Monitoramento das Produções

by Chiara Ronchini, Sara Gandini, Sebastiano Pasqualato, Luca Mazzarella, Federica Facciotti, Marina Mapelli, IEO Covid Team , Gianmaria Frige’, Rita Passerini, Luca Pase, Silvio Capizzi, Fabrizio Mastrilli, Roberto Orecchia, Gioacchino Natoli, Pier Giuseppe Pelicci

The correlation between immune responses and protection from SARS-CoV-2 infections and its duration remains unclear. We performed a sanitary surveillance at the European Institute of Oncology (IEO) in Milan over a 17 months period. Pre-vaccination, in 1,493 participants, we scored 266 infections (17.8%) and 8 possible reinfections (3%). Post-vaccination, we identified 30 infections in 2,029 vaccinated individuals (1.5%). We report that the probability of infection post-vaccination is i) significantly lower compared to natural infection, ii) associated with a significantly shorter median duration of infection than that of first infection and reinfection, iii) anticorrelated with circulating antibody levels.

Title: The application of spectroscopy techniques for diagnosis of malaria parasites and arboviruses and surveillance of mosquito vectors: A systematic review and critical appraisal of evidence
Authors: Goh, Brendon; Ching, Koek; Magalhães, Ricardo J. Soares; Ciocchetta, Silvia; Edstein, Michael D.; Freitas, Rafael Maciel de; Sikulu-Lord, Maggy T.

by Nora Hettich, Manfred E. Beutel, Mareike Ernst, Clara Schliessler, Hanna Kampling, Johannes Kruse, Elmar Braehler
Background In the context of the COVID-19 pandemic, many individuals have been found to endorse conspiracy beliefs. Socio-demographic variables, personality functioning, anxiety, and loneliness could be risk factors for this endorsement. Methods In a representative sample of the German population (N = 2,503) measures of conspiracy mentality, conspiracy-related beliefs toward COVID-19, personality functioning (OPD-SQS), anxiety (HADS), and loneliness (UCLA) were assessed. Pearson product-moment correlations and multiple linear regression analyses were conducted. Results Conspiracy mentality and conspiracy-related beliefs toward COVID-19 were strongly correlated. Regression analyses found younger age, male gender, lower education, and lower income to be associated with conspiracy mentality. The subscales relationship model and self-perception of the OPD-SQS were positively related to conspiracy mentality whereas interpersonal contact was negatively associated. Higher levels of anxiety were statistically predictive for conspiracy mentality. Conclusion Our findings indicate a contribution of personality functioning to the understanding of conspiracy mentality and thus to the advancement of interventions during the pandemic.

by Natanya Meyer, Thomas Niemand, Andrés Davila, Sascha Kraus

The impact that COVID-19 had on individuals globally has been immense. Our study aims to determine if the various COVID-19 related beliefs (information seeking; invulnerability; disruption; health importance and response effectiveness) are predictors of perceived stress and if self-efficacy acts as a mediator in reducing perceived COVID-19 related stress. From a large sample of 23,629, data were assessed using validated multi-item measures for seven COVID-19 related beliefs, self-efficacy and perceived stress. After conducting a series of tests and checks via Confirmatory Factor Analyses, linear modelling and mediation analyses with bootstrapping were applied to test direct and mediation hypotheses. It is found that stress perception is most strongly affected by self-efficacy and perceived disruption. Except for information seeking, which positively affected perceived stress, self-efficacy partially mediates all other COVID-19 related beliefs (perceptions of disruption, health importance and response effectiveness) in conjunction with their direct effects. Only perceived invulnerability elicited opposite effects on stress, increasing stress directly but decreasing stress indirectly by increasing self-efficacy. This finding gives reason to believe that individuals may disclose that they are less vulnerable to COVID-19, fostering their self-efficacy, but still accept that stressing factors such as economic and social consequences apply. Overall, reinforcing self-efficacy was carved out as the most important resilience factor against perceiving high levels of stress. On this basis, implications for research and practice are provided.

Title: Comprehensive Quantitative Proteome Analysis of Aedes aegypti Identifies Proteins and Pathways Involved in Wolbachia pipientis and Zika Virus Interference Phenomenon
Authors: Martins, Michele; Ramos, Luis Felipe Costa; Murillo, Jimmy Rodriguez; Torres, André; Carvalho, Stephanie Serafim de; Domont, Gilberto Barbosa; Oliveira, Danielle Maria Perpétua de; Mesquita, Rafael Dias; Nogueira, Fábio César Sousa; Freitas, Rafael Maciel de; Junqueira, Magno

by Raphaël Bonnet, Lee Mariault, Jean-François Peyron

Drug repurposing can be an interesting strategy for an emergency response to the severe acute respiratory syndrome-coronavirus-2, (SARS-COV-2), the causing agent of the coronavirus disease-19 (COVID-19) pandemic. For this, we applied the Connectivity Map (CMap) bioinformatic resource to identify drugs that generate, in the CMap database, gene expression profiles (GEP) that negatively correlate with a SARS-COV-2 GEP, anticipating that these drugs could antagonize the deleterious effects of the virus at cell, tissue or organism levels. We identified several anti-cancer compounds that target MDM2 in the p53 pathway or signaling proteins: Ras, PKBβ, Nitric Oxide synthase, Rho kinase, all involved in the transmission of proliferative and growth signals. We hypothesized that these drugs could interfere with the high rate of biomass synthesis in infected cells, a feature shared with cancer cells. Other compounds including etomoxir, triacsin-c, PTB1-IN-3, are known to modulate lipid metabolism or to favor catabolic reactions by activating AMPK. Four different anti-inflammatory molecules, including dexamethasone, fluorometholone and cytosporone-b, targeting the glucocorticoid receptor, cyclooxygenase, or NUR77 also came out of the analysis. These results represent a first step in the characterization of potential repositioning strategies to treat SARS-COV-2.

