The emergence and reemergence of mosquito-borne diseases in Brazil such as yellow fever, zika, chikungunya, and dengue have had serious impacts on public health. Concerns have been raised due to the rapid dissemination of the chikungunya virus across the country since its first detection in 2014 in Northeast Brazil. In this work, we carried out on-site training activities in genomic surveillance in partnership with the National Network of Public Health Laboratories that have led to the generation of 422 chikungunya virus genomes from 12 Brazilian states over the past two years (2021–2022), a period that has seen more than 312 thousand chikungunya fever cases reported in the country. These genomes increased the amount of available data and allowed a more comprehensive characterization of the dispersal dynamics of the chikungunya virus East-Central-South-African lineage in Brazil. Tree branching patterns revealed the emergence and expansion of two distinct subclades. Phylogeographic analysis indicated that the northeast region has been the leading hub of virus spread towards other regions. Increased frequency of C > T transitions among the new genomes suggested that host restriction factors from the immune system such as ADAR and AID/APOBEC deaminases might be driving the genetic diversity of the chikungunya virus in Brazil.

Introduction: Although fewer children have been affected by the severe form of the coronavirus disease 2019 (COVID-19), community-acquired pneumonia (CAP) continues to be the leading global cause of child hospitalizations and deaths. Aim: This study investigated the incidence of respiratory syncytial virus (RSV) as well its subtypes (RSV A and B), adenovirus (ADV), rhinovirus (HRV), metapneumovirus (HMPV), coronavirus (NL63, OC43, 229E and HKU1), parainfluenza virus subtypes (PI1, PI2 and PI3), bocavirus and influenza A and B viruses (FluA and FluB) in children diagnosed with CAP during the COVID-19 pandemic. Methods: A total of 200 children with clinically confirmed CAP were initially recruited, of whom 107 had negative qPCR results for SARS-CoV-2 and were included in this study. Viral subtypes were identified using a real-time polymerase chain reaction in the nasopharyngeal swab samples. Results: Viruses were identified in 69.2% of the patients. RSV infections were the most frequently identified (65.4%), with type RSV B being the most prevalent (63.5%). In addition, HCoV 229E and HRV were detected in 6.5% and 3.7% of the patients, respectively. RSV type B was associated with severe acute respiratory infection (ARI) and a younger age (less than 24 months). Conclusions: New strategies for preventing and treating viral respiratory infections, particularly RSV infections, are necessary.

The COVID-19 pandemic in Brazil has demonstrated an important public health impact, as has been observed in the world. In Brazil, the Amazon Region contributed with a large number of cases of COVID-19, especially in the beginning of the circulation of SARS-CoV-2 in the country. Thus, we describe the epidemiological profile of COVID-19 and the genetic diversity of SARS-CoV-2 strains circulating in the Amazon Region. We observe an extensive spread of virus in this Brazilian site. The data on sex, age and symptoms presented by the investigated individuals were similar to what has been observed worldwide. The genomic analysis of the viruses revealed important amino acid changes, including the D614G and the I33T in Spike and ORF6 proteins, respectively. The latter found in strains originating in Brazil. The phylogenetic analyzes demonstrated the circulation of the lineages B.1 and B.1.1, whose circulation in Brazil has already been previous reported. Our data reveals molecular epidemiology of SARS-CoV-2 in the Amazon Region. These findings also reinforce the importance of continuous genomic surveillance this virus with the aim of providing accurate and updated data to understand and map the transmission network of this agent in order to subsidize operational decisions in public health.

