Thyroid cancer: the quest for genetic susceptibility involving DNA repair genes

The incidence of thyroid cancer (TC), particularly well-differentiated forms (DTC), has been rising and remains the highest among endocrine malignancies. Although ionizing radiation (IR) is well established on DTC aetiology, other environmental and genetic factors may also be involved. DNA repair single nucleotide polymorphisms (SNPs) could be among the former, helping in explaining the high incidence. To further clarify the role of DNA repair SNPs in DTC susceptibility, we analyzed 36 SNPs in 27 DNA repair genes in a population of 106 DTCs and corresponding controls with the aim of interpreting joint data from previously studied isolated SNPs in DNA repair genes. Significant associations with DTC susceptibility were observed for XRCC3 rs861539, XPC rs2228001, CCNH rs2230641, MSH6 rs1042821 and ERCC5 rs2227869 and for a haplotype block on chromosome 5q. From 595 SNP-SNP combinations tested and 114 showing relevance, 15 significant SNP combinations (p < 0.01) were detected on paired SNP analysis, most of which involving CCNH rs2230641 and mismatch repair variants. Overall, a gene-dosage effect between the number of risk genotypes and DTC predisposition was observed. In spite of the volume of data presented, new studies are sought to provide an interpretability of the role of SNPs in DNA repair genes and their combinations in DTC susceptibility.info:eu-repo/semantics/publishedVersio

SAÚDE E TRABALHO DOS PROFESSORES DE EDUCAÇÃO FÍSICA QUE ATUAM COM ATIVIDADES AQUÁTICAS

Objetivo: O objetivo do presente estudo foi identificar a relação entre o processo de trabalho e a saúde dos professores de educação física que atuam com atividades aquáticas, bem como, verificar as diferenças entre os gêneros. Método: Foram pesquisados 184 professores de educação física, através de um levantamento realizado com questionários anônimos. Resultados: Foi observada desigualdade entre os gêneros no que se refere à distribuição da remuneração, embora não significativa. O estudo também permitiu observar uma excessiva queixa de dores (n=97; 52,72%). A percepção sobre o desgaste revelou um valor médio de 14,18 para escala de Borg e o sofrimento psíquico, medido pelo SRQ-20, apresentou valores de 2,58; 2,04 e 3,03 para todos, homens e mulheres, respectivamente, com diferença significativa entre os gêneros (

Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2016-04-14T19:34:48Z No. of bitstreams: 1 Santos MS Temporal trends....pdf: 774496 bytes, checksum: 2fdb06791f67252aa819b6399160844c (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2016-04-15T13:08:57Z (GMT) No. of bitstreams: 1 Santos MS Temporal trends....pdf: 774496 bytes, checksum: 2fdb06791f67252aa819b6399160844c (MD5)Made available in DSpace on 2016-04-15T13:08:57Z (GMT). No. of bitstreams: 1 Santos MS Temporal trends....pdf: 774496 bytes, checksum: 2fdb06791f67252aa819b6399160844c (MD5) Previous issue date: 2015Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Yale University. School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Universidade Federal da Bahia. Instituto Multidisciplinar em Saúde. Vitória da Conquista, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Estadual do Sudoeste da Bahia. Jequié, BA, BrasilUniversidade Federal da Bahia. Faculdade de Farmácia. Departamento de Análises Clínicas e Toxicológicas. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilUniversidade Federal da Bahia. Instituto de Ciências da Saúde. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilCenters for Disease Control and Prevention. Streptococcus Laboratory. Atlanta, GA, USAFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, USAFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Farmácia. Departamento de Análises Clínicas e Toxicológicas. Salvador, BA, BrasilBACKGROUND: Hospital-based surveillance for pneumococcal meningitis has been conducted since January 1996 in the city of Salvador, Brazil. The purpose of this study was to describe the temporal evolution of Penicillin Non-Susceptible Streptococcus pneumoniae (PNSSP) in regards to serotype distributions and clonal diversity recovered from meningitis cases over 17 years. METHODS: Broth microdilution was used to identify pneumococcal isolates that were PNSSP (Minimum Inhibitory Concentration > 0.12 µg/ml). The annual incidence rate of meningitis cases was calculated. Serotyping was defined using multiplex polymerase chain reaction assays and quellung reaction. Genetic diversity of PNSSP isolates was assessed using both pulsed-field gel electrophoresis (PFGE) and Multilocus Sequence Typing (MLST) analyses. RESULTS: A total of 854 cerebrospinal fluid (CSF) culture pneumococcal isolates were tested by broth microdilution method and serotyped. A total of 173 (20.3%) were penicillin non-susceptible (PNSSP) (Minimum Inhibitory concentration ≥ 0.12 µg/ml). The annual incidence of meningitis cases declined from 1.65/100,000 population (1996) to 0.2/100,000 population in 2012 and the rate due to PNSSP declined 82% over the 17-years of surveillance. PNSSP isolates were restricted to 13 serotypes, being the most common ones serotypes 14 (45.1%; 78/173), 23 F (19.1%; 33/173), 6B (14.4%; 25/173), 19 F (9.2%; 16/173) and 19A (5.2%; 9/173). Among the PNSSP isolates, 94% had serotypes represented in the 10-valent conjugate vaccine (PCV10). The predominant serotype 14 clonal groups were identified as PFGE group A/multilocus sequence type 66 (ST66) [35.3% (61/173)] and PFGE group GK/ST156 [4.6% (8/173)], the latter one associated with high level resistance to penicillin and ceftriaxone. CONCLUSIONS: Our results show sustained reductions in pneumococcal meningitis cases in the Metropolitan region of Salvador from 1996 to 2012. This might reflect a beneficial impact of conjugate vaccines. Continued surveillance and further studies need to be conducted to better understanding on PCV10 vaccine impact