by Julio Collazos, Pere Domingo, Nerio Fernández-Araujo, Elia Asensi-Díaz, Helem Vilchez-Rueda, Antonio Lalueza, Emilia Roy-Vallejo, Rosa Blanes, Manuel Raya-Cruz, Jaime Sanz-Cánovas, Arturo Artero, José-Manuel Ramos-Rincón, Carlos Dueñas-Gutiérrez, José Luis Lamas-Ferreiro, Víctor Asensi, the Valproic Acid in COVID-19 Study Group
Background Valproic acid (VPA) has shown beneficial effects in vitro against SARS-CoV-2 infection, but no study has analyzed its efficacy in the clinical setting. Methods This multicenter, retrospective study included 165 adult patients receiving VPA at the time of admission to hospital, and 330 controls matched for sex, age and date of admission. A number of clinical, outcome and laboratory parameters were recorded to evaluate differences between the two groups. Four major clinical endpoints were considered: development of lung infiltrates, in-hospital respiratory worsening, ICU admissions and death. Results VPA-treated patients had higher lymphocyte (P

by Tigist W. Leulseged, Kindalem G. Abebe, Ishmael S. Hassen, Endalkachew H. Maru, Wuletaw C. Zewde, Negat W. Chamiso, Kalkidan T. Yegele, Abdi B. Bayisa, Dagne F. Siyoum, Mesay G. Edo, Edmialem G. Mesfin, Meskerem N. Derejie, Helina K. Shiferaw
Background The COVID-19 pandemic started a little later in Ethiopia than the rest of the world and most of the initial cases were reported to have a milder disease course and a favorable outcome. This changed as the disease spread into the population and the more vulnerable began to develop severe disease. Understanding the risk factors for severe disease in Ethiopia was needed to provide optimal health care services in a resource limited setting. Objective The study assessed COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia for characteristics associated with COVID-19 disease severity. Methods A cross-sectional study was conducted from June to August 2020 among 686 randomly selected patients. Chi-square test was used to detect the presence of a statistically significant difference in the characteristics of the patients based on disease severity (Mild vs Moderate vs Severe). A multinomial logistic regression model was used to identify factors associated with COVID-19 disease severity where Adjusted Odds ratio (AOR), 95% CIs for AOR and P-values were used for significance testing. Results Having moderate as compared with mild disease was significantly associated with having hypertension (AOR = 2.30, 95%CI = 1.27,4.18), diabetes mellitus (AOR = 2.61, 95%CI = 1.31,5.19for diabetes mellitus), fever (AOR = 6.12, 95%CI = 2.94,12.72) and headache (AOR = 2.69, 95%CI = 1.39,5.22). Similarly, having severe disease as compared with mild disease was associated with age group (AOR = 4.43, 95%CI = 2.49,7.85 for 40–59 years and AOR = 18.07, 95%CI = 9.29,35.14for ≥ 60 years), sex (AOR = 1.84, 95%CI = 1.12,3.03), hypertension (AOR = 1.97, 95%CI = 1.08,3.59), diabetes mellitus (AOR = 3.93, 95%CI = 1.96,7.85), fever (AOR = 13.22, 95%CI = 6.11, 28.60) and headache (AOR = 4.82, 95%CI = 2.32, 9.98). In addition, risk factors of severe disease as compared with moderate disease were found to be significantly associated with age group (AOR = 4.87, 95%CI = 2.85, 8.32 for 40–59 years and AOR = 18.91, 95%CI = 9.84,36.331 for ≥ 60 years), fever (AOR = 2.16, 95%CI = 1.29,3.63) and headache (AOR = 1.79, 95%CI = 1.03, 3.11). Conclusions Significant factors associated with severe COVID-19 in Ethiopia are being older than 60 years old, male, a diagnosis of hypertension, diabetes mellitus, and the presence of fever and headache. This is consistent with severity indicators identified by WHO and suggests the initial finding of milder disease in Ethiopia may have been because the first people to get COVID-19 in the country were the relatively younger with fewer health problems.

