Monitoramento das Produções

by Florian Vogt, Karishma Krishna Kurup, Paul Mussleman, Caroline Habrun, Madeleine Crowe, Alexandra Woodward, Giovanna Jaramillo-Gutierrez, John Kaldor, Sirenda Vong, Victor del Rio Vilas
Background Contact tracing is one of the key interventions in response to the COVID-19 pandemic but its implementation varies widely across countries. There is little guidance on how to monitor contact tracing performance, and no systematic overview of indicators to assess contact tracing systems or conceptual framework for such indicators exists to date. Methods We conducted a rapid scoping review using a systematic literature search strategy in the peer-reviewed and grey literature as well as open source online documents. We developed a conceptual framework to map indicators by type (input, process, output, outcome, impact) and thematic area (human resources, financial resources, case investigation, contact identification, contact testing, contact follow up, case isolation, contact quarantine, transmission chain interruption, incidence reduction). Results We identified a total of 153 contact tracing indicators from 1,555 peer-reviewed studies, 894 studies from grey literature sources, and 15 sources from internet searches. Two-thirds of indicators were process indicators (102; 67%), while 48 (31%) indicators were output indicators. Only three (2%) indicators were input indicators. Indicators covered seven out of ten conceptualized thematic areas, with more than half being related to either case investigation (37; 24%) or contact identification (44; 29%). There were no indicators for the input area “financial resources”, the outcome area “transmission chain interruption”, and the impact area “incidence reduction”. Conclusions Almost all identified indicators were either process or output indicators focusing on case investigation, contact identification, case isolation or contact quarantine. We identified important gaps in input, outcome and impact indicators, which constrains evidence-based assessment of contact tracing systems. A universally agreed set of indicators is needed to allow for cross-system comparisons and to improve the performance of contact tracing systems.

by János Sándor, Ferenc Vincze, Maya Liza Shrikant, László Kőrösi, László Ulicska, Karolina Kósa, Róza Ádány

The segregated colonies (SCs) in Hungary are populated mainly but not exclusively by Roma. Their health care use is restricted in many respects. It has not been studied yet, whether fair COVID-19 vaccination coverage achieved in Hungary is accompanied with fair effectiveness in SCs. Using census data, the vaccination coverage in SCs and the complementary areas (CAs) in the same settlements of the country was determined. To describe the settlement level differences, the vaccination coverage (until June 30, 2021) in SCs were compared to those in CAs by age, sex, and eligibility for exemption certificate standardized measures. Aggregating settlement level data, the level of geographic discrimination in Hungary was also determined. According to nationwide aggregates, crude vaccination coverage was significantly lower in SCs (40.05%, 95% CI 39.87%-40.23%) than in CAs (65.42%, 95% CI 65.37%-65.46%). The relative standardized vaccination coverage was 0.643 (95% CI 0.639–0.647) in SCs. A total of 437 of the 938 investigated settlements showed significant local vaccination disparities. Hungarian citizens living in SCs, mainly of Roma ethnicity, are a distinct high-risk group. Special intervention adapted to SCs is needed to mitigate inequality in vaccination coverage and further consequences of the pandemic.

by Patrick Nürnberger, Dirk von Lewinski, Hans-Bernd Rothenhäusler, Celine Braun, Patrick Reinbacher, Ewald Kolesnik, Andreas Baranyi
Introduction COVID-19 is a respiratory infection that causes not only somatic health issues, but also frequently psychosocial burdens. The aims of this study were to investigate biopsychosocial factors that might further aggravate fear of COVID-19, and to establish a biopsychosocial model of severe fear of COVID-19. Methods 368 participants were included in this study. Biopsychosocial factors observed comprised biological factors (somatic risk), psychological factors (state/trait anxiety, physical symptoms of anxiety, severe health anxiety, specific phobias, depression), and psychosocial factors (social support, financial losses, social media consumption, social contacts with COVID-19 infected people). Psychometric questionnaires included State-Trait Anxiety Inventory, Beck’s Anxiety Inventory, Whiteley-Index / Illness Attitude Scales, Specific Phobia Questionnaire, WHO-5 and Social Support Survey. Results 162/368 (44.0%) participants had almost no fear, 170/368 (46.2%) participants had moderate fear, and 45/368 (12.2%) participants had severe fear of COVID-19. Female participants showed higher levels of fear of COVID-19 than male participants (gender: χ2 = 18.47, p

Title: Boletim BiblioCovid: covid-19 e gestantes
Authors: Mendes, Patrícia; Pereira, Isabella; Silva, Adriano da
Description: Apoio: Letícia Ramalho – Estagiária (ICICT/CRBF). Projeto Gráfico: Luciana Rocha Mariz Clua – Multimeios|Icict|Fiocruz. Diagramação: Letícia Ramalho – Estagiária (ICICT/CRBF); Luciana Rocha Mariz Clua – Multimeios|Icict|Fiocruz. Ilustração BiblioCovid: Luciana Rocha Mariz Clua - Multimeios|Icict|Fiocruz.

