Revista Do Instituto De Medicina Tropical De Sao Paulo最新文献

{"title":"First documentation of Aspergillus welwitschiae in COVID-19-associated pulmonary aspergillosis in the Americas.","authors":"Tiago Alexandre Cocio, Vivian Caso Coelho, Gilda Maria Barbaro Del Negro, Ingrid Gonçalves Costa Leite, Davi Carvalho Leal Gomes, Roseli Santos de Freitas Xavier, Roberto Martínez, Valdes Roberto Bollela, Gil Benard","doi":"10.1590/S1678-9946202567008","DOIUrl":"10.1590/S1678-9946202567008","url":null,"abstract":"<p><p>This study reports the first documented case of COVID-19-associated pulmonary aspergillosis (CAPA) caused by Aspergillus welwitschiae in the Americas, which occurred in a rural area of Sao Paulo State, Brazil. The case involves a 52-year-old woman with COVID-19, hypertension, and dyslipidemia, who was admitted following severe respiratory deterioration. Imaging tests revealed extensive pulmonary involvement, including nodular and cavitary lesions indicative of CAPA. Bronchoalveolar lavage (BAL) analysis identified Aspergillus spp. using morphological and molecular techniques, and sequencing of the benA gene confirmed the isolate as A. welwitschiae, closely related to the reference strain CBS 139.54. Matrix-assisted laser desorption/ionization-time of flight mass spectrometry further validated this identification. Traditionally recognized as a plant pathogen, A. welwitschiae has recently been implicated in human diseases, such as otomycosis, and is increasingly detected in respiratory samples. However, its association with CAPA remains underreported globally, particularly in the Americas. This case highlights the critical importance of accurate fungal diagnosis, as overlapping morphological features among Aspergillus species can hinder clinical management. The identification of A. welwitschiae in this context raises concerns about its potential as an emerging pathogen in agricultural regions, where environmental exposure may drive its epidemiological relevance. Given the growing recognition of A. welwitschiae as a CAPA agent, this report underscores its importance in the epidemiology of the disease and its potential role in regions with high agricultural activity. Accurate identification is essential for guiding targeted interventions and addressing the public health risks posed by this emerging fungal threat toCOVID-19 patients.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e8"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myiasis infestation in advanced lip squamous cell carcinoma due to COVID-19 pandemic-related treatment delays.","authors":"Lucas Emanuel Macena da Silva, Natália Vitória de Araújo Lopes, Diego de Sena Costa de Oliveira, Luiz Eduardo Marinho Vieira, Hianne Cristinne de Morais Medeiros, Bruno Augusto Benevenuto de Andrade, Carolina Carvalho de Souza, John Lennon Silva Cunha, Luan Éverton Galdino Barnabé","doi":"10.1590/S1678-9946202567006","DOIUrl":"10.1590/S1678-9946202567006","url":null,"abstract":"<p><p>Myiasis, a condition stemming from the parasitic infestation of Diptera fly larvae, constitutes a complication for cancer patients, particularly those with malignant skin wounds. The factors that contribute to myiasis include old age, inadequate hygiene, poor living conditions, vascular disease, and diabetes. Cases of myiasis in neoplastic wounds in the head and neck region are rare and guidelines or recommendations regarding the best treatment approach remain lacking. Herein, we describe a case of myiasis that developed into an extensive squamous cell carcinoma of the lip in an older male adult due to the delay in oncological treatment stemming from the COVID-19 pandemic. Patients with oral squamous cell carcinoma, especially those residing in rural areas, face a notable risk of developing oral myiasis. Therefore, it is imperative that patients and caregivers adopt strict preventive measures to avoid fly infestations in wounds. Maintaining optimal hygiene (including meticulous cleaning with antiseptic solutions before daily dressing changes) is essential to prevent myiasis. Adequate wound coverage is crucial, especially during warmer seasons.