by Alex Christensen, Suzanne Bond, James McKenna
Background Coronavirus (COVID-19) has severely impacted lifestyles worldwide. Responses to COVID-19 have intentionally restricted the factors that encourage regular and frequent PA; opportunity, capability and motivation. However, the effects of these restrictions are likely to have differed by gender and age and different intensities of PA. This rapid review builds on previous evidence by synthesising the global impact of COVID-19 on adult PA through specific intensities and types of PA and evaluating this by gender and age. Methods A rapid systematic search of seven electronic databases (PubMed, MEDLINE, CINAHL, SPORTDiscus, Academic Search Complete, APA PsycInfo, and APA PsycArticles) was performed from December 2019 to January 2021. Studies investigating adult change in PA, exercise or sedentary behaviour due to COVID-19 were included. Results From an initial database search identifying 3,863 articles, 66 remained for synthesis after applying eligibility criteria. Results demonstrate decreases among all intensities and types of PA—walking (6 out of 7 papers), moderate-only (5 out of 6 papers), vigorous-only (5 out of 6 papers) and MVPA (4 out of 5 papers); as well as overall PA (14–72% participants reported a decrease). Reflecting that COVID-19 responses were designed to have universal effects, they also achieved whole-society decreases in PA behaviour, accented in older age groups. Conclusion There is a universal need to address the low levels of PA post-COVID-19. The consequences of decreased PA across all intensities has powerful, potentially recoverable, impacts. Universal declines have implications for public health officials and PA advocates for post-COVID-19 initiatives to promote PA.

Title: A Cultura de Segurança no Cuidado Paliativo Oncológico durante a Pandemia de Covid-19
Authors: Bittencourt, Nair Caroline Cavalcanti de Mendonça; Souza, Maria das Graças Gazel de; Nigri, Regina Bokehi; Silva, Vanessa Gomes da
Abstract: Atualmente, o mundo vive um cenário de pandemia causada pela síndrome respiratória aguda grave do coronavírus 2 (severe acute respiratory syndrome coronavirus 2 – Sars-CoV-2), com impacto na economia, saúde pública e saúde mental de toda a sociedade1, cujos profissionais de saúde trabalham para o enfrentamento da doença pelo coronavírus 2019 (coronavirus disease 2019 – Covid-19), arriscando suas vidas e vivenciando situações que geram desgastes físicos e psicológicos2. E, em se tratando de cuidado paliativo oncológico, que tem por objetivo o alívio do sofrimento humano, seus princípios devem ser aplicados tanto de forma individual, diante de uma doença que ameaça à vida, como por exemplo o câncer avançado, quanto diante de uma população que sofre por risco de perda massiva de vidas.......

Title: Presence and clinical impact of human herpesvirus‐6 infection in patients with moderate to critical coronavirus disease‐19
Authors: Lino, Katia; Alves, Lilian S.; Raposo, Jessica V.; Medeiros, Thalia; Souza, Cintia F.; Silva, Andrea A. da; Paula, Vanessa Salete de; Almeida, Jorge R.

by J. Hunter Priniski, Keith J. Holyoak

Despite widespread communication of the health risks associated with the COVID-19 virus, many Americans underestimated its risks and were antagonistic regarding preventative measures. Political partisanship has been linked to diverging attitudes towards the virus, but the cognitive processes underlying this divergence remain unclear. Bayesian models fit to data gathered through two preregistered online surveys, administered before (March 13, 2020, N = 850) and during the first wave (April-May, 2020, N = 1610) of cases in the United States, reveal two preexisting forms of distrust––distrust in Democratic politicians and in medical scientists––that drove initial skepticism about the virus. During the first wave of cases, additional factors came into play, suggesting that skeptical attitudes became more deeply embedded within a complex network of auxiliary beliefs. These findings highlight how mechanisms that enhance cognitive coherence can drive anti-science attitudes.

by Giulia Cassone, Giovanni Dolci, Giulia Besutti, Luca Braglia, Paolo Pavone, Romina Corsini, Fabio Sampaolesi, Valentina Iotti, Elisabetta Teopompi, Marco Massari, Matteo Fontana, Giulia Ghidoni, Anaflorina Matei, Stefania Croci, Emanuele Alberto Negri, Massimo Costantini, Nicola Facciolongo, Carlo Salvarani
Objective The aim of this retrospective observational study is to analyse clinical, serological and radiological predictors of outcome in patients with COVID-19 pneumonia treated with tocilizumab, providing clinical guidance to its use in real-life. Method This is a retrospective, monocentric observational cohort study. All consecutive patients hospitalized between February the 11th and April 14th 2020 for severe COVID-19 pneumonia at Reggio Emilia AUSL and treated with tocilizumab were enrolled. The patient’s clinical status was recorded every day using the WHO ordinal scale for clinical improvement. Response to treatment was defined as an improvement of one point (from the status at the beginning of tocilizumab treatment) during the follow-up on this scale. Bivariate association of main patients’ characteristics with outcomes was explored by descriptive statistics and Fisher or Kruskal Wallis tests (respectively for qualitative or quantitative variables). Each clinically significant predictor was checked by a loglikelihood ratio test (in univariate logistic models for each of the considered outcomes) against the null model. Results A total of 173 patients were included. Only hypertension, the use of angiotensin-converting enzyme inhibitors, PaO2/FiO2, respiratory rate and C-reactive protein were selected for the multivariate analysis. In the multivariable model, none of them was significantly associated with response. Conclusions Evaluating a large number of clinical variables, our study did not find new predictors of outcome in COVID19 patients treated with tocilizumab. Further studies are needed to investigate the use of tocilizumab in COVID-19 and to better identify clinical phenotypes which could benefit from this treatment.

