Monitoramento das Produções

by Diego Casas-Deza, Vanesa Bernal-Monterde, Angel Nicolás Aranda-Alonso, Enrique Montil-Miguel, Ana Belen Julián-Gomara, Laura Letona-Giménez, Jose M. Arbones-Mainar
Background Risk for severe COVID-19 increases with age. Different vaccination strategies are currently being considered, including those aimed at slowing down transmission and those aimed at providing direct protection to those most at risk. Methods The objectives of the current study were i) to assess age-related incidence and survival between PCR-diagnosed COVID-19 cases (n = 61,993) in the Autonomous Community of Aragon from March to November 2020, and ii) to characterize age differences regarding the course of the disease in hospitalized patients in a tertiary university hospital. Results We found a similar incidence of COVID-19 in individuals between 10 and 79 years. Incidence increased in those over 80 years possibly because of the elevated transmission within the nursing homes. We observed a profound disparity among age groups; case fatality rates (CFRs) were near 0 in cases younger than 39 years throughout different waves. In contrast, there was an age-dependent and progressive increase in the CFRs, especially during the first pandemic wave. SARS-CoV-2 infection caused a more severe and rapid progression in older patients. The elderly required faster hospitalization, presented more serious symptoms on admission, and had a worse clinical course. Hospitalized older individuals, even without comorbidities, had an increased mortality risk directly associated with their age. Lastly, the existence of comorbidities dramatically increased the CFRs in the elderly, especially in males. Conclusion The elevated incidence of COVID-19 and the vulnerability of the elderly call for their prioritization in vaccination and targeted prevention measures specifically focused on this aged population.

by Mohammad Bellal Hossain, Md. Zakiul Alam, Md. Syful Islam, Shafayat Sultan, Md. Mahir Faysal, Sharmin Rima, Md. Anwer Hossain, Abdullah Al Mamun
Introduction Studies related to the COVID-19 vaccine hesitancy are scanty in Bangladesh, despite the growing necessity of understanding the population behavior related to vaccination. Thus, the present study was conducted to assess the prevalence of the COVID-19 vaccine hesitancy and its associated factors in Bangladesh to fill the knowledge gap. Methods and materials This study adopted a cross-sectional design to collect data from 1497 respondents using online (Google forms) and face-to-face interviews from eight administrative divisions of Bangladesh between 1–7 February 2021. We employed descriptive statistics and multiple logistic regression analysis. Results The prevalence of vaccine hesitancy was 46.2%. The Muslims (aOR = 1.80, p ≤ 0.01) and the respondents living in the city corporation areas (aOR = 2.14, p ≤0.001) had more hesitancy. There was significant variation in vaccine hesitancy by administrative divisions (geographic regions). Compared to the Sylhet division, the participants from Khulna (aOR = 1.31, p ≤0.001) had higher hesitancy. The vaccine hesitancy tended to decrease with increasing knowledge about the vaccine (aOR = 0.88, p≤0.001) and the vaccination process (aOR = 0.91, p ≤ 0.01). On the other hand, hesitancy increased with the increased negative attitudes towards the vaccine (aOR = 1.17, p≤0.001) and conspiracy beliefs towards the COVID-19 vaccine (aOR = 1.04, p≤0.01). The perceived benefits of COVID-19 vaccination (aOR = 0.85, p≤0.001) were negatively associated with hesitancy, while perceived barriers (aOR = 1.16, p ≤0.001) were positively associated. The participants were more hesitant to accept the vaccine from a specific country of origin (India, USA, Europe). Conclusions Our findings warrant that a vigorous behavior change communication campaign should be designed and implemented to demystify negative public attitudes and conspiracy beliefs regarding the COVID-19 Vaccine in Bangladesh. The policymakers should also think about revisiting the policy of the online registration process to receive the COVID-19 vaccine, as online registration is a key structural barrier for many due to the persistent digital divide in the country. Finally, the government should consider the population’s preference regarding vaccines’ country of manufacture to reduce the COVID-19 vaccine hesitancy.

by Daigo Sakamoto, Toyohiro Hamaguchi, Yasuhide Nakayama, Takuya Hada, Masahiro Abo
Background Outpatient rehabilitation was temporarily suspended because of coronavirus disease (COVID-19), and there was a risk that patients’ activities of daily living (ADLs) would decrease and physical functions unmaintained. Therefore, we investigated the ADLs and motor functions of chronic stroke patients whose outpatient rehabilitation was temporarily interrupted. Methods In this observational study, the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), and Barthel Index (BI) scores of 49 stroke hemiplegic patients at 6 and 3 months before rehabilitation interruptions were retrospectively determined and were prospectively investigated on resumption of outpatient rehabilitation. Presence or absence of symptoms and difficulties caused by the interruption period (IP) was investigated using a binomial method. Deltas were analyzed using a generalized linear model (GLM) according to the survey period. Age, sex, severity of FMA-UE immediately post-resumption and post-onset period were used as covariates. For survey items showing significant model fit, the 95% confidence interval of minimum detectable change (MDC95) was calculated, and the amount of change was compared. Questionnaire responses were tested via proportion ratio. Statistical significance was set at 5%. Results The FMA-UE part A and total scores were significantly model fit depending on periods. The estimated FMA-UE total score decreased by 1.64 (z = −2.38, p = 0.02) during the 3-month IP. No fits were observed by GLM in other parts of the FMA-UE, ARAT, or BI. The calculated MDC95 was 3.58 for FMA-UE part A and 4.50 for FMA-UE overall. Answers to questions regarding sleep disturbance and physical pain were significantly biased toward “no” in the psychosomatic function items (p

by Greg Chih-Hsin Sheen, Hans H. Tung, Wen-Chin Wu

During the outbreak of an epidemic, the success in risk communications to make the public comply with disease preventive measures depends on the public’s trust in the government. In this study, we aim to understand how media audiences update their trust in the government during the COVID-19 outbreak depending on the information they received. We conducted an online survey experiment in February 2020 in Hong Kong (n = 1,016) in which respondents were randomly provided with a government press release and an endorsement either from an official or a non-official source. This study shows that the information from a non-official source enhances the credibility of official government messages. Our findings imply that dictators can actually “borrow credibility” from their citizen journalists and even nondemocratic leaders can make themselves more trustworthy to potential dissenters through citizen journalism. Allowing information flow from non-official sources can be a practical measure for governments to address the problem of a credibility deficit during a pandemic.

