Monitoramento das Produções

by Hideharu Hagiya, Yuki Otsuka, Kazuki Tokumasu, Hiroyuki Honda, Yoshito Nishimura, Mikako Obika, Fumio Otsuka
Introduction The emergence of the novel coronavirus disease of 2019 (COVID-19) has led to huge disruptions in the medical field and society. The significance of training and education for experts has been increasingly acknowledged in Japan, where the number of infectious disease (ID) specialists is reportedly insufficient. In this paper, we report the results of a web-based survey that was conducted to reveal the ways in which the COVID-19 pandemic has influenced medical students’ awareness of ID specialists and future career choices. Method This cross-sectional descriptive study was conducted in March 2021 and targeted 717 medical students belonging to Medical School of Okayama University, Japan. The questionnaire consisted of four questions meant to assess students’ knowledge and future intentions of becoming ID specialists. Results We obtained 328 eligible questionnaires (response rate: 45.7%). Of 227 (69.2%) students who were aware of ID specialists, 99 (43.6%) answered that they came to know about them only after the pandemic, 12 (3.7%) answered that their interest in being an ID specialist arose during the pandemic, while 36 (11.0%) responded that they would rather not become ID specialists. At the time of the survey, 5 students (1.5%) were aiming to become ID specialists. Conclusion We observed a very low rate of interest to be an ID specialist among medical students. The experience of the pandemic does not seem to have influenced Japanese medical students to choose ID as a specialty for their careers. Continuous efforts to increase the number of ID specialists are necessary in Japan as a countermeasure against the coming pandemic.

by Martin Komenda, Jiří Jarkovský, Daniel Klimeš, Petr Panoška, Ondřej Šanca, Jakub Gregor, Jan Mužík, Matěj Karolyi, Ondřej Májek, Milan Blaha, Barbora Macková, Jarmila Rážová, Věra Adámková, Vladimír Černý, Jan Blatný, Ladislav Dušek

At the time of the COVID-19 pandemic, providing access to data (properly optimised regarding personal data protection) plays a crucial role in providing the general public and media with up-to-date information. Open datasets also represent one of the means for evaluation of the pandemic on a global level. The primary aim of this paper is to describe the methodological and technical framework for publishing datasets describing characteristics related to the COVID-19 epidemic in the Czech Republic (epidemiology, hospital-based care, vaccination), including the use of these datasets in practice. Practical aspects and experience with data sharing are discussed. As a reaction to the epidemic situation, a new portal COVID-19: Current Situation in the Czech Republic (https://onemocneni-aktualne.mzcr.cz/covid-19) was developed and launched in March 2020 to provide a fully-fledged and trustworthy source of information for the public and media. The portal also contains a section for the publication of (i) public open datasets available for download in CSV and JSON formats and (ii) authorised-access-only section where the authorised persons can (through an online generated token) safely visualise or download regional datasets with aggregated data at the level of the individual municipalities and regions. The data are also provided to the local open data catalogue (covering only open data on healthcare, provided by the Ministry of Health) and to the National Catalogue of Open Data (covering all open data sets, provided by various authorities/publishers, and harversting all data from local catalogues). The datasets have been published in various authentication regimes and widely used by general public, scientists, public authorities and decision-makers. The total number of API calls since its launch in March 2020 to 15 December 2020 exceeded 13 million. The datasets have been adopted as an official and guaranteed source for outputs of third parties, including public authorities, non-governmental organisations, scientists and online news portals. Datasets currently published as open data meet the 3-star open data requirements, which makes them machine-readable and facilitates their further usage without restrictions. This is essential for making the data more easily understandable and usable for data consumers. In conjunction with the strategy of the MH in the field of data opening, additional datasets meeting the already implemented standards will be also released, both on COVID-19 related and unrelated topics.

by Dong Hyuk Kang, Kang Su Cho, Young Joon Moon, Doo Yong Chung, Hae Do Jung, Joo Yong Lee
Purpose In the context of the COVID-19 outbreak, the European Association of Urology (EAU) guidelines Rapid Reaction Group provided recommendations to manage muscle invasive bladder cancer (MIBC) based on priority levels: neoadjuvant chemotherapy (NAC) should be avoided for patients with T2-3N0M0 MIBC. This meta-analysis aims to evaluate the efficacy of NAC compared with radical cystectomy (RC) alone in improving the overall survival (OS) of patients with T2-4aN0M0 MIBC. Materials and methods A systematic review was performed according to the PRISMA guidelines. The PubMed/Medline, EMBASE, and Cochrane Library databases were searched. The primary outcome was OS of patients with T2-4aN0M0 MIBC, and the secondary outcome was OS of patients with only T2N0M0 MIBC. Results Eight studies were included in this meta-analysis. Overall, the quality of all studies was relatively high, and little publication bias was demonstrated. The OS was significantly better in the NAC with RC group than in RC alone (HR, 0.79; 95% CI, 0.68–0.92; p = 0.002). A subgroup analysis was performed on only patients with T2N0M0 MIBC, and five studies were included. There was no difference in the OS between the NAC with RC and the RC alone groups (HR, 0.83; 95% CI, 0.69–1.01 p = 0.06). Conclusions As recommended by the EAU guidelines Rapid Reaction Group, patients with T2N0M0 MIBC should strongly consider omitting NAC until the end of the COVID-19 pandemic. Whether to omit NAC in T3-4aN0M0 MIBC needs further discussion, and studies targeting only T2-3N0M0 MIBC are expected to proceed further.