INDUÇÃO DA RESPOSTA IMUNE COM CÉLULAS TUMORAIS MCF7 PRÉ-TRATADAS COM MESOCARPO DE BABAÇU

A imunoterapia é uma estratégia promissora para o tratamento do câncer. E o mesocarpo obtido do fruto do Babaçu (Attalea speciosa) demonstra atividade imunomoduladora com relevantes pers- pectivas na atividade antitumoral. O objetivo deste trabalho foi avaliar resposta imune antitumoral contra células tumorais pré-tratadas com Extrato Aquoso de Mesocarpo de Babaçu (EAMB). As células tumorais MCF-7 foram ressuspensas no EAMB para determinação da viabilidade celular. Posteriormente, os ani- mais foram inoculados com MCF-7 ressuspensas em salina ou EAMB, por via subcutânea, nos dias 0, 5 e 10. No dia 15, os animais foram eutanasiados e o baço retirado cirurgicamente. Os esplenócitos foram caracterizados por fenotipagem com anticorpos monoclonais para células aderentes e não aderentes por citometria de fluxo. Parte das células não aderentes foram usadas para co-cultura com MCF-7 por 5 dias e depois feita fenotipagem dos esplenócitos. A viabilidade celular foi de 97% e não houve diferença no peso do baço entre os grupos. A frequência de células aderentes que expressam os marcadores IA/IE e Ly-6G foram maiores no grupo MCF-7 pré-tratadas com EAMB quando comparado com o controle. Na fe- notipagem de células não aderentes foi observada uma proporção de 1:2 linfócitos T CD8+ para linfócitos T CD4+. Contudo, após 5 dias de co-cultura com MCF-7, os esplenócitos obtidos dos animais estimulados com MCF-7 pré-tratados com EAMB apresentaram aumento de células T helper e citotóxicas, alterando a relação para 1:1. Os resultados mostram que o EAMB pode induzir uma resposta imunogênica específica, atuando como um adjuvante da resposta imune antitumoral.Palavras-chave: Mesocarpo de Babaçu. Células Tumorais MCF-7. Adjuvante Imunológico. ANTITUMOR IMMUNE RESPONSE BY MCF7 TUMOR CELLS PRETREATED WITH BABASSU MESOCARPABSTRACT: The immunotherapy is a promising strategy for the treatment of cancer. The mesocarp obtained from the fruit of the Babassu Palm (Attalea speciosa) demonstrates immunomodulating activity with relevant perspectives in antitumor activity. The aim of the study was to evaluate antitumoral immune response against tumor cells pre-treated with Aqueous Extract of Mesocarp of Babassu (AEMB). The tu- mor cells MCF-7 were resuspended in EAMB for determination of cell viability. Subsequently, the animals were inoculated with MCF-7 resuspended in saline or EAMB, subcutaneously, on days 0, 5 and 10. On day15, the animals were euthanized and the spleen surgically removed. The splenocyte were characterized by phenotyping with monoclonal antibodies for adherent cells and non-adhrent cells for flow cytometry. Part of non-adherent cells were used for co-culture with MCF-7 for 5 days and then made phenotyping