by Ayenew Mose, Kassahun Haile, Abebe Timerga
Background Medical and health science students are among the frontline health care workers who are at high risk of acquiring COVID-19 infection during their clinical attachments and future career. As health care providers, they are expected to promote and administer the COVID-19 vaccine and counsel vaccine-hesitant patients. It is, therefore, imperative to assess COVID-19 vaccine hesitancy among medical and health science students. Thus, this study aimed to assess COVID-19 vaccine hesitancy and its associated factors among medical and health science students of Wolkite University. Method An institutional-based cross-sectional study design was conducted among 420 medical and health science students attending Wolkite University from March 1 to 30, 2021. Simple random sampling technique was used to select study participants. Self-administered and structured questionnaires were used to collect data. Data were entered into Epi-Data version 4.2.0 and exported to SPSS version 23 software package for further analysis. Bivariable and multivariable analysis was used to identify associated factors. P values

by Shohei Inui, Soon Ho Yoon, Ozkan Doganay, Fergus V. Gleeson, Minsuok Kim
Background Coronavirus disease 2019 (COVID-19) may severely impair pulmonary function and cause hypoxia. However, the association of COVID-19 pneumonia on CT with impaired ventilation remains unexplained. This pilot study aims to demonstrate the relationship between the radiological findings on COVID-19 CT images and ventilation abnormalities simulated in a computational model linked to the patients’ symptoms. Methods Twenty-five patients with COVID-19 and four test-negative healthy controls who underwent a baseline non-enhanced CT scan: 7 dyspneic patients, 9 symptomatic patients without dyspnea, and 9 asymptomatic patients were included. A 2D U-Net-based CT segmentation software was used to quantify radiological futures of COVID-19 pneumonia. The CT image-based full-scale airway network (FAN) flow model was employed to assess regional lung ventilation. Functional and radiological features were compared across groups and correlated with the clinical symptoms. Heterogeneity in ventilation distribution and ventilation defects associated with the pneumonia and the patients’ symptoms were assessed. Results Median percentage ventilation defects were 0.2% for healthy controls, 0.7% for asymptomatic patients, 1.2% for symptomatic patients without dyspnea, and 11.3% for dyspneic patients. The median of percentage pneumonia was 13.2% for dyspneic patients and 0% for the other groups. Ventilation defects preferentially affected the posterior lung and worsened with increasing pneumonia linearly (y = 0.91x + 0.99, R2 = 0.73) except for one of the nine dyspneic patients who had disproportionally large ventilation defects (7.8% of the entire lung) despite mild pneumonia (1.2%). The symptomatic and dyspneic patients showed significantly right-skewed ventilation distributions (symptomatic without dyspnea: 0.86 ± 0.61, dyspnea 0.91 ± 0.79) compared to the patients without symptom (0.45 ± 0.35). The ventilation defect analysis with the FAN model provided a comparable diagnostic accuracy to the percentage pneumonia in identifying dyspneic patients (area under the receiver operating characteristic curve, 0.94 versus 0.96). Conclusions COVID-19 pneumonia segmentations from CT scans are accompanied by impaired pulmonary ventilation preferentially in dyspneic patients. Ventilation analysis with CT image-based computational modelling shows it is able to assess functional impairment in COVID-19 and potentially identify one of the aetiologies of hypoxia in patients with COVID-19 pneumonia.

Title: Timeline analysis of IgA and IgG levels in Covid-19 hospitalized patients according to the clinical outcome
Authors: Medeiros, Thalia; Carvalho, Fabiana R.; Faustino, Renan; Guimarães, Gabriel M. G.; Alves, Lilian S.; Oliveira, Any Caroline; Azeredo, Elzinandes L.; Almeida, Jorge R.; PInto, Luzia Maria O.; Silva, Andrea Alice
Abstract: Introdução: Estudos sugerem a associação entre a produção de anticorpos e a gravidade da coronavirus disease 2019 (Covid-19).
Objetivos: Avaliar as concentrações de imunoglobulinas da classe A (IgA) e da classe G (IgG) durante a internação de pacientes
com Covid-19 de acordo com o desfecho (sobrevida vs óbito). Materiais e métodos: Pacientes com infecção pela síndrome
respiratória aguda grave do coronavírus 2 (Sars-CoV-2) confirmada por reação da transcriptase reversa seguida de reação em
cadeia da polimerase (RT-PCR) foram incluídos neste estudo prospectivo. As amostras foram obtidas semanalmente durante o
acompanhamento dos indivíduos, considerando o início dos sintomas. Os títulos de IgA e IgG anti-Sars-CoV-2 foram mensurados
por meio de um imunoensaio comercial. Correlações entre IgA/IgG e valores de limiar de detecção [cycle thresholds (Ct)] para
os genes alvos N1 e N2 também foram avaliadas. Resultados: Estudamos 55 pacientes com Covid-19 (59,7 ± 6,2 anos; 63,6%
do sexo masculino); destes, 28 (50,9%) morreram. Observamos positividade para IgA e IgG (IgA+/IgG+) em 90,9% e 80% dos
pacientes, respectivamente. A maior frequência de IgA+ foi verificada nas semanas 2 e 3, e a maior frequência de IgG+, nas
semanas 3 e 4. É importante observar que os pacientes que morreram apresentaram títulos de IgA mais baixos nas primeiras duas semanas
(p 0,05); no entanto, um aumento significativo na concentração de IgA foi observado nas semanas subsequentes