by Adeeba Zaki, Salman Muhammad Soomar, Danish Hasan Khan, Hasan Shaharyar Sheikh, Raheel Iftikhar, Ayaz Mir, Zeba Aziz, Khadija Bano, Hafsa Naseer, Qamar un–Nisa Chaudhry, Syed Waqas Imam Bokhari, Munira Shabbir-Moosajee
Purpose COVID-19 infection resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began to spread across the globe in early 2020. Patients with hematologic malignancies are supposed to have an increased risk of mortality from coronavirus disease of 2019 (COVID-19) infection. From Pakistan, we report the analysis of the outcome and interaction between patient demographics and tumor subtype and COVID-19 infection and hematological malignancy. Patients and methods This multicenter, retrospective study included adult patients with a history of histologically proven hematological malignancies who were tested positive for COVID-19 via PCR presented at the oncology department of 5 tertiary care hospitals in Pakistan from February to August 2020. A patient with any known hematological malignancy who was positive for COVID-19 on RT-PCR, was included in the study. Chi-square test and Cox-regression hazard regression model was applied considering p ≤ 0.05 significant. Results A total of 107 patients with hematological malignancies were diagnosed with COVID-19, out of which 82 (76.64%) were alive, and 25 (23.36%) were dead. The significant hematological malignancy was B-cell Lymphoma in dead 4 (16.00%) and alive group 21 (25.61%), respectively. The majority of the patients in both the dead and alive group were on active treatment for hematological malignancy while they came positive for COVID-19 [21 (84.00%) & 48 (58.54%) p 0.020]. All patients in the dead group were admitted to the hospital 25 (100.00%), and among these, 14 (56.00%) were admitted in ICU with a median 11 (6–16.5) number of days. Among those who had contact exposure, the hazard of survival or death in patients with hematological malignancies and COVID-19 positive was 2.18 (CI: 1.90–4.44) times and 3.10 (CI: 2.73–4.60) times in patients with travel history compared to no exposure history (p 0.001). Conclusion Taken together, this data supports the emerging consensus that patients with hematologic malignancies experience significant morbidity and mortality resulting from COVID-19 infection.

by Rikki H. Sargent, Shaelyn Laurie, Leah Moncada, Leo F. Weakland, James V. Lavery, Daniel A. Salmon, Walter A. Orenstein, Robert F. Breiman

Various efforts to increase COVID-19 vaccination rates have been employed in the United States. We sought to rapidly investigate public reactions to these efforts to increase vaccination, including self-reported responses to widespread reduced masking behavior, monetary incentive programs to get vaccinated, and work vaccination requirements. Using a unique method for data collection (Random Domain Intercept Technology), we captured a large (N = 14,152), broad-based sample of the United States Web-using population (data collected from June 30 –July 26, 2021). About 3/4 of respondents reported being vaccinated. The likelihood of vaccination and vaccination intention differed across various demographic indicators (e.g., gender, age, income, political leaning). We observed mixed reactions to efforts aimed at increasing vaccination rates among unvaccinated respondents. While some reported that specific efforts would increase their likelihood of getting vaccinated (between 16% and 32%), others reported that efforts would decrease their likelihood of getting vaccinated (between 17% and 42%). Reactions differed by general vaccination intention, as well as other demographic indicators (e.g., race, education). Our results highlight the need to fully understand reactions to policy changes, programs, and mandates before they are communicated to the public and employed. Moreover, the results emphasize the importance of understanding how reactions differ across groups, as this information can assist in targeting intervention efforts and minimizing potentially differential negative impact.

by Jira Chansaenroj, Ritthideach Yorsaeng, Jiratchaya Puenpa, Nasamon Wanlapakorn, Chintana Chirathaworn, Natthinee Sudhinaraset, Manit Sripramote, Piti Chalongviriyalert, Supunee Jirajariyavej, Phatharaporn Kiatpanabhikul, Jatuporn Saiyarin, Chulikorn Soudon, Orawan Thienfaidee, Thitisan Palakawong Na Ayuthaya, Chantapat Brukesawan, Duangnapa Intharasongkroh, Dootchai Chaiwanichsiri, Mila Issarasongkhram, Rungrueng Kitphati, Anek Mungaomklang, Arunee Thitithanyanont, Pijaya Nagavajara, Yong Poovorawan

Understanding antibody responses after natural severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can guide the coronavirus disease 2019 (COVID-19) vaccine schedule, especially in resource-limited settings. This study aimed to assess the dynamics of SARS-CoV-2 antibodies, including anti-spike protein 1 (S1) immunoglobulin (Ig)G, anti-receptor-binding domain (RBD) total Ig, anti-S1 IgA, and neutralizing antibody against wild-type SARS-CoV-2 over time in a cohort of patients who were previously infected with the wild-type SARS-CoV-2. Between March and May 2020, 531 individuals with virologically confirmed cases of wild-type SARS-CoV-2 infection were enrolled in our immunological study. Blood samples were collected at 3-, 6-, 9-, and 12-months post symptom onset or detection of SARS-CoV-2 by RT-PCR (in asymptomatic individuals). The neutralizing titers against SARS-CoV-2 were detected in 95.2%, 86.7%, 85.0%, and 85.4% of recovered COVID-19 patients at 3, 6, 9, and 12 months after symptom onset, respectively. The seropositivity rate of anti-S1 IgG, anti-RBD total Ig, anti-S1 IgA, and neutralizing titers remained at 68.6%, 89.6%, 77.1%, and 85.4%, respectively, at 12 months after symptom onset. We observed a high level of correlation between neutralizing and SARS-CoV-2 spike protein-specific antibody titers. The half-life of neutralizing titers was estimated at 100.7 days (95% confidence interval = 44.5–327.4 days, R2 = 0.106). These results support that the decline in serum antibody levels over time in both participants with severe disease and mild disease were depended on the symptom severity, and the individuals with high IgG antibody titers experienced a significantly longer persistence of SARS-CoV-2-specific antibody responses than those with lower titers.

