GRAF SANTOS, JERÓNIMO
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GRAF SANTOS, JERÓNIMO
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jgraf@udd.cl
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7102778326

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Platelet Count in Patients with Mild Disease at Admission is Associated with Progression to Severe Hantavirus Cardiopulmonary Syndrome

2019 , LOPEZ HERNANDEZ, RENE RAMON , Mario Calvo , VIAL COX, MARIA CECILIA , Marcela Ferrés , GRAF SANTOS, JERÓNIMO , Gregory Mertz , Analía Cuiza , Begonia Agüero , Dante Aguilera , Diego Araya , Ignacia Pailamilla , Flavia Paratori , Víctor Torres-Torres , VIAL CLARO, PABLO AGUSTIN , DELGADO BECERRA, OROZIMBA IRIS

Background: Hantavirus cardiopulmonary syndrome (HCPS) has a mortality up to 35–40% and its treatment is mainly supportive. A variable to predict progression from mild to severe disease is unavailable. This study was performed in patients with documented infection by Andes orthohantavirus, and the aim was to find a simple variable to predict progression to moderate/severe HCPS in patients with mild disease at admission. Methods: We performed a retrospective analysis of 175 patients between 2001 and 2018. Patients were categorized into mild, moderate, and severe disease according to organ failure and advanced support need at hospital admission (e.g., mechanical ventilation, vasopressors). Progression to moderate/severe disease was defined accordingly. Clinical and laboratory variables associated with progression were explored. Results: Forty patients with mild disease were identified; 14 of them progressed to moderate/severe disease. Only platelet count was different between those who progressed versus those that did not (37 (34–58) vs. 83 (64–177) K/mm3, p < 0.001). A ROC curve analysis showed an AUC = 0.889 (0.78–1.0) p < 0.001, with a platelet count greater than 115K /mm3 ruling out progression to moderate/severe disease. Conclusions: In patients with mild disease at presentation, platelet count could help to define priority of evacuation to tertiary care centers.

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A non-randomized multicentre trial of human immune plasma for treatment of hantavirus cardiopulmonary syndrome caused by Andes virus

2015 , VIAL CLARO, PABLO AGUSTIN , Francisca Valdivieso , Mario Calvo , M Luisa Rioseco , Raul Riquelme , Andres Araneda , Vinko Tomicic , GRAF SANTOS, JERÓNIMO , Laura Paredes , Matias Florenzano , Teresa Bidart , Analia Cuiza , Claudia Marco , Brian Hjelle , Chunyan Ye , Diane Hanfelt-Goade , VIAL COX, MARIA CECILIA , Juan C Rivera , DELGADO BECERRA, OROZIMBA IRIS , Gregory J Mertz

Background In Chile, Andes virus (ANDV) is the sole aetiological agent of hantavirus cardiopulmonary syndrome (HCPS) with mean annual incidence of 55 cases, 32% case fatality rate (CFR) and no specific treatment. Neutralizing antibody (NAb) titres at hospital admission correlate inversely with HCPS severity. We designed an open trial to explore safety and efficacy and evaluate pharmacokinetics of immune plasma as a treatment strategy for this disease. Methods We performed plasmapheresis on donors at least 6 months after HCPS and measured NAb titres through a focus-reduction neutralization test. Subjects admitted to 10 study sites with suspected/confirmed HCPS were eligible for treatment with immune plasma by intravenous infusion at an ANDV NAb dose of 5,000 U/kg. HCPS was confirmed through immunoglobulin M serology or reverse transcriptase-PCR. The main outcome was mortality within 30 days. Results From 2008–2012, we enrolled and treated 32 cases and confirmed HCPS in 29. CFR of hantavirus plasma-treated cases was 4/29 (14%); CFR of non-treated cases in the same period in Chile was 63/199 (32%; P=0.049, OR=0.35, CI=0.12, 0.99); CFR of non-treated cases at the same study sites between 2005–2012 was 18/66 (27%; ( P=0.15, OR=0.43, CI=0.14, 1.34) and CFR in a previous methylprednisolone treatment study was 20/60 (33%; P=0.052, OR=0.32, CI=0.10, 1.00). We detected no serious adverse events associated to plasma infusion. Plasma NAb titres reached in recipients were variable and viral load remained stable. Conclusions Human ANDV immune plasma infusion appears safe for HCPS. We observed a decrease in CFR in treated cases with borderline significance that will require further studies for confirmation.

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Viral shedding and viraemia of Andes virus during acute hantavirus infection: a prospective study

2024 , Marcela Ferrés , Constanza Martínez-Valdebenito , Carolina Henriquez , Claudia Marco , Jenniffer Angulo , Aldo Barrera , Carlos Palma , Gonzalo Barriga Pinto , Analia Cuiza , Leonila Ferreira , María Luisa Rioseco , Mario Calvo , Ricardo Fritz , Sebastián Bravo , Alejandro Bruhn , Jerónimo Graf , Alvaro Llancaqueo , Gonzalo Rivera , Carolina Cerda , Nicole Tischler , Francisca Valdivieso , VIAL CLARO, PABLO AGUSTIN , Gregory Mertz , VIAL COX, MARIA CECILIA , Nicole Le Corre

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Proteinuria in Hantavirus Cardiopulmonary Syndrome: A Frequent Finding Linked To Mortality

2021 , LOPEZ HERNANDEZ, RENE RAMON , Gregory Mertz , GRAF SANTOS, JERÓNIMO , Mauricio Espinoza , Marcela Ferrés , Mario Calvo , VIAL CLARO, PABLO AGUSTIN , VIAL COX, MARIA CECILIA

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