by Mark A. Tully, Laura McMaw, Deepti Adlakha, Neale Blair, Jonny McAneney, Helen McAneney, Christina Carmichael, Conor Cunningham, Nicola C. Armstrong, Lee Smith
Background In response to the COVID-19 pandemic, most countries have introduced non-pharmaceutical interventions, such as stay-at-home orders, to reduce person-to-person contact and break trains of transmission. The aim of this systematic review was to assess the effect of different public health restrictions on mobility across different countries and cultures. The University of Bern COVID-19 Living Evidence database of COVID-19 and SARS-COV-2 publications was searched for retrospective or prospective studies evaluating the impact of COVID-19 public health restrictions on Google Mobility. Titles and abstracts were independently screened by two authors. Information from included studies was extracted by one researcher and double checked by another. Risk of bias of included articles was assessed using the Newcastle Ottowa Scale. Given the heterogeneous nature of the designs used, a narrative synthesis was undertaken. From the search, 1672 references were identified, of which 14 were included in the narrative synthesis. All studies reported data from the first wave of the pandemic, with Google Mobility Scores included from January to August 2020, with most studies analysing data during the first two months of the pandemic. Seven studies were assessed as having a moderate risk of bias and seven as a low risk of bias. Countries that introduced more stringent public health restrictions experienced greater reductions in mobility, through increased time at home and reductions in visits to shops, workplaces and use of public transport. Stay-at-home orders were the most effective of the individual strategies, whereas mask mandates had little effect of mobility. Conclusions Public health restrictions, particularly stay-at-home orders have significantly impacted on transmission prevention behaviours. Further research is required to understand how to effectively address pandemic fatigue and to support the safe return back to normal day-to-day behaviours.

Title: Immunomodulatory and Anti-fibrotic Effects Following the Infusion of Umbilical Cord Mesenchymal Stromal Cells in a Critically Ill Patient With COVID-19 Presenting Lung Fibrosis: A Case Report
Authors: Silva, Kátia Nunes da; Pinheiro, Priscila Carvalho Guedes; Gobatto, André Luiz Nunes; Passos, Rogério da Hora; Paredes, Bruno Diaz; França, Luciana Souza de Aragão; Nonaka, Carolina Kymie Vasques; Duarte, Beatriz Barreto; Pereira, Mariana Araújo; Tibúrcio, Rafael; Cruz, Fernanda Ferreira; Martins, Gabriele Louise Soares; Andrade, Bruno Bezerril de; Faria Neto, Hugo Caire de Castro; Rocco, Patricia Rieken Macêdo; Souza, Bruno Solano de Freitas
Description: 1 Center for Biotechnology and Cell Therapy, São Rafael Hospital, Salvador, Brazil, 2 D’Or Institute for Research and
Education (IDOR), Salvador, Brazil, 3 Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil, 4 Critical
Care Unit, São Rafael Hospital, Salvador, Brazil, 5 Curso de Medicina, Universidade Salvador (UNIFACS), Laureate
International Universities, Salvador, Brazil, 6 Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de
Janeiro, Rio de Janeiro, Brazil, 7Multinational Organization Network Sponsoring Translational and Epidemiological Research
(MONSTER) Initiative, Salvador, Brazil, 8 Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil, 9 Laboratory
of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro,
Brazil, 10 COVID-19 Virus Network from Brazilian Council for Scientific and Technological Development, Brasília, Brazil,
11 COVID-19 Virus Network from Foundation Carlos Chagas Filho Research Support of the State of Rio de Janeiro, Rio de
Janeiro, Brazil, 12 National Institute of Science and Technology for Regenerative Medicine, Rio de Janeiro, Brazil, 13 Laboratory
of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil

by Fatima-Zahra Jaouimaa, Daniel Dempsey, Suzanne Van Osch, Stephen Kinsella, Kevin Burke, Jason Wyse, James Sweeney

Strategies adopted globally to mitigate the threat of COVID–19 have primarily involved lockdown measures with substantial economic and social costs with varying degrees of success. Morbidity patterns of COVID–19 variants have a strong association with age, while restrictive lockdown measures have association with negative mental health outcomes in some age groups. Reduced economic prospects may also afflict some age cohorts more than others. Motivated by this, we propose a model to describe COVID–19 community spread incorporating the role of age-specific social interactions. Through a flexible parameterisation of an age-structured deterministic Susceptible Exposed Infectious Removed (SEIR) model, we provide a means for characterising different forms of lockdown which may impact specific age groups differently. Social interactions are represented through age group to age group contact matrices, which can be trained using available data and are thus locally adapted. This framework is easy to interpret and suitable for describing counterfactual scenarios, which could assist policy makers with regard to minimising morbidity balanced with the costs of prospective suppression strategies. Our work originates from an Irish context and we use disease monitoring data from February 29th 2020 to January 31st 2021 gathered by Irish governmental agencies. We demonstrate how Irish lockdown scenarios can be constructed using the proposed model formulation and show results of retrospective fitting to incidence rates and forward planning with relevant “what if / instead of” lockdown counterfactuals. Uncertainty quantification for the predictive approaches is described. Our formulation is agnostic to a specific locale, in that lockdown strategies in other regions can be straightforwardly encoded using this model.

by Eduarda T. C. Chagas, Pedro H. Barros, Isadora Cardoso-Pereira, Igor V. Ponte, Pablo Ximenes, Flávio Figueiredo, Fabricio Murai, Ana Paula Couto da Silva, Jussara M. Almeida, Antonio A. F. Loureiro, Heitor S. Ramos

