SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

Animais de estimação e a saúde mental de estudantes universitários

Dissertação de Mestrado realizada sob a orientação da Professora Doutora Diana Frasquilho, apresentada no Ispa – Instituto Universitário para obtenção de grau de Mestre na especialidade de Psicologia Clínica.Os estudantes universitários encontram-se num período de transição importante com um grande impacto na sua saúde mental. Os benefícios comprovados de ter animais de estimação no bem-estar psicológico podem ser relevantes para o estudo da saúde mental desta população. Desta forma, o presente estudo teve como objetivo estudar a relação entre o nível de saúde mental dos estudantes universitários portugueses com e sem animais de estimação, analisando fatores sociodemográficos relevantes. Foi aplicado um questionário sociodemográfico, uma escala de vantagens e desvantagens de ter animais de estimação, a escala MacArthur de estatuto social subjetivo e o Inventário de Saúde Mental a uma amostra de 259 estudantes universitários portugueses. Os estudantes universitários com animais de estimação apresentaram melhores níveis de saúde mental do que os seus pares. Foram encontradas correlações positivas entre o bem-estar psicológico e a promoção de atividade física pelos animais, relações sociais e rotinas diárias, e entre o distresse psicológico e sentir-se distraído dos estudos pelo animal de estimação e a ansiedade ao pensar na sua morte. Ter animais de estimação demonstrou ser um fator preditivo significativo da saúde mental dos estudantes, parcialmente amplificado pelo Estatuto Social Subjetivo, sugerindo que ter animais de estimação tem um efeito positivo na saúde mental desta população, principalmente nos estudantes do género masculino. Em contraste com estudos anteriores, não foram encontradas diferenças significativas no nível de saúde mental entre os grupos com diferentes números e tipos de animais de estimação. Sugere-se a futuros investigadores a elaboração de estudos longitudinais para explorar estes resultados.ABSTRACT: University students are undergoing a crucial transitional phase that significantly impacts their mental health. The documented advantages of pet ownership on mental well being could be particularly beneficial for better understanding of this population’s mental health. Thus, the current study aimed to study the relation between the mental health levels of Portuguese university students with and without pets, while analyzing relevant sociodemographic factors. A sociodemographic questionnaire, a scale of pros and cons of pet ownership, the MacArthur Scale of Subjective Social Status, and the Mental Health Inventory were administered to a sample of 259 Portuguese university students. Results indicated that university students with pets exhibited better mental health levels compared to their counterparts, and positive correlations were found between psychological well being and the promotion of physical activity by pets, social relationships, and daily routines, and between distress and feeling distracted from studies by the pet and anxiety when thinking about its death. Pet ownership was found to be a significant predictive factor of students' mental health, with the impact being partially amplified by Subjective Social Status. These findings suggest that pet ownership has a positive effect on the mental health of this population, particularly among male students. However, contrary to previous studies, no significant differences were found in the levels of mental health among groups with different numbers and types of pets. Future researchers may wish to conduct longitudinal studies to further delve into these results

Antibioterapia - uma análise retrospectiva de 3 anos

O ressurgimento de microorganismos multirresistentes resultantes do desadequado uso de antibióticos obrigam a um maior exercício na aplicabilidade de antibióticos face aos múltiplos padrões de resistências. O objetivo do trabalho foi analisar o consumo de antibióticos num hospital distrital, ao longo de 3 anos, e relacioná-lo com a microbiologia local e respectiva variabilidade durante os 3 anos. No período analisado, no Centro Hospitalar Médio Tejo (CHMT), assistiu-se a uma diminuição da utilização da Amoxicilina / Clavulanto contrapondo com o aumento da Piperacilina / Tazobactam, em sentido oposto à utilização de antibióticos na Unidade de Cuidados Intensivos (UCI). Contudo, tanto na UCI como no CHMT, observou-se um aumento dos microorganismos epidemiologicamente importantes face à evidente mudança de hábitos prescritivos

