PAULO HENRIQUE BRAZ DA SILVA
Projetos de Pesquisa
Unidades Organizacionais
ODE, FO - Docente
LIM/52 - Laboratório de Virologia, Hospital das Clínicas, Faculdade de Medicina
LIM/52 - Laboratório de Virologia, Hospital das Clínicas, Faculdade de Medicina
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- Torquetenovirus: predictive biomarker or innocent bystander in pathogenesis(2023) TOZETTO-MENDOZA, Tania Regina; BRAZ-SILVA, Paulo Henrique; GIANNECCHINI, Simone; WITKIN, Steven S.
- COVID-19 salivary signature: diagnostic and research opportunities(2021) SAPKOTA, Dipak; SOLAND, Tine Merete; GALTUNG, Hilde Kanli; SAND, Lars Peter; GIANNECCHINI, Simone; TO, Kelvin K. W.; MENDES-CORREA, Maria Cassia; GIGLIO, Daniel; HASSEUS, Bengt; BRAZ-SILVA, Paulo HenriqueThe COVID-19 (caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) epidemic started in Wuhan (Hubei Province, China) in mid-December 2019 and quickly spread across the world as a pandemic. As a key to tracing the disease and to implement strategies aimed at breaking the chain of disease transmission, extensive testing for SARS-CoV-2 was suggested. Although nasopharyngeal/oropharyngeal swabs are the most commonly used biological samples for SARS-CoV-2 diagnosis, they have a number of limitations related to sample collection and healthcare personnel safety. In this context, saliva is emerging as a promising alternative to nasopharyngeal/oropharyngeal swabs for COVID-19 diagnosis and monitoring. Saliva collection, being a non-invasive approach with possibility for self-collection, circumvents to a great extent the limitations associated with the use of nasopharyngeal/oropharyngeal swabs. In addition, various salivary biomarkers including the salivary metabolomics offer a high promise to be useful for better understanding of COVID-19 and possibly in the identification of patients with various degrees of severity, including asymptomatic carriers. This review summarises the clinical and scientific basis for the potential use of saliva for COVID-19 diagnosis and disease monitoring. Additionally, we discuss saliva-based biomarkers and their potential clinical and research applications related to COVID-19.
- Lack of direct association between oral mucosal lesions and SARS-CoV-2 in a cohort of patients hospitalised with COVID-19(2022) SCHWAB, Gabriela; PALMIERI, Michelle; ZERBINATI, Rodrigo M.; SARMENTO, Dmitry J. S.; REIS, Thais; ORTEGA, Karem L.; KANO, Italo T.; V, Rafael A. Caixeta; HASSEUS, Bengt; SAPKOTA, Dipak; JUNGES, Roger; GIANNECCHINI, Simone; COSTA, Andre L. F.; JALES, Sumatra M. C. P.; LINDOSO, Jose A. L.; GALLO, Camila Barros; BRAZ-SILVA, Paulo H.Background COVID-19 is a disease affecting various human organs and systems, in which the virus seeks to interact with angiotensin-converting enzyme 2 receptors. These receptors are present in the oral cavity, but the direct relationship between such an interaction and possible oral manifestations of COVID-19 is still unclear. Aim The present study evaluated oral manifestations in a cohort of COVID-19 patients during the period of hospitalisation. Methods In total, 154 patients presenting moderate-to-severe forms of COVID-19 had their oral mucosa examined twice a week until the final outcome, either discharge or death. The oral alterations observed in the patients were grouped into Group 1 (pre-existing conditions and opportunistic oral lesions) and Group 2 (oral mucosal changes related to hospitalization). Results Oral lesions found in the patients of Group 1 are not suggestive of SARS-CoV-2 infection as they are mainly caused by opportunistic infections. On the other hand, oral alterations found in the patients of Group 2 were statistically (P < 0.001) related to intubation and longer period of hospitalisation. Conclusion It is unlikely that ulcerative lesions in the oral cavity are a direct manifestation of SARS-CoV-2 or a marker of COVID-19 progression.
- Use of saliva and RT-PCR screening for SARS-CoV-2 variants of concern: Surveillance and monitoring(2022) ZERBINATI, Rodrigo Melim; PALMIERI, Michelle; SCHWAB, Gabriela; FELIX, Alvina Clara; MARTINHO, Herculano; GIANNECCHINI, Simone; TO, Kelvin Kai-Wang; LINDOSO, Jose Angelo Lauletta; ROMANO, Camila Malta; BRAZ-SILVA, Paulo HenriqueGenomic surveillance has been applied since the beginning of the COVID-19 pandemic to track the spread of the virus, leading to the characterization of multiple SARS-CoV-2 variants, including variants of concern (VOC). Although sequencing is the standard method, a rapid molecular test for screening and surveillance of VOC is considered for detection. Furthermore, using alternative saliva as specimen collection facilitates the implementation of a less invasive, self-collected sample. In this study, we applied a combinatory strategy of saliva collection and reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 VOC detection. Saliva samples from patients attending a tertiary hospital with suspected COVID-19 were collected and SARS-CoV-2 RNA was detected using SARS-CoV-2 RT-qPCR reagent kit (PerkinElmer). Positive saliva samples were screened for SARS-CoV-2 VOC with previously described RT-PCR for Alpha, Beta, and Gamma variants. Saliva samples were positive in 171 (53%) of 324 tested. A total of 108 (74%) from positive samples were also positive for VOC by RT-PCR screening. Those samples were found between January and August 2021. This approach allowed us to successfully use an alternative and complementary tool to genomic surveillance to monitor the circulation of SARS-CoV-2 VOC in the studied population.
