SANDRA GOFINET PASOTO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina

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Autor: PASOTO, S. G. × search.filters.applied.f.dateIssued: 2021 ×

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  • article 24 Citação(ões) na Scopus
    Influence of the age at diagnosis in the disease expression of primary Sjogren's syndrome. Analysis of 12,753 patients from the Sjogren Big Data Consortium
    (2021) RETAMOZO, S.; ACAR-DENIZLI, N.; HORVATH, I. F.; NG, W-F; RASMUSSEN, A.; DONG, X.; LI, X.; BALDINI, C.; OLSSON, P.; PRIORI, R.; SEROR, R.; GOTTENBERG, J-E; KRUIZE, A. A.; HERNANDEZ-MOLINA, G.; VISSINK, A.; SANDHYA, P.; ARMAGAN, B.; QUARTUCCIO, L.; SEBASTIAN, A.; PRAPROTNIK, S.; BARTOLONI, E.; KWOK, S-K; KVARNSTROM, M.; RISCHMUELLER, M.; SOLANS-LAQUE, R.; SENE, D.; PASOTO, S. G.; SUZUKI, Y.; ISENBERG, D. A.; VALIM, V.; NORDMARK, G.; NAKAMURA, H.; TREVISANI, V Fernandes Moca; HOFAUER, B.; SISO-ALMIRALL, A.; GIACOMELLI, R.; DEVAUCHELLE-PENSEC, V; BOMBARDIERI, M.; ATZENI, F.; HAMMENFORS, D.; MAURE, B.; CARSONS, S. E.; GHEITA, T.; SANCHEZ-BERNA, I; LOPEZ-DUPLA, M.; MOREL, J.; INANC, N.; FONSECA-AIZPURU, E.; MORCILLO, C.; VOLLENWEIDER, C.; MELCHOR, S.; VAZQUEZ, M.; DIAZ-CUIZA, E.; CONSANI-FERNANDEZ, S.; DE-MIGUEL-CAMPO, B.; SZANTO, A.; BOMBARDIERI, S.; GATTAMELATA, A.; HINRICHS, A.; SANCHEZ-GUERRERO, J.; DANDA, D.; KILIC, L.; VITA, S. de; WILAND, P.; GERLI, R.; PARK, S-H; WAHREN-HERLENIUS, M.; BOOTSMA, H.; MARIETTE, X.; RAMOS-CASALS, M.; BRITO-ZERON, P.
    Objective. To analyse how the main components of the disease phenotype (sicca symptoms, diagnostic tests, immunological markers and systemic disease) can be driven by the age at diagnosis of primary Sjogren's syndrome (pSS). Methods. By January 2021, the participant centres had included 12,753 patients from 25 countries that fulfilled the 2002/2016 classification criteria for pSS. The age at diagnosis was defined as the time when the attending physician confirmed fulfilment of the criteria. Patients were clustered according to age at diagnosis. 50 clusters with more than 100 observations (from 27 to 76 years) were used to study the influence of the age at diagnosis in the disease expression. Results. There was a consistent increase in the frequency of oral dryness according to the age at diagnosis, with a frequency of <90% in patients diagnosed at the youngest ages and >95% in those diagnosed at the oldest ages. The smooth curves that best fitted a linear model were the frequency of dry mouth (adjusted R-2 0.87) and the frequency of abnormal oral tests (adjusted R-2 0.72). Therefore, for each 1-year increase in the age at diagnosis, the frequency of dry mouth increased by 0.13%, and the frequency of abnormal oral diagnostic tests by 0.11%. There was a consistent year-by-year decrease in the frequency of all autoantibodies and immunological markers except for cryoglobulins. According to the linear models, for each 1-year increase in the age at diagnosis, the frequency of a positive result decreased by 0.57% (for anti-Ro antibodies), 0.47% (for RF) and 0.42% (for anti-La antibodies). The ESSDAI domains which showed a more consistent decrease were glandular and lymph node involvement (for each 1-year increase in the age at diagnosis, the frequency of activity decreased by 0.18%), and constitutional, cutaneous, and haematological involvements (the frequency decreased by 0.09% for each 1-year increase). In contrast, other domains showed an ascending pattern, especially pulmonary involvement (for each 1-year increase in the age at diagnosis, the frequency of activity increased by 0.22%), and peripheral nerve involvement (the frequency increased by 0.09% for each 1-year increase). Conclusion. The influence of the age at diagnosis on the key phenotypic features of pSS is strong, and should be considered critical not only for designing a personalised diagnostic approach, but also to be carefully considered when analysing the results of diagnostic tests and immunological parameters, and when internal organ involvement is suspected at diagnosis.
