Monitoramento das Produções

by Julio Cesar Tolentino, Ana Lucia Taboada Gjorup, Carolina Ribeiro Mello, Simone Gonçalves de Assis, André Casarsa Marques, Áureo do Carmo Filho, Hellen Rose Maia Salazar, Eelco van Duinkerken, Sergio Luis Schmidt
Background Anxiety symptoms (AS) are exacerbated in healthcare workers (HCWs) during the COVID-19 pandemic. Spirituality is known to protect against AS in the general population and it is a construct that differs from religion. It can be assessed using structured questionnaires. A validated questionnaire disclosed three spirituality dimensions: peace, meaning, and faith. In HCWs we investigated the predictors of chronic anxiety (pre-COVID-19 and during the pandemic) and acute anxiety (only during the pandemic), including spirituality in the model. Then, we verified which spirituality dimensions predicted chronic and acute anxiety. Lastly, we studied group differences between the mean scores of these spirituality dimensions. Material and methods The study was carried out in a Brazilian Hospital. HCWs (n = 118) were assessed for spirituality at a single time-point. They were also asked about AS that had started pre-COVID-19 and persisted during the pandemic (chronic anxiety), and AS that had started only during the pandemic (acute anxiety). The subjects without chronic anxiety were subdivided into two other groups: acute anxiety and without chronic and acute anxiety. Forward stepwise logistic regressions were used to find the significant AS predictors. First, the model considered sex, age, religious affiliation, and spirituality. Then, the analysis were performed considering only the three spirituality dimensions. Group means differences in the spirituality dimensions were compared using univariate ANCOVAS followed by T-tests. Results Spirituality was the most realible predictor of chronic (OR = 0.818; 95%CI:0.752–0.890; p

by Leonard Thomas S. Lim, Zypher Jude G. Regencia, J. Rem C. Dela Cruz, Frances Dominique V. Ho, Marcela S. Rodolfo, Josefina Ly-Uson, Emmanuel S. Baja
Introduction The COVID-19 pandemic declared by the WHO has affected many countries rendering everyday lives halted. In the Philippines, the lockdown quarantine protocols have shifted the traditional college classes to online. The abrupt transition to online classes may bring psychological effects to college students due to continuous isolation and lack of interaction with fellow students and teachers. Our study aims to assess Filipino college students’ mental health status and to estimate the effect of the COVID-19 pandemic, the shift to online learning, and social media use on mental health. In addition, facilitators or stressors that modified the mental health status of the college students during the COVID-19 pandemic, quarantine, and subsequent shift to online learning will be investigated. Methods and analysis Mixed-method study design will be used, which will involve: (1) an online survey to 2,100 college students across the Philippines; and (2) randomly selected 20–40 key informant interviews (KIIs). Online self-administered questionnaire (SAQ) including Depression, Anxiety, and Stress Scale (DASS-21) and Brief-COPE will be used. Moreover, socio-demographic factors, social media usage, shift to online learning factors, family history of mental health and COVID-19, and other factors that could affect mental health will also be included in the SAQ. KIIs will explore factors affecting the student’s mental health, behaviors, coping mechanism, current stressors, and other emotional reactions to these stressors. Associations between mental health outcomes and possible risk factors will be estimated using generalized linear models, while a thematic approach will be made for the findings from the KIIs. Results of the study will then be triangulated and summarized. Ethics and dissemination Our study has been approved by the University of the Philippines Manila Research Ethics Board (UPMREB 2021-099-01). The results will be actively disseminated through conference presentations, peer-reviewed journals, social media, print and broadcast media, and various stakeholder activities.

by Tina Mazaheri, Ruvini Ranasinghe, Wiaam Al-Hasani, James Luxton, Jessica Kearney, Allison Manning, Georgios K. Dimitriadis, Tracey Mare, Royce P. Vincent
Objectives Procalcitonin (PCT) is an acute-phase reactant with concentrations ≥0.5 μg/L indicative of possible bacterial infection in patients with SARS-CoV-2 infection (COVID-19). Some with severe COVID-19 develop cytokine storm secondary to virally driven hyper-inflammation. However, increased pro-inflammatory cytokines are also seen in bacterial sepsis. This study aimed to assess the clinical utility of a cytokine panel in the assessment of COVID-19 with bacterial superinfections along with PCT and C-reactive protein (CRP). Methods The retrospective analysis included serum cytokines (interleukins; IL-1β, IL-6, IL-8 and tumour necrosis factor (TNFα)) measured using Ella™ (Bio-Techne, Oxford, UK) and PCT measured by Roche Cobas (Burgess Hill, UK) in patients admitted with COVID-19 between March 2020 and January 2021. Patients enrolled into COVID-19 clinical trials, treated with Remdesivir/IL-6 inhibitors were excluded. The cytokine data was compared between intensive care unit (ICU) patients, age matched non-ICU patients and healthy volunteers as well as ICU patients with high and normal PCT (≥0.5 vs.