This article proposes a study of the SARS-CoV-2 virus spread and the efficacy of public policies in Brazil. Using both aggregated (from large Internet companies) and fine-grained (from Departments of Motor Vehicles) mobility data sources, our work sheds light on the effect of mobility on the pandemic situation in the Brazilian territory. Our main contribution is to show how mobility data, particularly fine-grained ones, can offer valuable insights into virus propagation. For this, we propose a modification in the SENUR model to add mobility information, evaluating different data availability scenarios (different information granularities), and finally, we carry out simulations to evaluate possible public policies. In particular, we conduct a case study that shows, through simulations of hypothetical scenarios, that the contagion curve in several Brazilian cities could have been milder if the government had imposed mobility restrictions soon after reporting the first case. Our results also show that if the government had not taken any action and the only safety measure taken was the population’s voluntary isolation (out of fear), the time until the contagion peak for the first wave would have been postponed, but its value would more than double.

by Imad M. Tleyjeh, Basema Saddik, Nourah AlSwaidan, Ahmed AlAnazi, Rakhee K. Ramakrishnan, Deema Alhazmi, Ahmad Aloufi, Fahad AlSumait, Elie Berbari, Rabih Halwani
Background Post-acute COVID-19 syndrome (PACS) is an emerging healthcare burden. The risk factors associated with PACS remain largely unclear. The aim of this study was to evaluate the frequency of new or persistent symptoms in COVID-19 patients post hospital discharge and identify associated risk factors. Methods Our prospective cohort comprised of PCR-confirmed COVID-19 patients admitted to King Fahad Medical City, Riyadh, Saudi Arabia between May and July 2020. The patients were interviewed through phone calls by trained physicians from 6 weeks up to 6 months post hospital discharge. Multivariate Cox proportional hazards and logistic regression models were used to examine for predictors associated with persistence of symptoms and non-return to baseline health. Results 222 COVID-19 patients responded to follow-up phone interviews after a median of 122 days post discharge. The majority of patients were men (77%) with mean age of 52.47 (± 13.95) years. 56.3% of patients complained of persistent symptoms; 66 (29.7%) experiencing them for >21 days and 64 (28.8%) reporting not having returned to their baseline health. Furthermore, 39 patients (17.6%) reported visiting an emergency room post discharge for COVID-19-related symptoms while 16 (7.2%) had required re-hospitalization. Shortness of breath (40.1%), cough (27.5%) and fatigue (29.7%) were the most frequently reported symptoms at follow-up. After multivariable adjustments, female gender, pre-existing hypertension and length of hospital stay were associated with an increased risk of new or persistent symptoms. Age, pre-existing lung disease and emergency room visits increased the likelihood of not fully recovering from acute COVID-19. Patients who were treated with interferon β-1b based triple antiviral therapy during hospital stay were less likely to experience new or persistent symptoms and more likely to return to their baseline health. Conclusions COVID-19 survivors continued to suffer from dyspnea, cough and fatigue at 4 months post hospital discharge. Several risk factors could predict which patients are more likely to experience PACS and may benefit from individualized follow-up and rehabilitation programs.

by Hue Trong Duong, Zachary B. Massey, Victoria Churchill, Lucy Popova

Research suggests that smoking may compound the risk of serious health problems to smokers who contract COVID-19. This study examines whether and how exposure to news stories reporting the severe COVID-19 risk to smokers may influence smokers’ emotional responses (fear, anxiety, and sadness) and intentions to take measures to quit smoking. Current smokers in the US participated in an online experiment (N = 495) and were randomized to read smoking risk news stories or news stories reporting the combined risk of smoking and COVID-19. We found that combined risk news stories lead to participants feeling more fearful and sadder than when they viewed smoking risk news stories (M = 5.74; SD = 2.57 vs. M = 5.20; SD = 2.74; p .05). Fear fully mediated the effect of news exposure on intentions to take measures to quit smoking (ß = .09; SE = 05; 95% CI [.010, .200]). Moreover, moderated-mediation analyses revealed that the mediating effect of fear was conditioned on the levels of comparative optimism, such that the association between fear and intentions to take measures to quit smoking was only significant among smokers whose comparative optimism was at the mean score (ß = .16; SE = 05; 95% CI [.071, .250]), and for those whose comparative optimism was high (ß = .27; SE = .06; 95% CI [.146, .395]). These results suggest that fear of the pandemic and optimism might play important roles in predicting and explaining the association between exposure to news stories and intentions to take measures to quit smoking. Messages about heightened risk of COVID-19 complications for smokers that increase fear might be an effective strategy to motivate smokers to quit. Such messages should be used to turn the adversity of COVID-19 pandemic into an intervention opportunity to reduce tobacco-related disease.