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e6"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gas necrosis and sepsis due to recreational ketamine use.","authors":"Alexandre Sacchetti Bezerra, Carla Maria Pasquareli Vazquez, Ana Carolina Troise Guilherme, Ana Beatriz Retamero Rodrigues, Murillo Barbosa Crivillari, Wladimir Queiroz","doi":"10.1590/S1678-9946202567009","DOIUrl":"10.1590/S1678-9946202567009","url":null,"abstract":"<p><p>Although ketamine is an FDA-approved drug, its mechanism of action is not fully understood. Currently, there is an increase in its recreational use, causing irreparable social and physical damage. We report the case of a musician who developed sepsis due to gas necrosis in his arm after using veterinary ketamine purchased via the internet. Despite the amputation recommendation, it was possible to save the arm and preserve motor and sensory function. The scientific community, as well as the police and the government, must ponder the prescription, efficacy and safety of ketamine for medical treatments.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e9"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An integrative review on treatment guidelines for complicated urinary tract infections: a synthesis of evidence-based recommendations.","authors":"Amanda Azevedo Bittencourt, Marina Della Negra de Paula, Ana Carolina Padula Ribeiro-Pereira, Paula de Mendonça Batista, Thales José Polis","doi":"10.1590/S1678-9946202567007","DOIUrl":"10.1590/S1678-9946202567007","url":null,"abstract":"<p><p>Urinary tract infections (UTI) lie among the most common bacterial infections worldwide. Since their manifestations can range from laboratory findings (asymptomatic bacteriuria) to septic shock, using appropriate antimicrobial agents is crucial to avoid complications and the misuse of antibiotics. This study aims to review scientific publications and the main guidelines to treat complicated UTI. A literature review was carried out in September 2022 on the LILACS, MEDLINE via PubMed, and SciELO databases. Descriptors, keywords, and MeSH terms were used to develop search strategies. Full documentation meeting the following criteria was included: management of patients with a diagnosis of complicated UTI; guidelines, recommendations, consensus articles, expert opinion articles (with recommendations), and meta-analyses including data from randomized controlled trials; and articles published from 2001 to 2022. Articles published in languages other than English, Spanish, French, and Portuguese and those unrelated to complicated UTI were excluded. After applying the eligibility criteria, 28 studies were included in this review. Fluoroquinolones are the most frequently recommended option for complicated cystitis and pyelonephritis. Guideline recommendations for recurrent UTI include antibiotic prophylaxis and treatment. Guidelines developed to propose treatment strategies for the pediatric population typically stratify cases according to their infection site (upper or lower),and the presence of fever. Guidelines propose different approaches, likely related to local antibiotic resistance and varying clinical manifestations. In this context, antimicrobial stewardship practices are essential to promote the adequate use of antibiotics for complicated UTI and to avoid antimicrobial resistance.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e7"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing under-registration in Chagas disease mortality: insights from the SaMi-Trop and REDS cohorts.","authors":"Ana Luiza Bierrenbach, Claudia Di Lorenzo Oliveira, Nayara Dornela Quintino, Nayara Ragi Baldoni, Carlos Henrique Valente Moreira, Ariela Mota Ferreira, Lea Campos de Oliveira da Silva, Márcio Oikawa, Maria do Carmo Pereira Nunes, Clareci Silva Cardoso, Desirée Sant'Ana Haikal, Fabio de Rose Ghilardi, Thallyta Maria Vieira, Antonio Luiz Pinho Ribeiro, Ester Cerdeira Sabino","doi":"10.1590/S1678-9946202567010","DOIUrl":"10.1590/S1678-9946202567010","url":null,"abstract":"<p><p>Chagas disease (ChD) remains a significant public health concern in the Americas, with challenges to accurately assessing its mortality burden due to under-reporting and misclassification. This study aimed to analyze mortality patterns of two cohorts of individuals with ChD-one