Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022

Detalhes bibliográficos
Autor(a) principal: Santos, Angela Maria Guimarães dos
Data de Publicação: 2022
Outros Autores: amgsantoss@gmail.com
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
Texto Completo: http://www.bdtd.uerj.br/handle/1/20951
Resumo: The descriptive and observational study was carried out with the objective of describing the clinical, epidemiological and phylogenetic aspects of patients infected with SARS-COV-2. The study cohort was based on the cases detected by SARS-CoV-2 of patients seen at Policlínica Piquet Carneiro from April 2020 to January 2022. From the registration forms, qRT-PCR results, NGS sequencing, titration of circulating antibodies and neutralizing antibodies, we identified 406 samples that were assigned to the study of geodistribution of lineages within the cohort. Of these, 360 were assigned to the study of the epidemiological profile of professionals treated at the PPC, 22 samples correspond to patients with reinfection and 5 samples from 2 patients with prolonged infection, in which phylogenetic analyzes and immunological profile were performed in the face of vaccination against COVID-19. Of the 406 samples, the dissemination of variants of concern (VOC) was observed in 17 municipalities, the main lineages found were Gamma (P.1), Delta (AY.99.2) and Ômicron (BA.1). Due to the phylogenetic analysis, it was possible to observe a high accumulation of mutations of the Ômicron lineages and the rapid dissemination according to the time of evolution. Within this study, we observed significantly different distributions between the number of substitutions of the Ômicron lineage and circulating antibodies. As for the analysis of professionals, we found that both health professionals and professionals from other areas had high exposure to the virus, but health professionals were the first to be contaminated within this cohort. As for the data from patients with prolonged infection and reinfected, we concluded that both circulating and neutralizing antibodies show a tendency to decrease over time, even with previous immunization due to another infection or vaccination, therefore, booster immunization is essential for the control the circulation of new strains. These data highlight the importance of genomic surveillance that can assist in the screening of new variants and minimize the impacts caused by SARS-CoV-2
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spelling Pôrto, Luís Cristóvão de Moraes Sobrinohttp://lattes.cnpq.br/8153025668900773Oigman, Willehttp://lattes.cnpq.br/4962697729705577Silva, Heitor Evangelista dahttp://lattes.cnpq.br/9179189728013478Medronho, Roberto de Andradehttp://lattes.cnpq.br/3929236898922521Aguiar, Renato Santana dehttp://lattes.cnpq.br/3007026070361272http://lattes.cnpq.br/3431251102361088Santos, Angela Maria Guimarães dosamgsantoss@gmail.com2024-01-18T19:10:28Z2022-08-05SANTOS, Angela Maria Guimarães dos. Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022. 2022. 106 f. Tese (Doutorado em Biologia Humana e Experimental) - Instituto de Biologia Roberto Alcântara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2022.http://www.bdtd.uerj.br/handle/1/20951The descriptive and observational study was carried out with the objective of describing the clinical, epidemiological and phylogenetic aspects of patients infected with SARS-COV-2. The study cohort was based on the cases detected by SARS-CoV-2 of patients seen at Policlínica Piquet Carneiro from April 2020 to January 2022. From the registration forms, qRT-PCR results, NGS sequencing, titration of circulating antibodies and neutralizing antibodies, we identified 406 samples that were assigned to the study of geodistribution of lineages within the cohort. Of these, 360 were