Monitoramento das Produções

by Tigist W. Leulseged, Ishmael S. Hassen, Endalkachew H. Maru, Wuletaw C. Zewsde, Negat W. Chamiso, Abdi B. Bayisa, Daniel S. Abebe, Birhanu T. Ayele, Kalkidan T. Yegle, Mesay G. Edo, Eyosyas K. Gurara, Dereje D. Damete, Yared A. Tolera
Background The COVID-19 pandemic seems to have a different picture in Africa; the first case was identified in the continent after it had already caused a significant loss to the rest of the world and the reported number of cases and mortality rate has been low. Understanding the characteristics and outcome of the pandemic in the African setup is therefore crucial. Aim To assess the characteristics and outcome of Patients with COVID-19 and to identify determinants of the disease outcome among patients admitted to Millennium COVID-19 Care Center in Ethiopia. Methods A prospective cohort study was conducted among 1345 consecutively admitted RT-PCR confirmed Patients with COVID-19 from July to September, 2020. Frequency tables, KM plots, median survival times and Log-rank test were used to describe the data and compare survival distribution between groups. Cox proportional hazard survival model was used to identify determinants of time to clinical recovery and the independent variables, where adjusted hazard ratio, P-value and 95% CI for adjusted hazard ratio were used for testing significance and interpretation of results. Binary logistic regression model was used to assess the presence of a statistically significant association between disease outcome and the independent variables, where adjusted odds ratio, P-value and 95% CI for adjusted odds ratio were used for testing significance and interpretation of results. Results Among the study population, 71 (5.3%) died, 72 (5.4%) were transferred and the rest 1202 (89.4%) were clinically improved. The median time to clinical recovery was 14 days. On the multivariable Cox proportional hazard model; temperature (AHR = 1.135, 95% CI = 1.011, 1.274, p-value = 0.032), COVID-19 severity (AHR = 0.660, 95% CI = 0.501, 0.869, p-value = 0.003), and cough (AHR = 0.705, 95% CI = 0.519, 0.959, p-value = 0.026) were found to be significant determinants of time to clinical recovery. On the binary logistic regression, the following factors were found to be significantly associated with disease outcome; SPO2 (AOR = 0.302, 95% CI = 0.193, 0.474, p-value = 0.0001), shortness of breath (AOR = 0.354, 95% CI = 0.213, 0.590, p-value = 0.0001) and diabetes mellitus (AOR = 0.549, 95% CI = 0.337, 0.894, p-value = 0.016). Conclusions The average duration of time to clinical recovery was 14 days and 89.4% of the patients achieved clinical recovery. The mortality rate of the studied population is lower than reports from other countries including those in Africa. Having severe COVID-19 disease severity and presenting with cough were found to be associated with delayed clinical recovery of the disease. On the other hand, being hyperthermic is associated with shorter disease duration (faster time to clinical recovery). In addition, lower oxygen saturation, subjective complaint of shortness of breath and being diabetic were associated with unfavorable disease outcome. Therefore, patients with these factors should be followed cautiously for a better outcome.

by Judith Derndorfer, Franziska Disslbacher, Vanessa Lechinger, Katharina Mader, Eva Six

A lockdown implies a shift from the public to the private sphere, and from market to non-market production, thereby increasing the volume of unpaid work. Already before the pandemic, unpaid work was disproportionately borne by women. This paper studies the effect of working from home for pay (WFH), due to a lockdown, on the change in the division of housework and childcare within couple households. While previous studies on the effect of WFH on the reconciliation of work and family life and the division of labour within the household suffered from selection bias, we are able to identify this effect by drawing upon the shock of the first COVID-19 lockdown in Austria. The corresponding legal measures left little choice over WFH. In any case, WFH is exogenous, conditional on a small set of individual and household characteristics we control for. We employ data from a survey on the gendered aspects of the lockdown. The dataset includes detailed information on time use during the lockdown and on the quality and experience of WFH. Uniquely, this survey data also includes information on the division, and not only magnitude, of unpaid work within households. Austria is an interesting case in this respect as it is characterized by very conservative gender norms. The results reveal that the probability of men taking on a larger share of housework increases if men are WFH alone or together with their female partner. By contrast, the involvement of men in childcare increased only in the event that the female partner was not able to WFH. Overall, the burden of childcare, and particularly homeschooling, was disproportionately borne by women.