by Di Peng, Jian Qian, Luyi Wei, Caiying Luo, Tao Zhang, Lijun Zhou, Yuanyuan Liu, Yue Ma, Fei Yin
Purpose The ongoing coronavirus disease 2019 (COVID-19) epidemic increasingly threatens the public health security worldwide. We aimed to identify high-risk areas of COVID-19 and understand how socioeconomic factors are associated with the spatial distribution of COVID-19 in China, which may help other countries control the epidemic. Methods We analyzed the data of COVID-19 cases from 30 provinces in mainland China (outside of Hubei) from 16 January 2020 to 31 March 2020, considering the data of demographic, economic, health, and transportation factors. Global autocorrelation analysis and Bayesian spatial models were used to present the spatial pattern of COVID-19 and explore the relationship between COVID-19 risk and various factors. Results Global Moran’s I statistics of COVID-19 incidences was 0.31 (P

by Ramy Arnaout, Rima Arnaout

For most of the COVID-19 pandemic, the daily focus has been on the number of cases, and secondarily, deaths. The most recent wave was caused by the omicron variant, first identified at the end of 2021 and the dominant variant through the first part of 2022. South Africa, one of the first countries to experience and report data regarding omicron (variant 21.K), reported far fewer deaths, even as the number of reported cases rapidly eclipsed previous peaks. However, as the omicron wave has progressed, time series show that it has been markedly different from prior waves. To more readily visualize the dynamics of cases and deaths, it is natural to plot deaths per million against cases per million. Unlike the time-series plots of cases or deaths that have become daily features of pandemic updates during the pandemic, which have time as the x-axis, in a plot of deaths vs. cases, time is implicit, and is indicated in relation to the starting point. Here we present and briefly examine such plots from a number of countries and from the world as a whole, illustrating how they summarize features of the pandemic in ways that illustrate how, in most places, the omicron wave is very different from those that came before. Code for generating these plots for any country is provided in an automatically updating GitHub repository.

by Karen Shen

The COVID-19 pandemic has been particularly deadly for residents of nursing homes and other long-term care facilities. This paper analyzes COVID-19 deaths at nursing homes during the first wave of the pandemic in the United States during the spring and early summer 2020. By combining data on facility-level COVID-19 deaths during this period with data on the neighborhoods where nursing home staff reside for a sample of eighteen states, this paper finds that staff neighborhood characteristics were a large and significant predictor of COVID-19 nursing home deaths. Even after controlling for the county where a facility is located, one standard deviation increases in average staff neighborhood (Census tract) population density, public transportation use, and non-white share were associated with 1.3 (p .001), 1.4 (p .001), and 0.9 (p .001) additional deaths per 100 beds, respectively. These effects are larger than all facility management or quality variables, and larger than the effect of the nursing home’s own neighborhood characteristics. These results suggest COVID-19 outbreaks in staff communities can have large consequences for the facilities where they work, even in highly-rated facilities, and that disparities in nursing home outbreaks may be related to differences in the types of neighborhoods nursing home staff live in.

by Galvin Sim Siang Lin, Hern Yue Lee, Jia Zheng Leong, Mohammad Majduddin Sulaiman, Wan Feun Loo, Wen Wu Tan
Background Dental practitioners and dental students are classified as high-risk exposure to COVID-19 due to the nature of dental treatments, but evidence of their acceptance towards COVID-19 vaccination is still scarce. Hence, this systemic review aims to critically appraise and analyse the acceptability of COVID-19 vaccination among dental students and dental practitioners. Materials and methods This review was registered in the PROSPERO database (CRD42021286108) based on PRISMA guidelines. Cross-sectional articles on the dental students’ and dental practitioners’ acceptance towards COVID-19 vaccine published between March 2020 to October 2021 were searched in eight online databases. The Joanna Briggs Institute critical appraisal tool was employed to analyse the risk of bias (RoB) of each article, whereas the Oxford Centre for Evidence-Based Medicine recommendation tool was used to evaluate the level of evidence. Data were analysed using the DerSimonian-Laird random effect model based on a single-arm approach. Results Ten studies were included of which three studies focused on dental students and seven studies focused on dental practitioners. Four studies were deemed to exhibit moderate RoB and the remaining showed low RoB. All the studies demonstrated Level 3 evidence. Single-arm meta-analysis revealed that dental practitioners had a high level of vaccination acceptance (81.1%) than dental students (60.5%). A substantial data heterogeneity was observed with the overall I2 ranging from 73.65% and 96.86%. Furthermore, subgroup analysis indicated that dental practitioners from the Middle East and high-income countries showed greater (p 0.05) acceptance levels, while meta-regression showed that the sample size of each study had no bearing on the degree of data heterogeneity. Conclusions Despite the high degree of acceptance of COVID-19 vaccination among dental practitioners, dental students still demonstrated poor acceptance. These findings highlighted that evidence-based planning with effective approaches is warranted to enhance the knowledge and eradicate vaccination hesitancy, particularly among dental students.

by Fares Qeadan, Benjamin Tingey, Jamie Egbert, Marcus G. Pezzolesi, Mark R. Burge, Kathryn A. Peterson, Trenton Honda
Objective To assess the risk of new-onset type 1 diabetes mellitus (T1D) diagnosis following COVID-19 diagnosis and the impact of COVID-19 diagnosis on the risk of diabetic ketoacidosis (DKA) in patients with prior T1D diagnosis. Research design and methods Retrospective data consisting of 27,292,879 patients from the Cerner Real-World Data were used. Odds ratios, overall and stratified by demographic predictors, were calculated to assess associations between COVID-19 and T1D. Odds ratios from multivariable logistic regression models, adjusted for demographic and clinical predictors, were calculated to assess adjusted associations between COVID-19 and DKA. Multiple imputation with multivariate imputation by chained equations (MICE) was used to account for missing data. Results The odds of developing new-onset T1D significantly increased in patients with COVID-19 diagnosis (OR: 1.42, 95% CI: 1.38, 1.46) compared to those without COVID-19. Risk varied by demographic groups, with the largest risk among pediatric patients ages 0–1 years (OR: 6.84, 95% CI: 2.75, 17.02) American Indian/Alaskan Natives (OR: 2.30, 95% CI: 1.86, 2.82), Asian or Pacific Islanders (OR: 2.01, 95% CI: 1.61, 2.53), older adult patients ages 51–65 years (OR: 1.77, 95% CI: 1.66, 1.88), those living in the Northeast (OR: 1.71, 95% CI: 1.61, 1.81), those living in the West (OR: 1.65, 95% CI: 1.56, 1.74), and Black patients (OR: 1.59, 95% CI: 1.47, 1.71). Among patients with diagnosed T1D at baseline (n = 55,359), 26.7% (n = 14,759) were diagnosed with COVID-19 over the study period. The odds of developing DKA for those with COVID-19 were significantly higher (OR 2.26, 95% CI: 2.04, 2.50) than those without COVID-19, and the largest risk was among patients with higher Elixhauser Comorbidity Index. Conclusions COVID-19 diagnosis is associated with significantly increased risk of new-onset T1D, and American Indian/Alaskan Native, Asian/Pacific Islander, and Black populations are disproportionately at risk. In patients with pre-existing T1D, the risk of developing DKA is significantly increased following COVID-19 diagnosis.