by Mona Gaber, Alzahraa Abdelraouf Ahmad, Asmaa M. El-Kady, Mohammed Tolba, Yutaka Suzuki, Shereen M. Mohammed, Nahed Ahmed Elossily
Background The recent increase in dengue virus (DENV) outbreaks and the absence of an effective vaccine have highlighted the importance of developing rapid and effective diagnostic surveillance tests and mosquito-based screening programs. To establish effective control measures for preventing future DENV transmission, the present study was established to identify the main mosquito vector involved in the dengue fever (DF) outbreak in Upper Egypt in 2016 and detect the diversity of dengue virus serotypes circulating in both humans and vectors. Methods We investigated the prevalence of DENV infection and circulating serotypes in the sera of 51 humans clinically suspected of DF and 1800 field-collected Aedes aegypti adult female mosquitoes grouped into 36 pooled samples. Both DENV non-structural protein (NS1) immunochromatographic strip assay and loop-mediated isothermal amplification (LAMP) were used for screening. Results Overall, the rate of DENV infection in both human sera and pooled mosquito homogenate was 33.3%, as revealed by rapid dipstick immunochromatographic analysis. However, higher detection rates were observed with RT-LAMP assay of 60.8% and 44.4% for humans and vector mosquitoes, respectively. DENV-1 was the most prevalent serotype in both populations. A combination of two, three, or even four circulating serotypes was found in 87.5% of total positive pooled mosquito samples and 83.87% of DENV-positive human sera. Conclusion The study reinforces the evidence of the reemergence of Aedes aegypti in Upper Egypt, inducing an outbreak of DENV. Mosquito-based surveillance of DENV infection is important to elucidate the viral activity rate and define serotype diversity to understand the virus dynamics in the reinfested area. Up to our knowledge, this is the first report of serotyping of DENV infection in an outbreak in Egypt using RT-LAMP assay.

by Martin Bicher, Claire Rippinger, Melanie Zechmeister, Beate Jahn, Gaby Sroczynski, Nikolai Mühlberger, Julia Santamaria-Navarro, Christoph Urach, Dominik Brunmeir, Uwe Siebert, Niki Popper
Background and objective The distribution of the newly developed vaccines presents a great challenge in the ongoing SARS-CoV-2 pandemic. Policy makers must decide which subgroups should be vaccinated first to minimize the negative consequences of the pandemic. These decisions must be made upfront and under uncertainty regarding the amount of vaccine doses available at a given time. The objective of the present work was to develop an iterative optimization algorithm, which provides a prioritization order of predefined subgroups. The results of this algorithm should be optimal but also robust with respect to potentially limited vaccine supply. Methods We present an optimization meta-heuristic which can be used in a classic simulation-optimization setting with a simulation model in a feedback loop. The meta-heuristic can be applied in combination with any epidemiological simulation model capable of depicting the effects of vaccine distribution to the modeled population, accepts a vaccine prioritization plan in a certain notation as input, and generates decision making relevant variables such as COVID-19 caused deaths or hospitalizations as output. We finally demonstrate the mechanics of the algorithm presenting the results of a case study performed with an epidemiological agent-based model. Results We show that the developed method generates a highly robust vaccination prioritization plan which is proven to fulfill an elegant supremacy criterion: the plan is equally optimal for any quantity of vaccine doses available. The algorithm was tested on a case study in the Austrian context and it generated a vaccination plan prioritization favoring individuals age 65+, followed by vulnerable groups, to minimize COVID-19 related burden. Discussion The results of the case study coincide with the international policy recommendations which strengthen the applicability of the approach. We conclude that the path-dependent optimum optimum provided by the algorithm is well suited for real world applications, in which decision makers need to develop strategies upfront under high levels of uncertainty.

by Stephanie T. Lanza, Courtney A. Whetzel, Ashley N. Linden-Carmichael, Craig J. Newschaffer
Objective The COVID-19 pandemic has potential for long-lasting effects on college students’ well-being. We examine changes from just before to during the pandemic in indicators of health and well-being and comprehensive profiles of health and well-being, along with links between covariates and profiles during the pandemic. Participants 1,004 students participated in a longitudinal study that began in November 2019. Methods Latent class analysis identified health and well-being profiles at both waves; covariates were included in relation to class membership. Results Mental health problems increased, whereas substance use, sexual behavior, physical inactivity, and food insecurity decreased. Six well-being classes were identified at each wave. Baseline class membership, sociodemographic characteristics, living situation, ethnicity, coping strategies, and belongingness were associated with profile membership at follow-up. Conclusions COVID-19 has had significant and differential impacts on today’s students; their health and well-being should be considered holistically when understanding and addressing long-term effects of this pandemic.

Title: Callitrichine gammaherpesvirus 3 and Human alphaherpesvirus 1 in New World Primate negative for yellow fever virus in Rio de Janeiro, Brazil
Authors: Bonfim, Flávia Freitas de Oliveira; Mares-Guia, Maria Angélica Monteiro de Mello; Horta, Marco Aurélio; Chame, Marcia; Lopes, Amanda de Oliveira; Santos, Rafael; Matias, Carlos Alexandre Rey; Pinto, Marcelo Alves; Filippis, Ana Maria Bispo de; Paula, Vanessa Salete de

Title: Presidential address: the Black Swan: ISPN and pediatric neurosurgery in times of COVID‑19
Authors: Salomão, José Francisco M.