assigned to the study of the epidemiological profile of professionals treated at the PPC, 22 samples correspond to patients with reinfection and 5 samples from 2 patients with prolonged infection, in which phylogenetic analyzes and immunological profile were performed in the face of vaccination against COVID-19. Of the 406 samples, the dissemination of variants of concern (VOC) was observed in 17 municipalities, the main lineages found were Gamma (P.1), Delta (AY.99.2) and Ômicron (BA.1). Due to the phylogenetic analysis, it was possible to observe a high accumulation of mutations of the Ômicron lineages and the rapid dissemination according to the time of evolution. Within this study, we observed significantly different distributions between the number of substitutions of the Ômicron lineage and circulating antibodies. As for the analysis of professionals, we found that both health professionals and professionals from other areas had high exposure to the virus, but health professionals were the first to be contaminated within this cohort. As for the data from patients with prolonged infection and reinfected, we concluded that both circulating and neutralizing antibodies show a tendency to decrease over time, even with previous immunization due to another infection or vaccination, therefore, booster immunization is essential for the control the circulation of new strains. These data highlight the importance of genomic surveillance that can assist in the screening of new variants and minimize the impacts caused by SARS-CoV-2O estudo descritivo e observacional foi realizado com o objetivo de descrever os aspectos clínicos e epidemiológicos dos pacientes infectados pelo SARS-CoV-2 assim como os aspectos filogenéticos do vírus. A coorte de estudo foi baseada nos casos detectados por SARS-CoV-2 dos pacientes atendidos na Policlínica Piquet Carneiro nos períodos de abril de 2020 a janeiro de 2022. A partir das fichas de cadastros, resultados de qRT-PCR, sequenciamento por NGS, titulação de anticorpos circulantes e anticorpos neutralizantes, identificamos 406 amostras que foram designadas ao estudo de geodistribuição das linhagens dentro da coorte. Dessas, 360 foram designadas ao estudo do perfil epidemiológico dos profissionais atendidos na PPC, 22 amostras correspondem a pacientes com reinfecção e 5 amostras de 2 pacientes com infecção prolongada, nesses foram realizadas as análises filogenéticas e perfil imunológico diante da vacinação contra a COVID-19. Das 406 amostras foi observada a disseminação de variantes de preocupação (VOC) por 17 municípios, as principais linhagens encontradas foram Gamma (P.1), Delta (AY.99.2) e Ômicron (BA.1). Devido as análises filogenéticas foi possível observar elevado acúmulo de mutações das linhagens Ômicron e a rápida disseminação de acordo com o tempo de evolução. Dentro desse estudo, observamos distribuições significativamente diferentes entre o número de substituições da linhagem Ômicron e anticorpos circulantes. Quanto às análises dos profissionais, constatamos que tanto os profissionais da saúde, quanto os profissionais de outras áreas tiveram alta exposição ao vírus, porém os profissionais da saúde foram os primeiros a se contaminar dentro dessa coorte. Quanto aos dados dos pacientes com infecção prolongada e reinfectados, concluímos que tanto os anticorpos circulantes, quanto os neutralizantes apresentam tendência de queda com o tempo, mesmo com imunização prévia devido a outra infecção ou vacinação, portanto, a imunização de reforço é essencial para o controle da circulação de novas cepas. Esses dados destacam a importância da vigilância genômica que possam auxiliar no rastreamento de novas variantes e minimizar os impactos causados pelo SARS-CoV-2Submitted by Felipe CB/A (felipebibliotecario@gmail.com) on 