by Binod Acharya, Keshab Subedi, Pramod Acharya, Shweta Ghimire
Background Past works have linked the COVID-19 pandemic and subsequent public health responses such as isolation, quarantine, and lockdown to increased anxiety, sleep disorders, depressive symptoms, and suicidal ideation. Only a few studies, mostly carried out in high-income countries, have investigated the association between the pandemic and suicide rate. We seek to investigate the changes in the monthly suicide rates during the COVID-19 pandemic in Nepal, compared to the pre-pandemic suicide rates. Methods and findings This is a retrospective study investigating the changes in suicide rates in Nepal during the COVID-19 pandemic period (April 2020 to June 2021), compared to the pre-pandemic period (July 2017 to March 2020), adjusted for seasonality and long-term trend in the suicide rate. We performed analysis for the entire country as well as sub-sample analyses stratified by gender and provinces. A total of 24350 suicides deaths during four years of the study window were analyzed. We found an overall increase in the monthly suicide rate in Nepal with an average increase of 0.28 (CI: 0.12,0.45) suicide per 100,000 during the pandemic months. The increase in suicide rate was significant both among males (increase in rate = 0.26, CI: 0.02,0.50) and females (increase in rate = 0.30, CI: 0.18,0.43). The most striking increments in suicide rates were observed in June, July, and August 2020. The pattern of increased suicide rates faded away early on among males, but the effect was sustained for a longer duration among females. Sudurpaschim and Karnali provinces had the highest increase in suicide rates associated with the COVID-19 pandemic. Conclusions The COVID-19 pandemic is associated with an increased suicide rate in Nepal. The findings may inform policymakers in designing appropriate public health responses to the pandemic that are considerate of the potential impact on mental health and suicide.

by Mohammed Yesuf, Mehd Abdu
Introduction As of February 2021 COVID-19 report in 57 African countries, there were 3,761,512 confirmed cases and 98,088 deaths. Ethiopia reported the highest number of cases in East Africa with a total of 147,092 cases and 2,194 deaths. Over 1.5 billion students from 195 countries across the world separated from school as a consequence of the closure of schools related to the pandemic. This study aimed to determine the level of knowledge, attitude, prevention practices, and determinant factors regarding COVID-19 among preparatory school students in southwest Ethiopia. Methods An institution-based cross-sectional study design was used for 422 samples. Each respondent was selected using simple random sampling. Data were collected using a self-administered questionnaire. The collected data were entered and analyzed using Statistical Package for social science software version 25.0. Multivariable binary logistic regression was used to identify factors that were significantly associated with the practice of COVID-19 prevention. Results The response rate in this study was 96.2%. A higher proportion of the respondents were female (53.9%), Bench (43.6%), and protestant (47.3%). The level of good knowledge, positive attitude, and good practice were 81.8%, 70.9%, and 47.0% respectively. Using social media [AOR: 1.801, 95% CI: 1.005, 3.226], watching television [AOR: 1.884 95% CI: 1.093, 3.247], being knowledgeable [AOR: 5.173 95% CI: 2.276, 11.755], and having a positive attitude [AOR: 4.300 95% CI: 2.351, 7.868] were positively associated with COVID-19 prevention practice. Conclusion Despite the high level of knowledge and a moderate level of positive attitude, the practice of COVID-19 prevention measures was low. Using social media, watching television, being knowledgeable, and having positive attitudes towards COVID-19 increases the tendency to practice COVID-19 prevention measures. School directors and teachers should strictly monitor students for their adherence to COVID-19 prevention measures as directed by the local and national health care departments.

by Ali Reza Yusefi, Mehrdad Sharifi, Narjes sadat Nasabi, Esmat Rezabeigi Davarani, Peivand Bastani
Background One of the main forthcoming challenges of healthcare systems against preparedness and management of the pandemic is the challenge of procurement and recruitment of the human resources. This study is aimed to explore the health human resources challenges during COVID-19 pandemic in Iran. Methods This qualitative content analysis study was conducted in 2020. The study population includes all the Iranian human resources managers affiliated in Universities of Medical Sciences, hospitals and health centers managers and the health networks managers all over the country. 23 participants were included via purposeful sampling considering the inclusion criteria and were interviewed individually. After 23 semi-structured interviews, data were saturated. Then the data were analyzed through content analysis approach applying MAXQDA10. Results Three main themes of “organizational challenges”, “legal challenges”, and “personal challenges” were explored as the main challenges of health human resources management during COVID-19. On the one hand, organizational challenges include restricted financial resources, compensation discrimination, staffing distinction points, imbalance in the workload, weak organizational coordination, inefficient inter-sectoral relationships, parallel decisions, inefficient distribution of the human resources, lack of applied education, lack of integrated health protocols, lack of appropriate evaluation of performance, employee turnover, lack of clear approaches for staffing, and shortage of specialized manpower, and on the other hand, the personal challenges include insufficient knowledge of the employees, psychological disorders, reduction of self-confidence, burnout, workload increase, reduced level of job satisfaction, effects of colleague and patients bereavement and unsafety sense against the work place. Finally, the legal challenges that mostly related to the governments laws and regulations include lack of protocols for continuous supportive services, inappropriate approaches and instructions for teleworking, and lack of alternative plans and regulations for the human resources. Conclusion Organizational, legal and personal challenges are among three main challenges of health human resources management during COVID-19 pandemic. Serious attention to these challenges should be considered by health policymakers in order to be prepared for facing new probable outbreaks and managing the present condition. The integrated comprehensive planning of human resources management for COVID-19 along with supportive packages for the personnel can be helpful.