Title: Collapse of the public health system and the emergence of new variants during the second wave of the COVID-19 pandemic in Brazil
Authors: Silva, Severino Jefferson Ribeiro da; Pena, Lindomar

Title: The COVID-19 pandemics and the relevance of biosafety facilities for metagenomics surveillance, structured disease prevention and control
Authors: Souza, Thiago Moreno Lopes; Morel, Carlos Medicis
Description: Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Title: Acinetobacter baumannii Infections in Times of COVID-19 Pandemic
Authors: Rangel, Karyne; Chagas, Thiago Pavoni Gomes; De-Simone, Salvatore Giovanni

Title: Younger Brazilians hit by COVID-19 – What are the implications?
Authors: Guimarães, Raphael Mendonça; Portela, Margareth Crisóstomo; Villela, Daniel Antunes Maciel; Matta, Gustavo Correa; Freitas, Carlos Machado de
Description: Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Title: Effect of physical distancing on Covid-19 incidence in Brazil: does the strictness of mandatory rules matter?
Authors: Guimarães, Raphael Mendonça; Silva, José Henrique Costa Monteiro da; Brusse, Gustavo Pedroso de Lima; Martins, Thalyta C´assia de Freitas

by Hio Wa Mak, Diana Wang, Arthur A. Stone

The COVID-19 pandemic has impacted many different facets of life. The infectious nature of the disease has led to significant changes in social interactions in everyday life. The present study examined how older adults’ patterns of everyday momentary social interactions (i.e., with no one, partner, family, and friends) and their affect varied across the early stages of the pandemic and whether the magnitude of affective benefits associated with social interactions changed across time. A total of 188 adults aged 50 or above (Mage = 62.05) completed momentary assessments in early March, late March, May, and July 2020. Overall, older adults spent more time in solitude and less time interacting with their friends after the declaration of the pandemic. Further, negative affect (NA) spiked after the pandemic declaration and then returned to pre-pandemic level. Finally, momentary interactions with close social ties were consistently associated with higher positive affect (PA) and lower NA whereas momentary solitude was associated with lower PA, but not related to NA. The magnitude of associations between specific social interactions (or solitude) and affect varied across time, and the onset of the pandemic appeared associated with this variation. During the presumably most stressful period, solitude was not associated with lower PA and family interaction was not associated with higher PA as they were at other times. Further, interactions with friends seemed to have diminished affective benefits following the onset of the pandemic.

by Dina Nurfarahin Mashudi, Norliza Ahmad, Salmiah Mohd Said
Background Dengue fever is a mosquito-borne viral infection that is endemic in more than 100 countries and has the highest incidence among infectious diseases in Malaysia. The increase of dengue fever cases during the COVID-19 pandemic and the movement control order (MCO) highlighted the necessity to assess the dengue preventive practices among the population. Thus, this study aimed to determine the level of dengue preventive practices and its associated factors among residents in a residential area in Johor, Malaysia during the COVID-19 pandemic. Method A community-based cross-sectional study was conducted on 303 respondents from a Johor residential area between May and June 2021. A validated self-administered questionnaire was created using google forms and distributed to the respondents via WhatsApp. The questionnaire consisted of three sections: (i) Sociodemographic characteristics and history of dengue fever, (ii) dengue preventive practices, and (iii) six constructs of the Health Belief Model (HBM). The association between the dependent and independent variables were examined using multiple logistic regression with a significant level set at less than 0.05. Result About half of the respondents have a good level of dengue preventive practices. Respondents with a history of dengue fever (aOR = 2.1, 95% CI: 1.1–4.2, p = 0.033), low perceived susceptibility (aOR = 1.8, 95% CI: 1.1–3.0, p = 0.018), high self-efficacy (aOR = 1.7, 95% CI: 1.0–2.8, p = 0.045), and high cues to take action (aOR = 2.5, 95% CI: 1.5–4.2, p 0.001) had higher odds of practicing good dengue preventive measures. Conclusion This study demonstrated a moderate level of dengue preventive practices during the COVID-19 pandemic. Therefore, a stronger dengue control programme is recommended by focusing on cues to take action, self-efficacy, and recruiting those with a history of dengue fever to assist health authorities in promoting good dengue preventive practices in the community.

by Bo Yu, Donell Barnett, Vidya Menon, Lara Rabiee, Yinelka Silverio De Castro, Moiz Kasubhai, Eren Watkins