comprising asymptomatic individuals with positive serology (REDS) and another with patients showing Chagas cardiomyopathy (SaMi-Trop)-to propose a method for estimating the potential under-registration of Chagas-related deaths and to find the factors influencing the identification of ChD as the underlying cause of death. We carried out a retrospective analysis of mortality data from these cohorts together with data on the Brazilian Mortality Information System. Causes of death were classified according to ICD-10 codes, and an expert review was used to find possible Chagas-related deaths. Logistic regression was used to explore predictors of ChD identification considering demographic and clinical variables. Of 2,488 patients, 381 died, 28.9% attributed to ChD, predominantly chronic ChD with cardiac involvement (B57.2). Using our method, we estimated a 53.8% potential under-registration rate for possible Chagas deaths. Males were negatively associated with Chagas disease identification, with an odds ratio of 0.52 (95%CI 0.24-1.1). No other significant associations were found, and the overall significance of the model was low. Our findings provide a potential measurement of under-registration, indicating that it may be substantial. These results underscore the need for improved identification and accurate reporting on death certificates. Strengthening the quality of mortality data is essential to understand Chagas-related mortality and guide public health strategies to reduce its impact.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e10"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro susceptibility pattern of Rhodococcus equi isolated from patients to antimicrobials recommended exclusively to humans, to domestic animals and to both.","authors":"Nícolas Garcia Ribeiro, Paulo da Silva, Patrick Júnior de Lima Paz, Marcelo Fagali Arabe Filho, Fernando Paganini Listoni, Evandro Paganini Listoni, Letícia Colin Panegossi, Márcio Garcia Ribeiro","doi":"10.1590/S1678-9946202567003","DOIUrl":"10.1590/S1678-9946202567003","url":null,"abstract":"<p><p>Rhodococcus equi is an opportunistic soil-borne bacterium that is eliminated in feces of multi-host animals. An increase in multidrug-resistant R. equi isolates has been reported in humans and domestic animals, and it has been hypothesized that the treatment of R. equi in foals could increase the selective pressure on multidrug-resistant isolates and favor human infections by resistant isolates. We investigated the in vitro antimicrobial susceptibility/resistance of 41 R. equi strains from humans, which were isolated from patients with pulmonary signs, using 19 antimicrobials from 10 distinct classes, recommended exclusively to humans, recommended exclusively to domestic animals and used in both. All isolates were subjected to mass spectrometry and identified as R. equi. Among the antimicrobials used exclusively in humans, tigecycline and vancomycin showed 100% efficacy. Amikacin, amoxicillin/clavulanic acid, imipenem, levofloxacin, clarithromycin, rifampin, ciprofloxacin, and gentamicin, used in both humans and animals, revealed high efficacy (97-100%). Conversely, a higher frequency of isolates was resistant to penicillin (87.8%) and trimethoprim/sulfamethoxazole (43.9%), which are used in both humans and animals. Among the antimicrobials used only in animals, isolates were resistant to florfenicol (46.4%), ceftiofur (17.1%), and enrofloxacin (2.5%). Multidrug resistance was observed in 34% of isolates. The identification of drug-resistant R. equi isolated from humans used exclusively in animals is circumstantial evidence of the pathogen transmission from domestic animals to humans. This study contributes to the molecular identification of Rhodococcus species from humans and to the epidemiological vigilance of the multidrug-resistant isolates.