by Ae-Young Her, Youngjune Bhak, Eun Jung Jun, Song Lin Yuan, Scot Garg, Semin Lee, Jong Bhak, Eun-Seok Shin

We sought to assess the impact of sex on in-hospital mortality of patients with COVID-19 infection in South Korea. The study recruited 5,628 prospective consecutive patients who were hospitalized in South Korea with COVID-19 infection, and enrolled in the Korea Centers for Disease Control and Prevention (KCDC) dataset between January 20, 2020, and April 30, 2020. The primary endpoint was in-hospital death from COVID-19. The cohort comprised of 3,308 women (59%) and 2,320 men (41%). In-hospital death was significantly lower in women than men (3.5% vs. 5.5%, hazard ratio (HR): 0.61; 95% confidence interval (CI): 0.47 to 0.79, p

Title: Risk factors associated with mortality in patients hospitalized for coronavirus disease 2019 in Rio de Janeiro, Brazil
Authors: Correal, Julio César Delgado; Solórzano, Victor Edgar Fiestas; Damasco, Paula Hesselberg; Martins, Maria de Lourdes; Oliveira, Adriana Guerreiro Soares de; Campos, Carla Salles; Fornasari, Marcos Fernando; Azeredo, Elzinandes Leal de; Damasco, Paulo Vieira

by Cassandra Guarino, Elisabeth Larson, Susanna Babasyan, Alicia Rollins, Lok R. Joshi, Melissa Laverack, Lara Parrilla, Elizabeth Plocharczyk, Diego G. Diel, Bettina Wagner

A serological COVID-19 Multiplex Assay was developed and validated using serum samples from convalescent patients and those collected prior to the 2020 pandemic. After initial testing of multiple potential antigens, the SARS-CoV-2 nucleocapsid protein (NP) and receptor-binding domain (RBD) of the spike protein were selected for the human COVID-19 Multiplex Assay. A comparison of synthesized and mammalian expressed RBD proteins revealed clear advantages of mammalian expression. Antibodies directed against NP strongly correlated with SARS-CoV-2 virus neutralization assay titers (rsp = 0.726), while anti-RBD correlation was moderate (rsp = 0.436). Pan-Ig, IgG, IgA, and IgM against NP and RBD antigens were evaluated on the validation sample sets. Detection of NP and RBD specific IgG and IgA had outstanding performance (AUC > 0.90) for distinguishing patients from controls, but the dynamic range of the IgG assay was substantially greater. The COVID-19 Multiplex Assay was utilized to identify seroprevalence to SARS-CoV-2 in people living in a low-incidence community in Ithaca, NY. Samples were taken from a cohort of healthy volunteers (n = 332) in early June 2020. Only two volunteers had a positive result on a COVID-19 PCR test performed prior to serum sampling. Serological testing revealed an exposure rate of at least 1.2% (NP) or as high as 5.7% (RBD), higher than the measured incidence rate of 0.16% in the county at that time. This highly sensitive and quantitative assay can be used for monitoring community exposure rates and duration of immune response following both infection and vaccination.

by Yuki Nagakubo, Yosuke Hirotsu, Makoto Maejima, Masahiro Shibusawa, Kazuhiro Hosaka, Kenji Amemiya, Hitomi Sueki, Miyoko Hayakawa, Hitoshi Mochizuki, Toshiharu Tsutsui, Yumiko Kakizaki, Yoshihiro Miyashita, Masao Omata

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has circulated worldwide and causes coronavirus disease 2019 (COVID-19). At the onset of the COVID-19 pandemic, infection control measures were taken, such as hand washing, mask wearing, and behavioral restrictions. However, it is not fully clear how the effects of these non-pharmaceutical interventions changed the prevalence of other pathogens associated with respiratory infections. In this study, we collected 3,508 nasopharyngeal swab samples from 3,249 patients who visited the Yamanashi Central Hospital in Japan from March 1, 2020 to February 28, 2021. We performed multiplex polymerase chain reaction (PCR) using the FilmArray Respiratory Panel and singleplex quantitative reverse transcription PCR targeting SARS-CoV-2 to detect respiratory disease-associated pathogens. At least one pathogen was detected in 246 (7.0%) of the 3,508 samples. Eleven types of pathogens were detected in the samples collected from March–May 2020, during which non-pharmaceutical interventions were not well implemented. In contrast, after non-pharmaceutical interventions were thoroughly implemented, only five types of pathogens were detected, and the majority were SARS-CoV-2, adenoviruses, or human rhinoviruses / enteroviruses. The 0–9 year age group had a higher prevalence of infection with adenoviruses and human rhinoviruses / enteroviruses compared with those 10 years and older, while those 10 years and older had a higher prevalence of infection with SARS-CoV-2 and other pathogens. These results indicated that non-pharmaceutical interventions likely reduced the diversity of circulating pathogens. Moreover, differences in the prevalence of pathogens were observed among the different age groups.