of splenocyte. The cell viability was 97% and there was no difference in the weight of the spleen between the groups. The frequency of adherent cells that express markers IA/IE and Ly-6G were higher in group MCF-7 pre-treated with EAMB when compared with the control. In phenotyping of non-adherent cells was observed a ratio of 1:2 T lymphocytes CD8+ to CD4+ T lymphocytes. However, after 5 days of co-culture with MCF-7, the splenocyte obtained from animals stimulated with MCF-7 pre-treated with EAMB showed increase of helper T cells and cytotoxic, changing the ratio to 1:1. The results show that the EAMB may induce an immunogenic response specifies, acting as an adjuvant of antitumour immune response.KEYWORDS: Babassu Mesocarp. Tumor Cells MCF-7. Immunological Adjuvant. RESPUESTA INDUCIDA POR LAS CÉLULAS TUMORALES MCF7 TRATADAS PREVIAMENTE CON MESOCARPIO “BABAÇU”RESUMEN: La inmunoterapia es una estrategia que fornece buenas perspectivas para el tratamiento del cáncer. El mesocarpio obtenido a partir del fruto del “babaçú” (Attalea speciosa) demuestra actividad inmunomoduladora con perspectivas de actividad antitumoral. El objetivo de este trabajo fue evaluar la respuesta inmune antitumoral contra las células tumorales tratadas previamente con extracto acuoso de mesocarpio de babaçú (EAMB). Las células tumorales MCF-7 fueron suspendidas nuevamente en EAMB para la determinación de viabilidad celular. Posteriormente, los animales fueron inoculados con MCF-7, cultivo en solución salina, o con EAMB, por vía subcutánea durante los días 0, 5 y 10. El día 15, los anima- les fueron sacrificados y el bazo extirpado quirúrgicamente. Los esplenócitos se caracterizaron mediante la prueba fenotípica con anticuerpos monoclonales de células adherentes y células no aderentes por cito- metría de flujo. Parte de las células adherentes fueron utilizadas para um co-cultivo con MCF-7 durante 5 días y luego realizó la prueba fenotípica de los esplenocitos. La viabilidad de las células fue del 97% y no hubo diferencia en el peso del bazo entre los grupos. La frecuencia de células adherentes que expresan marcadores IA/IE y Ly-6G fue mayor en el grupo MCF-7 pre-tratados con EAMB en comparación con el control. En la prueba fenotípica de las células adherentes se observó una proporción de 1:2 linfocitos T CD8+ con respecto a los linfocitos T CD4+. Sin embargo, después de los 5 días de co-cultivo con MCF-7, los esplenocitos obtenidos a partir de animales estimulados con MCF-7 pre-tratados con EAMB mostraron aumento de células T CD4+ y TCD8+, cambiando la proporción de 1:1. Los resultados muestran que la EAMB puede inducir una respuesta inmunogénica especifica, actuando como un adyuvante de respuesta inmune antitumoral.PALABRAS CLAVE: mesocarpio. Células tumorales MCF-7. Adyuvantes inmunológicos

