Monitoramento das Produções

by Upama Chowdhury, Md. Ahosan Habib Suvro, Syed M. D. Farhan, Md Jamal Uddin
Introduction Students generally struggle to build a good career after their graduation in developing countries like Bangladesh. Due to the COVID-19 pandemic, such struggle increased and faced with stress and depression. We aimed to inquire about the amplitude of depression and stress among university students during the COVID-19 pandemic regarding their future careers and to identify the factors associated with this depression and stress. Methods A total of 516 students at various universities participated in this cross-sectional survey. From October 2020 to February 2021, data was collected through an online survey. An e-questionnaire with socio-demographic, Patient Health Questionnaire (PHQ-9) and Perceived Stress Scale (PSS-10) questions was created using Google Forms and distributed via Facebook, WhatsApp, and other social media platforms. The universities included into the sample were selected randomly from eight divisions of Bangladesh. Descriptive statistics and Pearson chi-square tests were carried out and the association between the risk factors and the outcome (e.g. depression and stress) was assessed by the odds ratio (OR) including 95% confidence interval (CI) obtained from the binary logistic regression model. Results Among 516 participants, 380 (73.6%) were male and 136 (26.4%) were female. Around 414 (80.2%) participants had mild to severe depression and 399 (77.3%) reported having low to moderately perceived stress. Female students were 2.1 (95% CI: 1.21–3.76) times more depressed and 3.6 (95% CI: 1.87–6.76) times more stressed than the counterpart. Students, who think delaying graduation due to COVID-19 will reduce the chance of getting a job, were 1.72 (95% CI: 1.07–2.76) times more depressed. Respondents, whose department offers any internship were 36% less depressed (p = 0.053), while skilled students were 46% less stressed though it was not statistically significant (p = 0.43). Conclusion According to our findings, there is an increasing prevalence of depression and stress among students, particularly among female students and those who do not receive job-related facilities from their institutions or who are unskilled. Universities can provide mental health programs and strive to have enough space for students to participate in internships. In addition, the government and educational institutions should work together to address the growing challenge.

by Carlotta Pipolo, Daniele Bottai, Emanuela Fuccillo, Eleonora Aronica, Fabio Bruschi, Antonio Mario Bulfamante, Luca Castellani, Maria Paola Canevini, Davide Chiumello, Sergio Ferrari, Carla Martinelli, Stefano Muttini, Alberto Priori, Alberto Maria Saibene, Chiara Spoldi, Delfina Tosi, Gianluigi Zanusso, Gaetano Pietro Bulfamante, Giovanni Felisati

The aim of the present study is to detect the presence of SARS-CoV-2 of patients affected by COVID-19 in olfactory mucosa (OM), sampled with nasal brushing (NB) and biopsy, and to assess whether a non-invasive procedure, such as NB, might be used as a large-scale procedure for demonstrating SARS-CoV-2 presence in olfactory neuroepithelium. Nasal brushings obtained from all the COVID-19 patients resulted positive to SARS-CoV-2 immunocytochemistry while controls were negative. Double immunofluorescence showed that SARS-CoV-2 positive cells included supporting cells as well as olfactory neurons and basal cells. OM biopsies showed an uneven distribution of SARS-CoV-2 positivity along the olfactory neuroepithelium, while OM from controls were negative. SARS-CoV-2 was distinctively found in sustentacular cells, olfactory neurons, and basal cells, supporting what was observed in NB. Ultrastructural analysis of OM biopsies showed SARS-CoV-2 viral particles in the cytoplasm of sustentacular cells. This study shows the presence of SARS-CoV-2 at the level of the olfactory neuroepithelium in patients affected by COVID-19. For the first time, we used NB as a rapid non-invasive tool for assessing a potential neuroinvasion by SARS-CoV-2 infection.

by Sreshtha Chowdhury, Simanta Roy, Mohammad Azmain Iktidar, Shahidur Rahman, Mowshomi Mannan Liza, A. M. Khairul Islam, Sharmin Akhter, Madhuritu Bhadra Medha, Afia Tasnim, Antara Das Gupta, Auditia Deb, Shresta Chowdhury, Mohammad Delwer Hossain Hawlader
Background When caring for COVID-19 patients, using personal protective equipment (PPE) may significantly lower the risk of infection of health care workers (HCWs). However, adverse responses due to PPE use have been observed during the 2003 SARS pandemic. This study will highlight the different adverse reactions caused by face mask use, one of the essential components of PPE in the HCWs, and identify the factors associated with these problems. Methods This cross-sectional survey was conducted between September and October 2021. 404 HCWs were selected by snowball sampling from four randomly selected healthcare facilities of Bangladesh. Trained volunteers collected data by face-to-face interview using a pretested structured questionnaire. Data were analyzed using STATA (v.16) and summarized using frequency and relative frequency. Later, the chi-square test was used to explore bivariate relationships, and the binary logistic regression model was fit to identify the predictors. Results The majority of the respondents were 26–36 years (70.30%), male (69.80%), and doctors (74.50%). 48.76% of the respondents had unfavorable skin responses beneath the face masks; female gender, physicians, professionals working more than 32 hours a week, wearing N95, and more than one mask were predictors of skin problem. 28.47% and 60.15% of all participants suffered from some form of oral and neurological problems, respectively. Conclusion Face mask use sequelae, especially skin, oral and neurological problems, are prevalent among health care workers. Therefore, necessary precautionary measures should be taken to safeguard our frontlines.