- SARS-CoV-2: What can saliva tell us?(2021) BRAZ-SILVA, Paulo Henrique; PALLOS, Debora; GIANNECCHINI, Simone; TO, Kelvin Kai-Wang
- MALDI-TOF mass spectrometry of saliva samples as a prognostic tool for COVID-19(2022) LAZARI, Lucas C.; ZERBINATI, Rodrigo M.; ROSA-FERNANDES, Livia; SANTIAGO, Veronica Feijoli; ROSA, Klaise F.; ANGELI, Claudia B.; SCHWAB, Gabriela; PALMIERI, Michelle; SARMENTO, Dmity J. S.; MARINHO, Claudio R. F.; ALMEIDA, Janete Dias; TO, Kelvin; GIANNECCHINI, Simone; WRENGER, Carsten; SABINO, Ester C.; MARTINHO, Herculano; LINDOSO, Jose A. L.; DURIGON, Edison L.; BRAZ-SILVA, Paulo H.; PALMISANO, GiuseppeBackground The SARS-CoV-2 infections are still imposing a great public health challenge despite the recent developments in vaccines and therapy. Searching for diagnostic and prognostic methods that are fast, low-cost and accurate are essential for disease control and patient recovery. The MALDI-TOF mass spectrometry technique is rapid, low cost and accurate when compared to other MS methods, thus its use is already reported in the literature for various applications, including microorganism identification, diagnosis and prognosis of diseases. Methods Here we developed a prognostic method for COVID-19 using the proteomic profile of saliva samples submitted to MALDI-TOF and machine learning algorithms to train models for COVID-19 severity assessment. Results We achieved an accuracy of 88.5%, specificity of 85% and sensitivity of 91.5% for classification between mild/moderate and severe conditions. When we tested the model performance in an independent dataset, we achieved an accuracy, sensitivity and specificity of 67.18, 52.17 and 75.60% respectively. Conclusion Saliva is already reported to have high inter-sample variation; however, our results demonstrates that this approach has the potential to be a prognostic method for COVID-19. Additionally, the technology used is already available in several clinics, facilitating the implementation of the method. Further investigation using a larger dataset is necessary to consolidate the technique.
- Performance of at-home self-collected saliva and nasal-oropharyngeal swabs in the surveillance of COVID-19(2021) BRAZ-SILVA, Paulo H.; MAMANA, Ana C.; ROMANO, Camila M.; FELIX, Alvina C.; V, Anderson de Paula; FEREIRA, Noeli E.; BUSS, Lewis F.; TOZETTO-MENDOZA, Tania R.; V, Rafael A. Caixeta; LEAL, Fabio E.; GRESPAN, Regina M. Z.; BIZARIO, Joao C. S.; FERRAZ, Andrea B. C.; SAPKOTA, Dipak; GIANNECCHINI, Simone; TO, Kelvin K.; DOGLIO, Alain; MENDES-CORREA, Maria C.Background: SARS-CoV-2 quickly spreads in the worldwide population, imposing social restrictions to control the infection, being the massive testing another essential strategy to break the chain of transmission. Aim: To compare the performance of at-home self-collected samples - saliva and combined nasal-oropharyngeal swabs (NOP) - for SARS-CoV-2 detection in a telemedicine platform for COVID-19 surveillance. Material and methods: We analyzed 201 patients who met the criteria of suspected COVID-19. NOP sampling was combined (nostrils and oropharynx) and saliva collected using a cotton pad device. Detection of SARS-COV-2 was performed by using the Altona RealStar (R) SARS-CoV-2 RT-PCR Kit 1.0. Results: There was an overall significant agreement (kappa coefficient value of 0.58) between saliva and NOP. Considering results in either sample, 70 patients positive for SARS-CoV-2 were identified, with 52/70 being positive in NOP and 55/70 in saliva. This corresponds to sensitivities of 74.2% (95% CI; 63.7% to 83.1%) for NOP and 78.6% (95% CI; 67.6% to 86.6%) for saliva. Conclusion: Our data show the feasibility of using at-home self-collected samples (especially saliva), as an adequate alternative for SARS-CoV-2 detection. This new approach of testing can be useful to develop strategies for COVID-19 surveillance and for guiding public health decisions.