by Wolfgang Stroebe, Michelle R. vanDellen, Georgios Abakoumkin, Edward P. Lemay Jr, William M Schiavone, Maximilian Agostini, Jocelyn J. Bélanger, Ben Gützkow, Jannis Kreienkamp, Anne Margit Reitsema, Jamilah Hanum Abdul Khaiyom, Vjolica Ahmedi, Handan Akkas, Carlos A. Almenara, Mohsin Atta, Sabahat Cigdem Bagci, Sima Basel, Edona Berisha Kida, Allan B. I. Bernardo, Nicholas R. Buttrick, Phatthanakit Chobthamkit, Hoon-Seok Choi, Mioara Cristea, Sára Csaba, Kaja Damnjanović, Ivan Danyliuk, Arobindu Dash, Daniela Di Santo, Karen M Douglas, Violeta Enea, Daiane Gracieli Faller, Gavan Fitzsimons, Alexandra Gheorghiu, Ángel Gómez, Ali Hamaidia, Qing Han, Mai Helmy, Joevarian Hudiyana, Bertus F. Jeronimus, Ding-Yu Jiang, Veljko Jovanović, Željka Kamenov, Anna Kende, Shian-Ling Keng, Tra Thi Thanh Kieu, Yasin Koc, Kamila Kovyazina, Inna Kozytska, Joshua Krause, Arie W. Kruglanksi, Anton Kurapov, Maja Kutlaca, Nóra Anna Lantos, Cokorda Bagus Jaya Lemsmana, Winnifred R. Louis, Adrian Lueders, Najma Iqbal Malik, Anton Martinez, Kira O. McCabe, Jasmina Mehulić, Mirra Noor Milla, Idris Mohammed, Erica Molinario, Manuel Moyano, Hayat Muhammad, Silvana Mula, Hamdi Muluk, Solomiia Myroniuk, Reza Najafi, Claudia F. Nisa, Boglárka Nyú, Paul A. O’Keefe, Jose Javier Olivas Osuna, Evgeny N. Osin, Joonha Park, Gennaro Pica, Antonio Pierro, Jonas Rees, Elena Resta, Marika Rullo, Michelle K. Ryan, Adil Samekin, Pekka Santtila, Edyta Sasin, Birga M. Schumpe, Heyla A. Selim, Michael Vicente Stanton, Samiah Sultana, Robbie M. Sutton, Eleftheria Tseliou, Akira Utsugi, Jolien Anne van Breen, Caspar J. Van Lissa, Kees Van Veen, Alexandra Vázquez, Robin Wollast, Victoria Wai-Lan Yeung, Somayeh Zand, Iris Lav Žeželj, Bang Zheng, Andreas Zick, Claudia Zúñiga, N. Pontus Leander

by Imam Adli, Indah Suci Widyahening, Gilbert Lazarus, Jason Phowira, Lyanna Azzahra Baihaqi, Bagas Ariffandi, Azis Muhammad Putera, David Nugraha, Nico Gamalliel, Ardi Findyartini
Introduction The potential role of medical students in raising awareness during public health emergencies has been acknowledged. To further explore their potentials as public educators and role models for the communities during the coronavirus disease 2019 (COVID-19) pandemic, this study aims to assess the knowledge, attitude, and practice of these students toward COVID-19. Methods An online cross-sectional survey was conducted among undergraduate medical students in Indonesia. Socio-demographics characteristics, social interaction history, information-seeking behavior, as well as knowledge, attitude, and practice toward COVID-19 were collected through a self-reported questionnaire. A p-value of

by Noori Akhtar-Danesh, Andrea Baumann, Mary Crea-Arsenio, Valentina Antonipillai

The coronavirus disease 2019 (COVID-19) has had devastating consequences worldwide, including a spike in global mortality. Residents of long-term care homes have been disproportionately affected. We conducted a retrospective cohort study to determine the scale of pandemic-related deaths of long-term care residents in the province of Ontario, Canada, and to estimate excess mortality due to a positive COVID-19 test adjusted for demographics and regional variations. Crude mortality rates for 2019 and 2020 were compared, as were predictors of mortality among residents with positive and negative tests from March 2020 to December 2020. We found the crude mortality rates were higher from April 2020 to June 2020 and from November 2020 to December 2020, corresponding to Wave 1 and Wave 2 of the pandemic in Ontario. There were also substantial increases in mortality among residents with a positive COVID-19 test. The significant differences in excess mortality observed in relation to long-term care home ownership category and geographic region may indicate gaps in the healthcare system that warrant attention from policymakers. Further investigation is needed to identify the most relevant factors in explaining these differences.