Title: Clinical characteristics and outcomes of patients hospitalized with COVID-19 in Brazil: Results from the Brazilian COVID-19 registry
Authors: Marcolino, Milena Soriano; Ziegelmann, Patricia Klarmann; Silva, Maira Viana Rego Souza e; Nascimento, Israel Junior Borges do; Oliveira, Luana Martins de; Monteiro, Luanna da Silva; Sales, Thais Lorenna Souza; Ruschel, Karen Brasil; Martins, Karina Paula Medeiros Prado; Etges, Ana Paula Beck da Silva; Romero, Israel Molina; Polanczyk, Carisi Anne; Brazilian COVID-19 Registry Investigators, Nomes participantes em notas
Description: Brazilian COVID-19 Registry Investigators: Alexandre Vargas Schwarzbold, Amanda de Oliveira Maurílio, Ana Lara Rodrigues Monteiro de Barros, Ana Luiza Bahia Alves Scotton, Alfonso J Rodríguez-Morales, Anderson Lacerda Dos Reis, André Soares Moura Costa, Argenil José Assis de Oliveira, Bárbara Lopes Farace, Carla Thais Cândida Alves da Silva, Carolina Marques Ramos, Christiane Corrêa Rodrigues Cimini, Cíntia Alcantara de Carvalho, Daniel Vitório Silveira, Daniela Ponce, Emanuele Marianne Souza Kroger, Euler Roberto Fernandes Manenti, Fernanda Barbosa Lucas, Fernanda d'Athayde Rodrigues, Fernando Anschau, Fernando Antonio Botoni, Frederico Bartolazzi, Gabriela Petry Crestani, Guilherme Fagundes Nascimento, Helena Carolina Noal, Helena Duani, Heloisa Reniers Vianna, Henrique Cerqueira Guimarães, Joice Coutinho de Alvarenga, Júlia Drumond Parreiras de Morais, Juliana Machado Rugolo, Lara Monalyza Gonçalves Franco, Leila Beltrami Moreira, Leonardo Seixas de Oliveira, Lílian Santos Pinheiro, Liliane Souto Pacheco, Luciane Kopittke, Luciano de Souza Viana, Luis Cesar Souto de Moura, Luisa Elem Almeida Santos, Máderson Alvares de Souza Cabral, Maíra Dias Souza, Marcela Gonçalves Trindade Tofani, Marconi Franco da Silveira, Marcus Vinicius de Melo Andrade, Maria Angélica Pires Ferreira, Maria Aparecida Camargos Bicalho, Maria Auxiliadora Parreiras Martins, Maria Clara Pontello Barbosa Lima, Mariana Balbinot Borges, Mariana de Braga Lima Carvalho Canesso, Matheus Carvalho Alves Nogueira, Meire Pereira de Figueiredo, Milton Henriques Guimarães Junior, Mychelle Stefany Santos Almeida, Mônica Aparecida de Paula de Sordi, Natália da Cunha Severino Sampaio, Neimy Ramos de Oliveira, Paulo Tarso Lima Vianna, Pedro Guido Soares Andrade, Pedro Ledic Assaf, Rafael Fusaro Aguiar Oliveira, Rafael Lima Rodrigues de Carvalho, Rafaela Dos Santos Charão de Almeida, Raphael Castro Martins, Reginaldo Aparecido Valacio, Ricardo Bertoglio Cardoso, Ricardo Braga Coelho, Roberta Pozza, Rodolfo Lucas Silva Mourato, Rodrigo Costa Pereira Vieira, Roger Mendes de Abreu, Rufino de Freitas Silva, Saionara Cristina Francisco, Silvana Mangeon Mereilles Guimarães, Silvia Ferreira Araújo, Talita Fischer Oliveira, Tatiana de Vargas, Tatiani Oliveira Fereguetti, Thalita Martins Lage, Thulio Henrique Oliveira Diniz, Veridiana Baldon Dos Santos

by Evangelos Ntontis, Sara Vestergren, Patricio Saavedra, Fergus Neville, Klara Jurstakova, Chris Cocking, Siugmin Lay, John Drury, Clifford Stott, Stephen Reicher, Vivian L. Vignoles

Shopping behaviour in response to extreme events is often characterized as “panic buying” which connotes irrationality and loss of control. However, “panic buying” has been criticized for attributing shopping behaviour to people’s alleged psychological frailty while ignoring other psychological and structural factors that might be at play. We report a qualitative exploration of the experiences and understandings of shopping behaviour of members of the public at the onset of the COVID-19 pandemic. Through a thematic analysis of semi-structured interviews with 23 participants, we developed three themes. The first theme addresses people’s understandings of “panic buying”. When participants referred to “panic buying” they meant observed product shortages (rather than the underlying psychological processes that can lead to such behaviours), preparedness behaviours, or emotions such as fear and worry. The second theme focuses on the influence of the media and other people’s behaviour in shaping subsequent shopping behaviours. The third theme addresses the meaningful motivations behind increased shopping, which participants described in terms of preparedness; some participants reported increased shopping behaviours as a response to other people stockpiling, to reduce their trips to supermarkets, or to prepare for product shortages and longer stays at home. Overall, despite frequently using the term ‘panic’, the irrationalist connotations of “panic buying” were largely absent from participants’ accounts. Thus, “panic buying” is not a useful concept and should not be used as it constructs expected responses to threat as irrational or pathological. It can also facilitate such behaviours, creating a self-fulfilling prophecy.

by Sarafa A. Iyaniwura, Musa Rabiu, Jummy F. David, Jude D. Kong

The pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) took the world by surprise. Following the first outbreak of COVID-19 in December 2019, several models have been developed to study and understand its transmission dynamics. Although the spread of COVID-19 is being slowed down by vaccination and other interventions, there is still a need to have a clear understanding of the evolution of the pandemic across countries, states and communities. To this end, there is a need to have a clearer picture of the initial spread of the disease in different regions. In this project, we used a simple SEIR model and a Bayesian inference framework to estimate the basic reproduction number of COVID-19 across Africa. Our estimates vary between 1.98 (Sudan) and 9.66 (Mauritius), with a median of 3.67 (90% CrI: 3.31–4.12). The estimates provided in this paper will help to inform COVID-19 modeling in the respective countries/regions.