Healthcare workers (HCWs) faced a range of stressors during the coronavirus (COVID-19) pandemic, contributing to psychological stress. We use a psychological trauma framework to characterize the mental health burden for clinical and non-clinical healthcare worker occupations during the COVID-19 pandemic. The objective was to measure and characterize risk factors for trauma and anxiety-related mental health problems among HCWs at a public hospital in the epicenter of the COVID-19 pandemic in New York City (NYC). This study reports findings from a cross-sectional survey of NYC HCWs shortly after the initial 2020 infection surge. Over 800 hospital employees completed the survey that assessed professional quality of life indicators (compassion satisfaction [CS], burnout [BO], secondary traumatic stress [STS]), Coronavirus Anxiety (CS), Obsession with Coronavirus (OC), and PTSD symptoms. The survey also assessed pandemic-related work and life circumstances such as “do you have a family member or friend who tested positive for COVID”. Relatively small percentages of HCWs endorsed probable Coronavirus Anxiety (6%), PTSD (13%), and Coronavirus Obsession (21%). We observed higher proportions of Burnout (29%), Moderate or High Secondary Traumatic Stress (45%), and High Compassion Satisfaction (52%). Adjusted regression models showed important implications for prior behavioral/emotional health concerns among HCWs, providing care for a patient that died from COVID-19, and other characteristics. This study supports prior studies documenting the mental health consequences for the healthcare workforce during the COVID-19 pandemic. This study builds on that base by including non-clinical staff in the sample and assessing pandemic life-stressors such as caring for sick family members.

by Nina Eisenburger, David Friesen, Fabiola Haas, Marlen Klaudius, Lisa Schmidt, Susanne Vandeven, Christine Joisten

The aim of this analysis was to assess the effectiveness of a juvenile outpatient weight management program during the coronavirus pandemic in Germany, which was implemented digitally during the initial lockdown and thereafter under strict hygiene rules (e.g., adapted exercise sessions). Changes in body mass index standard deviation scores (BMI SDS), physical fitness, media consumption, health-related quality of life (HRQOL), and social self-concept of 28 children and adolescents were compared to data of 30 participants before the pandemic. Adjusted mean changes from baseline to follow-up in BMI SDS (M = −0.07 ± 0.30), relative physical fitness (M = 0.0 ± 0.3 W/kg), media use (M = 0.5 ± 2.6 hours/day), HRQOL (M = −1.6 ± 15.3), and social self-concept (M = −3.8 ± 13.2) during the pandemic were not significantly different from those of the pre-pandemic participants (all p > 0.05). Therefore, the results suggest that an adjusted approach to weight management, which combined digital and adapted in-person components to meet hygiene requirements during the pandemic, was as effective as the pre-pandemic program. It could thus be a potential solution to ensure continuity of care for vulnerable children with obesity during the pandemic and the associated restrictions.

Title: ABC 2-SPH risk score for in-hospital mortality in COVID-19 patients: development, external validation and comparison with other available scores
Authors: Marcolino, Milena Soriano; Pires, Magda Carvalho; Ramos, Lucas Emanuel F; Silva, Rafael T; Oliveira, Luana M; Carvalho, Rafael L R; Mourato, Rodolfo Lucas S; Sánchez-Montalvá, Adrián; Raventós, Berta; Anschau, Fernando; Chatkin, José Miguel; Nogueira, Matheus C A; Guimarães Júnior, Milton H; Vietta, Giovanna G; Duani, Helena; Ponce, Daniela; Ziegelmann, Patricia K; Castro, Luís C; Ruschel, Karen B; Cimini, Christiane C R; Francisco, Saionara C; Floriani, Maiara A; Nascimento, Guilherme F; Farace, Bárbara L; Monteiro, Luanna S; Silva, Maira V R Souza; Sales, Thais L S; Martins, Karina Paula M P; Nascimento, Israel J Borges do; Fereguetti, Tatiani O; Ferrara, Daniel T M O; Botoni, Fernando A; Etges, Ana Paula B S; Schwarzbold, Alexandre V; Maurílio, Amanda O; Scotton, Ana Luiza B A; Weber, André P; Costa, André S M; Glaeser, Andressa B; Madureira, Angélica Aparecida C; Bhering, Angelinda R; Castro, Bruno Mateus de; Silva, Carla Thais C A da; Ramos, Carolina M; Gomes, Caroline D; Carvalho, Cíntia A de; Silveira, Daniel V; Cezar, Edilson; Pereira, Elayne C; Kroger, Emanuele Marianne S; Vallt, Felipe B; Lucas, Fernanda B; Aranha, Fernando G; Bartolazzi, Frederico; Crestani, Gabriela P; Bastos, Gisele A N; Madeira, Glícia Cristina de C; Noal, Helena Carolina; Vianna, Heloisa R; Guimarães, Henrique C; Gomes, Isabela M; Molina, Israel; Batista, Joanna d'Arc L; Alvarenga, Joice C de; Guimarães, Júlia D S S; Morais, Júlia D P de; Rugolo, Juliana M; Pontes, Karen Cristina J R; Santos, Kauane Aline M Dos; Oliveira, Leonardo S de; Pinheiro, Lílian S; Pacheco, Liliane S; Sousa, Lucas de D; Couto, Luciana S F; Kopittke, Luciane; Moura, Luis Cesar S de; Santos, Luisa Elem A; Cabral, Máderson A S; Souza, Maíra D; Tofani, Marcela G T; Carneiro, Marcelo; Ferreira, Maria Angélica P; Bicalho, Maria Aparecida C; Lima, Maria Clara P B; Godoy, Mariana F; Cardoso, Marilia M A; Figueiredo, Meire P; Sampaio, Natália C S; Rangel, Natália L; Crespo, Natália T; Oliveira, Neimy R de; Assaf, Pedro L; Martelli, Petrônio José de L; Almeida, Rafaela S C; Martins, Raphael C; Lutkmeier, Raquel; Valacio, Reginaldo Aparecido; Finger, Renan G; Cardoso, Ricardo B; Pozza, Roberta; Campos, Roberta X; Menezes, Rochele M; Abreu, Roger M de; Silva, Rufino de F; Guimarães, Silvana M M; Araújo, Silvia F; Pereira, Susany Anastácia; Oliveira, Talita F; Kurtz, Tatiana; Oliveira, Thainara C de; Araújo, Thaíza Simônia M A; Diniz, Thulio Henrique O; Santos, Veridiana B Dos; Gomes, Virginia Mara R; Vale, Vitor Augusto L do; Ramires, Yuri C; Boersma, Eric; Polanczyk, Carisi A