Adenosine A2A receptors modulate α-Synuclein aggregation and toxicity

© The Author 2015. Published by Oxford University Press. All rights reserved.Abnormal accumulation of aggregated α-synuclein (aSyn) is a hallmark of sporadic and familial Parkinson's disease (PD) and related synucleinopathies. Recent studies suggest a neuroprotective role of adenosine A2A receptor (A2AR) antagonists in PD. Nevertheless, the precise molecular mechanisms underlying this neuroprotection remain unclear. We assessed the impact of A2AR blockade or genetic deletion (A2AR KO) on synaptic plasticity and neuronal cell death induced by aSyn oligomers. We found that impairment of LTP associated with aSyn exposure was rescued in A2AR KO mice or upon A2AR blockade, through an NMDA receptor-dependent mechanism. The mechanisms underlying these effects were evaluated in SH-SY5Y cells overexpressing aSyn and rat primary neuronal cultures exposed to aSyn. Cell death in both conditions was prevented by selective A2AR antagonists. Interestingly, blockade of these receptors did not interfere with aSyn oligomerization but, instead, reduced the percentage of cells displaying aSyn inclusions. Altogether, our data raise the possibility that the well-documented effects of A2AR antagonists involve the control of the latter stages of aSyn aggregation, thereby preventing the associated neurotoxicity. These findings suggest that A2AR represent an important target for the development of effective drugs for the treatment of PD and related synucleinopathies.T.F.O. and L.V.L. were supported by a grant from the Fritz Thyssen Stiftung (Az. 10.12.2.165), Germany. L.V.L. is an Investigator FCT, funded by Fundação para a Ciência e Tecnologia, Portugal. T.F.O. is supported by the DFG Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB; Germany).info:eu-repo/semantics/publishedVersio

Saliva molecular testing bypassing RNA extraction is suitable for monitoring and diagnosing SARS-CoV-2 infection in children

Funding Information: This work was funded by the Fundação para a Ciência and Tecnologia (FCT, Portugal) under RESEARCH4COVID 19 call with reference 283_596885654 and co-funded by ANI under INOV4COVID (Funding to V.M.B.). M.J.A. is funded by the FCT (CEECIND/02373/2020). M.A. is funded by a Junior Researcher working contract from FCT and Instituto Gulbenkian de Ciência (IGC, Portugal). This work benefited from COVID19 emergency funds 2020 from Calouste Gulbenkian Foundation and from Oeiras city council. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We would like to thank the technical support of IGC’s Advanced Imaging Facility (AIF-UIC).Background Adults are being vaccinated against SARS-CoV-2 worldwide, but the longitudinal protection of these vaccines is uncertain, given the ongoing appearance of SARS-CoV-2 variants. Children remain largely unvaccinated and are susceptible to infection, with studies reporting that they actively transmit the virus even when asymptomatic, thus affecting the community. Methods We investigated if saliva is an effective sample for detecting SARS-CoV-2 RNA and antibodies in children, and associated viral RNA levels to infectivity. For that, we used a saliva-based SARS-CoV-2 RT-qPCR test, preceded or not by RNA extraction, in 85 children aged 10 years and under, admitted to the hospital regardless of COVID-19 symptomatology. Amongst these, 29 (63.0%) presented at least one COVID-19 symptom, 46 (54.1%) were positive for SARS-CoV-2 infection, 28 (32.9%) were under the age of 1, and the mean (SD) age was 3.8 (3.4) years. Saliva samples were collected up to 48 h after a nasopharyngeal swab-RT-qPCR test. Results In children aged 10 years and under, the sensitivity, specificity, and accuracy of saliva-RT-qPCR tests compared to NP swab-RT-qPCR were, respectively, 84.8% (71.8%–92.4%), 100% (91.0%–100%), and 91.8% (84.0%–96.6%) with RNA extraction, and 81.8% (68.0%–90.5%), 100% (91.0%–100%), and 90.4% (82.1%–95.0%) without RNA extraction. Rescue of infectious particles from saliva was limited to CT values below 26. In addition, we found significant IgM positive responses to SARS-CoV-2 in children positive for SARS-CoV-2 by NP swab and negative by saliva compared to other groups, indicating late infection onset (>7–10 days). Conclusions Saliva is a suitable sample type for diagnosing children aged 10 years and under, including infants aged <1 year, even bypassing RNA extraction methods. Importantly, the detected viral RNA levels were significantly above the infectivity threshold in several samples. Further investigation is required to correlate SARS-CoV-2 RNA levels to viral transmission.publishersversionpublishe

Saliva molecular testing bypassing RNA extraction is suitable for monitoring and diagnosing SARS-CoV-2 infection in children