Title: Estudo de acompanhamento de um grupo de mães de crianças com microcefalia em Minas Gerais: da mobilização, organização, às reivindicações de direitos no contexto de Zika
Authors: Diniz, Berenice de Freitas
Abstract: A associação da alteração do padrão de ocorrência de microcefalias relacionadas ao vírus Zika no ano de 2015, trouxe enormes e complexos desafios para o sistema de saúde brasileiro, para a ciência e para a sociedade em geral. A reflexão e discussão sobre essas questões apontaram para a fragilidade dos serviços de saúde em atender as demandas advindas desse novo cenário sanitário imposto pela ocorrência do vírus Zika, a necessidade e importância de re-organização desses serviços, a premência do envolvimento da sociedade de forma mais participativa e efetiva nas políticas de saúde e a garantia dos direitos sociais no Brasil. Foi realizado um estudo de caso único, norteado pela abordagem qualitativa , cuja unidade de análise foi o Grupo de Mães de Anjos de Minas. O objetivo do estudo foi acompanhar esse grupo de mães de crianças com microcefalia buscando compreender como saúde e direitos humanos se conectam no contexto de Zika. Para contemplar esse objetivos foram realizados: revisão integrativa da literatura sobre a conexão entre saúde, direitos humanos e Zika; identificação e descrição de documentos, entre os anos de 2015 e 2020, referentes a: ações governamentais realizadas por meio do Sistema Único de Saúde (SUS) relacionadas ao ZIKV,
ações de organizações não governamentais e de grupos de pessoas afetadas pelo ZIKV; entrevistas semi estruturadas e observação participante buscando identificar redes de solidariedade acionadas e construídas pelas mulheres mães de crianças com microcefalia, para a garantia de cuidados a saúde e direitos e compreender as percepções de mães de crianças com microcefalia sobre a constituição do grupo Mães de Anjos de Minas, sobre o vírus Zika e suas conexões com direitos humanos. Para análise dos resultados foi utilizado analise de conteúdo. Identificou-se a poucos estudos no campo de direitos humanos, saúde e a Síndrome Congênita do Zika Vírus. Houve um esforço do SUS em responder à epidemia. Houve a organização da sociedade civil a partir do fenômeno Zika e da sua associação à microcefalia. Identificamos que o Grupo Mães de Anjos de Minas, constitui-se de mulheres mães que residem em todo o estado de Minas Gerais, no entanto a sua maioria está na Região Metropolitana de Belo Horizonte. A trajetória construída pelo grupo baseia-se no aprendizado coletivo, na solidariedade, no apoio entre suas integrantes e à sua organização enquanto grupo, se configurando assim um espaço também de lutas para a garantia de direitos, articulando-se para isso com movimentos sociais/outros grupos que pactuam dessas mesmas premissas. As em redes sociais eletrônicas eram utilizadas para comunicação e informação. Podemos compreender como tem sido o enfrentamento dos desafios das mulheres mães de crianças com microcefalia. Também foi evidenciado que existe uma rede de apoio e solidariedade composta pelo pai, familiares e vizinhos, no entanto o cuidado está centrado nas mulheres mães, que enfrentam uma rotina exaustiva e sistemática de cuidados com os filhos com microcefalia cotidianamente. Constatamos como a garantia dos direitos sociais por meio de políticas públicas são essenciais para a dignidade das crianças com microcefalia. Também se constatou a importância do SUS durante a epidemia de Zika, no entanto há vários desafios, principalmente de efetivar as ações de saúde do nível federal até os municípios e de acompanhar essas crianças e suas famílias de modo longitudinal. Verificou-se que partir do fenômeno Zika vírus e a sua associação à microcefalia, muitas organizações da sociedade civil foram criadas para lutar pela garantia de direitos, principalmente na Região Nordeste, Centro Oeste, Norte e Sudeste do país. A importância da participação das pessoas em coletivos para a busca e garantia de direitos é uma ação fundamental de exercício da cidadania e fortalecimento e aprimoramento das políticas públicas.

Title: SAGA: Sistema de análise genômica dos arbovírus Zika Virus, Dengue Virus, Chikungunya Virus e Yellow Fever Virus
Authors: Gonçalves, José Irahe Kasprzykowski
Abstract: INTRODUÇÃO: Doenças causadas por arbovírus (ARthropod-BOrne VIRUS) representam um grave problema de saúde pública. Com a expansão do vetor Aedes aegypti há o agravante crescimento dos casos de arboviroses no país nos últimos 10 anos. Para melhor abordar esse problema, é preciso obter o máximo de informações sobre os agentes etiológicos associados. Informações como classificação, mapeamento genômico e resposta imune. OBJETIVO: Assim, o objetivo deste trabalho é desenvolver uma plataforma de coleta e análise automáticas e contínuas de informações genômicas dos arbovírus Zika Virus, Dengue Virus, Chikungunya Virus e Yellow Fever Virus. MATERIAL E MÉTODOS: Para tal, foram importadas sequências nucleotídicas dos bancos de dados internacionais (GenBank, DDBJ e EMBL). Estas sequências foram classificadas quanto aos subtipos disponíveis na literatura para cada vírus, e mapeada ainda quanto a sua região de correspondência com a anotação do genoma completo do organismo. A partir daí, foram importados todos os epítopos do IEDB(Immune Epitope Database) e mapeados nas regiões codificantes das sequências. Foi então construido uma interface de acesso WEB onde é possível verificar secções semanais de dados. RESULTADOS: Do corte inicial foi possível obter informações como frequência de subtipo. Onde os mais frequentes são o subtipo tanzaniano, com presença de 73,10% nas sequências de Chikungunya virus; o Subtipo 1 com 34,53% de frequência nas sequências de Dengue vírus; o subtipo peruano com 59,18% nas sequências do vírus da febre amarela e o subtipo do Camboja com 51,35% das sequências do Zika virus. Em relação ao mapeamento genômico os dados mostram que a região mais bem representada no conjunto de dados é aquela que codifica a proteína do envelope viral. O mapeamento dos epítopos mostraram que o epítopo \201CAMTDTTPFGQQRVFK\201D é o mais frequente no vírus da dengue enquanto o \201CSTKDNFNVYKATRPYLAHC é mais frequente no Chikungunya. Já no vírus da zika, o epítopo mais frequentemente observado é o \201CDQRGSGQVVTYALNT\201D e, para o Vírus da Febre Amarela, o epítopo \201CDRDFIEGVHGGTWVS\201D. CONCLUSÃO: Assim, a plataforma desenvolvida representa uma importante ferramenta de suporte a estudos sobre os agentes etiológicos em questão. Uma vez que gera continuamente informações relevantes, além de organizar, armazenar e disponibilizar secções personalizadas de dados. Estas informações reduzem o tempo necessário para realizar estudos sobre estes organismos, acelerando assim os processos de desenvolvimento de vacinas e técnicas diagnósticas.

by Suhas Wasave, Sangita Wasave, Ketankumar Chaudhari, Prakash Shingare, Bharat Yadav, Sandesh Patil, Bhalchandra Naik