ATIVAÇÃO in vitro DO SISTEMA COMPLEMENTO COMO MECANISMO IMUNOMODULADOR INDUZIDO PELO MESOCARPO DE BABAÇU

O babaçu (Orbignya phalerata Mart), palmeira que representa o mais importante produto do extrativismo vegetal do  Maranhão,  produz  um  fruto,  côco  babaçu,  composto  predominantemente  por  carboidratos  e  que  apresenta  efeitos imunomodulatórios. O objetivo deste trabalho foi verifcar o potencial imunomodulador do mesocarpo de babaçu por ativação do sistema complemento. Foi utilizado o extrato aquoso de mesocarpo de babaçu, na concentração de 40 mg/mL e fltrado após 24 horas. A dosagem de proteínas  foi  realizada pelo método colorimétrico de Bradford. No ensaio hemaglutinante, usou-se um  lavado de hemácias 1%  tratadas por uma hora com extrato nas concentrações de 1,25, 2,5, 5, 10, 20 e 40mg/mL,   em  triplicata,  tendo como controle a suspensão de hemácias com  tampão salina fosfato. A aglutinação foi verifcada macro  e microscopicamente,  com  a  contagem  de  rosetas. O  ensaio  de  hemólise  foi  feito  usando  o  lavado  de  hemácias tratadas ou não com extrato na concentração de 40mg/mL, incubado por duas horas com soro normal ou inativado a 56°C, para verifcar desnaturação protéica. A concentração de hemoglobina no  sobrenadante da cultura  representou a atividade hemolisante. Nossos resultados mostraram que ensaio de hemaglutinação não apresentou diferença macroscópica entre os grupos. Microscópicamente, a presença de rosetas seguiu um padrão dose-dependente, sugerindo a presença de lectina no extrato,  entretanto  a  dosagem  de  proteínas  apresentou  concentrações  baixas. No  ensaio  de  hemólise,  a  concentração  de hemoglobina  foi maior na  cultura de hemácias  tratadas  com  extrato que o  controle. Para  confrmar  a  ação das proteinas do complemento, as hemácias tratadas com extrato foram incubadas com soro inativado, sendo verifcada uma redução da hemólise, se igualando ao controle. Os resultados mostram que o efeito imunomodulador do mesocapo de babaçu apresenta a participação do sistema complemento, possivelmente através da via das lectinas.Descritores: Mesocarpo de babaçu. Imunomodulação. Sistema Complemento; Lectinas. Carboidrato. AbstractEvaluation of complement system activation  in vitro as an  immunomodulation mechanism  induced by babassu mesocarp. Babassu (Orbignya phalerata Mart.), palm tree that represents the most important product extractive industry of Maranhão, produces a fruit, babassu coconut, composed mainly for carbohydrates and has immunomodulatory effects. The aim of the study was to investigate the immunomodulatory potencial of babassu mesocarp by activation of the complement system. We used the aqueous extract of babassu mesocarp concentration of 40 mg/mL and fltered after 24 hours. The measure protein concentration was performed by the colorimetric method of Bradford. In the hemagglutination assay was used a suspension of erythrocytes 1% treated or not  for one hour with extract concentrations 1,25, 2,5, 5, 10, 20 e 40mg/mL  in  triplicate, using  the suspension of erythrocytes  in phosphate buffered saline as control. Agglutination was observed macroscopically and microscopically by counting rosettes. The hemolysis assay was performed using the suspension of erythrocytes treated or not with extract concentration 40 mg/mL, incubated for two hours with normal serum or inactivated at 56º to check protein denaturation. Hemoglobin concentration in the in the culture supernatant represented hemolyzing  activity. Our  results  showed  that  hemagglutination  assay  showed  no macroscopic  difference  between  the groups. Microscopically,  the  presence  of  rosettes  followed  a  dose-dependent,  suggesting  the  presence  of  lectin  in  the extract, however measure protein showed low concentrations. In hemolysis assay, the concentration of hemoglobin was higher  in  culture  of  erythrocytes  treated with  extract  than  the  control. To  confrm  the  action  of  complement  proteins, erythrocytes treated with extract were incubated with inactivated serum, being observed a reduction of hemolysis similar to  control.  The  results  show  that  the  immunomodulatory  effect  of  babassu mesocarp  shows  the  participation  of  the complement system, possibly by way of lectins.Descriptors: Babassu Mesocarp. Immunomodulation. Complement System. Lectins. Carbohydrate

BIOLOGICAL INVASION OF Corythucha ciliata IN GREEN URBAN SPACES IN PORTUGAL: A NICHE MODELING APPROACH USING MAXIMUM ENTROPY