Title: Implementation of the Occupational Risk Management Program-ORMP in the production processes of the Covid-19 vaccine: Bio-Manguinhos case study
Authors: Teixeira, Marcelo Bouzas Barbosa; Horato, Caroline Mendonça

by Nur Aziah Ismail, Ahmad Nazrin Jaapar, Alwi Mohamed Yunus, Abdul Rais Sanusi, Mohamed Ezani Taib, Mohd Azhari Yakub
Background Ever since COVID-19 was declared a pandemic, the world medical landscape has changed dramatically. As cardiac surgeons we not only have the duty to protect our patients and staff from COVID-19 infection, but we are also tasked with the responsibility to ensure those cardiovascular patients awaiting surgery are not harmed from an extended delay in surgery as the world comes to a halt from COVID-19. Currently there is limited literature on the outcome of cardiac surgery in the pre-operative Covid positive group. In this study we aim to assess the safety and outcome of patients undergoing cardiac surgery following Covid-19 infection. Patients and methods This was a single centre retrospective observational study. All patients undergoing open heart surgery at Institut Jantung Negara from June 2020 to July 2021 were included in this study. Patients who were Covid positive pre-operatively were identified. Data from patient medical records collected contemporaneously were reviewed and analysed, supplemented by telephone call interviews after discharge. Results 2368 patients underwent open heart surgery from June 2020 until July 2021 in our centre. Of these, 0.5% (12 patients) were identified as Covid positive pre-operatively. Mean age of patients were 59.1 ± 14.8 years old. Mean Ejection Fraction was 46.4 ± 12.9. Most patients (75%) were asymptomatic with covid infection and only one patient were admitted to hospital for Covid infection. Mean duration from Covid PCR positive swab to surgery were 46.3 ± 32.7days. Most of the patients (66.7%) underwent operation on an emergency or urgent basis. Median time to extubation was 1 day. Median ICU length of stay was 1 day. 25% patients required non-invasive ventilation post-operatively and one patient was discharged home on long term oxygen therapy. There were 2 deaths- none of which were covid related mortality. Conclusion Cardiac surgery could be performed safely in patients with pre-operative Covid-19 infection after a period of recovery, especially in the asymptomatic to mild category of infection. Multi-disciplinary team approach may be useful in deciding the timing of surgery for complex cases.

by Florien S. van Royen, Linda P. T. Joosten, Maarten van Smeden, Pauline Slottje, Frans H. Rutten, Geert-Jan Geersing, Sander van Doorn
Objectives Cardiovascular conditions were shown to be predictive of clinical deterioration in hospitalised patients with coronavirus disease 2019 (COVID-19). Whether this also holds for outpatients managed in primary care is yet unknown. The aim of this study was to determine the incremental value of cardiovascular vulnerability in predicting the risk of hospital referral in primary care COVID-19 outpatients. Design Analysis of anonymised routine care data extracted from electronic medical records from three large Dutch primary care registries. Setting Primary care. Participants Consecutive adult patients seen in primary care for COVID-19 symptoms in the ‘first wave’ of COVID-19 infections (March 1 2020 to June 1 2020) and in the ‘second wave’ (June 1 2020 to April 15 2021) in the Netherlands. Outcome measures A multivariable logistic regression model was fitted to predict hospital referral within 90 days after first COVID-19 consultation in primary care. Data from the ‘first wave’ was used for derivation (n = 5,475 patients). Age, sex, the interaction between age and sex, and the number of cardiovascular conditions and/or diabetes (0, 1, or ≥2) were pre-specified as candidate predictors. This full model was (i) compared to a simple model including only age and sex and its interaction, and (ii) externally validated in COVID-19 patients during the ‘second wave’ (n = 16,693). Results The full model performed better than the simple model (likelihood ratio test p

