Vitamin D and prognostic factors in patients with severe Covid-19 in the amazon region

Vitamin D refers to a group of fat-soluble compounds involved in essential biological functions in the human body, besides playing a role in immunomodulation, lung and muscle function, cardiovascular health and in the prevention of infectious diseases. Evidence shows high prevalence of vitamin D insufficiency worldwide, which is considered a public health problem. In the context of Covid-19, a correlation between low vitamin D levels and cases/mortality was identified and that vitamin D deficiency increased hospitalization and total mortality, verifying a strong association between disease severity and vitamin D3 deficiency. To evaluate data on vitamin D3 dosage in patients with severe Covid-19 in the Amazon region, correlating it with prognostic variables (nosographic and anthropometric data) arising from the disease. The medical records of patients of both sexes, belonging to age groups equal to or greater than 18 years old, with the diagnosis of severe Covid-19 were evaluated. This was a cross-sectional epidemiological study between October and November 2021 involving patients with severe Covid-19 that presented in their medical records anthropometric data, seen at urgent and emergency healthcare units in the city of Manaus-AM, Northern region of Brazil. The sample consisted of 68 patients with a mean age of 56.8 ± 20.0 years, 50% female and 50% male, with a mean BMI of 28.5 ± 6.2 kg/m2 and most of them overweight or obese (69.8%). Hypertension (57.1%) and Diabetes Mellitus (44.6%) were the most frequent comorbidities among the evaluated patients. Body mass index showed weak inverse correlation with vitamin D3 (P=0.044) and overweight/obese patients had lower vitamin D3 serum levels than eutrophic participants (P=0.004). Classification of serum vitamin D3 levels indicated that most patients were deficient. Significant relationships were found between vitamin D levels and the number of cases of Covid-19 and, especially, the mortality caused by this infection. The population group most vulnerable to the disease, the aging population, is also the one with the most deficient vitamin D levels

Acute Chagas disease associated with ingestion of contaminated food in Brazilian western Amazon

Funding Information: We would like to thank the following institutions for all the support they accorded: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Amazonas Health Surveillance Foundation Dr. Rosimary Costa Pinto (FVS‐RCP/AM), the Municipal Health Departments of the affected by the outbreaks and Fundação de Amparo à Pesquisa do Estado do Amazonas for their financial support in acquiring materials for the molecular detection of the parasite. We would also like to thank the public health surveillance teams and the patients who agreed to participate in this study. Publisher Copyright: © 2023 Belgian Society of Tropical Medicine and the Prince Leopold Institute of Tropical Medicine.Objective: To describe clinical, epidemiological and management information on cases of acute Chagas disease (ACD) by oral transmission in the state of Amazonas in western Amazon. Methods: Manual and electronic medical records of patients diagnosed with ACD at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) were included. Results: There were 147 cases of acute CD registered from 10 outbreaks that occurred in the state of Amazonas between 2004 and 2022. The transmission pathway was through oral route, with probable contaminated palm fruit juice (açaí and/or papatuá), and involved people from the same family, friends or neighbours. Of 147 identified cases, 87 (59%) were males; cases were aged 10 months to 82 years. The most common symptom was the febrile syndrome (123/147; 91.8%); cardiac alterations were present in 33/100 (33%), (2/147; 1.4%) had severe ACD with meningoencephalitis, and 12 (8.2%) were asymptomatic. Most cases were diagnosed through thick blood smear (132/147; 89.8%), a few (14/147; 9.5%) were diagnosed by serology and (1/147; 0.7%) by polymerase chain reaction (PCR) and blood culture. In all these outbreaks, 74.1% of the patients were analysed by PCR, and Trypanosoma cruzi TcIV was detected in all of them. No deaths were recorded. The incidence of these foci coincided with the fruit harvest period in the state of Amazonas. Conclusion: The occurrence of ACD outbreaks in the Amazon affected individuals of both sexes, young adults, living in rural and peri-urban areas and related to the consumption of regional foods. Early diagnosis is an important factor in surveillance. There was a low frequency of cardiac alterations. Continuous follow-up of most patients was not carried out due to difficulty in getting to specialised centres; therefore, little is known about post-treatment.publishersversioninpres

Type 1 cardiorenal syndrome in a patient with an acute infection caused by Trypanosoma cruzi in the Brazilian Amazon region - a case report

Abstract Cardiorenal syndrome type 1 (CRS 1) occurs when acute heart failure leads to acute kidney injury. There are several etiologies of CRS 1, including Chagas disease. Here, we present the first case report of CRS 1 in a patient with acute Chagas disease. Electrocardiography, transthoracic echocardiography, and cardiac magnetic resonance imaging showed signs of acute myocarditis. Laboratory examination revealed severe loss of kidney function, with a creatinine clearance of 30 mL/min, which fully normalized after treatment. Due to emergence of Chagas disease in the Brazilian Amazon, it is important to report unique clinical features in order to improve patients’ outcomes