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e3"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher T-bet and IFN-γ expression in advanced chagasic megaesophagus indicates Th1 response in the chronic phase.","authors":"Betânia Maria Ribeiro, Fernanda Rodrigues Helmo, Denise Bertulucci Rocha Rodrigues, Marcos Vinícius da Silva, Virmondes Rodrigues","doi":"10.1590/S1678-9946202567004","DOIUrl":"10.1590/S1678-9946202567004","url":null,"abstract":"<p><p>Myenteric plexus injury is responsible for the morpho-functional alterations observed in chagasic megaesophagus (CME). The inflammatory response, characterized by elevated synthesis of IFN-γ, TNF-α, and IL-4, contributes to the persistence of parasitism and inflammation. This study assessed the mRNA expression of cytokines, transcription factors, and metalloproteases in subjects with CME. From 2011 to 2017, esophageal samples were collected from 54 subjects with CME (38 advanced and 16 nonadvanced) and eight subjects with idiopathic megaesophagus (IME). The quantitative mRNA expression of TNF-α, IFN-γ, IL-4, IL-10, IL-17, IL-22, IL-23, IL-27, T-bet, ROR-γT, GATA-3, MMP-1, MMP-2, and TIMP-3 genes was analyzed using SYBR Green systems. T-bet expression was significantly higher in the CME group compared to the IME group and the GATA-3 and ROR-γT expression in the CME group, corroborating the higher IFN-γ expression observed in subjects with advanced CME. The increased T-bet and IFN-γ expression in advanced CME reflects the maintenance of a Th1 response in situ and the morpho-functional changes seen in the organ.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e4"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunomodulatory effects of Triatoma dimidiata feces on Trypanosoma cruzi infection in a murine model.","authors":"Sergio Escobar-Laines, Victor Monteon, Carlos Ramírez-Sarmiento, Verónica Macedo-Reyes, Floribeth León Pérez","doi":"10.1590/S1678-9946202567005","DOIUrl":"10.1590/S1678-9946202567005","url":null,"abstract":"<p><p>Trypanosoma cruzi infection involves transmission of metacyclic trypomastigotes through injured skin or mucosa via contaminated feces from insect vectors like Triatoma dimidiata (Latreille, 1811). Currently, there is insufficient information describing the immune response to feces naturally contaminated with metacyclic trypomastigotes. Mice subcutaneously inoculated with tissue-culture derived trypomastigotes (TCT) or T. dimidiata feces containing metacyclic trypomastigotes (MT) or previously multi-exposed (ME) with feces without metacyclic trypomastigotes and then infected with feces containing metacyclic parasites or only T. dimidiata feces (F) was studied from 15 min to three months post-infection. PCR detection of parasite DNA at the inoculation site demonstrated persistence of T. cruzi DNA up to 20 days in MT and TCT but disappeared earlier in the ME test group. A rapid spread of T. cruzi DNA to regional lymph nodes was observed in all experimental groups. A lower amount of amastigote nests in the heart with concomitant intense inflammation was noticed in ME mice in comparison to the MT group. CD4 + T cell subtypes at popliteal lymph nodes shows early Th1 and Th17 responses at seven days in ME mice, whereas Th1, Th17 and Treg predominate in MT mice after three weeks, and feces induces Th1, Th17 and Treg at a later stage. Our study shows that previous exposure to feces prior to infection with T. cruzi helps control parasitism at the inoculation site and in heart tissue, and an early induction of Th1 and Th17 T cell subtypes.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e5"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune thrombocytopenia possibly triggered by multiple tick bites.","authors":"Carlos Ramiro Silva-Ramos, Andrés Eduardo Prieto-Torres, Abraham Katime Zuñiga, Jesús A Cortés-Vecino, Bertha Lacouture Ortiz, Constanza Cuellar, Leidy J Medina-Lozano, Álvaro A Faccini-Martínez","doi":"10.1590/S1678-9946202567001","DOIUrl":"10.1590/S1678-9946202567001","url":null,"abstract":"<p><p>Immune thrombocytopenia (ITP) is an autoimmune hematological condition characterized by a markedly isolated decrease in platelets without any apparent associated clinical conditions, resulting in bleeding and bruising of the skin, mucous membranes, and major organs. It is often triggered by preceding illness or several immune stimulants such as immunizations, infections, allergic reactions, among others. While uncommon, arthropod bites can trigger acute ITP. Four cases have been reported due to bee stings and insect bites, as well as a case of ITP following honeybee-venom therapy. Here, we report a case of acute ITP possibly triggered by multiple tick bites.