by Ana Florea, Lina S. Sy, Yi Luo, Lei Qian, Katia J. Bruxvoort, Bradley K. Ackerson, Gina S. Lee, Jennifer H. Ku, Julia E. Tubert, Yun Tian, Carla A. Talarico, Hung Fu Tseng
Background We conducted a prospective cohort study at Kaiser Permanente Southern California to study the vaccine effectiveness (VE) of mRNA-1273 over time and during the emergence of the Delta variant. Methods The cohort for this planned interim analysis consisted of individuals aged ≥18 years receiving 2 doses of mRNA-1273 through June 2021, matched 1:1 to randomly selected unvaccinated individuals by age, sex, and race/ethnicity, with follow-up through September 2021. Outcomes were SARS-CoV-2 infection, and COVID-19 hospitalization and hospital death. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHR) with 95% confidence intervals (CIs) comparing outcomes in the vaccinated and unvaccinated groups. Adjusted VE (%) was calculated as (1-aHR)x100. HRs and VEs were also estimated for SARS-CoV-2 infection by age, sex, race/ethnicity, and during the Delta period (June-September 2021). VE against SARS-CoV-2 infection and COVID-19 hospitalization was estimated at 0-

by Muhammed Elhadi, Ahmed Msherghi, Ahmed Khaled, Ahmed Alsoufi, Abdulmueti Alhadi, Asraa Kareem, Aimen Ashini, Tahani Alsharif, Alarabi Alhodiri, Emtenan Altaeb, Mona Hamed, Ahmed Itrunbah, Soha Mohmmed, Hind Alameen, Hanadi Idheiraj, Anshirah Shuwayyah, Sara Alhudhairy, Arowa Alansari, Wisam Abraheem, Hend Akl, Taha Nagib, Ayman Almugaddami, Basheer Aljameel, Siba Muamr, Suhir Alsuwiyah, Ateka Alsghair, Enas Soula, Anis Buzreg, Fatma Alagelli, Abdulfatah Aldireewi, Ahmed Bareem, Entisar Alshareea, Asmhan Gemberlo, Ahmed Zaid
Background The coronavirus disease 2019 (COVID-19) pandemic may have a potentially serious effect on mental health and increase the risk of anxiety, depression, and post-traumatic stress disorders in people. In this study, we aimed to determine the prevalence of psychological illness and the impact of the COVID-19 pandemic on the Libyan population’s mental health. Method A cross-sectional survey, conducted in both online and paper modes and consisting of five sections, was completed in more than 30 cities and towns across Libya. The first section consisted of questions on basic demographic characteristics. The second section contained a survey related to the lockdown status, activities, related stress levels, and quarantine. The third section comprised the self-administered 9-item Patient Health Questionnaire (PHQ-9). The fourth section contained the 7-item Generalized Anxiety Disorder Scale (GAD-7), and the fifth section contained the Impact of Event Scale-Revised (IES-R). Result Of the 31,557 respondents, 4,280 (13.6%) reported severe depressive symptoms, with a mean [standard deviation (SD)] PHQ-9 score of 8.32 (5.44); 1,767 (5.6%) reported severe anxiety symptoms, with a mean (SD) GAD-7 score of 6 (4.6); and 6,245 (19.8%) of the respondents reported post-traumatic stress disorder (PTSD), with a mean (SD) score of 15.3 (18.85). In multivariate analysis, young age, being female, unmarried, educated, or victims of domestic violence or abuse, work suspension during the pandemic, and having increased workload, financial issues, suicidal thoughts, or a family member with or hospitalized due to COVID-19 were significantly associated with a high likelihood of depressive and anxiety symptoms, as well as PTSD. Internal displacement due to civil war was also associated with PTSD. Conclusion To our knowledge, this is the first study to analyze the psychological impacts of the COVID-19 pandemic and civil war in Libya. Further study on the development of strategies and interventions aimed at reducing the mental disease burden on the Libyan population is warranted.