The knowledge, awareness, and practices (KAP) about COVID-19 among the marine fishers who are engaged in the high-risk occupations and depend on the vulnerable sources of income in the Maharashtra state of India, were investigated to understand the behavioral changes and vulnerability among the respondents because of COVID-19. Data were collected through an online survey from 1st July to 30th July 2020 during the first peak of COVID-19 in the study area by using the questionnaire. Authors based on the latest recommendations by the World Health Organization (WHO) developed the questionnaire and covered the KAP aspects under study. The questionnaire was administered through Google form link and the link was disseminated through social media such as Facebook and What’s App. The completed responses (n = 533) received from the eligible sample, excluding those outsides of the fisher community and duplicate entries were considered for analysis. Appropriate statistical tools were used to analyze the data. Among the respondents, 447 men (83.86%) and 86 women (16.14%), with a mean age of 45.4 years (M = 45.4, SD = 1.18). The results revealed that 70.92% of respondents perceived a low risk of infection because of COVID-19 with M = 1.77 and SD = 0.583, but authors found the perceived severity score high (M = 3.95, SD = 1.21) among the 60.97% of respondents. Around 95% of respondents were aware of the COVID-19, while almost all respondents knew the medium of infection and symptoms of COVID-19. The behavior of respondents towards COVID-19 infection was positive and was following sufficient precautionary measures suggested by WHO to protect themselves from COVID-19 infection. The results of multiple regression analysis revealed that the demographic features of respondents like age, education were significantly contributing to the KAP of the fisher community. The results confirmed the importance of KAP which is reflected in the behavioral responses of the fishers while tackling the COVID-19 pandemic situation. The results regarding the risk perception, severity, KAP about COVID-19 provide a collective understanding of the emerging infectious disease among the marine fishers of Maharashtra state of India.

by Manickam Ponnaiah, Rizwan Suliankatchi Abdulkader, Tarun Bhatnagar, Jeromie Wesley Vivian Thangaraj, Muthusamy Santhosh Kumar, Ramasamy Sabarinathan, Saravanakumar Velusamy, Yogesh Sabde, Harpreet Singh, Manoj Vasanth Murhekar
Background The Indian Council of Medical Research set up a pan-national laboratory network to diagnose and monitor Coronavirus disease 2019 (COVID-19). Based on these data, we describe the epidemiology of the pandemic at national and sub-national levels and the performance of the laboratory network. Methods We included surveillance data for individuals tested and the number of tests from March 2020 to January 2021. We calculated the incidence of COVID-19 by age, gender and state and tests per 100,000 population, the proportion of symptomatic individuals among those tested, the proportion of repeat tests and test positivity. We computed median (Interquartile range—IQR) days needed for selected surveillance activities to describe timeliness. Results The analysis included 176 million individuals and 188 million tests. The overall incidence of COVID-19 was 0.8%, and 12,584 persons per 100,000 population were tested. 6.1% of individuals tested returned a positive result. Ten of the 37 Indian States and Union Territories accounted for about 75.6% of the total cases. Daily testing scaled up from 40,000 initially to nearly one million in March 2021. The median duration between symptom onset and sample collection was two (IQR = 0,3) days, median duration between both sample collection and testing and between testing and data entry were less than or equal to one day. Missing or invalid entries ranged from 0.01% for age to 0.7% for test outcome. Conclusion The laboratory network set-up by ICMR was scaled up massively over a short period, which enabled testing a large section of the population. Although all states and territories were affected, most cases were concentrated in a few large states. Timeliness between the various surveillance activities was acceptable, indicating good responsiveness of the surveillance system.

by Jiuxia Guo, Yang Li, Zongxin Yang, Xinping Zhu

The resilience and vulnerability of airport networks are significant challenges during the COVID-19 global pandemic. Previous studies considered node failure of networks under natural disasters and extreme weather. Herein, we propose a complex network methodology combined with data-driven to assess the resilience of airport networks toward global-scale disturbance using the Chinese airport network (CAN) and the European airport network (EAN) as a case study. The assessment framework includes vulnerability and resilience analyses from the network- and node-level perspectives. Subsequently, we apply the framework to analyze the airport networks in China and Europe. Specifically, real air traffic data for 232 airports in China and 82 airports in Europe are selected to form the CAN and EAN, respectively. The complex network analysis reveals that the CAN and the EAN are scale-free small-world networks, that are resilient to random attacks. However, the connectivity and vulnerability of the CAN are inferior to those of the EAN. In addition, we select the passenger throughput from the top-50 airports in China and Europe to perform a comparative analysis. By comparing the resilience evaluation of individual airports, we discovered that the factors of resilience assessment of an airport network for global disturbance considers the network metrics and the effect of government policy in actual operations. Additionally, this study also proves that a country’s emergency response-ability towards the COVID-19 has a significantly affectes the recovery of its airport network.

by Jin Young Yu, Ji Sun Kim, Chae-Min Hong, Ka Young Lee, Nam-Jun Cho, Samel Park, Hyo-Wook Gil, Eun Young Lee
Introduction Previous studies have revealed that the COVID-19 pandemic can cause psychological distress such as depression and anxiety. Patients with chronic kidney disease (CKD) might be more vulnerable to psychological distress due to the COVID-19 pandemic. Its impact could be different according to dialysis modality. The aim of this study was to investigate COVID-19-related psychological stress experienced by end-stage kidney disease (ESKD) patients and identify differences in concerns about COVID-19 between hemodialysis (HD) and peritoneal dialysis (PD) patients. Methods This cross-sectional study included 148 dialysis patients at Soonchunhyang University Cheonan Hospital from August 2020 to September 2020. These patients responded to a questionnaire covering mental health status and COVID-19 related concerns. Symptoms of depression, anxiety, stress, and insomnia were measured using a 9-item Patient Health Questionnaire (PHQ-9), a 7-item Generalized Anxiety Disorder (GAD-7) scale, a 22-item Impact of Event Scale-Revised (IES-R), and a 7-item Insomnia severity Index (ISI), respectively. Outcomes of HD and PD patients were compared by propensity score matching analysis. Results Dialysis patients reported psychological distress including symptoms of depression, anxiety, stress, and insomnia. HD patients showed higher scores for depression (p = 0.018), anxiety(p = 0.005), stress(p

by Claus Kadelka, Audrey McCombs

Contact between people with similar opinions and characteristics occurs at a higher rate than among other people, a phenomenon known as homophily. The presence of clusters of unvaccinated people has been associated with increased incidence of infectious disease outbreaks despite high population-wide vaccination rates. The epidemiological consequences of homophily regarding other beliefs as well as correlations among beliefs or circumstances are poorly understood, however. Here, we use a simple compartmental disease model as well as a more complex COVID-19 model to study how homophily and correlation of beliefs and circumstances in a social interaction network affect the probability of disease outbreak and COVID-19-related mortality. We find that the current social context, characterized by the presence of homophily and correlations between who vaccinates, who engages in risk reduction, and individual risk status, corresponds to a situation with substantially worse disease burden than in the absence of heterogeneities. In the presence of an effective vaccine, the effects of homophily and correlation of beliefs and circumstances become stronger. Further, the optimal vaccination strategy depends on the degree of homophily regarding vaccination status as well as the relative level of risk mitigation high- and low-risk individuals practice. The developed methods are broadly applicable to any investigation in which node attributes in a graph might reasonably be expected to cluster or exhibit correlations.