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e1"},"PeriodicalIF":1.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of two-dose schedule of COVID-19 adsorbed inactivated vaccine (CoronaVac; Sinovac/Butantan) and heterologous additional doses of mRNA BNT162b2 (Pfizer/BioNTech) in immunocompromised and immunocompetent individuals.","authors":"Karina Takesaki Miyaji, Karim Yaqub Ibrahim, Vanessa Infante, Raquel Megale Moreira, Carolina Ferreira Dos Santos, Juliana de Cássia Belizário, Maria Isabel de Moraes Pinto, Ana Karolina Barreto Berselli Marinho, Juliana Marquezi Pereira, Liliane Saraiva de Mello, Vitor Gabriel Lopes da Silva, Paula Keiko Sato, Tânia Mara Varejão Strabelli, Lucas Ragiotto, Pedro Henrique Theotonio de Mesquita Pacheco, Patricia Emilia Braga, Ana Paula Loch, Alexander Roberto Precioso, Ana Marli Christovam Sartori, João Ítalo França, Marcos Alves de Lima, Mauricio Cesar Sampaio Ando, Camila Cristina Martini Rodrigues, Alice Tung Wan Song, Amanda Nazareth Lara, Ana Cristina Belizário, Anna Helena Simões Bortulucci de Lima, Ariane Cristina Barboza Zanetti, Audrey Rose da Silveira Amancio de Paulo, Barbara Miranda Dos Santos Rosa, Bruna Del Guerra de Carvalho Moraes, Bruna Ribeiro de Oliveira, Camila de Melo Picone, Carolina Sanches Aranda, Carolinne Paioli Troli, Cristina M Kokron, Debora Raquel Benedita Terrabuio, Edson Abdala, Elias David Neto, Érika Yoshie Shimoda Nakanishi, Fabiana Mascarenhas Souza Lima, Fabio Batista Firmino, Fernanda Barone Alves Dos Santos, Fernando Bacal, Giancarlo Fatobene, Jaqueline Oliveira Santana, Jorge Kalil, Julia Barbosa, Leandro Peres Gonçalves, Leonardo Jun Otuyama, Ligia Camera Pierrotti, Livia Caroline Mariano Compte, Livia Marinho, Livia Netto Chaer, Luis Fernando Seguro, Luiz Sergio Azevedo, Márcia Aiko Ueda, Maria Teresa Terreri, Myrthes Anna Maragna Toledo Barros, Octávio Grecco, Odeli Nicole Encinas Sejas, Priscila Tavares Musqueira, Raquel Keiko de Luca Ito, Samia Silveira Souza Teixeira, Serafim Fidalgo, Silvia Figueiredo Costa, Silvia Vidal Campos, Tamiris Hinsching Fernandes, Vanderson Geraldo Rocha, Vivian Caso Coelho","doi":"10.1590/S1678-9946202567002","DOIUrl":"10.1590/S1678-9946202567002","url":null,"abstract":"<p><p>Immunocompromised individuals were considered high-risk for severe disease due to SARS COV-2 infection. This study aimed to describe the safety of two doses of COVID-19 adsorbed inactivated vaccine (CoronaVac; Sinovac/Butantan), followed by additional doses of mRNA BNT162b2 (Pfizer/BioNTech) in immunocompromised (IC) adults, compared to immunocompetent/healthy (H) individuals. This phase 4, multicenter, open label study included solid organ transplant and hematopoietic stem cell transplant recipients, cancer patients and people with inborn errors of immunity with defects in antibody production, rheumatic, end-stage chronic kidney or liver disease, who were enrolled in the IC group. Participants received two doses of CoronaVac and additional doses of mRNA BNT162b2. Adverse reactions (AR) data were collected within seven days after each vaccination. Serious adverse events and of special interest (AESI) were monitored throughout the study. We included 241 immunocompromised and 100 immunocompetent subjects. Arthralgia, fatigue, myalgia, and nausea were more frequent in the IC group after CoronaVac. Following the first additional dose of mRNA BNT162, pain, induration, and tenderness at injection site, fatigue and myalgia were more frequent in the H group. A heart transplant recipient had a graft rejection temporally associated with the second CoronaVac dose, but there was no literature evidence of causal association. Four cases of AESI were considered related to the vaccine: three erythema multiforme after CoronaVac, all in IC participants, and one paresthesia after mRNA, in a H participant. Our findings were comparable to other studies that evaluated the safety of COVID-19 vaccines in different immunocompromised populations. Both vaccines were safe for immunocompromised participants.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e2"},"PeriodicalIF":1.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}