Browsing by Author "Almonacid L.I."

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    High prevalence of SARS-CoV-2 detection and prolonged viral shedding in stools: A systematic review and cohort studyElevada detección de SARS-CoV-2 y prolongada excreción viral en deposiciones: Estudio de cohorte y revisión sistemática
    (2022) Diaz L.A.; Chahuan J.; Alvarez M.; Pavez C.; Candia R.; Monrroy H.; Espino A.; Pizarro M.; Riquelme A.; Garcia-Salum T.; Levican J.; Almonacid L.I.; Valenzuela G.H.; Serrano E.; Ferres M.; Salinas E.; Medina R.A.; Fuentes-Lopez E.; Riquelme A.; Reyes D.; Ortiz J.; Rada G.; Valderrama S.; Budnik S.; Gandara V.; Gallardo A.; Seydewitz M.F.; Cofre C.; Rada G.; Ortiz L.; Rada G.; Toro A.; Ortega M.; Ortega M.
    © 2022 Elsevier España, S.L.U.Objectives: To: 1. Describe the frequency of viral RNA detection in stools in a cohort of patients infected with SARS-CoV-2, and 2. Perform a systematic review to assess the clearance time in stools of SARS-CoV-2. Methods: We conducted a prospective cohort study in two centers between March and May 2020. We included SARS-CoV-2 infected patients of any age and severity. We collected seriated nasopharyngeal swabs and stool samples to detect SARS-CoV-2. After, we performed a systematic review of the prevalence and clearance of SARS-CoV-2 in stools (PROSPERO-ID: CRD42020192490). We estimated prevalence using a random-effects model. We assessed clearance time by using Kaplan–Meier curves. Results: We included 32 patients; mean age was 43.7 ± 17.7 years, 43.8% were female, and 40.6% reported gastrointestinal symptoms. Twenty-five percent (8/32) of patients had detectable viral RNA in stools. The median clearance time in stools of the cohort was 11[10–15] days. Systematic review included 30 studies (1392 patients) with stool samples. Six studies were performed in children and 55% were male. The pooled prevalence of viral detection in stools was 34.6% (twenty-four studies, 1393 patients; 95%CI:25.4–45.1); heterogeneity was high (I2:91.2%, Q:208.6; p ≤ 0.001). A meta-regression demonstrates an association between female-gender and lower presence in stools (p = 0.004). The median clearance time in stools was 22 days (nineteen studies, 140 patients; 95%CI:19–25). After 34 days, 19.9% (95%CI:11.3–29.7) of patients have a persistent detection in stools. Conclusions: Detection of SARS-CoV-2 in stools is a frequent finding. The clearance of SARS-CoV-2 in stools is prolonged and it takes longer than nasopharyngeal secretions.
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    Short-term complications and post-acute sequelae in hospitalized paediatric patients with COVID-19 and obesity: A multicenter cohort study
    (SPRINGER INTERNATIONAL PUBLISHING AG, 2022) Valenzuela G.; Alarcon-Andrade G.; Schulze-Schiapacasse C.; Garcia-Salum T.; Pardo-Roa C.; Levican J.; Serrano E.; Avendano M.J.; Almonacid L.I.; Poblete-Cardenas E.; Salinas E.; Munoz-Marcos A.; Medina R.A.; Rodriguez R.; Manzur D.; Barriga J.; Gutierrez M.; Godoy L.; Aravena J.; Nicolaides I.; Martinez E.; Gomez-Canobbio C.; Jofre M.; Salinas A.; Loza C.; Munoz A.; Barja S.; Cespedes P.; Bermudez S.; Depaoli D.; Ormazabal N.
    © 2022 World Obesity Federation.Background: Obesity increases the severity of coronavirus disease 2019 illness in adults. The role of obesity in short-term complications and post-acute sequelae in children is not well defined. Objective: To evaluate the relationship between obesity and short-term complications and post-acute sequelae of SARS-CoV-2 infection in hospitalized paediatric patients. Methods: An observational study was conducted in three tertiary hospitals, including paediatric hospitalized patients with a confirmatory SARS-CoV-2 RT-PCR from March 2020 to December 2021. Obesity was defined according to WHO 2006 (0–2 years) and CDC 2000 (2–20 years) growth references. Short-term outcomes were intensive care unit admission, ventilatory support, superinfections, acute kidney injury, and mortality. Neurological, respiratory, and cardiological symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms were considered as post-acute sequalae. Adjusted linear, logistic regression and generalized estimating equations models were performed. Results: A total of 216 individuals were included, and 67 (31.02%) of them had obesity. Obesity was associated with intensive care unit admission (aOR = 5.63, CI95% 2.90–10.94), oxygen requirement (aOR = 2.77, CI95% 1.36–5.63), non-invasive ventilatory support (aOR = 6.81, CI95% 2.11–22.04), overall superinfections (aOR = 3.02 CI95% 1.45–6.31), and suspected bacterial pneumonia (aOR = 3.00 CI95% 1.44–6.23). For post-acute sequalae, obesity was associated with dyspnea (aOR = 9.91 CI95% 1.92–51.10) and muscle weakness (aOR = 20.04 CI95% 2.50–160.65). Conclusions: In paediatric hospitalized patients with COVID-19, severe short-term outcomes and post-acute sequelae are associated with obesity. Recognizing obesity as a key comorbidity is essential to develop targeted strategies for prevention of COVID-19 complications in children.