by Manmeet Kaur, Daniel Black, Jeffrey Fine, Barton L. Wise
Background Osteoarthritis (OA) is a leading cause of musculoskeletal pain and disability among Americans. Physical therapy (PT) is recommended per the 2019 ACR /Arthritis Foundation Guideline for Treatment of OA of the Hand, Hip, and Knee. During COVID-19, access to healthcare has been altered in a variety of clinical settings, with the pandemic creating delays in healthcare, with an unknown impact on access to PT care for OA. Objectives We sought to determine whether referrals to PT for OA were reduced in 2020 during the COVID-19 pandemic compared to 2019. Methods A retrospective analysis was done of 3586 PT referrals placed by the University of California, Davis for 206 OA ICD-10 codes from January to November 2019 and from January to November 2020. The numbers of PT referrals per month of each year were compared using both descriptive statistics and Poisson Regression analysis. Results A total of 1972 PT referrals for OA were placed from January to November 2019. Only 1614 referrals for OA were placed from January to November 2020, representing a significant decrease (p = 0.001). Month-by-month analysis of 2020 compared to 2019 revealed statistically significant drops in PT referrals for OA in April (p = 0.001), May (p = 0.001), and August (p = 0.001). Conclusions These findings reveal a significant reduction in the number of referrals for PT for OA placed in 2020 during the first year of the COVID-19 pandemic. These reductions were particularly evident in the months following state-mandated actions and closures. Factors associated with this outcome may include decreased access to primary care providers, perceptions of PT availability by health care providers, decreased mobility limiting access to both clinic and PT appointments, and/or willingness to engage in PT by patients during the pandemic.

by Jingxia Cheng, Jinbo Cui, Wenwen Yu, Hua Kang, Yongming Tian, Xiaolian Jiang
Objectives To investigate nurses’ behavioral intention toward caring for COVID-19 patients on mechanical ventilation, as well as the factors affecting their intention. Background COVID-19 patients undergoing mechanical ventilation have many care needs and pose more challenges for nurses, which might adversely affect nurses’ intention toward caring behavior. Methods A cross‐sectional study was conducted by using simple random sampling to recruit 598 nurses from five tertiary hospitals in Sichuan Province, China. The participants responded to an online questionnaire that included questions on demographic characteristics; the Attitude, Subjective Norms, and Behavioral Intention of Nurses toward Mechanically Ventilated Patients (ASIMP) questionnaire; the Nursing Professional Identity Scale (NPIS); and the Compassion Fatigue-Short Scale (CF-Short Scale). ANOVA, Spearman correlation analysis, and multiple linear regression were performed to analyze the data. Results The mean total behavioral intention score was 179.46 (± 14.83) out of a total score of 189.00, which represented a high level of intention toward caring for patients on mechanical ventilation. Multiple linear regression revealed that subjective norms (β = 0.390, P