- Detection of polyomavirus microRNA-5p expression in saliva shortly after kidney transplantation(2021) MAMANA, Ana Carolina; STINCARELLI, Maria; SARMENTO, Dmitry Jose De Santana; BATISTA, Alexandre Mendes; TOZETTO-MENDOZA, Tania Regina; GALLOTTINI, Marina; PESTANA, Jose Osmar Medina De Abreu; BRAZ-SILVA, Paulo Henrique; GIANNECCHINI, SimoneBackground: MicroRNAs (miRNAs) of polyomavirus (PyV) are present in several biological fluids and are suggested to be relevant viral factors for monitoring its persistence. Aim: To evaluate the effect of an immunosuppressive regimen on the status of PyV-miRNA-5p in the oral cavity. Materials and Methods: The JCPyV, BKPyV, MCPyV miRNA-5p were investigated in paired saliva and plasma samples obtained from 23 patients before and shortly after renal-transplantation by using real-time RT-PCR. Results: Overall, within a short-time after transplantation, patients exhibited decreased numbers of leukocyte and lymphocyte as well as low levels of creatinine. During the clinical management of the patients, a significant amount of saliva samples were positive for JCPyV and BKPyV miRNA-5p (range: 26%-91%) compared to paired plasma samples (range: 9%-35%). Among the two polyomaviruses showing positive expression of miRNA-5p, BKPyV presented the highest positivity in saliva (91%) and MCPyV-miRNA-5p was constantly negative in both saliva and plasma samples. Compared to the time before transplantation, a significant reduction in the expression of JCPyV-miRNA-5p was observed in saliva samples obtained after transplantation. Conclusions: Altogether, these data suggest that additional investigations of polyomavirus miRNA-5p in saliva should be performed shortly after renal-transplantation to evaluate the potential role in early viral reactivation.
- Factors associated with death due to severe acute respiratory syndrome caused by influenza: Brazilian population study(2022) MORAIS, Richarlisson B. de; SHIMABUKURO, Patricia M. S.; GONCALVES, Thayna M.; HIRAKI, Karen R. N.; BRAZ-SILVA, Paulo H.; GIANNECCHINI, Simone; TO, Kelvin K. W.; BARBOSA, Dulce A.; TAMINATO, MonicaIntroduction: Influenza infection is characterized by acute viral infection of high transmissibility. Worsening of the case can lead to the need for hospitalization, severe acute respiratory syndrome (SARS) and even death. Method: This is a cross-sectional population-based study that used secondary database from the Brazilian Influenza Epidemiological Surveillance Information System. Only cases of adults with diagnosis of influenza by RT-PCR and case evolution recorded were included. Results: We identified 2273 adults with SARS by influenza, 343 of which had death as an outcome. The main risk factors for death were lack of hospitalization, not having cough and age, both with p < 0.001. In addition, without asthma, having black skin color, not receiving flu vaccine, having brown skin color and not having a sore throat (p <= 0.005) were risk factors too. Conclusion: Factors associated with death due to SARS caused by influenza in Brazil, risk factors and protective factors to death were identified. It was evident that those who did not receive the flu vaccine presented twice the risk of unfavorable outcome, reinforcing the need to stimulate adherence to vaccination adhering and propose changes in public policies to make influenza vaccines available to the entire population, in order to prevent severe cases and unfavorable outcomes. (c) 2022 The Authors.
- Severe acute respiratory syndrome by influenza and factors associated with death in older adults: a population study(2023) GONCALVES, Thayna Martins; SHIMABUKURO, Patricia Mitsue Saruhashi; HIRAKI, Karen Renata Nakamura; BRAZ-SILVA, Paulo Henrique; GIANNECCHINI, Simone; TO, Kelvin Kai-Wang; TAMINATO, Monica; MORAIS, Richarlisson Borges deIntroduction: Influenza is characterized by an acute viral infection, which can lead to severe conditions and death, especially in vulnerable populations, such as older adults. Therefore, we sought to analyze cases of severe acute respiratory syndrome (SARS) due to influenza in older adults registered in Brazil and investigate the factors related to death due to this disease.Methodology: This is a cross-sectional, population-based study that used secondary data from the Influenza Epidemiological Surveillance Information System (IESIS-Influenza). Older adults aged 60 years and above with laboratory diagnosis of influenza were included.Results: A total of 3,547 older adults with SARS due to influenza were included, out of which 1,185 cases with death as the outcome were identified. Among older adults with death as the outcome, 87.4% were not vaccinated against influenza. The main risk factors for death were invasive ventilatory support use, intensive care unit admission, brown skin color and dyspnea (p < 0.001).Conclusions: This study described the profile of older adults with SARS due to influenza in Brazil. Factors associated with death in this population were identified. Moreover, the need to encourage compliance with vaccination among older adults is evident in order to prevent severe cases and unfavorable outcomes related to influenza.