by Jason Cham, Amitabh C. Pandey, Jacob New, Tridu Huynh, Lee Hong, Natalia Orendain, Eric J. Topol, Laura J. Nicholson
Aim Healthcare workers (HCWs) were among the first group of people vaccinated with the Pfizer-BioNTech Covid-19 vaccine (BNT162b2). Characterization of the kinetics of antibody response to vaccination is important to devise future vaccination strategies. To better characterize the antibody response to BNT162b2, we analyzed the kinetics of IgG and IgM antibody response to 5 different SARS-CoV-2 epitopes over a period of 6 months. Methods and results An observational single-centered study was conducted to evaluate the temporal dynamics of anti-SARS-CoV-2 antibodies following immunization with two doses of BNT162b2. Anti-SARS-CoV-2 antibodies were assessed using the Maverick SARS-CoV-2 multi-antigen panel (Genalyte Inc.). Healthcare workers aged ≥18 receiving BNT162b2 vaccination who self-reported no prior symptoms of COVID-19 nor prior COVID-19 PCR test positivity, were included in this study. HCWs developed an IgG antibody response to SARS-CoV-2 Spike S1, Spike S1 receptor binding domain (RBD), Spike S1S2 and Spike S2 after vaccination. IgG response was observed at two weeks following immunization in most participant samples and continued to increase at week 4, but subsequently decreased significantly starting at 3 months and up to 6 months. In contrast, IgM response to respective epitopes was minimal. Conclusion Multiplex results demonstrate that, contrary to natural infection, immunization with BNT162b2 produces minimal anti-Spike IgM response. Polyclonal IgG response to Spike declined at 3 months and continued to do so up to 6 months.

by Hailemichael Bizuneh, Shikur Mohammed, Aman Yesuf
Background Despite efforts to contain the spread of COVID-19, Addis Ababa, the country’s COVID-19 epicenter, is experiencing a sharp increase in the number of cases and death rate. While poor public adherence to COVID-19 precautionary practices is evident, factors associated with it are not well studied. We aimed to assess the level of practice of COVID-19 precaution and associated factors. Methods This was a hospital-based cross-sectional study conducted from February 1st to 15th, 2021 at Saint Paul’s Hospital Millennium Medical College, a tertiary teaching hospital in Addis Ababa, Ethiopia. We used a structured questionnaire to conduct a face-to-face exit interview with clients visiting the hospital. Systematic random sampling was employed to recruit study participants. Binary and multivariable logistic regressions were implemented to examine factors associated with precautionary practices. Statistical significance was declared at p-value

by Antonio José Sánchez-Guarnido, Beatriz Machado Urquiza, Maria del Mar Soler Sánchez, Carmen Masferrer, Francisca Perles, Eleni Petkari
Background Interventions with patients with Serious Mental Illness (SMI) had to adapt rapidly to the COVID-19 safety restrictive measures, leading to the widespread use of teletherapy as an alternative. Objectives The aims of this study were to compare the use of different intervention modalities with patients with SMI during the first wave of the pandemic and examine their association with emergency hospital visits and hospitalization rates six months later. Methods Records of 270 service users of fifteen outpatient mental health services across Spain, were retrospectively assessed. We retrieved clinical data and data on the modality of intervention received (in-person, over the phone, videoconferencing) in three time points (before, during and after the first COVID-19 wave). Also, data were retrieved regarding the frequency of their emergency hospital visits and hospitalization rates, two, four and six months later. Results During the first wave of the pandemic, teletherapy (over the phone and videoconferencing) was the modality most widely used, whilst in-person therapy sessions were significantly reduced, though they seemed to return to pre-COVID levels after the first wave had passed. Importantly, patients receiving teletherapy during the first wave seemed to have significantly fewer emergency visits and hospitalization rates four and six months later (χ2 = 13.064; p .001). Multilevel analyses revealed that patients receiving videoconferencing interventions had fewer hospitalizations six months after the first wave (OR = 0.25; p = .012). Conclusions Under challenging circumstances as those created by the COVID pandemic, teletherapy is a useful tool for protection against hospitalizations and can be used as an alternative to in-person therapy, to ensure continuity of care for patients with SMI.