by Muhammad Junaid Tahir, Najma Iqbal Malik, Irfan Ullah, Hamza Rafique Khan, Shahida Perveen, Rodrigo Ramalho, Ahsun Rizwan Siddiqi, Summaiya Waheed, Mahmoud Mohamed Mohamed Shalaby, Domenico De Berardis, Samiksha Jain, Gautham Lakshmipriya Vetrivendan, Harshita Chatterjee, William Xochitun Gopar Franco, Muhammad Ahsan Shafiq, Naira Taiba Fatima, Maria Abeysekera, Qudsia Sayyeda, Shamat Fathi Shamat, Wajeeha Aiman, Qirat Akhtar, Arooj Devi, Anam Aftab, Sheikh Shoib, Chung-Ying Lin, Amir H. Pakpour
Background The emergence of the COVID-19 pandemic has affected the lives of many people, including medical students. The present study explored internet addiction and changes in sleep patterns among medical students during the pandemic and assessed the relationship between them. Methods A cross-sectional study was carried out in seven countries, the Dominican Republic, Egypt, Guyana, India, Mexico, Pakistan, and Sudan, using a convenience sampling technique, an online survey comprising demographic details, information regarding COVID-19, the Pittsburgh Sleep Quality Index (PSQI), and the Internet Addiction Test (IAT). Results In total, 2749 participants completed the questionnaire. Of the total, 67.6% scored above 30 in the IAT, suggesting the presence of an Internet addiction, and 73.5% scored equal and above 5 in the PSQI, suggesting poor sleep quality. Internet addiction was found to be significant predictors of poor sleep quality, causing 13.2% of the variance in poor sleep quality. Participants who reported COVID-19 related symptoms had disturbed sleep and higher internet addiction levels when compared with those who did not. Participants who reported a diagnosis of COVID-19 reported poor sleep quality. Those living with a COVID-19 diagnosed patient reported higher internet addiction and worse sleep quality compared with those who did not have any COVID-19 patients in their surroundings. Conclusion The results of this study suggest that internet addiction and poor sleep quality are two issues that require addressing amongst medical students. Medical training institutions should do their best to minimize their negative impact, particularly during the current COVID-19 pandemic.

by André Hajek, Freia De Bock, Philipp Sprengholz, Benedikt Kretzler, Hans-Helmut König
Introduction Our aim was to examine attitudes of the general population towards reasonableness of these costs, as well as the degree to which these costs are shared across society (solidarity financing) and to determine the factors associated with them. Method Repeated cross-sectional data from a nationally representative online-survey. More precisely, data from wave 8 (21–22 April 2020) and wave 16 (7–8 July 2020) were used (in wave 8: analytical sample with n = 976, average age was 47.0 years (SD: 15.3 years), ranging from 18 to 74 years, 51.8% female; in wave 16: analytical sample with n = 978, average age was 46.1 years (SD: 15.9 years), ranging from 18 to 74 years, 50.9% female). After a short introduction emphasizing considerable economic costs associated with the measures against the spread of the coronavirus, individuals were asked to rate the following statements (outcome measures), in each case from 1 = strongly disagree to 7 = strongly agree: “These economic costs are currently reasonable in relation to the objective pursued” (reasonableness of costs), “These economic costs should be borne jointly by all citizens and depending on income” (solidarity financing). Results In wave 8 (wave 16 in parentheses), the average rating for the attitude towards reasonableness of costs was 4.3, SD: 1.8 (wave 16, average: 4.2, SD: 1.8) and the average rating for the attitude towards solidarity financing was 3.7, SD: 1.9 (wave 16, average: 3.3, SD: 2.0). In wave 8, more positive attitudes towards the reasonableness of costs and solidarity financing were associated with being male, higher education, not being in a partnership/being unmarried, higher affect regarding COVID-19 and higher presumed severity with respect to COVID-19. Furthermore, more positive attitudes towards the reasonableness of costs were associated with having a migration background. More positive attitudes towards solidarity financing was associated with higher age groups. Mainly similar findings were observed in wave 16. Discussion Agreement with reasonableness of costs of preventative measures as well as solidarity financing was moderately high. Knowledge of these attitudes is important to ensure social cohesion during the fight against COVID-19.