by Young Hyun Yun, Dong Hyun Jo, Su Kyoung Jeon, Hyeok Yi Kwon, Yu Mi Jeon, Dong Hoon Shin, Hyung Jin Choi
Background The coronavirus disease 2019 (COVID-19) pandemic substantially undermined medical education and healthcare systems. Owing to the pandemic in South Korea, most medical schools needed to be flexible when conducting online and offline classes, but the guidelines did not reflect the specificity of medical schools. This study described the impact of modified anatomy education schedules at the Seoul National University College of Medicine (SNUCM) on students’ academic performance and satisfaction. Methods Anatomy education in SNUCM is divided into three regional units (the upper and lower limbs, trunk, and head and neck). Owing to the COVID-19 pandemic, the schedule was mixed with simultaneous and rotating schedules. The authors conducted exceptions for online lectures, cadaver dissections, and written and practical examinations in three classes of approximately 50 students each. Furthermore, the authors assessed students’ performance using three sets of written and practical examinations, and students completed a questionnaire regarding modified anatomy laboratory schedules. Results Despite the pandemic events in Seoul and South Korea during the laboratory sessions, all sessions were completed without any confirmed COVID-19 cases among the students, faculty, and staff. Most of the scores on the written and practical examinations significantly decreased in 2020 compared to those in 2019. However, in the trunk session that used the virtual anatomy application, the score on the practical examination in 2020 was significantly higher than that in 2019. Over 70% (79 and 77 out of 105 respondents on the upper and lower limbs and trunk, respectively) and 53% (55/105) students reported that there were no significant difficulties in studying anatomy in a face-to-face laboratory. Conclusions In conclusion, an adequate education program for cadaver dissection should be developed and provided to overcome the pandemic restrictions. The study findings could serve as a reference for anatomy education during the COVID-19 pandemic.

Title: Predictability of COVID-19 worldwide lethality using permutation-information theory quantifiers
Authors: Fernandes, Leonardo H. S.; Araujo, Fernando H. A.; Silva, Maria A. R.; Acioli-Santos, Bartolomeu
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: Epidemiological and clinical characteristics of the first 557 successive patients with COVID-19 in Pernambuco state, Northeast Brazil
Authors: Magalhães, Jurandy Júnior Ferraz de; Mendes, Renata Pessoa Germano; Silva, Caroline Targino Alves da; Silva, Severino Jefferson Ribeiro da; Guarines, Klarissa Miranda; Pena, Lindomar José
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.; Others for the Pernambuco COVID-19 Research

Title: Air pollution data in COVID-19 time: A call for improving availability and accessibility
Authors: Nascimento, Cleonilde; Oliveira, Sheilla; Carvalho, Helotonio

Title: High-risk sexual behavior, access to HIV prevention services and HIV incidence during the COVID-19 pandemic among men who have sex with men and transgender women in Brazil
Authors: Grangeiro, Alexandre; Magno, Laio; Ferraz, Dulce; Escuder, M.M.; Zucchi, Eliana Miura; Koyama, M.; Massa, P.; Soares, F.; Santos, Lorruan Alves dos; Westin, Mateus; Préau, Marie; Mabire, Xavier; Dourado, Inês
Description: Trabalho apresentado AT IAS 2021 – the 11th IAS Conference on HIV Science, entre os dias 18-21 de julho de 2021.

by Josefin Sundh, Andreas Palm, Josefin Wahlberg, Michael Runold, Magnus Ekström
Introduction Covid-19 can cause chronic hypoxic respiratory failure, but the impact on the need for long-term oxygen therapy (LTOT) is unknown. The aim was to investigate change in incidence and characteristics of patients starting LTOT in Sweden 2020 after the outbreak of the pandemic. Material and methods Population-based observational study using data from the National Registry for Respiratory Failure (Swedevox) and from a survey to all centres prescribing LTOT in Sweden. Swedevox data provided information on incidence of LTOT and characteristics of patients starting LTOT during 2015–2020. Results Between March-Dec 2020, 131 patients started LTOT due to covid-19, corresponding to 20.5% of incident LTOT in Sweden. Compared with 2015–19, the total number of patients starting LTOT did not increase. No significant differences in patient characteristics or underlying causes of hypoxemia were found between patients starting LTOT during 2020 compared 2015–2019. The majority of the LTOT centres estimated that, since the start of the pandemic, the incidence of LTOT was unchanged and the time devoted for LTOT work was the same or slightly less. Conclusions Covid-19 caused one fifth of all LTOT starts during the pandemic in 2020. The LTOT incidence overall did not increase possibly due to reduction in other infections.

by Gail M. Thornton, Brian A. Fleck, Natalie Fleck, Emily Kroeker, Dhyey Dandnayak, Lexuan Zhong, Lisa Hartling