by Diana Tejada, Regina Juanbeltz, María Rivero, Ramón San Miguel, Ferrán Capdevila, Juan José Beloqui, Maite Sarobe
Background There is currently much uncertainty regarding the most optimal treatment for COVID-19. This study analyze the change in the clinical condition of patients hospitalized for severe COVID-19 pneumonia and treated with remdesivir in a real-life setting, based on the WHO Ordinal Scale. Clinical complications, treatment safety, and impact of other associated drugs were also analyzed. Methods We conducted an observational, retrospective study including patients treated with remdesivir. The need for admission to the ICU, the length of ICU and hospital stay, and the need for ventilatory support were analyzed. The laboratory parameters, drugs administered concomitantly, and difference in the length of hospital stay according to the concomitant treatment received were also evaluated. A univariate and multivariate Cox regression analysis was performed to analyze associated factors. Results A total of 92 patients were included. The mean length of hospital stay was 15 days, and 90% of the patients had been discharged from the hospital 28 days after starting treatment with remdesivir. The likelihood of hospital discharge among patients not presenting with hypertension as a comorbidity was significantly higher than that of those with this condition (HR = 3.19, P = 0.008). Nineteen patients had to be admitted to the ICU (mean of 18 days). Approximately 11% required invasive mechanical ventilation (mean of 22 days). Almost 37% of the patients received high-flow oxygen therapy and 14% non-invasive mechanical ventilation. Four deaths were recorded within the first week. Main adverse events were increases in transaminase and creatinine levels. Nosocomial infections were more frequent when remdesivir was combined with immunosuppressive drugs. Conclusions Patients with severe COVID-19 pneumonia and treated with remdesivir require relatively prolonged hospital stays, many with a need for ventilatory support and, in a considerable proportion of cases, admission to the ICU. However, the observed survival rate is high, and the drug is well tolerated.

by Helen L. Richards, Joseph Eustace, Amanda O’ Dwyer, Andrew Wormald, Yvonne Curtin, Dónal G. Fortune
Objectives We sought to examine healthcare workers (HCWs) utilisation of formal and informal psychological support resources in the workplace during the first and third waves of the COVID-19 pandemic in Ireland. Methods A convergent mixed methods approach was undertaken. Four hundred and thirty HCWs in the Mid West and South of Ireland responded to an online survey in terms of their use of psychological support resources during Wave 1 (April/May 2020) of COVID-19. Thirty-nine HCWs undertook in depth interviews at Wave 3 (January/February 2021), and a further quantitative survey was distributed and completed by 278 HCWs at this time. Quantitative data arising at Wave 1 and Wave 3, were synthesised with Qualitative data collected at Wave 3. A Pillar Integration Process (PIP) was utilised in the analysis of the quantitative and qualitative data. Results Five pillars were identified from the integration of results. These were: a) the primacy of peer support, b) the importance of psychologically informed management, c) a need to develop the organisational well-being ethos, d) support for all HCWs, and e) HCWs ideas for developing the well-being path. These pillars encapsulated a strong emphasis on collegial support, an emphasis on the need to support managers, a questioning of the current supports provided within the healthcare organisations and critical reflections on what HCWs viewed as most helpful for their future support needs. Conclusions HCWs who utilised supportive resources indicated ‘in house’ supports, primarily collegial resources, were the most frequently used and perceived as most helpful. While formal psychological supports were important, the mechanism by which such psychological support is made available, through utilising peer support structures and moving towards psychologically informed supervisors and workplaces is likely to be more sustainable and perceived more positively by HCWs.

by Charles Nicholson, Lex Beattie, Matthew Beattie, Talayeh Razzaghi, Sixia Chen

COVID-19 is a global pandemic threatening the lives and livelihood of millions of people across the world. Due to its novelty and quick spread, scientists have had difficulty in creating accurate forecasts for this disease. In part, this is due to variation in human behavior and environmental factors that impact disease propagation. This is especially true for regionally specific predictive models due to either limited case histories or other unique factors characterizing the region. This paper employs both supervised and unsupervised methods to identify the critical county-level demographic, mobility, weather, medical capacity, and health related county-level factors for studying COVID-19 propagation prior to the widespread availability of a vaccine. We use this feature subspace to aggregate counties into meaningful clusters to support more refined disease analysis efforts.

by Francesco Scotti, Francesco Pierri, Giovanni Bonaccorsi, Andrea Flori

Due to the COVID-19 pandemic, countries around the world are facing one of the most severe health and economic crises of recent history and human society is called to figure out effective responses. However, as current measures have not produced valuable solutions, a multidisciplinary and open approach, enabling collaborations across private and public organizations, is crucial to unleash successful contributions against the disease. Indeed, the COVID-19 represents a Grand Challenge to which joint forces and extension of disciplinary boundaries have been recognized as main imperatives. As a consequence, Open Innovation represents a promising solution to provide a fast recovery. In this paper we present a practical application of this approach, showing how knowledge sharing constitutes one of the main drivers to tackle pressing social needs. To demonstrate this, we propose a case study regarding a data sharing initiative promoted by Facebook, the Data For Good program. We leverage a large-scale dataset provided by Facebook to the research community to offer a representation of the evolution of the Italian mobility during the lockdown. We show that this repository allows to capture different patterns of movements on the territory with increasing levels of detail. We integrate this information with Open Data provided by the Lombardy region to illustrate how data sharing can also provide insights for private businesses and local authorities. Finally, we show how to interpret Data For Good initiatives in light of the Open Innovation Framework and discuss the barriers to adoption faced by public administrations regarding these practices.