by Kin Wah Fung, Seo H. Baik, Fitsum Baye, Zhaonian Zheng, Vojtech Huser, Clement J. McDonald
Background Maintenance drugs are used to treat chronic conditions. Several classes of maintenance drugs have attracted attention because of their potential to affect susceptibility to and severity of COVID-19. Methods Using claims data on 20% random sample of Part D Medicare enrollees from April to December 2020, we identified patients diagnosed with COVID-19. Using a nested case-control design, non-COVID-19 controls were identified by 1:5 matching on age, race, sex, dual-eligibility status, and geographical region. We identified usage of angiotensin-converting enzyme inhibitors (ACEI), angiotensin-receptor blockers (ARB), statins, warfarin, direct factor Xa inhibitors, P2Y12 inhibitors, famotidine and hydroxychloroquine based on Medicare prescription claims data. Using extended Cox regression models with time-varying propensity score adjustment we examined the independent effect of each study drug on contracting COVID-19. For severity of COVID-19, we performed extended Cox regressions on all COVID-19 patients, using COVID-19-related hospitalization and all-cause mortality as outcomes. Covariates included gender, age, race, geographic region, low-income indicator, and co-morbidities. To compensate for indication bias related to the use of hydroxychloroquine for the prophylaxis or treatment of COVID-19, we censored patients who only started on hydroxychloroquine in 2020. Results Up to December 2020, our sample contained 374,229 Medicare patients over 65 who were diagnosed with COVID-19. Among the COVID-19 patients, 278,912 (74.6%) were on at least one study drug. The three most common study drugs among COVID-19 patients were statins 187,374 (50.1%), ACEI 97,843 (26.2%) and ARB 83,290 (22.3%). For all three outcomes (diagnosis, hospitalization and death), current users of ACEI, ARB, statins, warfarin, direct factor Xa inhibitors and P2Y12 inhibitors were associated with reduced risks, compared to never users. Famotidine did not show consistent significant effects. Hydroxychloroquine did not show significant effects after censoring of recent starters. Conclusion Maintenance use of ACEI, ARB, warfarin, statins, direct factor Xa inhibitors and P2Y12 inhibitors was associated with reduction in risk of acquiring COVID-19 and dying from it.

Title: Análise espaço temporal do primeiro ano da pandemia de COVID-19 no município do Rio de Janeiro
Authors: Santos, Cleber Vinicius Brito dos; Cavalcante, João Roberto; Pungartnik, Paula Cristina; Guimarães, Raphael Mendonça
Abstract: Objetivo: Descrever a evolução espaço temporal de detecção de casos e mortalidade por COVID‑19 no município do Rio de Janeiro durante o primeiro ano da pandemia. Métodos: Foi realizado um estudo ecológico cujas unidades de análise foram os bairros do município do Rio de Janeiro. Calcularam‑se as taxas de incidência e mortalidade, excesso de risco, índice de Moran global (I de Moran), indicador local de associação espacial, razão de incidência padronizada e razão de mortalidade padronizada para bairros do município do Rio de Janeiro. Resultados: Foram notificados 204.888 casos e 19.017 óbitos por COVID‑19. O município apresentou durante os três primeiros meses de pandemia taxas de incidência superiores às do estado do Rio de Janeiro e do Brasil e taxas de mortalidade superiores às do estado do Rio de Janeiro e Brasil de maio de 2020 até fevereiro de 2021. Bonsucesso foi o bairro com maiores taxas de incidência e mortalidade, e ao longo dos bairros e dos meses não há sincronia entre os piores momentos da pandemia de COVID‑19. Conclusão: Ressaltamos a necessidade de implantação de medidas mais rígidas para controle e prevenção da COVID‑19, aumento na detecção de casos e aceleração da campanha de imunização.

by Kangzhuang Yuan, Yuan Chen, Meifeng Zhong, Yongping Lin, Lidong Liu
Background Dengue is a major public health issue worldwide and severe dengue (SD) is life threatening. It is critical to triage patients with dengue infection in the early stage. However, there is limited knowledge on early indicators of SD. The objective of this study is to identify risk factors for the prognosis of SD and try to find out some potential predictive factors for SD from dengue fever (DF) in the early of infection. Methods The PubMed, Cochrane Library and Web of Science databases were searched for relevant studies from June 1999 to December 2020. The pooled odds ratio (OR) or standardized mean difference (SMD) with 95% confidence intervals (CI) of identified factors was calculated using a fixed or random effect model in the meta-analysis. Tests for heterogeneity, publication bias, subgroup analyses, meta-regression, and a sensitivity analysis were further performed. Findings A total of 6,848 candidate articles were retrieved, 87 studies with 35,184 DF and 8,173 SD cases met the eligibility criteria. A total of 64 factors were identified, including population and virus characteristics, clinical symptoms and signs, laboratory biomarkers, cytokines, and chemokines; of these factors, 34 were found to be significantly different between DF and SD, while the other 30 factors were not significantly different between the two groups after pooling the data from the relevant studies. Additionally, 9 factors were positive associated with SD within 7 days after illness when the timing subgroup analysis were performed. Conclusions Practical factors and biomarkers for the identification of SD were established, which will be helpful for a prompt diagnosis and early effective treatment for those at greatest risk. These outcomes also enhance our knowledge of the clinical manifestations and pathogenesis of SD.

by Chanapai Chaiyakulsil, Paskorn Sritipsukho, Araya Satdhabudha, Pornumpa Bunjoungmanee, Auchara Tangsathapornpong, Phakatip Sinlapamongkolkul, Naiyana Sritipsukho
Background There were limited epidemiological data of pediatric COVID-19 in Asia outside China, especially during the era of the variants of concern such as the Delta and Alpha variants. The objective was to describe the clinical epidemiology of pediatric COVID-19 in a tertiary care center in Thailand from April to August 2021. The identification of risk factors for the development of pneumonia in these children was also performed. Methods This retrospective cohort study was conducted by retrospective chart review of all children aged 0–15 years admitted to Thammasat University Hospital care system during the study period. The risk factors for the development of pneumonia were analyzed using logistic regression. Results A total of 698 children were included for analysis, of which 52% were male. The mean age of the cohort was 7.2 + 4.5 years old. Radiographic pneumonia was identified in 100 children (14.3%) and a total of 16 children (2.3%) were diagnosed with severe and critical diseases. The mortality rate was 0.1%. Children younger than 1 year and children with comorbidity were at higher risk of developing pneumonia (Adjusted odds ratios 2.99 (95% confidence interval (CI): 1.56–5.74) and 2.32 (95% CI: 1.15–4.67), respectively). Conclusion In the era of the variants of concern, the proportion of children with severe and critical diseases remained low. However, prudence must be taken in caring for younger children and children with comorbidity.

