Dados do Trabalho

Título

Rotavirus A, norovirus, sapovirus, SARS-CoV-2 frequency and genetic susceptibility in children up to 3 years old, living in the Northwestern Amazon region, presenting acute gastroenteritis or acute respiratory infection.

Objetivos(s)

Evaluate the frequency of gastroenteric viruses (Rotavirus A_RVA, norovirus and Sapovirus_SaV) and severe acute respiratory syndromes caused by coronavirus 2 (SARS-CoV-2) in children ≤3 years old presenting AGE (acute gastroenteritis) or ARI (acute respiratory infection), living in the Northwestern Amazon region (NWAR), and an eventual association with genetic susceptibility.

Relato do Caso

In this study, an epidemiological inquiry was carried out with young children under 3 years of age living in the NWAR, verifying the frequency of the main causers of AGE as well as SARS-CoV-2. AGE as a clinical symptom and genetic factors associated with the comorbidities of hypertension and Type 1 diabetes (T1D) were verified as a risk for COVID-19. Combinations of polymorphisms in the ACE (angiotensin-converting enzyme)1 I/D and ACE2 G8780A genes were verified for hypertension and the secretor status (FUT_Fucosyltransferase 2 gene) was verified for T1D through phenotyping/Enzyme-Linked Immunosorbent Array. 202 fecal and 202 saliva samples were collected from 202 children presenting AGE or ARI. RVA, norovirus, SaV and SARS-CoV-2 were investigated by Reverse transcription-quantitative polymerase chain reaction (RT-qPCR); while polymorphisms on the ACE1 I/D (rs4646994) and ACE2 G8780A (rs2285666) genes were investigated by SYBR GREEN Real time PCR and PCR/Alul digestion, respectively. Secretor and Lewis status of the Histo blood group antigen (HBGA) through phenotyping/ELISA. Odds rate (OR) was applied for the association measurement. Frequencies for the AGE group: norovirus 39.6% (40/101) (OR = 2.66; 95% CI-1.41-5.0; P 0.0024); RVA and SARS-CoV-2 8.9% (9/101) each; SaV 4.9% (5/101); ARI group: norovirus 19.8% (20/101); RVA 13.9% (14/101); SARS-CoV-2 2.9% (3/101); SaV 7.9% (8/101). The ACE1 (rs4646994) I/I homozygous polymorphism was predominant in relation to the I/D and D/D profiles. The frequencies of the ACE2 SNP (rs2285666) differed between male and female. Males with the rs2285666 SNP were more susceptible to ARI symptoms than AGE (OR = 3.85; 95% CI-1.42-10.38; P 0.007). No significant clinical association was observed for the combination of the ACE1 ID + ACE2 G8780A polymorphisms. Children were predominantly of the secretor phenotype (92.6%; 187/202).

Conclusão

Norovirus is the predominant causative agent of AGE in children from the NWAR.
The low frequencies of SARS-CoV-2 did not render statistical associations with AGE and with
the investigated genetic factors.