Respiratory viruses are capable of transmitting via an aerosol route. Emerging evidence suggests that SARS-CoV-2 which causes COVID-19 can be spread through airborne transmission, particularly in indoor environments with poor ventilation. Heating, ventilation, and air conditioning (HVAC) systems can play a role in mitigating airborne virus transmission. Ultraviolet germicidal irradiation (UVGI), a feature that can be incorporated into HVAC systems, can be used to impede the ability of viruses to replicate and infect a host. We conducted a systematic review of the scientific literature examining the effectiveness of HVAC design features in reducing virus transmission—here we report results for ultraviolet (UV) radiation. We followed international standards for conducting systematic reviews and developed an a priori protocol. We conducted a comprehensive search to January 2021 of published and grey literature using Ovid MEDLINE, Compendex, and Web of Science Core. Two reviewers were involved in study selection, data extraction, and risk of bias assessments. We presented study characteristics and results in evidence tables, and synthesized results across studies narratively. We identified 32 relevant studies published between 1936 and 2020. Research demonstrates that: viruses and bacteriophages are inactivated by UV radiation; increasing UV dose is associated with decreasing survival fraction of viruses and bacteriophages; increasing relative humidity is associated with decreasing susceptibility to UV radiation; UV dose and corresponding survival fraction are affected by airflow pattern, air changes per hour, and UV device location; and UV radiation is associated with decreased transmission in both animal and human studies. While UV radiation has been shown to be effective in inactivating viruses and reducing disease transmission, practical implementation of UVGI in HVAC systems needs to consider airflow patterns, air changes per hour, and UV device location. The majority of the scientific literature is comprised of experimental, laboratory-based studies. Further, a variety of viruses have been examined; however, there are few studies of coronaviruses and none to date of SARS-CoV-2. Future field studies of UVGI systems could address an existing research gap and provide important information on system performance in real-world situations, particularly in the context of the current COVID-19 pandemic. This comprehensive synthesis of the scientific evidence examining the impact of UV radiation on virus transmission can be used to guide implementation of systems to mitigate airborne spread and identify priorities for future research.
Trial registration PROSPERO 2020 CRD42020193968.

by Maja Graso

I test the possibility that over-estimating negative consequences of COVID-19 (e.g., hospitalizations, deaths, and threats to children) will be associated with stronger support the ‘new normal’ (i.e., continuation of restrictions for an undefined period starting with wide-spread access to vaccines and completed vaccinations of vulnerable people). The new normal was assessed by endorsing practices such as vaccine passports, travel restrictions, mandatory masking, continuing contact tracing, and pursuing elimination. Results are based on five samples (N = 1,233 from April 2021 and N = 264 from January 2022) and suggest that people over-estimate COVID-19 risks to children and healthy people, as evidenced by median estimates that 5% of all global deaths were children, 29% were generally healthy people under 65, and that a healthy person under the age of 65 has 5% chance of dying from COVID-19. Over-estimates observed in this study align with those based on representative samples, and they were consistently related to stronger support for the new normal. This relationship emerged when participants estimated risks with percentages (core indicators) and indicated the extent to which risk-based statements are true/supported with evidence or false/unsupported (alternative indicators). People were notably more likely to support continuing restrictions if they believed that COVID-19 risk and risk mitigation tactics are true, even when they are not (e.g., children need to be prioritized for boosters). These relationships persisted when considering competing explanations (political ideology, statistics literacy, belief in conspiracy theories). I trace these effects to well-meaning efforts to prevent under-estimation. Public policy and people’s perceptions of risks are intertwined, where even inaccurate judgments may influence decisions. Failure to combat all misinformation with equal rigor may jeopardize the restoration of the social and economic life essential for building adaptive post-pandemic societies.

by Martha Sedegah, Chad Porter, Michael R. Hollingdale, Harini Ganeshan, Jun Huang, Carl W. Goforth, Maria Belmonte, Arnel Belmonte, Dawn L. Weir, Rhonda A. Lizewski, Stephen E. Lizewski, Stuart C. Sealfon, Vihasi Jani, Ying Cheng, Sandra Inoue, Rachael Velasco, Eileen Villasante, Peifang Sun, Andrew G. Letizia

SARS-CoV-2 T cell responses are associated with COVID-19 recovery, and Class I- and Class II-restricted epitopes have been identified in the spike (S), nucleocapsid (N) and membrane (M) proteins and others. This prospective COVID-19 Health Action Response for Marines (CHARM) study enabled assessment of T cell responses against S, N and M proteins in symptomatic and asymptomatic SARS-CoV-2 infected participants. At enrollment all participants were negative by qPCR; follow-up occurred biweekly and bimonthly for the next 6 weeks. Study participants who tested positive by qPCR SARS-CoV-2 test were enrolled in an immune response sub-study. FluoroSpot interferon-gamma (IFN-γ) and IL2 responses following qPCR-confirmed infection at enrollment (day 0), day 7 and 14 and more than 28 days later were measured using pools of 17mer peptides covering S, N, and M proteins, or CD4+CD8 peptide pools containing predicted epitopes from multiple SARS-CoV-2 antigens. Among 124 asymptomatic and 105 symptomatic participants, SARS-CoV-2 infection generated IFN-γ responses to the S, N and M proteins that persisted longer in asymptomatic cases. IFN-γ responses were significantly (p = 0.001) more frequent to the N pool (51.4%) than the M pool (18.9%) among asymptomatic but not symptomatic subjects. Asymptomatic IFN-γ responders to the CD4+CD8 pool responded more frequently to the S pool (55.6%) and N pool (57.1%), than the M pool (7.1%), but not symptomatic participants. The frequencies of IFN-γ responses to the S and N+M pools peaked 7 days after the positive qPCR test among asymptomatic (S pool: 22.2%; N+M pool: 28.7%) and symptomatic (S pool: 15.3%; N+M pool 21.9%) participants and dropped by >28 days. Magnitudes of post-infection IFN-γ and IL2 responses to the N+M pool were significantly correlated with IFN-γ and IL2 responses to the N and M pools. These data further support the central role of Th1-biased cell mediated immunity IFN-γ and IL2 responses, particularly to the N protein, in controlling COVID-19 symptoms, and justify T cell-based COVID-19 vaccines that include the N and S proteins.