by Chenyang Lin, Yuxin Tong, Yaying Bai, Zixi Zhao, Wenxiang Quan, Zhaorui Liu, Jiuju Wang, Yanping Song, Ju Tian, Wentian Dong
Background Previous studies showed that the COVID-19 outbreak increased the levels of depression and anxiety in heterogeneous populations. However, none has explored the prevalence and correlates of depression and anxiety among Chinese international students studying in US colleges during the pandemic. Objective This study examines the prevalence of depression and anxiety among Chinese international students enrolled in US universities during the COVID-19 pandemic and identifies the associated factors, including habits, social and psychological support, sleep quality, and remote learning. Methods Between June and July 2020, we conducted a cross-sectional study through Wenjuanxing, a web-based survey platform. Participants were recruited with snowball sampling through 21 Chinese international student associations in US universities. The survey consisted of demographic questions, the Social Support Rating Scale (SSRS), the Insomnia Severity Index (ISI), the Patient Health Questionnaire-9 (PHQ-9), the General Anxiety Disorder-7 (GAD-7), and self-constructed questions on academic performance, financial concerns, use of social media, physical exercise, and psychological support. Cut-off scores of 10 were used for both PHQ-9 and GAD-7 to determine the binary outcomes of depression and anxiety, respectively. Bivariant analyses and multivariable logistic regression analyses were performed to identify the associated factors. Results Among 1881 participants, we found a prevalence of depression (PHQ-9 score⩾ 10) at 24.5% and that of anxiety (GAD-7 score⩾ 10) at 20.7%. A higher risk of depression was associated with recent exposure to traumatic events, agreement to pandemic’s negative impacts on financial status, agreement and strong agreement to the negative impacts of remote learning on personal relationships, and a higher ISI score. A lower risk of depression was associated with disagreement to the negative impacts of remote learning on academic performance and future careers, strong willingness to seek professional help with emotional issues, and a higher SSRS score. In addition, a higher risk of anxiety was associated with recent exposure to traumatic events, a lot of workloads, often staying up for online classes, agreement and strong agreement to the negative impacts of remote learning on personal relationships, and a higher ISI score. A lower risk of anxiety was associated with the willingness and strong willingness to seek professional help with emotional issues, and a higher SSRS score. Conclusion This study showed a high prevalence of depression and anxiety among Chinese international students studying in US colleges during the COVID-19 pandemic. Multiple correlates—including recent exposure to traumatic events, pandemic-related financial concerns, workload, social support, remote learning, willingness to seek professional help, and sleep quality—were identified. It is critical for future studies to further investigate this student population and for universities to provide more flexible learning options and more access to psychological services.

by Nadia N. Abuelezam, Kristina L. Greenwood, Sandro Galea, Raed Al-Naser
Background Understanding of COVID-19 acquisition and severity risk in minoritized groups is limited by data collection on race and ethnicity; very little is known about COVID-19 risk among Arab Americans in the United States. Purpose To quantify whether Arab Americans in the El Cajon region of California experienced differential levels of SARS-CoV-2 infection, severity and mortality when compared to other racial/ethnic groups. Methods A retrospective study was conducted using Sharp Grossmont Hospital’s electronic medical records. Patients were included in the study if they were: 18 years of age or older, tested for SARS-CoV-2, admitted for COVID-19 infection, or had COVID-19 listed as a cause of death between March 1, 2020 and January 31, 2021. The primary outcomes of interest were a positive COVID-19 test result, admission to the hospital due to COVID-19, and in hospital COVID-19 related mortality. Comparisons were made across racial/ethnic groups using chi-squared statistics and logistic regression models adjusted for sociodemographics, comorbidities, and time from March 2020. Results Arab Americans had greater odds of testing positive for SARS-CoV-2 than non-Hispanic White (adjusted odds ratio, AOR: 3.83, 95% confidence interval, CI: 3.29, 4.46) and non-Hispanic Black (AOR: 2.34, 95% CI: 1.91, 2.88) patients but lower odds of admission (AOR: 0.47, 95% CI: 0.36, 0.63) and in-hospital mortality (AOR: 0.43, 95% CI: 0.28, 0.65) than Hispanic patients. Conclusions There were distinct patterns for COVID-19 infection, severity, and mortality for Arab Americans in Southern California. Without a dedicated ethnic identifier, COVID-19 disparities facing Arab Americans will continue to go undocumented.

by Yvonne J. Kuipers, Roxanne Bleijenbergh, Laura Van den Branden, Yannic van Gils, Sophie Rimaux, Charlotte Brosens, Astrid Claerbout, Eveline Mestdagh
Background The COVID-19 pandemic is likely to influence psychological health of pregnant and postpartum women. Methods We conducted a non-concurrent cross-sectional study among 1145 women living in the Dutch-speaking part of Belgium, 541 pregnant and 604 postpartum women. We measured psychological health with the Whooley questions, Generalized Anxiety Disorder 2-item (GAD-2) and the Edinburgh Postnatal Depression Scale (EPDS) and compared the scores of pregnant and postpartum women before and during the COVID-19 pandemic. Results No differences were observed in the Whooley, GAD-2 or EPDS scores among pregnant women. The postpartum total GAD-2 scores before vs during the pandemic showed significant differences. Controlling for confounders, we observed a small main positive effect of having an infant during time of COVID-19 (F(1.13) = 5.06, p.025, d.27). The effect was significantly larger for women with (a history of) perinatal psychological problems (F(1.12) = 51.44, p .001, d.82). Emotional support was significantly related to GAD-2 scores of postpartum women during the pandemic (F(1.90) = 35.54, p .001). Postpartum women reported significant higher effects of the pandemic on their behavior compared to pregnant women (p.034). Conclusion The COVID-19 pandemic seems to have a positive effect on postpartum women during the first year postpartum, in particular for women with (a history of) perinatal psychological problems and for those women who experienced emotional support. The findings suggest that less external stimuli caused by lockdown restrictions might have a positive effect on postpartum women’s emotional wellbeing. The sample consisted of white, educated women in a relationship and information regarding the extent of exposure to adverse COVID-19 consequences was lacking. We relied on self-selection and self-report. The postpartum pandemic sample was small.