Background Adults are being vaccinated against SARS-CoV-2 worldwide, but the longitudinal protection of these vaccines is uncertain, given the ongoing appearance of SARS-CoV-2 variants. Children remain largely unvaccinated and are susceptible to infection, with studies reporting that they actively transmit the virus even when asymptomatic, thus affecting the community. Methods We investigated if saliva is an effective sample for detecting SARS-CoV-2 RNA and antibodies in children, and associated viral RNA levels to infectivity. For that, we used a saliva-based SARS-CoV-2 RT-qPCR test, preceded or not by RNA extraction, in 85 children aged 10 years and under, admitted to the hospital regardless of COVID-19 symptomatology. Amongst these, 29 (63.0%) presented at least one COVID-19 symptom, 46 (54.1%) were positive for SARS-CoV-2 infection, 28 (32.9%) were under the age of 1, and the mean (SD) age was 3.8 (3.4) years. Saliva samples were collected up to 48 h after a nasopharyngeal swab-RT-qPCR test. Results In children aged 10 years and under, the sensitivity, specificity, and accuracy of saliva-RT-qPCR tests compared to NP swab-RT-qPCR were, respectively, 84.8% (71.8%–92.4%), 100% (91.0%–100%), and 91.8% (84.0%–96.6%) with RNA extraction, and 81.8% (68.0%–90.5%), 100% (91.0%–100%), and 90.4% (82.1%–95.0%) without RNA extraction. Rescue of infectious particles from saliva was limited to CT values below 26. In addition, we found significant IgM positive responses to SARS-CoV-2 in children positive for SARS-CoV-2 by NP swab and negative by saliva compared to other groups, indicating late infection onset (&gt;7–10 days). Conclusions Saliva is a suitable sample type for diagnosing children aged 10 years and under, including infants aged &lt;1 year, even bypassing RNA extraction methods. Importantly, the detected viral RNA levels were significantly above the infectivity threshold in several samples. Further investigation is required to correlate SARS-CoV-2 RNA levels to viral transmission. </jats:sec

What Changed Between the Peak and the Plateau Periods of the First COVID-19 Pandemic Wave? A Multicentric Portuguese Cohort Study in Intensive Care.

Abstract BackgroundThe COVID-19 pandemic represented a challenge for intensive care units (ICU) with overwhelming demand, heterogenous outcomes and clinical practices. To improve care a profound knowledge on severe COVID-19 patients during different time points is crucial. This data is still scarce. We aimed to analyze and compare COVID-19 patient demographics, clinical management, and outcomes between two periods from the first pandemic wave.MethodsWe performed a multicentric ambispective cohort study including severe COVID-19 patients between March and August 2020 from 16 Portuguese ICUs. A peak and a plateau period were defined, corresponding to weeks 10-16 and 17-34 of the first pandemic wave. All patients had SARS-CoV-2 pneumonia diagnosis and complete hospital follow-up.ResultsWe included 541 adult patients with a median age of 65 [57-74] years and mostly male (71.2%). Severe acute respiratory distress syndrome developed in 63.9% of cases. Overall, 28-day mortality rate was 23.7% with age and SAPSII (both p&lt;0.001) as independent risk factors.Between peak and plateau periods there were no significant differences in age (65 vs. 66, p=0.6), SAPS II (40 vs. 39, p=0.8), PaO2/FiO2 ratio (139 vs. 136, p=0.6), and antibiotic therapy (57.2% vs. 63.8%, p=0.2) at admission, nor in 28-day mortality (24.4% vs. 22.8%, p=0.7). Adjuvant therapy with corticosteroids had no impact on 28-day mortality (26.9% vs. 22.5% without, p=0.4). The peak period included 53.8% of patients and they had less comorbidities (no comorbidities 29% vs. 36%, p=0.01), presented at admission a higher use of vasopressors (81% vs. 63%, p&lt;0.001), invasive mechanical ventilation (58 vs 49%, p&lt;0.001), prone positioning (60% vs 48%, p=0.009), and hydroxychloroquine (80.2% vs. 13.4%; p&lt;0.001) and lopinavir/ritonavir (60.4% vs. 13.4%; p&lt;0.001) prescription, as compared with the plateau period. In the plateau period, there was a greater use of high flow nasal canula (5% vs 16%, p&lt;0.001) on admission, remdesivir (0.5% vs. 19.9%; p&lt;0.001) and corticosteroid (39% vs. 61%, p&lt;0.001) therapy, and a shorter ICU length-of-stay for survivors (12 days vs. 7, p&lt;0.001).ConclusionThere were significant changes in patient comorbidities, therapies and ICU length-of-stay between peak and plateau periods of the first COVID-19 wave with similar 28-day mortality.</jats:p