by Shahram Heydari, Garyfallos Konstantinoudis, Abdul Wahid Behsoodi

The COVID-19 pandemic has been influencing travel behaviour in many urban areas around the world since the beginning of 2020. As a consequence, bike-sharing schemes have been affected—partly due to the change in travel demand and behaviour as well as a shift from public transit. This study estimates the varying effect of the COVID-19 pandemic on the London bike-sharing system (Santander Cycles) over the period March–December 2020. We employed a Bayesian second-order random walk time-series model to account for temporal correlation in the data. We compared the observed number of cycle hires and hire time with their respective counterfactuals (what would have been if the pandemic had not happened) to estimate the magnitude of the change caused by the pandemic. The results indicated that following a reduction in cycle hires in March and April 2020, the demand rebounded from May 2020, remaining in the expected range of what would have been if the pandemic had not occurred. This could indicate the resiliency of Santander Cycles. With respect to hire time, an important increase occurred in April, May, and June 2020, indicating that bikes were hired for longer trips, perhaps partly due to a shift from public transit.

by Ashadun Nobi, Kamrul Hasan Tuhin, Jae Woo Lee

The COVID-19 is one of the worst pandemics in modern history. We applied principal component analysis (PCA) to the daily time series of the COVID-19 death cases and confirmed cases for the top 25 countries from April of 2020 to February of 2021. We calculated the eigenvalues and eigenvectors of the cross-correlation matrix of the changes in daily accumulated data over monthly time windows. The largest eigenvalue describes the overall evolution dynamics of the COVID-19 and indicates that evolution was faster in April of 2020 than in any other period. By using the first two PC coefficients, we can identify the group dynamics of the COVID-19 evolution. We observed groups under critical states in the loading plot and found that American and European countries are represented by strong clusters in the loading plot. The first PC plays an important role and the correlations (C1) between the normalized logarithmic changes in deaths or confirmed cases and the first PCs may be used as indicators of different phases of the COVID-19. By varying C1 over time, we identified different phases of the COVID-19 in the analyzed countries over the target time period.

by Rachel E. Pollreis, Clay Roscoe, Rachel J. Phinney, Surabhi S. Malesha, Matthew C. Burns, Aimee Ceniseros, Charles H. Washington, Andrew J. Nutting, Christopher L. Ball

SARS-CoV-2 RT-PCR, the gold standard for diagnostic testing, may not be readily available or logistically applicable for routine COVID-19 testing in many rural communities in the United States. In this validation study, we compared the BinaxNOW™ COVID-19 Test Ag Card with SARS-CoV-2 RT-PCR in 214 participants who sought COVID-19 testing from a local public health district in Idaho, USA. The median age of participants was 35 and 82.7% were symptomatic. Thirty-seven participants (17.3%) had positive RT-PCR results. Results between the two tests were 94.4% concordant. The sensitivity of the BinaxNOW™ COVID-19 Test Ag Card was 67.6% (95% CI: 50.2–81.9%), and the specificity was 100.0% (95% CI: 97.9–100.0%). The positive predictive value (PPV) for the BinaxNOW™ COVID-19 Test Ag Card was 100.0% (95% CI: 86.2–100.0%), and the negative predictive value (NPV) was 93.6% (95% CI: 89.1–96.6%). Although the sensitivity of BinaxNOW™ COVID-19 Test Ag Card was lower than RT-PCR, rapid results and high specificity support its use for early detection of COVID-19, especially in settings where SARS-CoV-2 RT-PCR testing is not readily available. Rapid antigen tests, such as the BinaxNOW™ COVID-19 Test Ag Card, may be a more convenient tool in quickly identifying and preventing COVID-19 transmission, especially in rural settings.

by Stewart Ndutard Ngasa, Leticia Armelle Sani Tchouda, Christabel Abanda, Neh Chang Ngasa, Eric Wah Sanji, Therence Nwana Dingana, Carlson-Sama Babila

Studies assessing the mental health of patients with COVID-19 infection remain limited. Disasters and major emergencies, not just COVID-19, undoubtedly lead to greater incidence of mental health problems. Previous studies indicate that the novel Coronavirus disease can cause panic and stress in patients. Our literature search didn’t reveal any previous published data from Cameroon and the Central African sub-region. In order to bridge this gap, we assessed the prevalence and factors associated with depression and anxiety in COVID-19 patients. We carried out a cross-sectional study in a secondary hospital in the Littoral Region of Cameroon. We recruited hospitalised COVID-19 patients during a 4-month period. We collected data on sociodemographic characteristics. The HADS score was used to assess levels of anxiety and depression. All analysis were done using Stata 14. A P value of = 30kg/m2 (OR: 1.78, P = 0.02), presence of COVID-19 complications (OR: 1.28, P = 0.01) and anxiety (OR: 4.60, P

by Shade T. Shutters

While ensuring employment opportunities is critical for global progress and stability, workers are now subject to several disruptive trends, including automation, rapid changes in technology and skill requirements, and transitions to low-carbon energy production. Yet, these trends seem almost insignificant compared to labor impact of the COVID-19 pandemic. While much has been written about the pandemic’s short-term impacts, this study analyzes anticipated long-term impacts on the labor force of 2029 by comparing original 2029 labor projections to special COVID-adjusted projections recently published by the US Bureau of Labor Statistics. Results show that future demand for nearly every type of labor skill and knowledge will increase, while the nature of work shifts from physical to more cognitive activities. Of the nearly three million jobs projected to disappear by 2029 due to COVID, over 91% are among workers without a bachelor’s degree. Among workers with a degree demand shifts primarily from business-related degrees to computer and STEM degrees. Results further show that the socialness of labor, which is important for both innovation and productivity, increases in many more industries than it decreases. Finally, COVID will likely accelerate the adoption of teleworking and slightly decrease the rate of workforce automation. These impacts, combined with a shift to more cognitive worker activities, will likely impact the nature of workforce health and safety with less focus on physical injuries and more on illnesses related to sedentary lifestyles. Overall, results suggest that future workers will need to engage more often in training and skill acquisition, requiring life-long learning and skill maintenance strategies.