Introduction: SARS-CoV-2 infection usually presents similarly to other respiratory viral pathogens. Children and adolescents do not present as a group that is highly affected by the disease, having low infection rates. However, limited publications are associated with the findings of pneumonia in pediatric patients with COVID-19. Objective: To analyze the clinical and epidemiological aspects of children and adolescents hospitalized with SARS-CoV-2 in a pre-Amazon region. Methods: A retrospective study, carried out in four public hospitals in São Luís, Brazil where medical records of children and adolescents aged from 0 to 13 years, of both sexes, with clinical diagnosis of community-acquired pneumonia were evaluated from March 2020 to March 2021. Results: Almost 40.0% of children were aged between 1 year and 5 years. Of the 128 children who had SARS-CoV-2, 3 are of indigenous ethnicity. Additionally, 78.6% of the children had fever and there was no significant difference between COVID-19 patients and those of other respiratory viruses. Eighteen patients had chronic neurological disease, which is the most common comorbidity observed in patients with coronavirus infection. Ground glass opacity attenuation was observed in 24.8% of children and adolescents with COVID-19. Anemia and increased inflammatory response markers were related to SARS-CoV-2 infection. More than 90.0% of patients admitted to hospital, regardless of etiology, were treated with antibiotics. Eighteen patients died. Pediatric multisystem inflammatory syndrome (PMIS) was diagnosed in 17 patients. Conclusions: SARS-CoV-2 in children and adolescents is mild, but the condition of patients with PMIS is more serious, with an increase in inflammatory biomarkers which can lead to death. Therefore, rapid diagnosis and differentiation of agents causing respiratory diseases are necessary for better therapeutic decision making, since the results of this study make us question the excessive use of antibiotics without meeting well-defined clinical–epidemiological criteria.

Introdução. A pandemia da COVID-19 desencadeou uma crise sanitária com mais de 700 milhões de infectados e 7 milhões de óbitos. Hoje, compreende-se que os impactos da pandemia ultrapassam o sistema respiratório, abrangendo uma diversidade de manifestações clínicas sistêmicas, incluindo o sistema nervoso. Objetivo. Realizar uma revisão científica de literatura com o intuito de elucidar a capacidade de infecção neurológica do SARS-CoV-2 bem como avaliar as manifestações neurológicas provocadas pela COVID-19. Método. Revisão de literatura de caráter integrativo com estudos publicados entre 2020 e 2023 obtidos nas plataformas Pubmed e Elsevier. Foram empregados os seguintes descritores: SARS-CoV-2, COVID-19, sistema nervoso, manifestações neurológicas e neurotropismo. Resultados. As principais manifestações obtidas, foram no sistema nervoso central: cefaleia, encefalopatia, encefalite e acidente vascular cerebral (AVC). Sistema nervoso periférico: anosmia, ageusia, disgeusia, síndrome de Guillain-Barré (SGB) e hiposmia. Destaca-se também sintomas neuropsicológicos que foram desenvolvidos após infecção: irritabilidade, ansiedade, distúrbios do sono, instabilidade emocional, baixo ânimo, perda de memória e depressão, bem como sintomas de confusão, vertigem, zumbido no ouvido e queda de cabelo. Além dos persistentes mesmo após cura da infecção: anosmia/ageusia, cefaleia, mialgia, encefalopatia, encefalite, AVC, SGB, paralisia de nervos cranianos, ataxia cerebelar aguda e mioclonia. Conclusão. A pesquisa das manifestações neurológicas torna-se crucial para o entendimento da complexidade das interações do vírus e o sistema nervoso, assim como a contínua investigação do neurotropismo viral, que transcende a COVID-19 e nos leva um futuro mais informado e preparado para enfrentar desafios emergentes de saúde pública.

The crisis generated by the pandemic impacted several factors in people's daily lives and promoted changes that led to increased stress. This situation draws attention to possible psychiatric complications, not only in patients who have already been infected by the virus, but also in the entire population who had to deal with the measures implemented by the government. Thus, this study is based on evaluating the population's immune compromise associated with stress conditions in the face of the COVID-19 pandemic. This is an integrative literature review, with a qualitative approach based on the collection of national and international data from the following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Scientific Electronic Library Online (SciELO) and Google Scholar. In the study, the relationship between the nervous, immune and endocrine systems was observed, altering mechanisms in the neuroendocrine immune circuits and causing damage to health due to the stress processes of social isolation. There was increased expression of pro-inflammatory genes and decreased expression of antiviral genes, increasing the risk of complications from COVID-19 due to changes in cytokine transmission. Stress and COVID-19 increase the secretion of IL-6, a cytokine that is associated with death in cases of COVID-19. In health professionals there were changes in immune cells after being exposed to stressors. In view of the results obtained, it was found that stress during the pandemic affected the immune system by altering the response against SARS-CoV-2, increasing viral pathogenesis.