by Rupesh Raina, Isabelle Mawby, Ronith Chakraborty, Sidharth Kumar Sethi, Kashin Mathur, Shefali Mahesh, Michael Forbes
Background Despite extensive research into acute kidney injury (AKI) in adults, research into the epidemiology, associated risk factors, treatment, and mortality of AKI in pediatric COVID-19 patients is understudied. Advancing understanding of this disease is crucial to further developing treatment and preventative care strategies to reduce morbidity and mortality. Methods This is a retrospective analysis of 2,546 COVID-19 pediatric patients (age ≤ 21 years) who were admitted the ICU in North America. Analysis of the Virtual Pediatric Systems (VPS) COVID-19 database was conducted between January 1, 2020, and June 30, 2021. Results Out of a total of 2,546 COVID positive pediatric patients, 10.8% (n = 274) were diagnosed with AKI. Significantly higher continuous and categorical outcomes in the AKI subset compared to the non-AKI cohort included: length of stay at the hospital (LOS) [9.04 (5.11–16.66) vs. 5.09 (2.58–9.94) days], Pediatric Index of Mortality (PIM) 2 probability of death [1.20 (0.86–3.83) vs. 0.96 (0.79–1.72)], PIM 3 probability of death [0.98 (0.72–2.93) vs. 0.78 (0.69–1.26)], mortality [crude OR (95% CI): 5.01 (2.89–8.70)], airway and respiratory support [1.63 (1.27–2.10)], cardio-respiratory support [3.57 (1.55–8.23)], kidney support [12.52 (5.30–29.58)], and vascular access [4.84 (3.70–6.32)]. Conclusions This is one of the first large scale studies to analyze AKI among pediatric COVID-19 patients admitted to the ICU in North America. Although the course of the COVID-19 virus appears milder in the pediatric population, renal complications may result, increasing the risk of disease complication and mortality.

by Danika Lipman, Sandra E. Safo, Thierry Chekouo

COVID-19 is a disease characterized by its seemingly unpredictable clinical outcomes. In order to better understand the molecular signature of the disease, a recent multi-omics study was done which looked at correlations between biomolecules and used a tree- based machine learning approach to predict clinical outcomes. This study specifically looked at patients admitted to the hospital experiencing COVID-19 or COVID-19 like symptoms. In this paper we examine the same multi-omics data, however we take a different approach, and we identify stable molecules of interest for further pathway analysis. We used stability selection, regularized regression models, enrichment analysis, and principal components analysis on proteomics, metabolomics, lipidomics, and RNA sequencing data, and we determined key molecules and biological pathways in disease severity, and disease status. In addition to the individual omics analyses, we perform the integrative method Sparse Multiple Canonical Correlation Analysis to analyse relationships of the different view of data. Our findings suggest that COVID-19 status is associated with the cell cycle and death, as well as the inflammatory response. This relationship is reflected in all four sets of molecules analyzed. We further observe that the metabolic processes, particularly processes to do with vitamin absorption and cholesterol are implicated in COVID-19 status and severity.

by Audrey Pettifor, Bethany L. DiPrete, Bonnie E. Shook-Sa, Lakshmanane Premkumar, Kriste Kuczynski, Dirk Dittmer, Allison Aiello, Shannon Wallet, Robert Maile, Joyce Tan, Ramesh Jadi, Linda Pluta, Aravinda M. de Silva, David J. Weber, Min Kim, Arlene C. Seña, Corbin D. Jones
Background Early in the pandemic, transmission risk from asymptomatic infection was unclear, making it imperative to monitor infection in workplace settings. Further, data on SARS-CoV-2 seroprevalence within university populations has been limited. Methods We performed a longitudinal study of University research employees on campus July-December 2020. We conducted questionnaires on COVID-19 risk factors, RT-PCR testing, and SARS-CoV-2 serology using an in-house spike RBD assay, laboratory-based Spike NTD assay, and standard nucleocapsid platform assay. We estimated prevalence and cumulative incidence of seroconversion with 95% confidence intervals using the inverse of the Kaplan-Meier estimator. Results 910 individuals were included in this analysis. At baseline, 6.2% (95% CI 4.29–8.19) were seropositive using the spike RBD assay; four (0.4%) were seropositive using the nucleocapsid assay, and 44 (4.8%) using the Spike NTD assay. Cumulative incidence was 3.61% (95% CI: 2.04–5.16). Six asymptomatic individuals had positive RT-PCR results. Conclusions Prevalence and incidence of SARS-CoV-2 infections were low; however, differences in target antigens of serological tests provided different estimates. Future research on appropriate methods of serological testing in unvaccinated and vaccinated populations is needed. Frequent RT-PCR testing of asymptomatic individuals is required to detect acute infections, and repeated serosurveys are beneficial for monitoring subclinical infection.