by Amelia Fiske, Franziska Schönweitz, Johanna Eichinger, Bettina Zimmermann, Nora Hangel, Anna Sierawska, Stuart McLennan, Alena Buyx

Public perceptions of COVID-19 vaccines are critical in reaching protective levels of herd immunity. Vaccine skepticism has always been relatively high in Germany, and surveys suggest that over the course of the pandemic, enthusiasm for the COVID-19 vaccine has dropped. Looking at the period just prior to the approval of the Pfizer/BioNTech and Moderna vaccines in Germany in the latter half of 2020, this paper aims to assess the reasons for and against COVID-19 vaccine uptake among residents of Germany, and to provide in-depth qualitative data to better understand and address concerns surrounding the safety and efficacy of a COVID-19 vaccine. Our findings indicate that there is widespread trust in German institutions and health experts to provide a safe vaccine for those who need it most. However, interviewees also point to the need for more information and the centrality of support from trusted medical authorities in making individual vaccination decisions. We also present the complexity of individual positions on vaccination, and suggest that vaccine hesitancy in relation to COVID-19 needs to be understood as a nuanced, and socially malleable, territory. This indicates that the goal of a vaccination campaign is not only achieving ‘herd immunity,’ but also a social endorsement of the collaborative effort that is required for a vaccine to be successful.

by Daniel Griffiths, Luke Sheehan, Dennis Petrie, Caryn van Vreden, Peter Whiteford, Alex Collie
Objectives To determine health impacts during, and following, an extended community lockdown and COVID-19 outbreak in the Australian state of Victoria, compared with the rest of Australia. Methods A national cohort of 898 working-age Australians enrolled in a longitudinal cohort study, completing surveys before, during, and after a 112-day community lockdown in Victoria (8 July– 27 October 2020). Outcomes included psychological distress, mental and physical health, work, social interactions and finances. Regression models examined health changes during and following lockdown. Results The Victorian lockdown led to increased psychological distress. Health impacts coincided with greater social isolation and work loss. Following the extended lockdown, mental health, work and social interactions recovered to an extent whereby no significant long-lasting effects were identified in Victoria compared to the rest of Australia. Conclusion The Victorian community lockdown had adverse health consequences, which reversed upon release from lockdown. Governments should weigh all potential health impacts of lockdown. Services and programs to reduce the negative impacts of lockdown may include increases in mental health care, encouraging safe social interactions and supports to maintain employment relationships.

by Saud Mohammed Raja, Murwan Eissa Osman, Abdelmageed Osman Musa, Asim Abdelmoneim Hussien, Kabirat Yusuf
Background The COVID-19 vaccination in Sudan launched in March 2021 but the extent of its acceptance has not been formally studied. This study aimed to determine the acceptance and hesitancy of the COVID-19 vaccine and associated factors among medical students in Sudan. Methods A descriptive cross-sectional study was conducted using an online self-administered questionnaire designed on Google Form and sent to randomly-selected medical students via their Telegram accounts from 30th June to 11th July 2021. Data were analyzed using Statistical Package for Social Sciences software. Chi-square or Fisher’s exact test and logistic regression were used to assess the association between vaccine acceptance and demographic as well as non-demographic factors. Results Out of the 281 students who received the questionnaire, 220 (78%) responded, of whom 217 consented and completed the form. Males accounted for 46. 1%. Vaccine acceptance was 55. 8% (n = 121), and vaccine hesitancy was 44. 2% (n = 96). The commonly cited reasons for accepting the vaccine were to protect themselves and others from getting COVID-19. Concerns about vaccine safety and effectiveness were the main reasons reported by those who were hesitant. Factors associated with vaccine acceptance were history of COVID-19 infection (adjusted odds ratio (aOR) = 2. 2, 95% CI 1. 0–4.7, p = 0. 040), belief that vaccines are generally safe (aOR = 2.3, 95% CI 1. 2–4.5, p = 0.020), confidence that the vaccine can end the pandemic (aOR = 7.5, 95% CI 2. 5–22. 0, p