Corythucha ciliata (Hemiptera: Tingidae) \ue9 um inseto nativo da Am\ue9rica do Norte que foi introduzido na Europa, pela It\ue1lia, em 1964. Desde ent\ue3o tem se expandido por toda a Europa, desconhecendo-se a data de chegada e a sua \ue1rea de distribui\ue7\ue3o em Portugal. Esta importante praga invasora alimenta-se na face inferior das folhas de pl\ue1tano, uma das mais importantes \ue1rvores ornamentais nos espa\ue7os verdes urbanos em Portugal, causando senesc\ueancia prematura e eventualmente morte, em casos de infesta\ue7\uf5es severas consecutivas. A modela\ue7\ue3o de nicho est\ue1 se tornando uma ferramenta cada vez mais importante na gest\ue3o de invas\uf5es biol\uf3gicas, tanto antes como depois da introdu\ue7\ue3o do organismo invasor. Neste estudo, o software MaxEnt (m\ue1xima entropia) foi usado na modela\ue7\ue3o da distribui\ue7\ue3o invasiva potencial de Corythucha ciliata em Portugal, a partir de um conjunto de vari\ue1veis ambientais e de dados de presen\ue7a do inseto, obtidos a partir da observa\ue7\ue3o de folhas de pl\ue1tanos amostrados por todo o pa\ueds. De acordo com o melhor modelo gerado pelo MaxEnt, as \ue1reas de maior adequabilidade potencial \ue0 invas\ue3o de Corythucha ciliata encontram-se no norte de Portugal apresentando o sul e as regi\uf5es de maior altitude do norte e centro adequabilidade reduzida ou nula. Observa\ue7\uf5es laboratoriais da biologia de Corythucha ciliata aliadas aos registos de aus\ueancia em v\ue1rias localidades do sul de Portugal e ocorr\ueancia predominante na metade norte de Espanha suportam o modelo desenvolvido. Por\ue9m, a valida\ue7\ue3o do modelo requer futuras prospec\ue7\uf5es nas \ue1reas de reduzida adequabilidade e onde a praga se encontrava virtualmente ausente no momento em que foi realizada a amostragem. Os modelos de adequabilidade podem ser usados como ferramenta auxiliar na tomada de decis\ue3o no que concerne \ue0 gest\ue3o dos espa\ue7os verdes.Corythucha ciliata (Hemiptera: Tingidae) is an insect native to North America which has been introduced into Europe, through Italy, in 1964. Since then it has expanded across Europe being its date of arrival and distributional range in Portugal unknown. This important invasive pest feeds on the underside of the leaves of sycamore trees, one of the most widespread ornamental tree in urban areas of Portugal, causing their premature senescence and eventually death, in case of consecutive severe infestations. Habitat modeling is becoming an increasingly important tool for managing biological invasions, either prior or after the introduction of the invasive organism. In this study the software MaxEnt (maximum entropy) was used to model the distribution of Corythucha ciliata in its Portuguese invasive range, from a set of environmental variables and georeferenced occurrence data obtained from observation of Platanus spp. leaves sampled all over the country. According to the best model developed, the areas of greater suitability to invasion of Corythucha ciliata are located in the northern portion of the country whereas the more southern and mountainous areas are of low or virtually null suitability. Laboratory observations of Corythucha ciliata biology allied to records of pest absence across several localities of southern Portugal and predominant occurrence in the northern half of Spain support the model developed. However, model validation requires future prospection in the areas of predicted reduced suitability and where the pest was virtually absent at the moment of sampling. Suitability models can be a useful tool for decision making in management of green spaces

Ecological aspects and molecular detection of Leishmania DNA Ross (Kinetoplastida: Trypanosomatidae) in phlebotomine sandflies (Diptera: Psychodidae) in terra firme and várzea environments in the Middle Solimões Region, Amazonas State, Brazil

Background: Phlebotomine sand flies (Diptera: Psychodidae) are insects of medical importance due to the role that some species play in the transmission of leishmaniasis. This work aimed to study some ecological aspects among sand flies fauna inhabiting two different environments: the várzea (lowland Amazonian forest) and terra firme (upland Amazonian forest), both located in Tefé Municipality, Amazonas State, Braziland to detect Leishmania infection in those phlebotomine populations. Methods: Sand flies were collected using HP light traps. Collection took place over the course of six months: January, February, April, August, September, and October of 2013. To detect natural infection by Leishmania, DNA samples were extracted from female sand flies and submitted to Polymerase Chain Reaction (PCR) targeting the kDNA gene; Leishmania species were identified by PCR-RFLP targeting the hsp70 gene and genetic sequencing. Results: In all, 5,716 individuals were collected, and 46 species were identified. Trichophoromyia ubiquitalis (3,330 - 58.26%) and Nyssomyia antunesi (661 - 11.26%) were the most abundant species. Species richness was greater in terra firme environments (42 species) than in the várzea environments (22 species), and forests ecotopes (43 species) were richer than peridomiciles (28 species). DNA of Leishmania was found in Th. ubiquitalis and Psychodopygus davisi, both of which inhabit the terra firme environment and sequencing analysis confirmed the presence of Leishmania (Viannia) lainsoni DNA in Th. ubiquitalis in Tefé Municipality. Conclusions: The high abundance of Th. ubiquitalis and Ps. davisi and detection of DNA of Leishmania sp. may indicate that both species could be putative vectors for American Cutaneous Leishmaniasis (ACL) in the terra firme environment of Tefé. The sand fly fauna found in várzea is rich and diverse, exhibiting several species, nevertheless the seasonal hydric stress during part of the year that could influence the local diversity, if compared with other studies. This is the first report in Amazonas State of Th. ubiquitalis with presence of L. (V.) lainsoni DNA. © 2015 Pereira et al.; licensee BioMed Central

