38 research outputs found

    Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

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    Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity components. Dendritic cells (DCs) play a key role in the defense against viral infections, for instance plasmacytoid DCs (pDCs), have the capacity to produce vast amounts of interferon-alpha (IFN-α). In COVID-19 there is a deficit in DC numbers and IFN-α production, which has been associated with disease severity. In this work, we described that in addition to the DC deficiency, several DC activation and homing markers were altered in acute COVID-19 patients, which were associated with multiple inflammatory markers. Remarkably, previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+ myeloid DCs and pDCs seven months after SARS-CoV-2 infection. Moreover, the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients, while no restoration of integrin β7 and indoleamine 2,3-dyoxigenase (IDO) levels were observed. These findings contribute to a better understanding of the immunological sequelae of COVID-19

    The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

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    Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

    Efecto de la exposición a contaminación atmosférica durante el embarazo sobre el crecimiento fetal

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    Antecedentes y objetivo: Un creciente número de estudios epidemiológicos han asociado la exposición prenatal a contaminación atmosférica urbana con un menor crecimiento fetal, pero pocos están basados en cohortes prospectivas con modelos de exposición que capten la variabilidad espacial a pequeña escala de la contaminación dentro de una misma ciudad. Métodos: A partir de modelos basados en medidas de contaminación con captadores pasivos y variables geográficas, se estimó la exposición prenatal a dióxido de nitrógeno (NO2) y compuestos orgánicos volátiles (COVs) en una cohorte de 611 embarazadas de Sabadell. El crecimiento fetal se midió como peso al nacer y también longitudinalmente mediante ecografías obstétricas.Resultados: Tras estratificar por determinados patrones de tiempo-actividad, se halló un efecto negativo de la exposición prenatal a COVs por incremento en el rango intercuartílico sobre el peso al nacer (-77 gr, pConclusiones: La variabilidad en la exposición a contaminación atmosférica asociada al tráfico dentro de una misma ciudad tiene un efecto negativo sobre el crecimiento fetal. Este efecto comienza a manifestarse hacia la mitad del embarazo y parece persisitir hasta el nacimiento.Background and objective: A growing number of studies have found an association between prenatal exposure to urban air pollution and fetal growth, but few of them are based on prospective cohorts with exposure models developed to capture the small-scale spatial variability in air pollution levels within a city.Methods: We developed models based on air pollution measurements with passive samplers and geographic variables. They were applied to estimate prenatal exposure to nitrogen dioxide (NO2) and volatile organic compounds (VOCs) in a cohort of 611 pregnant women from Sabadell. Fetal growth was assessed as birth weight and also through obstetric ultrasounds.Results: After stratifying by some specific time-activity patterns, a negative effect of prenatal exposure to VOCs was found on birth weight (-77 gr, pConclusiones: Within-city variations in exposure to traffic-related air pollution have an effect on fetal growth. This effect already manifests during mid-pregnancy and seems to persist until birth

    Prenatal exposure to traffic-related air pollution and ultrasound measures of fetal growth in the INMA Sabadell cohort

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    Background: Few studies have used longitudinal ultrasound measurements to assess the effect of traffic-related air pollution on fetal growth./nObjective: We examined the relationship between exposure to nitrogen dioxide (NO2) and aromatic hydrocarbons [benzene, toluene, ethylbenzene, m/p-xylene, and o-xylene (BTEX)] on fetal growth assessed by 1,692 ultrasound measurements among 562 pregnant women from the Sabadell cohort of the Spanish INMA (Environment and Childhood) study./nMethods: We used temporally adjusted land-use regression models to estimate exposures to NO2 and BTEX. We fitted mixed-effects models to estimate longitudinal growth curves for femur length (FL), head circumference (HC), abdominal circumference (AC), biparietal diameter (BPD), and estimated fetal weight (EFW). Unconditional and conditional SD scores were calculated at 12, 20, and 32 weeks of gestation. Sensitivity analyses were performed considering time–activity patterns during pregnancy./nResults: Exposure to BTEX from early pregnancy was negatively associated with growth in BPD during weeks 20–32. None of the other fetal growth parameters were associated with exposure to air pollution during pregnancy. When considering only women who spent 2 hr/day in nonresidential outdoor locations, effect estimates were stronger and statistically significant for the association between NO2 and growth in HC during weeks 12–20 and growth in AC, BPD, and EFW during weeks 20–32./nConclusions: Our results lend some support to an effect of exposure to traffic-related air pollutants from early pregnancy on fetal growth during mid-pregnancy.This study was funded by grants from the European Union: NEWGENERIS FP6-2003- Food-3-A-016320, FP7-ENV-2011 cod 282957, HEALTH.2010.2.4.5-1; and by grants from Spain: Instituto de Salud Carlos III (Red INMA G03/176, CB06/02/0031, and FIS-FEDER PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI04/2018, PI04/1436, PI05/1079, PI05/1052, PI06/1213, PI07/0314, PI08/1151, PI09/02647, PI09/02311, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/02429, PI14/0891, PI14/1687, and Miguel Servet CP11/00178 and MS13/00054), Conselleria de Sanitat Generalitat Valenciana, Generalitat de Catalunya (CIRIT 1999SGR 00241), Diputación Foral de Guipúzcoa (DFG/004), Departamento de Sanidad y Consumo Gobierno Vasco (2005111093), Obra Social Cajastur, and Oviedo University

    Annoyance caused by noise and air pollution during pregnancy: associated factors and correlation with outdoor NO2 and benzene estimations

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    This study aimed to describe the degree of annoyance among pregnant women in a Spanish cohort and to examine associations with proximity to traffic, NO2 and benzene exposure. We included 2457 participants from the Spanish Childhood and Environment study. Individual exposures to outdoor NO2 and benzene were estimated, temporally adjusted for pregnancy. Interviews about sociodemographic variables, noise and air pollution were carried out. Levels of annoyance were assessed using a scale from 0 (none) to 10 (strong and unbearable); a level of 8 to 10 was considered high. The reported prevalence of high annoyance levels from air pollution was 11.2% and 15.0% from noise; the two variables were moderately correlated (0.606). Significant correlations between NO2 and annoyance from air pollution (0.154) and that from noise (0.181) were observed. Annoyance owing to noise and air pollution had a low prevalence in our Spanish population compared with other European populations. Both factors were associated with proximity to traffic. In multivariate models, annoyance from air pollution was related to NO2, building age, and country of birth; annoyance from noise was only related to the first two. The health burden of these exposures can be increased by stress caused by the perception of pollution sources.This study was funded by grants from Spain: Instituto de Salud Carlos III, Red INMA G03/176, CB06/02/0031, FIS-FEDER 03/1615, 04/1509, 04/1112, 04/1931, 04/2018, 04/1436, 05/1079, 05/1052, 06/1213, 07/0314, 08/1151,/n09/02647, 09/02311, 11/01007, 11/02591, 11/02038, 13/1944, 13/02429, 14/00891 and 14/01687,/nObra Social Cajastur, University of Oviedo, Conselleria de Sanitat Generalitat Valenciana , Generalitat/nde Catalunya (CIRIT 1999SGR 00241), Diputación Foral de Guipúzcoa (DFG/004), Departamento de/nSanidad y Consumo Gobierno Vasco (2005111093) and Fundación Roger Torné./nhttp://www.proyectoinma.org/instituciones-participantes/en_entidades-colaboradoras/
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