by Jiaqi Yao, Ginenus Fekadu, Xinchan Jiang, Joyce H. S. You
Background and aim COVID-19 pandemic burdens the healthcare systems, causes healthcare avoidance, and might worsen the outcomes of inflammatory bowel disease (IBD) management. We aimed to estimate the impact of pandemic-related avoidance on outpatient IBD management, and the cost-effectiveness of adding telemonitoring during pandemic from the perspective of Hong Kong public healthcare provider. Methods The study was performed by a decision-analytic model to estimate the quality-adjusted life-years (QALYs) and cost of care for IBD patients before and during the pandemic, and to compare the cost and QALYs of adding telemonitoring to standard care (SC-TM) versus standard care alone (SC) for IBD patients during the pandemic. The sources of model inputs included publications (retrieved from literature search) and public data. Sensitivity analyses were conducted to examine the robustness of base-case results. Results Standard care with pandemic-related avoidance (versus without avoidance) lost 0.0026 QALYs at higher cost (by USD43). The 10,000 Monte Carlo simulations found standard care with pandemic-related avoidance lost QALYs and incurred higher cost in 100% and 96.82% of the time, respectively. Compared with the SC group, the SC-TM group saved 0.0248 QALYs and reduced cost by USD799. Monte Carlo simulations showed the SC-TM group gained higher QALYs at lower cost in 100% of 10,000 simulations. Conclusions Standard care for IBD patients during pandemic with healthcare avoidance appears to worsen treatment outcomes at higher cost and lowered QALYs. The addition of telemonitoring to standard care seems to gain higher QALYs and reduce cost, and is therefore a potential cost-effective strategy for IBD management during the pandemic.

by Geoff Kaine, Vic Wright, Suzie Greenhalgh

Governments around the world are seeking to slow the spread of Covid-19 and reduce hospitalisations by encouraging mass vaccinations for Covid-19. The success of this policy depends on most of the population accepting the vaccine and then being vaccinated. Understanding and predicting the motivation of individuals to be vaccinated is, therefore, critical in assessing the likely effectiveness of a mass vaccination programme in slowing the spread of the virus. In this paper we draw on the I3 Response Framework to understand and predict the willingness of New Zealanders to be vaccinated for Covid-19. The Framework differs from most studies predicting willingness to be vaccinated because it is based on the idea that the willingness to adopt a behaviour depends on both involvement (a measure of motivational strength) with the behaviour and attitudes towards the behaviour. We show that predictions of individuals’ willingness to be vaccinated are improved using involvement and attitudes together, compared to attitudes alone. This result has important implications for the implementation of mass vaccination programmes for Covid-19.

by Edwin D. Archila, Lady S. López, Jaime E. Castellanos, Eliana P. Calvo

Chikungunya virus is an arthropod-transmitted virus that causes chikungunya fever, a disease characterized by severe muscle and joint pain. In 2013, the virus was introduced to the Americas and caused approximately 2.7 million cases of infection during the subsequent two years. The lack of knowledge regarding the biological behavior of the viral strains circulating during the outbreak motivated the characterization of an isolate from the Colombian outbreak, starting from analysis of the complete genome to the biological behavior in vitro. The full genome was retrieved using next-generation sequencing. The infective and replicative capacities were evaluated in HEK293T, Huh-7, and MRC-5 cell lines. The infection rates were determined by flow cytometry, and the cytopathic effect was assessed by a resazurin fluorescent metabolic assay. The viral yield was quantified using the virus plaque formation assay, while the viral proteins and genomic RNA kinetics were subsequently evaluated by western-blot and RT-qPCR. The COL7624 isolate clustered with other American and Caribbean sequences in the Asian American lineage. The T669A substitution in E2 protein distinguished it from other Colombian sequences reported in 2014. After 48 h post infection (hpi), the three cell lines analyzed reached infection percentages exceeding 65%, generating a high load of infectious viral progeny. The infection kinetics indicated that the replication peak of this CHIKV isolate is around 24 hpi, although gRNA is detectable in the culture supernatant from 4 hpi onwards. The infection caused the overexpression of interferon and pro-inflammatory cytokines, such as IL-1β, TNF-α, and IL-8. The COL7624 CHIKV isolate exhibited a high infective and replicative capacity as well as activation of cellular immune responses, similar to isolates belonging to the other genotypes.