by Yessika Adelwin Natalia, Christel Faes, Thomas Neyens, Geert Molenberghs

Soon after SARS-CoV-2 emerged in late 2019, Belgium was confronted with a first COVID-19 wave in March-April 2020. SARS-CoV-2 circulation declined in the summer months (late May to early July 2020). Following a successfully trumped late July-August peak, COVID-19 incidence fell slightly, to then enter two successive phases of rapid incline: in the first half of September, and then again in October 2020. The first of these coincided with the peak period of returning summer travelers; the second one coincided with the start of higher education’s academic year. The largest observed COVID-19 incidence occurred in the period 16–31 October, particularly in the Walloon Region, the southern, French-speaking part of Belgium. We examine the potential association of the higher education population with spatio-temporal spread of COVID-19, using Bayesian spatial Poisson models for confirmed test cases, accounting for socio-demographic heterogeneity in the population. We find a significant association between the number of COVID-19 cases in the age groups 18–29 years and 30–39 years and the size of the higher education student population at the municipality level. These results can be useful towards COVID-19 mitigation strategies, particularly in areas where virus transmission from higher education students into the broader community could exacerbate morbidity and mortality of COVID-19 among populations with prevalent underlying conditions associated with more severe outcomes following infection.

Title: Brazilian Aedes aegypti as a Competent Vector for Multiple Complex Arboviral Coinfections
Authors: Rodrigues, Nilton Barnabé; Godoy, Raquel Soares Maia; Orfano, Alessandra Silva; Chaves, Barbara Aparecida; Campolina, Thais Bonifácio; Costa, Breno Dos Anjos; Félix, Luíza Dos Santos; Silva, Breno Melo; Norris, Douglas Eric; Pimenta, Paulo Filemon Paolucci; Secundino, Nagila Francinete Costa

by James Kyle Miller, Kimberly Elenberg, Artur Dubrawski

We consider whether one can forecast the emergence of variants of concern in the SARS-CoV-2 outbreak and similar pandemics. We explore methods of population genetics and identify key relevant principles in both deterministic and stochastic models of spread of infectious disease. Finally, we demonstrate that fitness variation, defined as a trait for which an increase in its value is associated with an increase in net Darwinian fitness if the value of other traits are held constant, is a strong indicator of imminent transition in the viral population.

by Giuseppe Carlo Calafiore, Giulia Fracastoro

The COVID-19 pandemic is bringing disruptive effects on the healthcare systems, economy and social life of countries all over the world. Even though the elder portion of the population is the most severely affected by the COVID-19 disease, the counter-measures introduced so far by governments took into little account the age structure, with restrictions that act uniformly on the population irrespectively of age. In this paper, we introduce a SIRD model with age classes for studying the impact on the epidemic evolution of lockdown policies applied heterogeneously on the different age groups of the population. The proposed model is then applied to age-stratified COVID-19 Italian data. The simulation results suggest that control measures focused to specific age groups may bring benefits in terms of reduction of the overall mortality rate.

by Abdul Rahman Taha, Mustafa Shehadeh, Ali Alshehhi, Tariq Altamimi, Emma Housser, Mecit Can Emre Simsekler, Buthaina Alfalasi, Shammah Al Memari, Farida Al Hosani, Yousif Al Zaabi, Shereena Almazroui, Hamed Alhashemi, Noora Alhajri

Telemedicine is a rapidly expanding field of medicine and an alternative method for delivering quality medical care to patients’ fingertips. With the COVID-19 pandemic, there has been an increase in the use of telemedicine to connect patients and healthcare providers, which has been made possible by mobile health (mHealth) applications. The goal of this study was to compare the satisfaction of patients with telemedicine among mHealth users and non-users. This was a survey-based study that included outpatients from Abu Dhabi. The association between patient satisfaction with telemedicine and use of mHealth technologies was described using regression models. This study included a total of 515 completed responses. The use of mHealth application was significantly associated with ease of booking telemedicine appointments (OR 2.61, 95% CI 1.63–4.18; P .001), perception of similarity of quality of care between telemedicine consultations and in-person visits (OR 1.81, 95% CI 1.26–2.61; P = .001), and preference for using telemedicine applications over in-person visits during the COVID-19 pandemic (OR 1.74, 95% CI 1.12–2.72; P = .015). Our study results support that the use of mHealth applications is associated with increased patient satisfaction with telemedicine appointments.

by Halimat Adedeji-Adenola, Olubusola A. Olugbake, Shakirat A. Adeosun
Background Emerging variants of Coronavirus disease 2019 (COVID-19) has claimed over 3000 lives in Nigeria and vaccination remains a means of reducing the death toll. Despite ongoing efforts by the government to ensure COVID-19 vaccination of most residents to attain herd immunity, myths and beliefs have adversely shaped the perception of most Nigerians, challenging the uptake of COVID-19 vaccine. This study aimed to assess the factors influencing the awareness, perception, and willingness to receive COVID-19 vaccine among Nigerian adults. Methods A cross-sectional online nationwide study was conducted from April to June 2021 among Nigerian adult population using the snowballing method. Descriptive analysis was used to summarise the data. Univariate and multivariate analysis was used to identify the predictors of COVID-19 uptake among the respondents. A p value

by Arundhati Bakshi, Alicia Van Doren, Colette Maser, Kathleen Aubin, Collette Stewart, Shannon Soileau, Kate Friedman, Alexis Williams