by Hajime Tomura
Background Social distancing measures to prevent the spread of COVID-19 included restrictions on retail services in many countries. In some countries, the governments also subsidized consumer spending on part of retail services to help struggling businesses. To evaluate the costs and benefits of government interventions in retail services, it is necessary to measure the infectiousness of each type of consumer activity. Methods This study regresses the log difference over seven days in the number of new confirmed cases of COVID-19 in Japan on lagged values of household expenditures per household on eating out, traveling, admissions to entertainment facilities, clothing and footwear, and the other items, as well as a measure of mobility in public transportation in the past 14 days. The sample period of the dependent variable is set from March 1, 2020, to February 1, 2021, in order to avoid a possible structural break due to the spread of mutant strains in 2021. The regression model is estimated by the Bayesian method with a non-informative (improper) prior. The estimated model is evaluated by out-of-sample forecast performance from February 2, 2021, onward. Results The out-of-sample forecasts of the regression by the posterior means of regression coefficients perform well before the spread of the Delta variant in Japan since June 2021. R2 for the out-of-sample forecasts from February 2, 2021, to June 30, 2021, is 0.60. The dependent variable of the regression overshot the out-of-sample forecasts from mid-June to August 2021. Then, the out-of-sample forecasts overpredicted the dependent variable for the rest of 2021. Conclusion The estimated model can be potentially useful in simulating changes in the number of new confirmed cases due to household spending on retail services, if it can be adjusted to real-time developments of mutant strains and vaccinations. Such simulations would help in designing cost-efficient government interventions.

Title: Virucidal activity evaluation of hydrogen peroxide wipes against the AZD1222-chimpanzee adenovirus in active pharmaceutical ingredient and the recombinant COVID-19 vaccine
Authors: Rhodes, Vinícius Pessanha; Ajorio, Ana Carolina Ferreira Ballestê; Rodrigues, Anderson Peclat; Costa, Luciana Veloso da; Miranda, Rebeca Vitória da Silva Lage de

Title: Continued Process Verification for COVID-19 Vaccine Formulation and Packaging (recombinant)
Authors: Silva, Paulo Vitor Carvalho da; Correia, Pedro Guilherme Muniz; Grugel, Daiane Martins; Ferreira, Victor de Oliveira Silva; Gonçalves, Rayane Natashe

Title: Radar Covid-19: favelas: edição 15
Authors: Lima, André; Araújo, Fábio; Madureira, José Leonídio; Martins, Mariane; Gondim, Roberta; Batistella, Carlos Eduardo
Abstract: Radar COVID-19 Favelas é um informativo produzido no âmbito da Sala de Situação Covid-19 nas Favelas do Rio de Janeiro, vinculada ao Observatório COVID-19 da Fiocruz. Estruturado com base no monitoramento ativo (vigilância de rumores) de fontes não oficiais – mídias, redes sociais e contato direto com moradores, coletivos, movimentos sociais, instituições e articuladores locais – busca sistematizar, analisar e disseminar informações sobre a situação de saúde nos territórios selecionados, visando promover a visibilidade das diversas situações de vulnerabilidade e antecipar as iniciativas de enfrentamento da pandemia.
Description: Movimentos Sociais e coletivos: Conselho Comunitário de Manguinhos; Iniciativa Direito à Memória e Justiça Racial; Teia de Solidariedade Zona Oeste. Revisão: Fábio Araújo, Luiza Gomes Henriques; Projeto Gráfico: Mariane Martins; Diagramação: Paulo Roberto de Oliveira Ribeiro.

by Mila Nu Nu Htay, Laurence Lloyd Parial, Ma. Carmen Tolabing, Kevin Dadaczynski, Orkan Okan, Angela Yee Man Leung, Tin Tin Su

During the COVID-19 pandemic, there is a growing interest in online information about coronavirus worldwide. This study aimed to investigate the digital health literacy (DHL) level, information-seeking behaviour, and satisfaction of information on COVID-19 among East and South-East Asia university students. This cross-sectional web-based study was conducted between April to June 2020 by recruiting students from universities in China, Malaysia, and the Philippines. University students who have Internet access were invited to participate in the study. Items on sociodemographic variables, DHL, information-seeking behaviour, and information satisfaction were included in the questionnaire. Descriptive statistics and logistic regression analysis were conducted. A total of 5302 university students responded to the survey. The overall mean score across the four DHL subscales was 2.89 (SD: 0.42). Search engines (e.g., Google, Bing, Yahoo) (92.0%) and social media (88.4%) were highly utilized by the students, whereas Websites of doctors or health insurance companies were of lower utilization (64.7%). Across the domains (i.e., adding self-generated content, determining relevance, evaluating reliability, and protecting privacy) higher DHL was positively associated with higher usage of trustworthy resources. Providing online information on COVID-19 at official university websites and conducting health talks or web-based information dissemination about the strategies for mental health challenges during pandemic could be beneficial to the students. Strengthening DHL among university students will enhance their critical thinking and evaluation of online resources, which could direct them to the quality and trustworthy information sources on COVID-19.

by Bienvenido León, María-Pilar Martínez-Costa, Ramón Salaverría, Ignacio López-Goñi