by Vivian Yi-Ju Chen, Kiwoong Park, Feinuo Sun, Tse-Chuan Yang
Purpose Research on the novel coronavirus diseases 2019 (COVID-19) mainly relies on cross-sectional data, but this approach fails to consider the temporal dimension of the pandemic. This study assesses three temporal dimensions of the COVID-19 infection risk in US counties, namely probability of occurrence, duration of the pandemic, and intensity of transmission, and investigate local patterns of the factors associated with these risks. Methods Analyzing daily data between January 22 and September 11, 2020, we categorize the contiguous US counties into four risk groups—High-Risk, Moderate-Risk, Mild-Risk, and Low-Risk—and then apply both conventional (i.e., non-spatial) and geographically weighted (i.e., spatial) ordinal logistic regression model to understand the county-level factors raising the COVID-19 infection risk. The comparisons of various model fit diagnostics indicate that the spatial models better capture the associations between COVID-19 risk and other factors. Results The key findings include (1) High- and Moderate-Risk counties are clustered in the Black Belt, the coastal areas, and Great Lakes regions. (2) Fragile labor markets (e.g., high percentages of unemployed and essential workers) and high housing inequality are associated with higher risks. (3) The Monte Carlo tests suggest that the associations between covariates and COVID-19 risk are spatially non-stationary. For example, counties in the northeastern region and Mississippi Valley experience a stronger impact of essential workers on COVID-19 risk than those in other regions, whereas the association between income ratio and COVID-19 risk is stronger in Texas and Louisiana. Conclusions The COVID-19 infection risk levels differ greatly across the US and their associations with structural inequality and sociodemographic composition are spatially non-stationary, suggesting that the same stimulus may not lead to the same change in COVID-19 risk. Potential interventions to lower COVID-19 risk should adopt a place-based perspective.

by Ulrich T. Jensen, Stephanie Ayers, Alexis M. Koskan

Vaccines are highly effective for curbing the spread of SARS-CoV-2 (COVID-19). Yet, millions of Americans remain hesitant about getting vaccinated, jeopardizing our ability to end the COVID-19 pandemic by fueling the spread and development of new variants. We show that brief video-based messages of encouragement addressing specific COVID-19 vaccine concerns increase vaccination intentions, and that vaccination intentions, in turn, are predictive of future vaccine uptake. Results from our online experiment reveal that willingness to get vaccinated is driven by messages that increase confidence in COVID-19 vaccines and perceived behavioral control to get vaccinated. Importantly, messages were particularly effective among more skeptical populations including people who identify as politically conservative or moderate and those who express low trust in government institutions. Our findings corroborate the real-world behavioral significance of vaccination intentions, and devise how even short, scalable online messages can provide governments and health authorities an inexpensive, yet effective tool for increasing intentions to vaccinate against COVID-19 among populations most reluctant to get them.

by Nguyen Toan Tran, Jessica Franzen, Françoise Jermann, Serge Rudaz, Guido Bondolfi, Paolo Ghisletta
Introduction University students’ psychological health is linked to their academic satisfaction. This study aimed to investigate students’ psychological health and academic satisfaction in the context of COVID-19 and academic year-end stress. Materials and methods Standardized self-filled scales for anxiety, depression, stress, psychological well-being, academic satisfaction (subjective assessment of students’ quality of life in their educational setting), and an ad-hoc scale for stress on the learning experience due to COVID-19 were used in this cross-sectional study. Participants were first- to third-year students of eight different health-related tracks in Geneva, Switzerland. Descriptive statistics and hierarchical regression analyses were applied. Results In June 2020, out of 2835 invited students, 433 (15%) completed the survey. Academic satisfaction was a stronger mental health predictor than COVID-19 stress on the learning experience, which mainly predicted stress and anxiety. Lower academic satisfaction scores were significantly associated with stress (β = −0.53, p 0.001), depression (β = −0.26, p 0.001), anxiety (β = −0.20, p 0.001), while higher scores with psychological well-being (β = 0.48, p 0.001). Identifying as female was strongly associated with anxiety and stress but not with depression or psychological well-being. Lower age was associated with stress only. The nature of the academic training had a lesser impact on mental health and the academic year had no impact. Conclusions Academic satisfaction plays a more substantial role than COVID-19 stress on the learning experience in predicting students’ overall mental health status. Training institutions should address the underlying factors that can enhance students’ academic satisfaction, especially during the COVID-19 period, in addition to ensuring that they have a continuous and adequate learning experience, as well as access to psychosocial services that help them cope with mental distress and enhance their psychological well-being.

by Jessica Gasparello, Chiara Papi, Matteo Zurlo, Lucia Carmela Cosenza, Giulia Breveglieri, Cristina Zuccato, Roberto Gambari, Alessia Finotti

The pandemic caused by the SARS-CoV-2 virus (COVID-19) is still a major health issue. The COVID-19 pandemic has forced the university teaching to consider in high priority the switch from in-presence teaching to remote teaching, including laboratory teaching. While excellent virtual-laboratory teaching has been proposed and turned out to be very useful, the need of a real-laboratory in-presence teaching is still a major need. This study was aimed at presenting a laboratory exercise focusing (a) on a very challenging therapeutic strategy, i.e. SARS-CoV-2 diagnostics, and (b) on technologies that are playing a central role in applied biochemistry and molecular biology, i.e. PCR and RT-PCR. The aims of the practical laboratory were to determine: (a) the possibility to identify SARS-CoV-2 sequences starting from a recombinant plasmid and (b) the possibility to discriminate cells with respect to the expression of SARS-CoV-2 Spike protein. This activity is simple (cell culture, RNA extraction, RT-qPCR are all well-established technologies), fast (starting from isolated and characterized RNA, few hours are just necessary), highly reproducible (therefore easily employed by even untrained students). We suggest that this laboratory practical exercises should be considered for face-to-face teaching especially if the emergency related to the COVID-19 pandemic is maintained. The teaching protocol here described might be considered in order to perform fast but meaningful in-presence teaching, making feasible the division of crowded classes in low-number cohorts of students, allowing the maintenance of the required social distance.