A comprehensive assessment of the transcriptome of cork oak (Quercus suber) through EST sequencing

Background: Cork oak (Quercus suber) is one of the rare trees with the ability to produce cork, a material widely used to make wine bottle stoppers, flooring and insulation materials, among many other uses. The molecular mechanisms of cork formation are still poorly understood, in great part due to the difficulty in studying a species with a long life-cycle and for which there is scarce molecular/genomic information. Cork oak forests are of great ecological importance and represent a major economic and social resource in Southern Europe and Northern Africa. However, global warming is threatening the cork oak forests by imposing thermal, hydric and many types of novel biotic stresses. Despite the economic and social value of the Q. suber species, few genomic resources have been developed, useful for biotechnological applications and improved forest management. Results: We generated in excess of 7 million sequence reads, by pyrosequencing 21 normalized cDNA libraries derived from multiple Q. suber tissues and organs, developmental stages and physiological conditions. We deployed a stringent sequence processing and assembly pipeline that resulted in the identification of ~159,000 unigenes. These were annotated according to their similarity to known plant genes, to known Interpro domains, GO classes and E.C. numbers. The phylogenetic extent of this ESTs set was investigated, and we found that cork oak revealed a significant new gene space that is not covered by other model species or EST sequencing projects. The raw data, as well as the full annotated assembly, are now available to the community in a dedicated web portal at http://www.corkoakdb.org. Conclusions: This genomic resource represents the first trancriptome study in a cork producing species. It can be explored to develop new tools and approaches to understand stress responses and developmental processes in forest trees, as well as the molecular cascades underlying cork differentiation and disease response.Peer Reviewe

High levels of immunosuppression are related to unfavourable outcomes in hospitalised patients with rheumatic diseases and COVID-19 : first results of ReumaCoV Brasil registry

Objectives To evaluate risk factors associated with unfavourable outcomes: emergency care, hospitalisation, admission to intensive care unit (ICU), mechanical ventilation and death in patients with immune-mediated rheumatic disease (IMRD) and COVID-19. Methods Analysis of the first 8 weeks of observational multicentre prospective cohort study (ReumaCoV Brasil register). Patients with IMRD and COVID-19 according to the Ministry of Health criteria were classified as eligible for the study. Results 334 participants were enrolled, a majority of them women, with a median age of 45 years; systemic lupus erythematosus (32.9%) was the most frequent IMRD. Emergency care was required in 160 patients, 33.0% were hospitalised, 15.0% were admitted to the ICU and 10.5% underwent mechanical ventilation; 28 patients (8.4%) died. In the multivariate adjustment model for emergency care, diabetes (prevalence ratio, PR 1.38; 95% CI 1.11 to 1.73; p=0.004), kidney disease (PR 1.36; 95% CI 1.05 to 1.77; p=0.020), oral glucocorticoids (GC) (PR 1.49; 95% CI 1.21 to 1.85; p50 years (PR 1.89; 95% CI 1.26 to 2.85; p=0.002), no use of tumour necrosis factor inhibitor (TNFi) (PR 2.51;95% CI 1.16 to 5.45; p=0.004) and methylprednisolone pulse therapy (PR 2.50; 95% CI 1.59 to 3.92; p<0.001); for ICU admission, oral GC (PR 2.24; 95% CI 1.36 to 3.71; p<0.001) and pulse therapy with methylprednisolone (PR 1.65; 95% CI 1.00 to 2.68; p<0.043); the two variables associated with death were pulse therapy with methylprednisolone or cyclophosphamide (PR 2.86; 95% CI 1.59 to 5.14; p<0.018). Conclusions Age >50 years and immunosuppression with GC and cyclophosphamide were associated with unfavourable outcomes of COVID-19. Treatment with TNFi may have been protective, perhaps leading to the COVID-19 inflammatory process