The COVID-19 pandemic has disproportionately affected the socially and environmentally vulnerable, including through indirect effects on other health conditions. Asthma is one such condition, which may be exacerbated by both prolonged adverse in-home exposures if quarantining in unhealthy homes and prolonged outdoor exposures if the ambient air quality is unhealthy or hazardous. As both are often the case in Environmental Justice (EJ) communities, here we have analyzed data at the census tract (CT) level for Louisiana to assess any correlation between social and environmental vulnerability, and health issues like COVID-19 and asthma. Higher Social Vulnerability Index (SVI), Particulate Matter less than 2.5 μm in diameter (PM2.5) and Ozone levels were associated with higher rates of cumulative COVID-19 incidence at various time points during the pandemic, as well as higher average annual asthma hospitalization rates and estimated asthma prevalence. Further, cumulative COVID-19 incidence during the first three months of the pandemic was moderately correlated with both asthma hospitalizations and estimated prevalence, suggesting similar underlying factors may be affecting both conditions. Additionally, 137 CTs were identified where social and environmental vulnerabilities co-existed, of which 75 (55%) had high estimated prevalence of asthma. These areas are likely to benefit from asthma outreach that considers both social and environmental risk factors. Fifteen out of the 137 CTs (11%) not only had higher estimated prevalence of asthma but also a high burden of COVID-19. Further research in these areas may help to elucidate any common social determinants of health that underlie both asthma and COVID-19 burdens, as well as better clarify the possible role of the environment as related to the COVID-19 burden in Louisiana.

by Subhadra Mandadi, Harish Pulluru, Frank Annie

Remdesivir (RDV) reduces time to clinical improvement in hospitalized COVID -19 patients requiring supplemental oxygen. Dexamethasone improves survival in those requiring oxygen support. Data is lacking on the efficacy of combination therapy in patients on mechanical ventilation. We analyzed for comparative outcomes between Corticosteroid (CS) therapy with combined Corticosteroid and Remdesivir (CS-RDV) therapy. We conducted an observational cohort study of patients aged 18 to 90 with COVID-19 requiring ventilatory support using TriNetX (COVID-19 Research Network) between January 20, 2020, and February 9, 2021. We compared patients who received at least 48 hours of CS-RDV combination therapy to CS monotherapy. The primary outcome was 28-day all-cause mortality rates in propensity-matched (PSM) cohorts. Secondary outcomes were Length of Stay (LOS), Secondary Bacterial Infections (SBI), and MRSA (Methicillin-Resistant Staphylococcus aureus), and Pseudomonas infections. We used univariate and multivariate Cox proportional hazards models and stratified log-rank tests. Of 388 patients included, 91 (23.5%) received CS-RDV therapy, and 297 (76.5%) received CS monotherapy. After propensity score matching, with 74 patients in each cohort, all-cause mortality was 36.4% and 29.7% in the CS-RDV and CS therapy, respectively (P = 0.38). We used a Kaplan-Meier with a log-rank test on follow up period (P = 0.23), and a Hazards Ratio model (P = 0.26). SBI incidence was higher in the CS group (13.5% vs. 35.1%, P = 0.02) with a similar LOS (13.4 days vs. 13.4 days, P = 1.00) and similar incidence of MRSA/Pseudomonas infections (13.5% vs. 13.5%, P = 1.00) in both the groups. Therefore, CS-RDV therapy is non-inferior to CS therapy in reducing 28-day all-cause in-hospital mortality but associated with a significant decrease in the incidence of SBI in critically ill COVID-19 patients.

by Giancarlo Pasquini, Giselle Ferguson, Isabella Bouklas, Huy Vu, Mohammadzaman Zamani, Ruixue Zhaoyang, Karra D. Harrington, Nelson A. Roque, Jacqueline Mogle, H. Andrew Schwartz, Stacey B. Scott

In March 2020, residents of the Bronx, New York experienced one of the first significant community COVID-19 outbreaks in the United States. Focusing on intensive longitudinal data from 78 Bronx-based older adults, we used a multi-method approach to (1) examine 2019 to early pandemic (February-June 2020) changes in momentary psychological well-being of Einstein Aging Study (EAS) participants and (2) to contextualize these changes with community distress scores collected from public Twitter posts posted in Bronx County. We found increases in mean loneliness from 2019 to 2020; and participants that were higher in neuroticism had greater increases in thought unpleasantness and feeling depressed. Twitter-based Bronx community scores of anxiety, depressivity, and negatively-valenced affect showed elevated levels in 2020 weeks relative to 2019. Integration of EAS participant data and community data showed week-to-week fluctuations across 2019 and 2020. Results highlight how community-level data can characterize a rapidly changing environment to supplement individual-level data at no additional burden to individual participants.

by Joni Wahyuhadi, Ferry Efendi, Makhyan Jibril Al Farabi, Iman Harymawan, Atika Dian Ariana, Hidayat Arifin, Qorinah Estiningtyas Sakilah Adnani, Inbar Levkovich
Background and objective Coronavirus disease 2019 (COVID-19) survivors face societal stigma. The study aims to analyze the association of this stigma with the mental health and quality of life of COVID-19 survivors. Methods In this cross-sectional study, we observed 547 adults who were previously documented as severe acute respiratory syndrome coronavirus (SARS-CoV-2) positive by a polymerase chain reaction (PCR) test, treated in a hospital or an emergency hospital and proven to be SARS-CoV-2 negative by their latest PCR test. We adopted the Berger HIV Stigma Scale to measure stigma; the World Health Organization Quality of Life Brief Form to measure quality of life; and the Mental Health Inventory-38 to measure mental health. The chi-square and binary logistic regression tests were used to find the correlation between the variables. Results The multivariate analysis revealed that medium stigma was more likely related to quality of life and mental health than low stigma. Females were less likely to experience stigma related to mental health than men, and respondents who worked as laborers and entrepreneurs were less likely to experience stigma related to mental health than those who worked as civil workers/army personnel/teachers/lecturers. COVID-19 survivors experienced medium stigma in society and lower quality of life and mental health status. We found that quality of life and mental health were affected by stigma, sex, and occupation. Conclusion COVID-19 survivors are a vulnerable group that is most at risk when they return to their communities. Creating a safe environment and providing respectful care, including addressing complex stigma factors, is vital for developing appropriate interventions.