2024-01-18T19:10:28Z No. of bitstreams: 1 Tese - Angela Maria Guimarães dos Santos - 2022 - Completa.pdf: 3989279 bytes, checksum: 3b94bc3ab3ed123a869df8478eb31a7e (MD5)Made available in DSpace on 2024-01-18T19:10:28Z (GMT). No. of bitstreams: 1 Tese - Angela Maria Guimarães dos Santos - 2022 - Completa.pdf: 3989279 bytes, checksum: 3b94bc3ab3ed123a869df8478eb31a7e (MD5) Previous issue date: 2022-08-05application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Biologia Humana e ExperimentalUERJBrasilCentro Biomédico::Instituto de Biologia Roberto Alcantara GomesNext generation sequencingVariant of concernGenomic analysisEpidemiologyAntibody anti SARS-CoV-2COVID-19 (Doença) – EpidemiologiaCOVID-19 (Doença) – Aspectos genéticosBiologia molecularReações antígeno-anticorpoCOVID-19, Pandemia de, 2020Sequenciamento de nova geraçãoVariante de preocupaçãoAnálise genômicaEpidemiologiaAnticorpo anti SARS-CoV-2CIENCIAS DA SAUDE::SAUDE COLETIVADinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022Dynamics of SARS-CoV-2 variants and the different phenotypes of COVID-19 in a cohort of patients seen at Policlínica Piquet Carneiro from April 2020 to January 2022info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTese - Angela Maria Guimarães dos Santos - 2022 - Completa.pdfTese - Angela Maria Guimarães dos Santos - 2022 - Completa.pdfapplication/pdf3989279http://www.bdtd.uerj.br/bitstream/1/20951/2/Tese+-+Angela+Maria+Guimar%C3%A3es+dos+Santos+-+2022+-+Completa.pdf3b94bc3ab3ed123a869df8478eb31a7eMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/20951/1/license.txte5502652da718045d7fcd832b79fca29MD511/209512024-02-26 15:24:05.136oai:www.bdtd.uerj.br:1/20951Tk9UQTogTElDRU7Dh0EgUkVERSBTSVJJVVMKRXN0YSBsaWNlbsOnYSBkZSBleGVtcGxvIMOpIGZvcm5lY2lkYSBhcGVuYXMgcGFyYSBmaW5zIGluZm9ybWF0aXZvcy4KCkxJQ0VOw4dBIERFIERJU1RSSUJVScOHw4NPIE7Dg08tRVhDTFVTSVZBCgpDb20gYSBhcHJlc2VudGHDp8OjbyBkZXN0YSBsaWNlbsOnYSwgdm9jw6ogKG8gYXV0b3IgKGVzKSBvdSBvIHRpdHVsYXIgZG9zIGRpcmVpdG9zIGRlIGF1dG9yKSBjb25jZWRlIMOgIFVuaXZlcnNpZGFkZSAKZG8gRXN0YWRvIGRvIFJpbyBkZSBKYW5laXJvIChVRVJKKSBvIGRpcmVpdG8gbsOjby1leGNsdXNpdm8gZGUgcmVwcm9kdXppciwgIHRyYWR1emlyIChjb25mb3JtZSBkZWZpbmlkbyBhYmFpeG8pLCBlL291IApkaXN0cmlidWlyIGEgc3VhIHRlc2Ugb3UgZGlzc2VydGHDp8OjbyAoaW5jbHVpbmRvIG8gcmVzdW1vKSBwb3IgdG9kbyBvIG11bmRvIG5vIGZvcm1hdG8gaW1wcmVzc28gZSBlbGV0csO0bmljbyBlIAplbSBxdWFscXVlciBtZWlvLCBpbmNsdWluZG8gb3MgZm9ybWF0b3Mgw6F1ZGlvIG91IHbDrWRlby4KClZvY8OqIGNvbmNvcmRhIHF1ZSBhIFVFUkogcG9kZSwgc2VtIGFsdGVyYXIgbyBjb250ZcO6ZG8sIHRyYW5zcG9yIGEgc3VhIHRlc2Ugb3UgZGlzc2VydGHDp8OjbyAKcGFyYSBxdWFscXVlciBtZWlvIG91IGZvcm1hdG8gcGFyYSBmaW5zIGRlIHByZXNlcnZhw6fDo28uCgpWb2PDqiB0YW1iw6ltIGNvbmNvcmRhIHF1ZSBhIFVFUkogcG9kZSBtYW50ZXIgbWFpcyBkZSB1bWEgY8OzcGlhIGEgc3VhIHRlc2Ugb3UgCmRpc3NlcnRhw6fDo28gcGFyYSBmaW5zIGRlIHNlZ3VyYW7Dp2EsIGJhY2stdXAgZSBwcmVzZXJ2YcOnw6NvLgoKVm9jw6ogZGVjbGFyYSBxdWUgYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvIMOpIG9yaWdpbmFsIGUgcXVlIHZvY8OqIHRlbSBvIHBvZGVyIGRlIGNvbmNlZGVyIG9zIGRpcmVpdG9zIGNvbnRpZG9zIApuZXN0YSBsaWNlbsOnYS4gVm9jw6ogdGFtYsOpbSBkZWNsYXJhIHF1ZSBvIGRlcMOzc2l0byBkYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvIG7Do28sIHF1ZSBzZWphIGRlIHNldSAKY29uaGVjaW1lbnRvLCBpbmZyaW5nZSBkaXJlaXRvcyBhdXRvcmFpcyBkZSBuaW5ndcOpbS4KCkNhc28gYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvIGNvbnRlbmhhIG1hdGVyaWFsIHF1ZSB2b2PDqiBuw6NvIHBvc3N1aSBhIHRpdHVsYXJpZGFkZSBkb3MgZGlyZWl0b3MgYXV0b3JhaXMsIHZvY8OqIApkZWNsYXJhIHF1ZSBvYnRldmUgYSBwZXJtaXNzw6NvIGlycmVzdHJpdGEgZG8gZGV0ZW50b3IgZG9zIGRpcmVpdG9zIGF1dG9yYWlzIHBhcmEgY29uY2VkZXIgw6AgVUVSSiBvcyBkaXJlaXRvcyBhcHJlc2VudGFkb3MgbmVzdGEgbGljZW7Dp2EsIGUgcXVlIGVzc2UgbWF0ZXJpYWwgZGUgcHJvcHJpZWRhZGUgZGUgdGVyY2Vpcm9zIGVzdMOhIGNsYXJhbWVudGUgCmlkZW50aWZpY2FkbyBlIHJlY29uaGVjaWRvIG5vIHRleHRvIG91IG5vIGNvbnRlw7pkbyBkYSB0ZXNlIG91IGRpc3NlcnRhw6fDo28gb3JhIGRlcG9zaXRhZGEuCgpDQVNPIEEgVEVTRSBPVSBESVNTRVJUQcOHw4NPIE9SQSBERVBPU0lUQURBIFRFTkhBIFNJRE8gUkVTVUxUQURPIERFIFVNIFBBVFJPQ8ONTklPIE9VIApBUE9JTyBERSBVTUEgQUfDik5DSUEgREUgRk9NRU5UTyBPVSBPVVRSTyBPUkdBTklTTU8gUVVFIE7Dg08gU0VKQSBFU1RBClVOSVZFUlNJREFERSwgVk9Dw4ogREVDTEFSQSBRVUUgUkVTUEVJVE9VIFRPRE9TIEUgUVVBSVNRVUVSIERJUkVJVE9TIERFIFJFVklTw4NPIENPTU8gClRBTULDiU0gQVMgREVNQUlTIE9CUklHQcOHw5VFUyBFWElHSURBUyBQT1IgQ09OVFJBVE8gT1UgQUNPUkRPLgoKQSBVbml2ZXJzaWRhZGUgZG8gRXN0YWRvIGRvIFJpbyBkZSBKYW5laXJvIChVRVJKKSBzZSBjb21wcm9tZXRlIGEgaWRlbnRpZmljYXIgY2xhcmFtZW50ZSBvIHNldSBub21lIChzKSBvdSBvKHMpIG5vbWUocykgZG8ocykgCmRldGVudG9yKGVzKSBkb3MgZGlyZWl0b3MgYXV0b3JhaXMgZGEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvLCBlIG7Do28gZmFyw6EgcXVhbHF1ZXIgYWx0ZXJhw6fDo28sIGFsw6ltIGRhcXVlbGFzIApjb25jZWRpZGFzIHBvciBlc3RhIGxpY2Vuw6dhLgo=Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T18:24:05Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false
dc.title.por.fl_str_mv Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022
dc.title.alternative.eng.fl_str_mv Dynamics of SARS-CoV-2 variants and the different phenotypes of COVID-19 in a cohort of patients seen at Policlínica Piquet Carneiro from April 2020 to January 2022
title Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022
spellingShingle Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022
Santos, Angela Maria Guimarães dos
Next generation sequencing
Variant of concern
Genomic analysis
Epidemiology
Antibody anti SARS-CoV-2
COVID-19 (Doença) – Epidemiologia
COVID-19 (Doença) – Aspectos genéticos
Biologia molecular
Reações antígeno-anticorpo
COVID-19, Pandemia de, 2020
Sequenciamento de nova geração
Variante de preocupação
Análise genômica
Epidemiologia
Anticorpo anti SARS-CoV-2
CIENCIAS DA SAUDE::SAUDE COLETIVA
title_short Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022
title_full Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022
title_fullStr Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022
title_full_unstemmed Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022
title_sort Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022
author Santos, Angela Maria Guimarães dos
author_facet Santos, Angela Maria Guimarães dos
amgsantoss@gmail.com
author_role author
author2 amgsantoss@gmail.com
author2_role author
dc.contributor.advisor1.fl_str_mv Pôrto, Luís Cristóvão de Moraes Sobrino
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/8153025668900773
dc.contributor.referee1.fl_str_mv Oigman, Wille
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/4962697729705577
dc.contributor.referee2.fl_str_mv Silva, Heitor Evangelista da
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/9179189728013478
dc.contributor.referee3.fl_str_mv Medronho, Roberto de Andrade
dc.contributor.referee3Lattes.fl_str_mv http://lattes.cnpq.br/3929236898922521
dc.contributor.referee4.fl_str_mv Aguiar, Renato Santana de
dc.contributor.referee4Lattes.fl_str_mv http://lattes.cnpq.br/3007026070361272
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/3431251102361088
dc.contributor.author.fl_str_mv Santos, Angela Maria Guimarães dos
amgsantoss@gmail.com
contributor_str_mv Pôrto, Luís Cristóvão de Moraes Sobrino
Oigman, Wille
Silva, Heitor Evangelista da
Medronho, Roberto de Andrade
Aguiar, Renato Santana de
dc.subject.eng.fl_str_mv Next generation sequencing
Variant of concern
Genomic analysis
Epidemiology
Antibody anti SARS-CoV-2
topic Next generation sequencing
Variant of concern
Genomic analysis
Epidemiology
Antibody anti SARS-CoV-2
COVID-19 (Doença) – Epidemiologia
COVID-19 (Doença) – Aspectos genéticos
Biologia molecular
Reações antígeno-anticorpo
COVID-19, Pandemia de, 2020
Sequenciamento de nova geração
Variante de preocupação
Análise genômica
Epidemiologia
Anticorpo anti SARS-CoV-2
CIENCIAS DA SAUDE::SAUDE COLETIVA
dc.subject.por.fl_str_mv COVID-19 (Doença) – Epidemiologia