by AbdulAzeez A. Anjorin, Ismail A. Odetokun, Ajibola I. Abioye, Hager Elnadi, Mfon Valencia Umoren, Bamu F. Damaris, Joseph Eyedo, Haruna I. Umar, Jean B. Nyandwi, Mena M. Abdalla, Sodiq O. Tijani, Kwame S. Awiagah, Gbolahan A. Idowu, Sifeuh N. Achille Fabrice, Aala M. O. Maisara, Youssef Razouqi, Zuhal E. Mhgoob, Salim Parker, Osaretin E. Asowata, Ismail O. Adesanya, Maureen A. Obara, Shameem Jaumdally, Gatera F. Kitema, Taofik A. Okuneye, Kennedy M. Mbanzulu, Hajj Daitoni, Ezekiel F. Hallie, Rasha Mosbah, Folorunso O. Fasina

The economic and humanistic impact of COVID-19 pandemic is enormous globally. No definitive treatment exists, hence accelerated development and approval of COVID-19 vaccines, offers a unique opportunity for COVID-19 prevention and control. Vaccine hesitancy may limit the success of vaccine distribution in Africa, therefore we assessed the potentials for coronavirus vaccine hesitancy and its determinants among Africans. An online cross-sectional African-wide survey was administered in Arabic, English, and French languages. Questions on demographics, self-reported health status, vaccine literacy, knowledge and perception on vaccines, past experience, behavior, infection risk, willingness to receive and affordability of the SARS-COV-2 vaccine were asked. Data were subjected to descriptive and inferential statistics. A total of 5,416 individuals completed the survey. Approximately, 94% were residents of 34 African countries while the other Africans live in the Diaspora. Only 63% of all participants surveyed were willing to receive the COVID-19 vaccination as soon as possible and 79% were worried about its side effects. Thirty-nine percent expressed concerns of vaccine-associated infection. The odds of vaccine hesitancy was 0.28 (95% CI: 0.22, 0.30) among those who believed their risk of infection was very high, compared to those who believed otherwise. The odds of vaccine hesitancy was one-fifth (OR = 0.21, 95% CI: 0.16, 0.28) among those who believed their risk of falling sick was very high, compared to those who believed their risk of falling very sick was very low. The OR of vaccine hesitancy was 2.72 (95% CI: 2.24, 3.31) among those who have previously refused a vaccine for themselves or their child compared to counterparts with no self-reported history of vaccine hesitancy. Participants want the vaccines to be mandatory (40%), provided free of charge (78%) and distributed in homes and offices (44%). COVID-19 vaccine hesitancy is substantial among Africans based on perceived risk of coronavirus infection and past experiences.

Title: Epidemiology, Biodiversity, and Technological Trajectories in the Brazilian Amazon: From Malaria to COVID-19
Authors: Codeço, Claudia T.; Dal’Asta, Ana P.; Rorato, Ana C.; Lana, Raquel M.; Neves, Tatiana C.; Andreazzi, Cecilia S.; Barbosa, Milton; Escada, Maria I. S.; Fernandes, Danilo A.; Rodrigues, Danuzia L.; Reis, Isabel C.; Nunes, Monica Silva; Gontijo, Alexandre B.; Coelho, Flavio C.; Monteiro, Antonio M. V.

by Agnaldo José Lopes, Patrícia Frascari Litrento, Bruna Cuoco Provenzano, Alícia Sales Carneiro, Laura Braga Monnerat, Mariana Soares da Cal, Angelo Thomaz Abalada Ghetti, Thiago Thomaz Mafort
Background Thousands of people worldwide are suffering the consequences of coronavirus disease-2019 (COVID-19), and impulse oscillometry (IOS) and lung ultrasound (LUS) might be important tools for the follow-up of this population. Our objective was to prospectively evaluate abnormalities detected using these two methods in a cohort of COVID-19 survivors with respiratory symptoms. Methods In this follow-up study, 59 patients underwent clinical evaluations, spirometry, IOS and LUS in the 2nd (M1) and 5th (M2) months after diagnostic confirmation of COVID-19 by real-time reverse transcriptase–polymerase chain reaction. Aeration scores were obtained from the LUS exams based on the following findings: B-lines >2, coalescent B-lines, and subpleural consolidations. Results Fifty-nine (100%) participants had cough and/or dyspnea at M1, which decreased to 38 (64.4%) at M2 (p = 0.0001). Spirometry was abnormal in 26 (44.1%) and 20 (33.9%) participants at M1 and M2, respectively, although without statistical significance (p = 0.10). Normal examination, restrictive patterns, and obstructive patterns were observed in 33 (55.9%), 18 (30.5%), and 8 (13.6%) participants, respectively, at M1 and in 39 (66.1%), 13 (22%), and 7 (11.9%) participants at M2 (p = 0.14). Regarding IOS, considering changes in resistive and reactive parameters, abnormal exams were detected in 52 (88.1%) and 42 (71.2%) participants at M1 and M2, respectively (p = 0.002). Heterogeneity of resistance between 4 and 20 Hz >20% was observed in 38 (64.4%) and 33 (55.9%) participants at M1 and M2, respectively (p = 0.30). Abnormal LUS was observed in 46 (78%) and 36 (61%) participants at M1 and M2, respectively (p = 0.002), with a reduction in aeration scores between M1 and M2 [5 (2–8) vs. 3 (0–6) points, p

by Mohammed Mustapha, Basira Kankia Lawal, Abubakar Sha’aban, Abubakar Ibrahim Jatau, Abubakar Sadiq Wada, Auwal Adam Bala, Sagir Mustapha, Anas Haruna, Abbas Musa, Mubarak Hussaini Ahmad, Salim Iliyasu, Surajuddeen Muhammad, Fatima Zaji Mohammed, Ahmed Danbala Ahmed, Hadzliana Zainal