by Gioele Castelli, Umberto Semenzato, Sara Lococo, Elisabetta Cocconcelli, Nicol Bernardinello, Giulia Fichera, Chiara Giraudo, Paolo Spagnolo, Annamaria Cattelan, Elisabetta Balestro

During the SARS-CoV-2 pandemic, chest X-Ray (CXR) scores are essential to rapidly assess patients’ prognoses. This study evaluates a published CXR score in a different national healthcare system. In our study, this CXR score maintains a prognostic role in predicting length of hospital stay, but not disease severity. However, our results show that the predictive role of CXR score could be influenced by socioeconomic status and healthcare system.

by Rui Marçalo, Sonya Neto, Miguel Pinheiro, Ana J. Rodrigues, Nuno Sousa, Manuel A. S. Santos, Paula Simão, Carla Valente, Lília Andrade, Alda Marques, Gabriela R. Moura
Background Populations seem to respond differently to the global pandemic of severe acute respiratory syndrome coronavirus 2. Recent studies show individual variability in both susceptibility and clinical response to COVID-19 infection. People with chronic obstructive pulmonary disease (COPD) constitute one of COVID-19 risk groups, being already associated with a poor prognosis upon infection. This study aims contributing to unveil the underlying reasons for such prognosis in people with COPD and the variability in the response observed across worldwide populations, by looking at the genetic background as a possible answer to COVID-19 infection response heterogeneity. Methods SNPs already associated with susceptibility to COVID-19 infection (rs286914 and rs12329760) and severe COVID-19 with respiratory failure (rs657152 and rs11385942) were assessed and their allelic frequencies used to calculate the probability of having multiple risk alleles. This was performed on a Portuguese case-control COPD cohort, previously clinically characterized and genotyped from saliva samples, and also on worldwide populations (European, Spanish, Italian, African, American and Asian), using publicly available frequencies data. A polygenic risk analysis was also conducted on the Portuguese COPD cohort for the two mentioned phenotypes, and also for hospitalization and survival to COVID-19 infection. Findings No differences in genetic risk for COVID-19 susceptibility, hospitalization, severity or survival were found between people with COPD and the control group (all p-values > 0.01), either considering risk alleles individually, allelic combinations or polygenic risk scores. All populations, even those with European ancestry (Portuguese, Spanish and Italian), showed significant differences from the European population in genetic risk for both COVID-19 susceptibility and severity (all p-values 0.0001). Conclusion Our results indicate a low genetic contribution for COVID-19 infection predisposition or worse outcomes observed in people with COPD. Also, our study unveiled a high genetic heterogeneity across major world populations for the same alleles, even within European sub-populations, demonstrating the need to build a higher resolution European genetic map, so that differences in the distribution of relevant alleles can be easily accessed and used to better manage diseases, ultimately, safeguarding populations with higher genetic predisposition to such diseases.

by Nicole J. Johnson, Caterina G. Roman

This study examines changes in gun violence at the census tract level in Philadelphia, PA before and after the onset of the COVID-19 pandemic. Piecewise generalized linear mixed effects models are used to test the relative impacts of social-structural and demographic factors, police activity, the presence of and proximity to drug markets, and physical incivilities on shooting changes between 2017 and June, 2021. Model results revealed that neighborhood structural characteristics like concentrated disadvantage and racial makeup, as well as proximity to drug markets and police activity were associated with higher shooting rates. Neighborhood drug market activity and police activity significantly predicted changes in shooting rates over time after the onset of COVID-19. This work demonstrates the importance of understanding whether there are unique factors that impact the susceptibility to exogenous shocks like the COVID-19 pandemic. The increasing risk of being in a neighborhood with an active drug market during the pandemic suggests efforts related to disrupting drug organizations, or otherwise curbing violence stemming from drug markets, may go a long way towards quelling citywide increases in gun violence.

by Viridiana Ríos, Edgar Denova-Gutiérrez, Simón Barquera
Background The World Health Organization stated a pandemic by severe acute respiratory syndrome coronavirus SARS-Cov2 (COVID-19) on March, 2020 with devastating implications for populations, healthcare systems, and economies globally. Objective The present study explores the association between patients living in municipalities with crowding conditions and poverty and mortality from COVID-19 in Mexico; specifically evaluating the socioeconomic characteristics of the municipality in which the patients reside and some individual characteristics. Methods In the present study, we examined public information collected from the National Epidemiological Surveillance System informing all persons tested for SARS-CoV-2 and published by the Ministry of Health. The present analysis was restricted to those with the date of registration to October 12, 2021. The association between the main exposures (overcrowded conditions and poverty) and the outcomes of interest (death by COVID-19) was explored using Cox proportional hazard regression models, including frailty penalties to accommodate multilevel data and random effects for the municipality of case occurrence. Results A total of 9619917 subjects were included in the Epidemiological Surveillance System for viral respiratory disease platform. Of those for which results were available, 6141403 were negative for COVID-19 and 3478514 were positive for COVID-19; with a total of 273216 deaths in those who tested positive. Among those positive to COVID-19 mean age was 46.9. Patients living in municipalities with high rates of crowding conditions increased the risk of dying from COVID-19 by 8% (95% CI: 1.03, 1.14). Individuals living in municipalities with indigenous background was associated with an increased risk of dying from COVID-19 (HR = 1.10; 95% CI: 1.04, 1.17). Individuals living in municipalities with illiteracy (HR = 1.09; 95% CI: 1.03, 1.11), poverty (HR = 1.17; 95% CI: 1.14, 1.19), food insecurity (HR = 1.094; 95% CI 1.02, 1.06), limited access to social security (HR = 1.10; 95% CI: 1.08, 1.13) and health services (HR = 1.06; 95% CI: 1.04, 1.08) had a higher risk of mortality from COVID-19. Conclusion Our data suggest that patients living in municipalities with higher rates of crowding conditions and higher rates of poverty had elevated risk of mortality from COVID-19. In Mexico, the COVID-19 pandemic is a systemic crisis linked to human development since we have seen that it affects less developed and more vulnerable municipalities. Policies to reduce vulnerabilities and develop strategies to deal with health crises like the current one needs to be considered.