by Delphina Gomes, Andreas Beyerlein, Katharina Katz, Gabriele Hoelscher, Uta Nennstiel, Bernhard Liebl, Klaus Überla, Rüdiger von Kries
Background The efficacy of the BioNTech-Pfizer BNT162b2 vaccination in the elderly (≥80 years) could not be fully assessed in the BioNTech-Pfizer trial due to low numbers in this age group. We aimed to evaluate the effectiveness of the BioNTech-Pfizer (BNT162b2) vaccine to prevent SARS-CoV-2 infection and severe outcomes in octo- and novo-generians in a German state setting. Methods and findings A prospective observational study of 708,187 persons aged ≥80 years living in Bavaria, Germany, was conducted between Jan 9 to Apr 11, 2021. We assessed the vaccine effectiveness (VE) for two doses of the BNT162b2 vaccine with respect to SARS-CoV-2 infection and related hospitalisations and mortality. Additionally, differences in VE by age groups ≥80 to ≤89 years and ≥90 years were studied. Analyses were adjusted by sex. By the end of follow-up, 63.8% of the Bavarian population ≥80 years had received one dose, and 52.7% two doses, of the BNT162b2 vaccine. Two doses of the BNT162b2 vaccine lowered the proportion of SARS-CoV-2 infections and related outcomes, resulting in VE estimates of 68.3% (95% confidence interval (CI) 65.5%, 70.9%) for infection, 73.2% (95% CI 65.3%, 79.3%) for hospitalisation, and 85.1% (95% CI 80.0%, 89.0%) for mortality. Sex differences in the risk of COVID-19 outcomes observed among unvaccinated persons disappeared after two BNT162b2 vaccine doses. Overall, the BNT162b2 vaccine was equally effective in octo- and novo-genarians. Conclusions Two doses of BioNTech-Pfizer’s BNT162b2 vaccine is highly effective against COVID-19 outcomes in elderly persons.

by Michael König, Adalbert Winkler

We analyze whether and to what extent strategies employed by governments to fight the COVID-19 pandemic made a difference for GDP growth developments in 2020. Based on the strength and speed with which governments imposed non-pharmaceutical interventions (NPIs) when confronted with waves of infections we distinguish between countries pursuing an elimination strategy and countries following a suppression / mitigation strategy. For a sample of 44 countries fixed effect panel regression results show that NPI changes conducted by elimination strategy countries had a less severe effect on GDP growth than NPI changes in suppression / mitigation strategy countries: strategy matters. However, this result is sensitive to the countries identified as “elimination countries” and to the sample composition. Moreover, we find that exogenous country characteristics drive the choice of strategy. At the same time our results show that countries successfully applying the elimination strategy achieved better health outcomes than their peers without having to accept lower growth.

by Leonard Chiu, Max Shen, Chun-Han Lo, Nicholas Chiu, Austin Chen, Hyun Joon Shin, Elizabeth Horn Prsic, Chin Hur, Ronald Chow, Benjamin Lebwohl
Introduction Famotidine is a competitive histamine H2-receptor antagonist most commonly used for gastric acid suppression but thought to have potential efficacy in treating patients with Coronavirus disease 2019 (COVID-19). The aims of this systematic review and meta-analysis are to summarize the current literature and report clinical outcomes on the use of famotidine for treatment of hospitalized patients with COVID-19. Methods Five databases were searched through February 12, 2021 to identify observational studies that reported on associations of famotidine use with outcomes in COVID-19. Meta-analysis was conducted for composite primary clinical outcome (e.g. rate of death, intubation, or intensive care unit admissions) and death separately, where either aggregate odds ratio (OR) or hazard ratio (HR) was calculated. Results Four studies, reporting on 46,435 total patients and 3,110 patients treated with famotidine, were included in this meta-analysis. There was no significant association between famotidine use and composite outcomes in patients with COVID-19: HR 0.63 (95% CI: 0.35, 1.16). Across the three studies that reported mortality separated from other endpoints, there was no association between famotidine use during hospitalization and risk of death—HR 0.67 (95% CI: 0.26, 1.73) and OR 0.79 (95% CI: 0.19, 3.34). Heterogeneity ranged from 83.69% to 88.07%. Conclusion Based on the existing observational studies, famotidine use is not associated with a reduced risk of mortality or combined outcome of mortality, intubation, and/or intensive care services in hospitalized individuals with COVID-19, though heterogeneity was high, and point estimates suggested a possible protective effect for the composite outcome that may not have been observed due to lack of power. Further randomized controlled trials (RCTs) may help determine the efficacy and safety of famotidine as a treatment for COVID-19 patients in various care settings of the disease.

