Some COVID-19 patients have higher mortality and the responsible factors for this unfavorable outcome is still not well understood. To study the association between ferritin levels at admission, representing an inflammatory state, and hospital mortality in COVID-19 patients. From May through July 2020, SARS-CoV-2 positive patients with moderate to severe clinical symptoms were evaluated at admission, regarding clinical and laboratory data on renal and hepatic function, hematologic parameters, cytomegalovirus co-infection, and acute phase proteins. A total of 97 patients were included; mean age = 59.9 ± 16.3 years, 58.8% male, 57.7% non-white, in-hospital mortality = 45.4%. Age, ferritin, C-reactive protein, serum albumin and creatinine were significantly associated with mortality. Ferritin showed area under the curve (AUC) of 0.79 (pp < 0.001) for the cut-off of 1873.0 ng/mL, sensitivity of 68.4% and specificity of 79.3% in predicting in-hospital mortality. Age ≥60 years had an odds ratio (OR) of 10.5 (95% CI = 1.859.5; p–59.5; p = 0.008) and ferritin ≥1873.0 ng/mL had an OR of 6.0 (95% CI = 1.426.2; p–26.2; p = 0.016), both independently associated with mortality based on logistic regression analysis. The magnitude of inflammation present at admission of COVID-19 patients, represented by high ferritin levels, is independently predictive of in-hospital mortality.

Background: Brazil has witnessed the co-circulation of dengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV), with outbreaks exacerbated by environmental factors, social determinants, and poor sanitation. The recent re-emergence of Oropouche virus (OROV) has added complexity to vector control strategies, emphasizing the need for integrated approaches to curb arboviruses spread. We aimed to analyze temporal trends and spatial distributions with national scope of these emerging arboviruses. Methods: An ecological study using data from the Brazilian Notifiable Diseases Information System the period from 2023 to 2024 was undertaken. Temporal trends were evaluated using Joinpoint regression, while spatial analysis was conducted using Moran’s I, and local indicators of spatial association. Results: Dengue fever cases increased by 322%, while Oropouche fever (OF) increased by 300%. The states of Amazonas and Espírito Santo reported increases in OF cases. Moran’s I test revealed spatial clustering of DENV and CHIKV. Two municipalities in the state of Mato Grosso do Sul showed cocirculation of DENV, CHIKV, and ZIKV. Conclusions: This study identified a surge in arbovirus cases between 2023 and 2024, with peak incidences from January to March and October to December, linked to favorable climatic conditions. Clustering patterns and co-circulation of arboviruses highlight the need for tailored control and prevention strategies and targeted interventions to mitigate their impact.

Chikungunya virus (CHIKV) vertical transmission occurs due to maternal viremia in the prepartum. Clinical presentation in neonates can be varied; however, the consequences of intrauterine exposure on the immune response are unclear. Thus, we aimed to analyze inflammatory alterations in children exposed to maternal CHIKV infection. This is a cross-sectional study that included children exposed to maternal CHIKV infection (confirmed by RT-qPCR and/or IgM). Circulant immune mediators were analyzed by a multiplex assay. RESULTS: We included 33 children, with a mean age of 3 ± 2.9 months-old, and 19 (57.6%) were male. Only one child presented neurological alterations. CHIKV-exposed infants showed elevated levels of MIP-1α, MIP-1β, and CCL-2 (p < 0.05). Pro-inflammatory cytokines such as TNFα, IL-6, and IL-7 (p < 0.0001) were also increased. In addition, lower levels of PDGF-BB and GM-CSF were observed in the same group (p < 0.0001). Principal component (PC) analysis highlighted a distinction in the inflammatory profile between groups, where PC explained 56.6% of the alterations. Our findings suggest that maternal exposure to CHIKV can affect the circulating levels of pro-inflammatory cytokines during the infants’ first year of life. The long-term clinical consequences of these findings should be investigated.

This study aimed to evaluate the hematological and coagulation parameters according to the clinical outcomes of coronavirus disease (COVID-19). We analyzed the hematological and coagulation parameters of hospitalized patients with COVID-19 at admission, and two and three weeks during hospitalization. To assess the performance of these parameters in predicting poor outcomes, receiver operating characteristic (ROC) curves were created. We studied 128 patients with COVID-19 (59.2±17.7 years, 56% male). Non-survivors (n=54, 42%) presented significant alterations in hematological and coagulation parameters at admission, such as increased in white blood cells (WBC), neutrophil, and band cell counts, as well as elevated prothrombin time (PT), activated partial thromboplastin time, and D-dimer levels. During follow-up, the same group presented a gradual increase in D-dimer and PT levels, accompanied by a reduction in PT activity, hemoglobin, and red blood cell count (RBC). ROC curves showed that WBC, neutrophil, and band cell counts presented the best area under the curve (AUC) values with sensitivity and specificity of >70%; however, a logistic regression model combining all the parameters, except for RBC, presented an AUC of 0.89, sensitivity of 84.84%, and specificity of 77.41%. Our study shows that significant alterations in hematological and coagulation tests at admission could be useful predictors of disease severity and mortality in COVID-19.