by Enas A. Bsoul, Peter M. Loomer
Objectives The purpose of this study was to evaluate the COVID-19 vaccination experience among United States-based dental professionals and students: to understand their beliefs, concerns, safety and confidence levels, and side effects experienced after vaccination; striving to boost vaccination acceptability to curtail the pandemic. Methods An observational survey study approved by The University of Texas Health San Antonio Institutional Review Board was distributed to members of the School of Dentistry community using Qualtrics XM software. The survey was completed anonymously. Data were analyzed using R statistical computing software, χ2 test and Fisher’s Exact test. Results Over 80% of all participants felt moderately to very safe working after the COVID-19 vaccine was made available, and more than 75% were moderately to very confident that the vaccine can protect them during the pandemic. At least 35% were moderately to very concerned about immediate and long-term side effects of the vaccine; despite the concerns, 94% received the vaccine. Side effects were more common after the second dose of the vaccine. Most common side effects were injection site pain, and general side effects of fatigue/tiredness, headache, muscle/body ache, and chills/fever. 74% reported no effect of the vaccine on daily activities, and the severity of side effects no worse than mild (about 60%). Conclusions Majority of the participants felt safe and confident that the vaccine would protect them against COVID-19 infection. Sharing these findings and reliable information that the vaccine is safe and effective is paramount to fostering the vaccine uptake and curtailing the pandemic. Practical implications Findings of this study demonstrated the confidence of the UT Health San Antonio, School of Dentistry community that the benefits of the vaccines greatly outweigh the risks; boosting the vaccination acceptance while creating a COVID-19 free environment both for the academic dental setting and the community it serves.

by Julian Hannemann, Alan Abdalrahman, Yesim Erim, Eva Morawa, Lucia Jerg-Bretzke, Petra Beschoner, Franziska Geiser, Nina Hiebel, Kerstin Weidner, Susann Steudte-Schmiedgen, Christian Albus
Background In times of the global corona pandemic health care workers (HCWs) fight the disease at the frontline of healthcare services and are confronted with an exacerbated load of pandemic burden. Psychosocial resources are thought to buffer adverse effects of pandemic stressors on mental health. This rapid review summarizes evidence on the specific interplay of pandemic burden and psychosocial resources with regard to the mental health of HCWs during the COVID-19 pandemic. The goal was to derive potential starting points for supportive interventions. Methods We conducted a rapid systematic review following the recommendations of the Cochrane Rapid Reviews Methods Group. We searched 7 databases in February 2021 and included peer-reviewed quantitative studies, that reported related data on pandemic stressors, psychosocial resources, and mental health of HCWs. Results 46 reports were finally included in the review and reported data on all three outcomes at hand. Most studies (n = 41) applied a cross-sectional design. Our results suggest that there are several statistically significant pandemic risk factors for mental health problems in HCWs such as high risk and fear of infection, while resilience, active and emotion-focused coping strategies as well as social support can be considered beneficial when protecting different aspects of mental health in HCWs during the COVID-19 pandemic. Evidence for patterns of interaction between outcomes were found in the context of coping style when facing specific pandemic stressors. Conclusions Our results indicate that several psychosocial resources may play an important role in buffering adverse effects of pandemic burden on the mental health of HCWs in the context of the COVID-19 pandemic. Nevertheless, causal interpretations of mentioned associations are inadequate due to the overall low study quality and the dominance of cross-sectional study designs. Prospective longitudinal studies are required to elucidate the missing links.

by Dalal Youssef, Linda Abou-Abbas, Atika Berry, Janet Youssef, Hamad Hassan

Since Health care workers (HCWs) are at high occupational risk for COVID-19, they are prioritized for immunization. This study aimed to assess the acceptance rate of the COVID-19 vaccine among HCWs and to identify its determinants. A web-based cross-sectional study was conducted between10 and 31 December 2020 among Lebanese HCWs. The Health Belief Model (HBM) was used as a theoretical framework. Multivariable logistic analyses were carried out to identify the factors associated with the acceptance of the COVID-19 vaccine among HCWs. A total of 1800 HCWs have completed the survey. Around half (58.10%) of them were frontline HCWs and aged between (30–49) years old. Over two-thirds (67.33%) of the participants have received the seasonal influenza vaccine. The acceptance rate of the COVID-19 vaccine among surveyed HCWs was 58%. HCWs who were male (aOR = 1.99, 95% CI (1.41–2.80)), working in the frontlines (aOR = 1.61, 95% CI (1.17–2.21), and those who have received influenza vaccination for the current year (aOR = 1.38, 95% CI(0.99–1.92)) were more willing to get the COVID-19 vaccine. However, factors such as living in rural areas (aOR = 0.61, 95% CI (0.44–0.84)), and being previously diagnosed with COVID-19 (aOR = 0.66, 95%CI (0.45–0.96) were found negatively associated with vaccine acceptance. In terms of health beliefs items, concerns related to the novelty of vaccine (aOR = 0.42, 95% CI (0.25–0.71)), side effects/vaccine safety (aOR = 0.41, 95% CI (0.23–0.73), reliability of manufacturer (aOR = 0.43, 95% CI (0.30–0.63)), and the number of required doses (aOR = 0.58, 95% CI (0.40–0.84)) were also negatively associated with the willingness to get vaccinated against COVID-19. Remarkably, concerns such as the limited accessibility (aOR = 1.68, 95% CI (1.14–2.47)), and availability of vaccines (aOR = 2.16, 95% CI (1.46–3.20)) were associated with an increased likelihood of willingness to receive the COVID-19 vaccine. With regards to cues of action, receiving reliable and adequate information about the vaccine (aOR = 1.98, 95% CI (1.36–2.88)), recommendation by health authorities (aOR = 1.93, 95% CI(1.33–2.81)), and recommendations from health facilities (aOR = 2.68, 95% CI(1.80–3.99)) were also positively associated with vaccine acceptance. Lastly, perception of COVID-19 vaccine benefits by HCWs in terms of protecting them and their close contacts (patients, family members, and friends) from COVID-19 infection (aOR = 4.21, 95% CI (2.78–7.11)) was associated with an increased likelihood of vaccine uptake. The moderate acceptance rate of the COVID-19 vaccine among HCWs found in our study could have broader extents. Understanding and pointing out factors impairing vaccine acceptance such as concerns about the novelty of vaccine and manufacturers’ reliability are required to reach a higher vaccination rate.