Students of the health sciences are the future frontliners to fight pandemics. The students’ participation in COVID-19 response varies across countries and are mostly for educational purposes. Understanding the determinants of COVID-19 vaccine acceptability is necessary for a successful vaccination program. This study aimed to investigate the factors associated with COVID-19 vaccine acceptance among health sciences students in Northwest Nigeria. The study was an online self-administered cross-sectional study involving a survey among students of health sciences in some selected universities in Northwest Nigeria. The survey collected pertinent data from the students, including socio-demographic characteristics, risk perception for COVID-19, and willingness to accept the COVID-19 vaccine. Multiple logistic regression was used to determine the predictors of COVID-19 vaccine acceptance. A total of 440 responses with a median (interquartile range) age of 23 (4.0) years were included in the study. The prevalence of COVID-19 vaccine acceptance was 40.0%. Factors that independently predict acceptance of the vaccine were age of 25 years and above (adjusted odds ratio, aOR, 2.72; 95% confidence interval, CI, 1.44–5.16; p = 0.002), instructions from heads of institutions (aOR, 11.71; 95% CI, 5.91–23.20; p

by Sooyoung Kim, Ariadna Capasso, Stephanie H. Cook, Shahmir H. Ali, Abbey M. Jones, Joshua Foreman, Ralph J. DiClemente, Yesim Tozan

This study assessed the modifying role of primary source of COVID-19 information in the association between knowledge and protective behaviors related to COVID-19 among adults living in the United States (US). Data was collected from 6,518 US adults through an online cross-sectional self-administered survey via social media platforms in April 2020. Linear regression was performed on COVID-19 knowledge and behavior scores, adjusted for sociodemographic factors. An interaction term between knowledge score and primary information source was included to observe effect modification by primary information source. Higher levels of knowledge were associated with increased self-reported engagement with protective behaviors against COVID-19. The primary information source significantly moderated the association between knowledge and behavior, and analyses of simple slopes revealed significant differences by primary information source. This study shows the important role of COVID-19 information sources in affecting people’s engagement in recommended protective behaviors. Governments and health agencies should monitor the use of various information sources to effectively engage the public and translate knowledge into behavior change during an evolving public health crisis like COVID-19.

by Asger Sand Paludan-Müller, Andreas Lundh, Matthew J. Page, Klaus Munkholm
Background Effective drug treatments for Covid-19 are needed to decrease morbidity and mortality for the individual and to alleviate pressure on health care systems. Remdesivir showed promising results in early randomised trials but subsequently a large publicly funded trial has shown less favourable results and the evidence is interpreted differently in clinical guidelines. Systematic reviews of remdesivir have been published, but none have systematically searched for unpublished data, including regulatory documents, and assessed the risk of bias due to missing evidence. Methods We will conduct a systematic review of randomised trials comparing remdesivir to placebo or standard of care in any setting. We will include trials regardless of the severity of disease and we will include trials examining remdesivir for indications other than Covid-19 for harms analyses. We will search websites of regulatory agencies, trial registries, bibliographic databases, preprint servers and contact trial sponsors to obtain all available data, including unpublished clinical data, for all eligible trials. Our primary outcomes will be all-cause mortality and serious adverse events. Our secondary outcomes will be length of hospital stay, time to death, severe disease, and adverse events. We will assess the risk of bias using the Cochranes Risk of Bias 2 tool and the risk of bias due to missing evidence (e.g. publication bias, selective reporting bias) using the ROB-ME tool. Where appropriate we will synthesise study results by conducting random-effects meta-analysis. We will present our findings in a Summary of Findings table and rate the certainty of the evidence using the GRADE approach. Discussion By conducting a comprehensive systematic review including unpublished data (where available), we expect to be able to provide valuable information for patients and clinicians about the benefits and harms of remdesivir for the treatment of Covid-19. This will help to ensure optimal treatment for individual patients and optimal utilisation of health care resources. Systematic review registration CRD42021255915.

Title: NK Cell Responses in Zika Virus Infection Are Biased towards Cytokine-Mediated Effector Functions
Authors: Maucourant, Christopher; Queiroz, Gabriel Andrade Nonato; Corneau, Aurelien; Gois, Luana Leandro; Kheddar, Aida Meghraoui; Tarantino, Nadine; Bandeira, Antonio Carlos; Samri, Assia; Blanc, Catherine; Yssel, Hans; Grassi, Maria Fernanda Rios; Vieillard, Vincent

Title: Produção pública de medicamentos no Brasil no contexto da pandemia da COVID-19
Authors: Neto, Paula Teixeira Pinto Ferreira; Cunha, Camila Rocha da
Abstract: No Brasil, o Sistema Único de Saúde foi instituído nas bases da Constituição Federal de 1988, que estabeleceu, dentre outros campos de atuação, a sua participação na produção de medicamentos e na promoção do desenvolvimento científico e tecnológico e a inovação em saúde. Este ensaio discute a produção pública de medicamentos no âmbito dos laboratórios oficiais e seus desafios no contexto da pandemia de COVID-19, utilizando-se como base os medicamentos do estudo Solidarity. O Brasil conta com 20 laboratórios oficiais que juntos possuem 289 medicamentos aprovados, compostos por 169 fármacos, em diferentes apresentações, além de 86 Parcerias para o Desenvolvimento Produtivo vigentes que envolvem o desenvolvimento e transferência de tecnologias de outros 55 medicamentos. Nos últimos anos, diversas políticas desenvolvidas no Brasil promoveram o desenvolvimento e a produção de medicamentos estratégicos para a população, reduzindo a dependência produtiva e tecnológica e contribuindo para a diminuição da vulnerabilidade do SUS. Contudo, desafios como a deficiência de infraestrutura e de competências técnicas e gerenciais dos laboratórios públicos, dependência externa de insumos farmacêuticos e políticas recentes de austeridade fiscal, fragilizam o País para o enfrentamento da pandemia.