Clinical characteristics and risk for severe COVID-19: a systematic review: Características clínicas e risco para COVID-19 grave: uma revisão sistemática

COVID-19 has evolved into a serious clinical condition, especially in patients with comorbidities. However, the literature has diverged in relation to the main characteristics of patients prone to severe evolution. Objective: This study aimed to understand different variables that may be associated with the clinical management of COVID-19 for a better clinical response and prognosis. Methods: This is a systematic review in which the search in PubMed, Cochrane, EMBASE and LILACS databases. A manual and gray literature search on Google Scholar was also conducted. There was no country or region restriction and only studies in Portuguese, English and Spanish were included. Results: Of the 21 studies included in Primary Health Care (PHC) for eligibility, five studies from five countries involving 27,754 patients were analysed and, of the four eligible studies, one study was included for secondary care. Overall, the mean age of the COVID-19 population in PHC was around 41 years old, the number of cases was higher for females and, there was no difference between the groups without and with exposure, sex (ρ=0.322) and age (ρ=0.395). More than half of the patients had symptoms and, 47% had comorbidities. Heart diseases were the most prevalent among them. Approximately 79% of those infected had non-essential occupation. There was evidence that non-essential occupation was associated with infected individuals (ρ=0.002). Conclusions: This review identified that there may be greater vulnerability to contamination and aggravation of COVID-19 in female individuals, with adult age in non-essential activity, presence of chronic non-communicable diseases

HTLV-1/2 in Indigenous Peoples of the Brazilian Amazon: Seroprevalence, Molecular Characterization and Sociobehavioral Factors Related to Risk of Infection

HTLV-1/2 infection is endemic in Indigenous peoples of the Americas. Its origin is attributed to the migratory flow of Amerindian ancestral peoples. The present study aimed to investigate the seroprevalence of HTLV-1/2 infection in Indigenous peoples of the Brazilian Amazon. A total of 3350 Indigenous people belonging to 15 communities were investigated. The investigation was performed using serological (ELISA), molecular (qPCR) and confirmatory (Western blot and/or Inno-Lia) tests to detect and differentiate the infection. The seroprevalence was 8.3% for HTLV-1/2 infection, with 0.1% of individuals seropositive for HTLV-1 and 8.1% for HTLV-2. The prevalence of infection was statistically higher in women (10.1%) than in men (6.5%) (p = 0.0002). This female predominance was observed in all age groups; in females the prevalence was significant from 41 years old (p p < 0.0001). Here, we present a prevalence of HTLV-1/2 among Indigenous peoples of the Brazilian Amazon. The endemic infection in these groups must reflect the different epidemiological profiles observed in these peoples, such as sexual transmission through rejection of condom use, breastfeeding, especially in cases of cross-breastfeeding, and the high rate of pregnancy in the villages

Prevalence and Risk Factors for HTLV-1/2 Infection inRiverside and Rural Populations of the State of Par&aacute;

Human T-lymphotropic viruses 1 and 2 (HTLV-1 and HTLV-2) infection has been described in several Amazonian populations; however, there is still a lack of data on the prevalence of the virus in riparian populations living in rural areas of the state of Par&aacute;. The present study aimed to evaluate the prevalence of HTLV-1/2 infection in four riverine communities and one rural area in the state of Par&aacute; and to describe the possible risk factors for infection. A total of 907 individuals responded to an epidemiological survey and gave blood samples collected for anti-HTLV-1/2 antibodies by immunoenzymatic assay (EIA). The serum-reactive samples were subjected to confirmation by an in-line assay (Inno-Lia) and by proviral DNA screening using real-time PCR (qPCR). The total prevalence was 0.8% (7/907) for HTLV-1/2 (CI: 0.2&minus;1.3%), with 0.66% HTLV-1 and 0.11% HTLV-2. The prevalence by sex was 0.7% in women (4/565) and 0.9% in men (3/342). Among seropositive patients, 83.3% (5/7) reported being sexually active, and 57.1% (4/7) reported not having the habit of using condoms during their sexual relations. Intrafamily infection was also observed. The results reinforce the need for public policies to prevent and block the spread of HTLV, especially in riparian communities that are subject to difficulties in accessing the Unified Health System (Sistema &Uacute;nico de Sa&uacute;de/SUS) because infected individuals need clinical monitoring for surveillance and early diagnosis of symptoms associated with HTLV-1