by Mi Yeon Hong, Ji Won Yoon

The purpose of our study is to figure out the transitions of the cryptocurrency market due to the outbreak of COVID-19 through network analysis, and we studied the complexity of the market from different perspectives. To construct a cryptocurrency network, we first apply a mutual information method to the daily log return values of 102 digital currencies from January 1, 2019, to December 31, 2020, and also apply a correlation coefficient method for comparison. Based on these two methods, we construct networks by applying the minimum spanning tree and the planar maximally filtered graph. Furthermore, we study the statistical and topological properties of these networks. Numerical results demonstrate that the degree distribution follows the power-law and the graphs after the COVID-19 outbreak have noticeable differences in network measurements compared to before. Moreover, the results of graphs constructed by each method are different in topological and statistical properties and the network’s behavior. In particular, during the post-COVID-19 period, it can be seen that Ethereum and Qtum are the most influential cryptocurrencies in both methods. Our results provide insight and expectations for investors in terms of sharing information about cryptocurrencies amid the uncertainty posed by the COVID-19 pandemic.

by Cristián Mansilla, Cristian A. Herrera, Laura Boeira, Andrea Yearwood, Analia S. Lopez, Luis E. Colunga-Lozano, Eva Brocard, Tatiana Villacres, Marcela Vélez, Gabriel Di Paolantonio, Ludovic Reveiz
Introduction The Coronavirus Disease 2019 (COVID19) pandemic has struck Latin America and the Caribbean (LAC) particularly hard. One of the crucial areas in the international community’s response relates to accelerating research and knowledge sharing. The aim of this article is to map and characterise the existing empirical research related to COVID-19 in LAC countries and contribute to identify opportunities for strengthening future research. Methods In this scoping review, articles published between December 2019 and 11 November 2020 were selected if they included an empirical component (explicit scientific methods to collect and analyse primary data), LAC population was researched, and the research was about the COVID-19 pandemic, regardless of publication status or language. MEDLINE, EMBASE, LILACS, Scielo, CENTRAL and Epistemonikos were searched. All titles and abstracts, and full texts were screened by two independent reviewers. Data from included studies was extracted by one reviewer and checked by a second independent reviewer. Results 14,406 records were found. After removing duplicates, 5,458 titles and abstracts were screened, of which 2,323 full texts were revised to finally include 1,626 empirical studies. The largest portion of research came from people/population of Brazil (54.6%), Mexico (19.1%), Colombia (11.2%), Argentina (10.4%), Peru (10.3%) and Chile (10%), while Caribbean countries concentrated 15.3%. The methodologies most used were cross-sectional studies (34.7%), simulation models (17.5%) and randomized controlled trials (RCTs) (13.6%). Using a modified version of WHO’s COVID-19 Coordinated Global Research Roadmap classification, 54.2% were epidemiological studies, followed by clinical management (22.3%) and candidate therapeutics (12.2%). Government and public funds support were reported in 19.2% of studies, followed by universities or research centres (9%), but 47.5% did not include any funding statement. Conclusion During the first part of the COVID-19 pandemic, LAC countries have contributed to the global research effort primarily with epidemiological studies, with little participation on vaccines research, meaning that this type of knowledge would be imported from elsewhere. Research agendas could be further coordinated aiming to enhance shared self-sufficiency regarding knowledge needs in the region.

by Amanda P. Miller, Stephen Mugamba, Robert M. Bulamba, Emmanuel Kyasanku, James Nkale, Fred Nalugoda, Gertrude Nakigozi, Godfrey Kigozi, Grace K. Nalwoga, Joseph Kagaayi, Stephen Watya, Jennifer A. Wagman
Introduction Uganda confirmed its first COVID-19 case in March 2020, leading to country-wide closures and a stay-at-home order. Infectious disease pandemics can overwhelm adaptive coping capacity (e.g., general self-efficacy and resilience) and increase the risk for mental distress. For individuals experiencing intimate partner violence (IPV) and cohabitating with a perpetrator, stay-at-home orders can also increase risk of violence, which can further exacerbate mental distress. The present study explores women’s perceived self-efficacy and resilient coping, mental health outcomes (depression and COVID-19 related anxiety), hazardous alcohol use and IPV in the context of Uganda’s national 2020 lockdown. Methods A phone-based survey was undertaken from June-August of 2020 in Wakiso District, Uganda. The study sample consisted of Africa Medical and Behavioral Sciences Organization (AMBSO) Population Health Surveillance (APHS) study participants who agreed to be contacted for future research. The analytic sample was restricted to women aged 13–80 years. Bivariate analysis and multivariable models explored associations between experiences of IPV and measures of adaptive coping, mental health and alcohol use. Results A total of 556 women aged 13–79 years (mean age of 33.4 years) participated. Over half (55%) were currently married. The majority (60%) reported a decrease in alcohol use during the lockdown. Nearly half of the sample were experiencing physical or verbal IPV and reported an increase in violence during the lockdown. In adjusted analysis, alcohol use was associated with four times greater odds of recent physical IPV (aOR 4.06, 95% CI = 1.65–10.02, p = 0.0024), while participants had lower odds of experiencing any form of IPV as general self-efficacy increased (aOR 0.95, 95% CI = 0.91–0.99, p = 0.0308). Conclusion Lockdown measures in Uganda may have mitigated increased alcohol consumption. IPV was exacerbated during lockdown; more than 2 in 5 IPV victims experienced increased physical or verbal violence. Development of programming and policies aimed at mitigating women’s risk of IPV during future lockdowns are needed.