by Vess Stamenova, Cherry Chu, Andrea Pang, Jiming Fang, Ahmad Shakeri, Peter Cram, Onil Bhattacharyya, R. Sacha Bhatia, Mina Tadrous
Purpose It is currently unclear how the shift towards virtual care during the 2019 novel coronavirus (COVID-19) pandemic may have impacted chronic disease management at a population level. The goals of our study were to provide a description of the levels of use of virtual care services relative to in-person care in patients with chronic disease across Ontario, Canada and to describe levels of healthcare utilization in low versus high virtual care users. Methods We used linked health administrative data to conduct a population-based, repeated cross-sectional study of all ambulatory patient visits in Ontario, Canada (January 1, 2018 to January 16, 2021). Further stratifications were also completed to examine patients with COPD, heart failure, asthma, hypertension, diabetes, mental illness, and angina. Patients were classified as low (max 1 virtual care visit) vs. high virtual care users. A time-series analysis was done using interventional autoregressive integrated moving average (ARIMA) modelling on weekly hospitalizations, outpatient visits, and diagnostic tests. Results The use of virtual care increased across all chronic disease patient populations. Virtual care constituted at least half of the total care in all conditions. Both low and high virtual care user groups experienced a statistically significant reduction in hospitalizations and laboratory testing at the start of the pandemic. Hospitalization volumes increased again only among the high users, while testing increased in both groups. Outpatient visits among high users remained unaffected by the pandemic but dropped in low users. Conclusion The decrease of in-person care during the pandemic was accompanied by an increase in virtual care, which ultimately allowed patients with chronic disease to return to the same visit rate as they had before the onset of the pandemic. Virtual care was adopted across various chronic conditions, but the relative adoption of virtual care varied by condition with highest rates seen in mental health.

by Stacey B. Whitbourne, Xuan-Mai T. Nguyen, Rebecca J. Song, Emily Lord, Michelle Lyden, Kelly M. Harrington, Rachel Ward, Yanping Li, Jessica V. V. Brewer, Kelly M. Cho, Luc Djousse, Sumitra Muralidhar, Philip S. Tsao, J. Michael Gaziano, Juan P. Casas, on behalf of the MVP COVID-19 Science Program
Background In response to the novel Coronavirus Disease 2019 (COVID-19) pandemic, the Department of Veterans Affairs (VA) Million Veteran Program (MVP) organized efforts to better understand the impact of COVID-19 on Veterans by developing and deploying a self-reported survey. Methods The MVP COVID-19 Survey was developed to collect COVID-19 specific elements including symptoms, diagnosis, hospitalization, behavioral and psychosocial factors and to augment existing MVP data with longitudinal collection of key domains in physical and mental health. Due to the rapidly evolving nature of the pandemic, a multipronged strategy was implemented to widely disseminate the COVID-19 Survey and capture data using both the online platform and mailings. Results We limited the findings of this paper to the initial phase of survey dissemination which began in May 2020. A total of 729,625 eligible MVP Veterans were invited to complete version 1 of the COVID-19 Survey. As of October 31, 2020, 58,159 surveys have been returned. The mean and standard deviation (SD) age of responders was 71 (11) years, 8.6% were female, 8.2% were Black, 5.6% were Hispanic, and 446 (0.8%) self-reported a COVID-19 diagnosis. Over 90% of responders reported wearing masks, practicing social distancing, and frequent hand washing. Conclusion The MVP COVID-19 Survey provides a systematic collection of data regarding COVID-19 behaviors among Veterans and represents one of the first large-scale, national surveillance efforts of COVID-19 in the Veteran population. Continued work will examine the overall response to the survey with comparison to available VA health record data.

by Rebecca De Lorenzo, Clara Sciorati, Giuseppe A. Ramirez, Barbara Colombo, Nicola I. Lorè, Annalisa Capobianco, Cristina Tresoldi, Bio Angels for COVID-BioB Study Group , Daniela M. Cirillo, Fabio Ciceri, Angelo Corti, Patrizia Rovere-Querini, Angelo A. Manfredi
Background Chromogranin A (CgA) and its fragment vasostatin I (VS-I) are secreted in the blood by endocrine/neuroendocrine cells and regulate stress responses. Their involvement in Coronavirus 2019 disease (COVID-19) has not been investigated. Methods CgA and VS-I plasma concentrations were measured at hospital admission from March to May 2020 in 190 patients. 40 age- and sex-matched healthy volunteers served as controls. CgA and VS-I levels relationship with demographics, comorbidities and disease severity was assessed through Mann Whitney U test or Spearman correlation test. Cox regression analysis and Kaplan Meier survival curves were performed to investigate the impact of the CgA and VS-I levels on in-hospital mortality. Results Median CgA and VS-I levels were higher in patients than in healthy controls (CgA: 0.558 nM [interquartile range, IQR 0.358–1.046] vs 0.368 nM [IQR 0.288–0.490] respectively, p = 0.0017; VS-I: 0.357 nM [IQR 0.196–0.465] vs 0.144 nM [0.144–0.156] respectively, p