Title: Educação em saúde como estratégia no controle integrado da Dengue: reflexões e perspectivas.
Authors: Schall, Virginia Torres; Assis, Sheila Soares de; Pimenta, Denise Nacif

Title: A (Des)Construção da Dengue: de tropical a negligenciada
Authors: Pimenta, Denise Nacif

by Josh W. Newbury, Wee Lun Foo, Matthew Cole, Adam L. Kelly, Richard J. Chessor, S. Andy Sparks, Mark A. Faghy, Hannah C. Gough, Lewis A. Gough

Strict lockdown measures were introduced in response to the COVID-19 pandemic, which caused mass disruption to adolescent swimmers’ daily routines. To measure how lockdown impacted nutritional practices in this cohort, three-day photograph food diaries were analysed at three time points: before (January), during (April), and after (September) the first UK lockdown. Thirteen swimmers (aged 15 ± 1 years) from a high-performance swimming club submitted satisfactory food diaries at all time points. During lockdown, lower amounts of energy (45.3 ± 9.8 vs. 31.1 ± 7.7 kcal∙kg BM∙day-1, p

by Zhenxiao Ren, Mitsuhiro Nishimura, Lidya Handayani Tjan, Koichi Furukawa, Yukiya Kurahashi, Silvia Sutandhio, Kaito Aoki, Natsumi Hasegawa, Jun Arii, Kenichi Uto, Keiji Matsui, Itsuko Sato, Jun Saegusa, Nonoka Godai, Kohei Takeshita, Masaki Yamamoto, Tatsuya Nagashima, Yasuko Mori

Continuous appearance of SARS-CoV-2 variants and mass vaccination have been intricately influencing on the COVID-19 situation. To elucidate the current status in Japan, we analyzed totally 2,000 sera in August (n = 1,000) and December (n = 1,000) 2021 collected from individuals who underwent a health check-up. The anti-N seropositive rate were 2.1% and 3.9% in August and December 2021, respectively, demonstrating a Delta variant endemic during that time; it was approximately twofold higher than the rate based on the PCR-based diagnosis. The anti-S seropositive rate was 38.7% in August and it reached 90.8% in December, in concordance with the vaccination rate in Japan. In the December cohort, 78.7% of the sera showed neutralizing activity against the Delta variant, whereas that against the Omicron was much lower at 36.6%. These analyses revealed that effective immunity against the Delta variant was established in December 2021, however, prompt three-dose vaccination is needed to overcome Omicron’s outbreak.

by Farah Yasmin, Hala Najeeb, Abdul Moeed, Wardah Hassan, Mahima Khatri, Muhammad Sohaib Asghar, Ahmed Kunwer Naveed, Waqas Ullah, Salim Surani
Background Colchicine has been used an effective anti-inflammatory drug to treat gout diseases. Owing to its pharmacodynamic of inhibiting interleukins, it has been repurposed to target the cytokine storm post-SARS-CoV-2 invasion. The goal of this meta-analysis was to evaluate the safety profile of colchicine in COVID-19 patients using the gold-standard randomised-control trials. Methods Electronic databases (Pubmed, Google Scholar, and Cochrane) were systematically searched until June 2021 and RCTs were extracted. Outcomes of interest included all-cause mortality, COVID-19 severity, mechanical ventilation, C-reactive protein and D-dimer levels. Using a random-effects model, dichotomous outcomes were pooled using odds ratios (OR) through the generic inverse variance formula while weighted mean differences were calculated using the Wan’s method. P-values 0.05 were considered statistically significant for all outcomes. Results A total population of 16,048 from five RCTs were included in the analysis. Of this, 7957 were randomized to colchicine, and 8091 received standard care, with an average age of 60.67 years. Colchicine was observed to significantly reduce COVID-19 severity (OR: 0.41, 95% CI [0.22, 0.76]; p = 0.005), and CRP levels (WMD: -19.99, 95% CI [-32.09, -7.89]; p = 0.001). However, there was no significant difference in D-dimer levels (WMD: 0.31, 95% CI [-0.61, 1.23]; p = 0.51), mechanical ventilation (OR: 0.42, 95% CI [0.17, 1.03]; p = 0.06; I2 = 74%) and all-cause mortality (OR: 0.98, 95% CI [0.83, 1.16]; p = 0.84) among patients receiving colchicine or standard care. Conclusion Colchicine treatment decreased CRP levels and COVID-19 severity, with dimer levels, all-cause mortality and mechanical ventilation remaining seemingly unaffected. Thus, clinical trials need to be carried out that allow effective evaluation of colchicine in COVID-19 patients.