by H. M. R. K. G. Nandasena, M. L. Pathirathna, A. M. M. P. Atapattu, P. T. S. Prasanga
Background Understanding the impact of COVID 19 on patients’ quality of life (QOL) following discharge or recovery is essential for planning necessary interventions in advance. As such, this systematic review aimed to provide an overview of the QOL, and the factors associated with it in COVID-19 patients following discharge or recovery. Methods The Databases of PubMed, Cochrane Library, and Science Direct were searched. The review included studies that (1) assessed the QOL of COVID 19 patients following discharge or recovery, (2) were written in English, (3) used a validated instrument to assess the quality of life and (4) used an observational or cohort study design. The PRISMA guidelines were followed. Following the initial search, 2866 articles were identified as being related. A total of 1089 articles were identified as duplicates. 1694 studies were excluded during the title and abstract screening stage, and 83 studies were screened at the full-text screening stage. Finally, 21 studies were included in this systematic review. Results This systematic review included 4408 patients who tested positive for COVID 19. Of them 50.2% (n = 2212) were males. Regardless of the time since discharge or recovery, COVID 19 patients’ QOL has been significantly impacted. Female sex, older age, co-morbidities, Intensive Care Unit (ICU) admission, prolonged ICU stay, and being mechanically ventilated were the most frequently reported factors associated with the low level of QOL. Conclusion The QOL of the post COVID19 patients was significantly impacted, regardless of the time elapses since discharge or recovery. Thus, when implementing programs to improve the QOL of post COVID19 patients, the most affected domains of QOL and associated factors should be considered.

by Davide Golinelli, Francesco Sanmarchi, Angelo Capodici, Giorgia Gribaudo, Mattia Altini, Simona Rosa, Francesco Esposito, Maria Pia Fantini, Jacopo Lenzi
Introduction As COVID-19 roared through the world, governments worldwide enforced containment measures that affected various treatment pathways, including those for hip fractures (HFs). This study aimed to measure process and outcome indicators related to the quality of care provided to non-COVID-19 elderly patients affected by HF in Emilia-Romagna, a region of Italy severely hit by the pandemic. Methods We collected the hospital discharge records of all patients admitted to the hospitals of Emilia-Romagna with a diagnosis of HF from January to May in the years 2019 (pre-pandemic period) and 2020 (pandemic period). We analyzed surgery rate, surgery delays, length of hospital stay, timely rehabilitation, and 30-day mortality for each HF patient. We evaluated monthly data (2020 vs. 2019) with the chi-square and t-test, where appropriate. Logistic regression was used to investigate the differences in 30-day mortality. Results Our study included 5379 patients with HF. In April and May 2020, there was a significant increase in the proportion of HF patients that did not undergo timely surgery. In March 2020, we found a significant increase in mortality (OR = 2.22). Male sex (OR = 1.92), age ≥90 years (OR = 4.33), surgery after 48 hours (OR = 3.08) and not receiving surgery (OR = 6.19) were significantly associated with increased mortality. After adjusting for the aforementioned factors, patients hospitalized in March 2020 still suffered higher mortality (OR = 2.21). Conclusions There was a reduction in the overall quality of care provided to non-COVID-19 elderly patients affected by HF, whose mortality increased in March 2020. Patients’ characteristics and variations in processes of care partially explained this increase. Policymakers and professionals involved in the management of COVID-19 patients should be aware of the needs of patients with other health needs, which should be carefully investigated and included in future emergency preparedness and response plans.

by Rachel Sapire, Jennifer Ostrowski, Malia Maier, Goleen Samari, Clarisa Bencomo, Terry McGovern
Introduction Gender-based violence (GBV) policies and services in the United States (U.S.) have historically been underfunded and siloed from other health services. Soon after the onset of the COVID-19 pandemic, reports emerged noting increases in GBV and disruption of health services but few studies have empirically investigated these impacts. This study examines how the existing GBV funding and policy landscape, COVID-19, and resulting state policies in the first six months of the pandemic affect GBV health service provision in the U.S. Methods This is a mixed method study consisting of 1) an analysis of state-by-state emergency response policies review; 2) a quantitative analysis of a survey of U.S.-based GBV service providers (N = 77); and 3) a qualitative analysis of in-depth interviews with U.S.-based GBV service providers (N = 11). Respondents spanned a range of organization types, populations served, and states. Results Twenty-one states enacted protections for GBV survivors and five states included explicit exemptions from non-essential business closures for GBV service providers. Through the surveys and interviews, GBV service providers note three major themes on COVID-19’s impact on GBV services: reductions in GBV service provision and quality and increased workload, shifts in service utilization, and funding impacts. Findings also indicate GBV inequities were exacerbated for historically underserved groups. Discussion The noted disruptions on GBV services from the COVID-19 pandemic overlaid long-term policy and funding limitations that left service providers unprepared for the challenges posed by the pandemic. Future policies, in emergency and non-emergency contexts, should recognize GBV as essential care and ensure comprehensive services for clients, particularly members of historically underserved groups.