COVID-19 (Doença) – Aspectos genéticos
Biologia molecular
Reações antígeno-anticorpo
COVID-19, Pandemia de, 2020
Sequenciamento de nova geração
Variante de preocupação
Análise genômica
Epidemiologia
Anticorpo anti SARS-CoV-2
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE::SAUDE COLETIVA
description The descriptive and observational study was carried out with the objective of describing the clinical, epidemiological and phylogenetic aspects of patients infected with SARS-COV-2. The study cohort was based on the cases detected by SARS-CoV-2 of patients seen at Policlínica Piquet Carneiro from April 2020 to January 2022. From the registration forms, qRT-PCR results, NGS sequencing, titration of circulating antibodies and neutralizing antibodies, we identified 406 samples that were assigned to the study of geodistribution of lineages within the cohort. Of these, 360 were assigned to the study of the epidemiological profile of professionals treated at the PPC, 22 samples correspond to patients with reinfection and 5 samples from 2 patients with prolonged infection, in which phylogenetic analyzes and immunological profile were performed in the face of vaccination against COVID-19. Of the 406 samples, the dissemination of variants of concern (VOC) was observed in 17 municipalities, the main lineages found were Gamma (P.1), Delta (AY.99.2) and Ômicron (BA.1). Due to the phylogenetic analysis, it was possible to observe a high accumulation of mutations of the Ômicron lineages and the rapid dissemination according to the time of evolution. Within this study, we observed significantly different distributions between the number of substitutions of the Ômicron lineage and circulating antibodies. As for the analysis of professionals, we found that both health professionals and professionals from other areas had high exposure to the virus, but health professionals were the first to be contaminated within this cohort. As for the data from patients with prolonged infection and reinfected, we concluded that both circulating and neutralizing antibodies show a tendency to decrease over time, even with previous immunization due to another infection or vaccination, therefore, booster immunization is essential for the control the circulation of new strains. These data highlight the importance of genomic surveillance that can assist in the screening of new variants and minimize the impacts caused by SARS-CoV-2
publishDate 2022
dc.date.issued.fl_str_mv 2022-08-05
dc.date.accessioned.fl_str_mv 2024-01-18T19:10:28Z
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dc.identifier.citation.fl_str_mv SANTOS, Angela Maria Guimarães dos. Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022. 2022. 106 f. Tese (Doutorado em Biologia Humana e Experimental) - Instituto de Biologia Roberto Alcântara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2022.
dc.identifier.uri.fl_str_mv http://www.bdtd.uerj.br/handle/1/20951
identifier_str_mv SANTOS, Angela Maria Guimarães dos. Dinâmica das variantes do SARS-CoV-2 e os diversos fenótipos da COVID-19 em uma coorte de pacientes atendidos na Policlínica Piquet Carneiro no período de abril de 2020 a janeiro de 2022. 2022. 106 f. Tese (Doutorado em Biologia Humana e Experimental) - Instituto de Biologia Roberto Alcântara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2022.
url http://www.bdtd.uerj.br/handle/1/20951
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dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Biologia Humana e Experimental
dc.publisher.initials.fl_str_mv UERJ
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Centro Biomédico::Instituto de Biologia Roberto Alcantara Gomes
publisher.none.fl_str_mv Universidade do Estado do Rio de Janeiro
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