright: © 2021, The Author(s).Vitamin D is a fundamental regulator of host defences by activating genes related to innate and adaptive immunity. Previous research shows a correlation between the levels of vitamin D in patients infected with SARS-CoV-2 and the degree of disease severity. This work investigates the impact of the genetic background related to vitamin D pathways on COVID-19 severity. For the first time, the Portuguese population was characterized regarding the prevalence of high impact variants in genes associated with the vitamin D pathways. This study enrolled 517 patients admitted to two tertiary Portuguese hospitals. The serum concentration of 25 (OH)D, was measured in the hospital at the time of patient admission. Genetic variants, 18 variants, in the genes AMDHD1, CYP2R1, CYP24A1, DHCR7, GC, SEC23A, and VDR were analysed. The results show that polymorphisms in the vitamin D binding protein encoded by the GC gene are related to the infection severity (p = 0.005). There is an association between vitamin D polygenic risk score and the serum concentration of 25 (OH)D (p = 0.04). There is an association between 25 (OH)D levels and the survival and fatal outcomes (p = 1.5e−4). The Portuguese population has a higher prevalence of the DHCR7 RS12785878 variant when compared with its prevalence in the European population (19% versus 10%). This study shows a genetic susceptibility for vitamin D deficiency that might explain higher severity degrees in COVID-19 patients. These results reinforce the relevance of personalized strategies in the context of viral diseases. Trial registration: NCT04370808.publishersversionpublishe