  • article 16 Citação(ões) na Scopus
    Post-COVID-19 syndrome in patients with primary Sjogren's syndrome after acute SARS-CoV-2 infection
    (2021) BRITO-ZERON, P.; ACAR-DENIZLI, N.; ROMAO, V. C.; ARMAGAN, B.; SEROR, R.; CARUBBI, F.; MELCHOR, S.; PRIORI, R.; VALIM, V.; RETAMOZO, S.; PASOTO, S. G.; TREVISANI, V. Fernandes Moca; HOFAUER, B.; SZANTO, A.; INANC, N.; HERNANDEZ-MOLINA, G.; SEBASTIAN, A.; BARTOLONI, E.; DEVAUCHELLE-PENSEC, V; AKASBI, M.; GIARDINA, F.; BANDEIRA, M.; SISO-ALMIRALL, A.; RAMOS-CASALS, M.
    Objective. To analyse the frequency and characteristics of post-COVID-19 syndrome in patients with primary Sjogren's syndrome (pSS) affected by acute SARS-CoV-2 infection. Methods. By the first week of April 2021, all centres included in the Big Data Sjogren Consortium were contacted asking for patients included in the Registry diagnosed with SARS-CoV-2 infection according to the ECDC guidelines. According to the NICE definitions, symptoms related to COVID-19 were classified as acute COVID-19 (signs and symptoms for up to 4 weeks), ongoing symptomatic COVID-19 (presence of signs and symptoms from 4 to 12 weeks) and post-COVID-19 syndrome (signs and symptoms that continue for >12 weeks not explained by an alternative diagnosis after a protocolised study). Results. We identified 132 patients who were followed a mean follow-up of 137.8 days (ranging from 5 days to 388 days) after being diagnosed with COVID-19. In the last visit, 75 (57%) patients remained symptomatic: 68 (52%) remained symptomatic for more than 4 weeks fulfilling the NICE definition for ongoing symptomatic postCOVID-19, and 38 (29%) remained symptomatic for more than 12 weeks fulfilling the definition of post-COVID-19 syndrome. More than 40% of pSS patients reported the persistence of four symptoms or more, including anxiety/ depression (59%), arthralgias (56%), sleep disorder (44%), fatigue (40%), anosmia (34%) and myalgias (32%). Age-sex adjusted multivariate analysis identified raised LDH levels (OR 10.36), raised CRP levels (OR 7.33), use of hydroxychloroquine (OR 3.51) and antiviral agents (OR 3.38), hospital admission (OR 8.29), mean length of hospital admission (OR 1.1) and requirement of supplemental oxygen (OR 6.94) as factors associated with a higher risk of developing post-COVID-19 syndrome. A sensitivity analysis including hospital admission in the adjusted model confirmed raised CRP levels (OR 8.6, 95% CI 1.33-104.44) and use of hydroxychloroquine (OR 2.52, 95% CI 1.00-6.47) as the key independent factors associated with an enhanced risk of developing post-COVID-19 syndrome. Conclusion. This is the first study that analyses the frequency and characteristics of post-COVID-19 syndrome in patients affected by a systemic autoimmune disease. We found that 57% of patients with pSS affected by COVID-19 remain symptomatic after a mean follow-up of 5 months. The risk of developing post-COVID-19 syndrome in patients who required hospitalisation was 8-times higher than in non-hospitalised patients, with baseline raised CRP levels and the use of hydroxychloroquine being independent risk factors for postCOVID-19.