A massive “infodemic” developed in parallel with the global COVID-19 pandemic and contributed to public misinformation at a time when access to quality information was crucial. This research aimed to analyze the science and health-related hoaxes that were spread during the pandemic with the objectives of (1) identifying the characteristics of the form and content of such false information, and the platforms used to spread them, and (2) formulating a typology that can be used to classify the different types of hoaxes according to their connection with scientific information. The study was conducted by analyzing the content of hoaxes which were debunked by the three main fact-checking organizations in Spain in the three months following WHO’s announcement of the pandemic (N = 533). The results indicated that science and health content played a prominent role in shaping the spread of these hoaxes during the pandemic. The most common hoaxes on science and health involved information on scientific research or health management, used text, were based on deception, used real sources, were international in scope, and were spread through social networks. Based on the analysis, we proposed a system for classifying science and health-related hoaxes, and identified four types according to their connection to scientific knowledge: “hasty” science, decontextualized science, badly interpreted science, and falsehood without a scientific basis. The rampant propagation and widespread availability of disinformation point to the need to foster media and scientific caution and literacy among the public and increase awareness of the importance of timing and substantiation of scientific research. The results can be useful in improving media literacy to face disinformation, and the typology we formulate can help develop future systems for automated detection of health and science-related hoaxes.

by Agnieszka Bieńkowska, Anna Koszela, Anna Sałamacha, Katarzyna Tworek

The COVID-19 crisis forced many changes to occur within organizations, which were necessary to keep the continuance of the organization’s operations. Job performance seems to be an important factor determining such continuance, through its influence on the performance of entire organization. Shaping and keeping job performance in times of COVID-19 pandemic was a challenge for organizations, due to its negative impact on employees, causing their stress or lack of sense of security. There is a growing role of HRM specialists in appropriately shaping HRM strategies that can positively shape job-related attitudes, resulting in enhanced job performance during such difficult times. Therefore, this study aims to explain the role of COVID-19 oriented HRM strategies in shaping job performance through job-related attitudes such as work motivation, job satisfaction, and organizational commitment in a time of crisis occurring in the organization due to the COVID-19 pandemic. The study was conducted among 378 organizations operating in Poland during 2nd wave of COVID-19 pandemic. To verify the hypotheses, descriptive statistics were calculated using IBM SPSS and path analysis was performed using IBM AMOS. The result shows that combined set of "hard" HRM strategies related to the financial aspects and "soft" HRM strategies related to keeping employees’ wellbeing during the crisis gives the best results in shaping job performance through job-related attitudes and consequently strengthening organizational performance. This study contributes to the knowledge concerning the development of COVID-19 oriented HRM strategies, which may also have practical application.

by Katherine LeMasters, Shabbar Ranapurwala, Morgan Maner, Kathryn M. Nowotny, Meghan Peterson, Lauren Brinkley-Rubinstein
Background COVID-19 and mass incarceration are closely intertwined with prisons having COVID-19 case rates much higher than the general population. COVID-19 has highlighted the relationship between incarceration and health, but prior work has not explored how COVID-19 spread in communities have influenced case rates in prisons. Our objective was to understand the relationship between COVID-19 case rates in the general population and prisons located in the same county. Methods Using North Carolina’s (NC) Department of Health and Human Services data, this analysis examines all COVID-19 tests conducted in NC from June-August 2020. Using interrupted time series analysis, we assessed the relationship between substantial community spread (50/100,000 detected in the last seven days) and active COVID-19 case rates (cases detected in the past 14 days/100,000) within prisons. Results From June-August 2020, NC ordered 29,605 tests from prisons and detected 1,639 cases. The mean case rates were 215 and 427 per 100,000 in the general and incarcerated population, respectively. Once counties reached substantial COVID-19 spread, the COVID-19 prison case rate increased by 118.55 cases per 100,000 (95% CI: -3.71, 240.81). Conclusions Community COVID-19 spread contributes to COVID-19 case rates in prisons. In counties with prisons, community spread should be closely monitored. Stringent measures within prisons (e.g., vaccination) and decarceration should be prioritized to prevent COVID-19 outbreaks.

by Vidya Eswaran, Anna Marie Chang, R. Gentry Wilkerson, Kelli N. O’Laughlin, Brian Chinnock, Stephanie A. Eucker, Brigitte M. Baumann, Nancy Anaya, Daniel G. Miller, Adrianne N. Haggins, Jesus R. Torres, Erik S. Anderson, Stephen C. Lim, Martina T. Caldwell, Ali S. Raja, Robert M. Rodriguez, The REVVED-UP Investigators
Study objective Facemask use is associated with reduced transmission of SARS-CoV-2. Most surveys assessing perceptions and practices of mask use miss the most vulnerable racial, ethnic, and socio-economic populations. These same populations have suffered disproportionate impacts from the pandemic. The purpose of this study was to assess beliefs, access, and practices of mask wearing across 15 urban emergency department (ED) populations. Methods This was a secondary analysis of a cross-sectional study of ED patients from December 2020 to March 2021 at 15 geographically diverse, safety net EDs across the US. The primary outcome was frequency of mask use outside the home and around others. Other outcome measures included having enough masks and difficulty obtaining them. Results Of 2,575 patients approached, 2,301 (89%) agreed to participate; nine had missing data pertaining to the primary outcome, leaving 2,292 included in the final analysis. A total of 79% of respondents reported wearing masks “all of the time” and 96% reported wearing masks over half the time. Subjects with PCPs were more likely to report wearing masks over half the time compared to those without PCPs (97% vs 92%). Individuals experiencing homelessness were less likely to wear a mask over half the time compared to those who were housed (81% vs 96%). Conclusions Study participants reported high rates of facemask use. Respondents who did not have PCPs and those who were homeless were less likely to report wearing a mask over half the time and more likely to report barriers in obtaining masks. The ED may serve a critical role in education regarding, and provision of, masks for vulnerable populations.