Navegando por Palavras-chave "Respiratory Syncytial Virus"

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    Avaliação da frequência e carga viral do vírus sincicial respiratório em amostras de diferentes populações atendidas em um hospital terciário da cidade de São Paulo
    (Universidade Federal de São Paulo (UNIFESP), 2020-12-01) Cruz, Jessica Santiago [UNIFESP]; Bellei, Nancy Cristina Junqueira [UNIFESP]; Universidade Federal de São Paulo
    The human respiratory syncytial virus (RSV) has a great impact on the world population, as one of the main agents in serious infections of the lower respiratory tract, affecting all age groups. Due to its easy transmission, spread rapidly in the community and in the hospital environment. Some patients can develop severe symptoms such as bronchiolitis and bronchopneumonia, causing a large number of hospitalizations and death. Thus, our study aimed to assess the frequency of RSV infection and viral load in different populations. A total of 1,402 samples were collected from 2004 to 2014 and analyzed in three patient populations: 622 hospitalized, 357 outpatients, and 423 undergoing transplantation. The real-time quantitative RT-PCR technique was used as the diagnostic test for RSV. The overall positivity for RSV was 15.98% (224 / 1,402), and the average viral load was 5.01 ± 2.41 Log10 copies of RNA/mL, with variation in the studied patient populations, respectively: 1) hospitalized, 47.32% and 6.29 ± 1.74; 2) ambulatory, 27.23% and 4.11 ± 2.01; and 3) undergoing transplantation, 25.45% and 4.48 ± 2.41. Overall, 83.81% of positive cases occurred between March and September. Hospitalized patients had a higher average viral load than outpatients (p <0.0001), both among children in general (p = 0.0013), and children older than 2 years of age (p = 0.0010). In hospitalized patients, children had a higher average viral load than adults (p = 0.0421). In outpatients, children with congenital heart disease had a lower average viral load than those without this comorbidity (p = 0.0187). In immunocompromised patients, those who were undergoing a transplant had a lower average viral load than those who were not in this condition (p = 0.0037). Thus, our study described viral load in different populations of patients affected by RSV infection, in addition to the risk of RSV infection regardless of age and immune status of patients. Currently, there is a lack of studies that can clarify important questions, such as specific clinical manifestations, in addition to the absence of drugs and vaccines that can clear the virus infection effectively. We described some parameters of frequency and viral load of RSV that could contribute to the study of future therapeutic or vaccine interventions.
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    High Rate of Viral Identification and Coinfections in Infants with Acute Bronchiolitis
    (Hospital Clinicas, Univ São Paulo, 2010-01-01) Nascimento, Milena Siciliano [UNIFESP]; Souza, Andrea Vieira de [UNIFESP]; Ferreira, Adriana Vada de Souza; Rodrigues, Joaquim Carlos [UNIFESP]; Abramovici, Sulim; Silva Filho, Luiz Vicente Ferreira da; Hosp Israelita Albert Einstein; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: To determine the viruses and risk factors associated with hospital and intensive care unit (ICU) admissions in infants with acute bronchiolitis.INTRODUCTION: Bronchiolitis is a major cause of morbidity in infants. Widespread use of molecular-based methods has yielded new insights about its etiology, but the impact of viral etiologies on early outcomes is still unclear.METHODS: Seventy-seven infants with bronchiolitis who were under two years of age and visited an emergency unit were included. Using molecular-based methods, samples were tested for 12 different respiratory viruses. Logistic regression models were used to identify clinical and virological variables associated with the main endpoints: hospital admission and ICU admission.RESULTS: We identified at least one virus in 93.5% of patients, and coinfections were found in nearly 40% of patients. RSV was the most common pathogen (63.6%), followed by rhinovirus (39%). Identification of RSV was only associated with an increased risk of hospital admission in the univariate model. Younger age and enterovirus infection were associated with an increased risk of hospital admission, while atopy of a first-degree relative showed a protective effect. Prematurity was associated with an increased risk of admission to the ICU. Coinfections were not associated with worse outcomes.CONCLUSIONS: Molecular-based methods resulted in high rates of viral identification but did not change the significant role of RSV in acute bronchiolitis. Younger age and enterovirus infection were risk factors for hospital admission, while prematurity appeared to be a significant risk factor for admission to the ICU in acute viral bronchiolitis.