Journal of medical virology
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Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic spread rapidly and this scenario is concerning in South America, mainly in Brazil with more than seven million cases of infection. Three major pandemic lineages/clades could be identified along with SARS-CoV-2 dissemination (G, GR, and GH) in the Americas. These clades differ according to their genomic characteristics, virulence, and spreading times. ⋯ The phylodynamic analysis indicated that all these main lineages increased viral spreading from February to early March and after an evolutionary stationary phase was observed. The decrease observed in the virus dissemination was directly associated to the reduction of social movement after March. In conclusion, these data demonstrated the current predominance of clades G, GR, and GH in South America because of the early dissemination of them in the first pandemic phase in South America.
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Data are conflicting regarding the impact of tobacco smoking in people with pneumonia due to SARS-CoV-2 infection (COVID-19). We performed a retrospective multicentre cohort study of 9991 consecutive patients hospitalized in a major New York academic center between March 7th and June 5th, 2020 with laboratory-confirmed COVID-19. The clinical outcomes assessed included risk of hospitalization, in-hospital mortality, risk of intensive care unit (ICU) admission, and need for mechanical ventilation among smokers (current and former). ⋯ In the current COVID-19 pandemic, smokers may have increased risk and severe pneumonia. In the current COVID-19 pandemic, smokers are believed to have an increased risk of mortality as well as severe pneumonia. However, in our analysis of real-world clinical data, smoking was not associated with increased in-patient mortality in COVID-19 pneumonia, in accordance with prior reports.
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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic calls for rapid actions, now principally oriented to a world-wide vaccination campaign. In this study we verified if, in individuals with a previous SARS-CoV-2 infection, a single dose of messenger RNA (mRNA) vaccine would be immunologically equivalent to a full vaccine schedule in naïve individuals. Health care workers (184) with a previous SARS-CoV-2 infection were sampled soon before the second dose of vaccine and between 7 and 10 days after the second dose, the last sampling time was applied to SARS-CoV-2 naïve individuals, too. ⋯ Adverse events after vaccine injection were more frequent after the second dose of vaccine (mean: 0.95; 95% confidence interval [CI]: 0.75-1.14 vs. mean: 1.91; 95% CI: 1.63-2.19) (p < .0001) and in exposed compared to naïve (mean: 1.63; 95% CI: 1.28-1.98 vs. mean: 2.35; 95% CI: 1.87-2.82) (p = .015). In SARS-CoV-2 naturally infected individuals a single mRNA vaccine dose seems sufficient to reach immunity. Modifying current dosing schedules would speed-up vaccination campaigns.
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Multicenter Study
Efficacy of corticosteroid in patients with COVID-19: A multi-center retrospective study and meta-analysis.
To evaluate the efficacy of corticosteroids on coronavirus disease 2019 (COVID-19) patients with different levels of disease severity. In our multicenter study, 543 patients with confirmed COVID-19 were classified as non-severe group and severe group, and then were compared respectively for all-cause mortality and length of hospital stay between those who received corticosteroids and not. By searching in PubMed, Web of Science, Embase, and CNKI, we identified 13 retrospective studies and 6 random control trials eligible for criteria of inclusion, and conducted comprehensive meta-analyses assessing the impacts of corticosteroids on mortality, length of stay, duration of RNA clearance and duration of fever. ⋯ Corticosteroids should be considered based on patient's condition. For patients with non-severe COVID-19, corticosteroid was not recommended as a routine therapeutic initiative as that presented prolonged duration of hospitalization and delayed viral clearing, as well as no positive impact on prognosis. While low-dose corticosteroids may benefit patients with severe COVID-19 for it can manifestly lower risk of death and improve the clinical status to some extent.
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Multicenter Study Observational Study
The role of teicoplanin in the treatment of SARS-CoV-2 infection: A retrospective study in critically ill COVID-19 patients (Tei-COVID study).
Teicoplanin has a potential antiviral activity expressed against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was suggested as a complementary option to treat coronavirus disease 2019 (COVID-19) patients. In this multicentric, retrospective, observational research the aim was to evaluate the impact of teicoplanin on the course of COVID-19 in critically ill patients. Fifty-five patients with severe COVID-19, hospitalized in the intensive care units (ICUs) and treated with best available therapy were retrospectively analysed. ⋯ No side effects related to teicoplanin use were observed. Despite several limitations require further research, in this study the use of teicoplanin is not associated with a significant improvement in outcomes analysed. The antiviral activity of teicoplanin against SARS-CoV-2, previously documented, is probably more effective at early clinical stages.