by Sunggyun Park, Soon Hee Chang, Jae Hee Lee, Jong Ho Lee, Ji Yeon Ham, Yu Kyung Kim, Sang-Gyung Kim, Nam Hee Ryoo
Background Early and accurate detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical to prevent spread of the infection. Understanding of the antibody response to SARS-CoV-2 in patients with coronavirus disease 2019 (COVID-19) is insufficient, particularly in relation to those whose responses persist for more than 1 month after the onset of symptoms. We conducted a SARS-CoV-2 antibody test to identify factors affecting the serological response and to evaluate its diagnostic utility in patients with COVID-19. Methods and finding We collected 1,048 residual serum samples from 396 patients with COVID-19 confirmed by real-time reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. The samples had been used for routine admission tests in six healthcare institutions in Daegu. Antibody to SARS-CoV-2 was analyzed and the cutoff index (COI) was calculated for quantitative analysis. The patients’ information was reviewed to evaluate the relationship between antibody positivity and clinical characteristics. The anti-SARS-CoV-2 antibody positivity rate was 85% and the average COI was 24·3. The positivity rate and COI increased with time elapsed since symptom onset. Anti-SARS-CoV-2 antibody persisted for at least 13 weeks after symptom onset at a high COI. There was a significant difference in anti-SARS-CoV-2 antibody positivity rate between patients with and without symptoms, but not according to sex or disease course. The descending COI pattern at weeks 1 to 5 after symptom onset was significantly more frequent in patients who died than in those who recovered. Conclusions Anti-SARS-CoV-2 antibody persisted for at least 13 weeks at a high COI in patients with COVID-19. A decreasing COI pattern up to fifth week may be associated with a poor prognosis of COVID-19. As new treatments and vaccines are introduced, it is important to monitor continuously the usefulness of anti-SARS-CoV-2 antibody assays.

Title: Entomological surveillance of mosquitoes (Diptera: Culicidae), vectors of arboviruses, in an ecotourism park in Cachoeiras de Macacu, state of Rio de Janeiro-RJ, Brazil
Authors: Balthazar, Thamiris D’A.; Maia, Danielle A.; Oliveira, Alexandre A.; Marques, William A.; Bastos, Amanda Q.; Vilela, Maurício L.; Mallet, Jacenir R. S.

by Stephanie Daley, Nicolas Farina, Laura Hughes, Elise Armsby, Nazire Akarsu, Joanna Pooley, Georgia Towson, Yvonne Feeney, Naji Tabet, Bethany Fine, Sube Banerjee
Introduction COVID-19 has placed unprecedented pressure on dementia health and social care systems worldwide. This has resulted in reduced services and support for people with dementia and their family carers. There are gaps in the evidence on the impact of the pandemic on Quality of Life (QoL). We carried out a study on the impact of the pandemic on the QoL of a group of people with dementia and their family carers who were part of a larger existing cohort study. Methods We quantitatively measured QoL, on two occasions during the two national lockdowns in 2020 and compared these data with those obtained when they entered the study (before the pandemic). Measures used included: DEMQOL-Proxy, Clinical Dementia Rating Scale and C-DEMQOL. To understand how QoL changed over time, a repeated measures ANOVA was run for each dependent variable with the following variables entered as co-variates: duration in study, baseline dementia severity, gender of the family carer, gender of the person with dementia, family carer relationship, dementia type, living status, age of the person with dementia, and age of the family carer. Results 248 participants took part in the study. QoL scores did not significantly decline between either time period for the person with dementia or their family carer. There was variation in subgroups; with co-resident status, carer relationship, gender of the person with dementia, age of the person with dementia, and baseline cognitive status influencing QoL outcomes in family carers. Discussion It is striking that people with dementia and their carers did not report a decline in QoL during the pandemic or in the months following restrictions suggesting the possibility of resilience. Variation in subgroups suggests that specific groups of family carers were more vulnerable to lower QoL; indicating the need for more tailored, nuanced support during this period.

by Fabia Morales-Vives, Jorge-Manuel Dueñas, Pere J. Ferrando, Andreu Vigil-Colet, Maria Dolores Varea

Several studies in different countries have reported that part of the population does not fully comply with the measures recommended to prevent COVID-19, and therefore poses a risk to public health. For this reason, several measures have been developed to assess the level of compliance, although many of them have methodological limitations or do not include a comprehensive set of items. The main goal of the current study was to develop a new instrument with suitable psychometric properties, which includes a more complete set of items and controls the impact of acquiescence bias. The participants were 1410 individuals (59.2% women) from Spain, who answered the new questionnaire and several items on sociodemographic and attitudinal issues. Exploratory and confirmatory factor analyses were carried out, and the results suggested that only one content factor was underlying the data. This solution was replicated in a different subsample, which shows the stability of the solution. Furthermore, the relationships between the scores of the new questionnaire and the sociodemographic and attitudinal variables are similar to those obtained in previous studies, which can be regarded as evidence of the validity of the new questionnaire.