by Bradley S. Price, Maryam Khodaverdi, Adam Halasz, Brian Hendricks, Wesley Kimble, Gordon S. Smith, Sally L. Hodder

During the COVID-19 pandemic, West Virginia developed an aggressive SARS-CoV-2 testing strategy which included utilizing pop-up mobile testing in locations anticipated to have near-term increases in SARS-CoV-2 infections. This study describes and compares two methods for predicting near-term SARS-CoV-2 incidence in West Virginia counties. The first method, Rt Only, is solely based on producing forecasts for each county using the daily instantaneous reproductive numbers, Rt. The second method, ML+Rt, is a machine learning approach that uses a Long Short-Term Memory network to predict the near-term number of cases for each county using epidemiological statistics such as Rt, county population information, and time series trends including information on major holidays, as well as leveraging statewide COVID-19 trends across counties and county population size. Both approaches used daily county-level SARS-CoV-2 incidence data provided by the West Virginia Department Health and Human Resources beginning April 2020. The methods are compared on the accuracy of near-term SARS-CoV-2 increases predictions by county over 17 weeks from January 1, 2021- April 30, 2021. Both methods performed well (correlation between forecasted number of cases and the actual number of cases week over week is 0.872 for the ML+Rt method and 0.867 for the Rt Only method) but differ in performance at various time points. Over the 17-week assessment period, the ML+Rt method outperforms the Rt Only method in identifying larger spikes. Results show that both methods perform adequately in both rural and non-rural predictions. Finally, a detailed discussion on practical issues regarding implementing forecasting models for public health action based on Rt is provided, and the potential for further development of machine learning methods that are enhanced by Rt.

by Mahdi Ghaemi Asl, Hamid Reza Tavakkoli, Muhammad Mahdi Rashidi

Infectious diseases and widespread outbreaks influence different sectors of the economy, including the stock market. In this article, we investigate the effect of EBOV and COVID-19 outbreaks on stock market indices. We employ time-varying and constant bivariate copula methods to measure the dependence structure between the infectious disease equity market volatility index (IEMV) and the stock market indices of several sectors. The results show that the financial and communication services sectors have the highest and the lowest negative dependency on IEMV during the Ebola virus (EBOV) pandemic, respectively. However, the health care and energy sectors have the highest and lowest negative dependency on IEMV during the COVID-19 outbreak, respectively. Therefore, the results confirm the heterogeneous time-varying dependency between infectious diseases and the stock market indices. The finding of our study contributes to the ongoing literature on the impact of disease outbreaks, especially the novel coronavirus outbreak on global large-cap companies in the stock market.

by Climent Quintana-Domeque, Ines Lee, Anwen Zhang, Eugenio Proto, Michele Battisti, Antonia Ho

Healthcare workers have had the longest and most direct exposure to COVID-19 and consequently may suffer from poor mental health. We conducted one of the first repeated multi-country analysis of the mental wellbeing of medical doctors (n = 5,275) at two timepoints during the COVID-19 pandemic (June 2020 and November/December 2020) to understand the prevalence of anxiety and depression, as well as associated risk factors. Rates of anxiety and depression were highest in Italy (24.6% and 20.1%, June 2020), second highest in Catalonia (15.9% and 17.4%, June 2020), and lowest in the UK (11.7% and 13.7%, June 2020). Across all countries, higher risk of anxiety and depression symptoms were found among women, individuals below 60 years old, those feeling vulnerable/exposed at work, and those reporting normal/below-normal health. We did not find systematic differences in mental health measures between the two rounds of data collection, hence we cannot discard that the mental health repercussions of the pandemic are persistent.

by Alvaro Quincho-Lopez, Christeam A. Benites-Ibarra, Maryori M. Hilario-Gomez, Renatta Quijano-Escate, Alvaro Taype-Rondan
Background Previous studies have assessed the prevalence and characteristics of self-medication in COVID-19. However, no systematic review has summarized their findings. Objective We conducted a systematic review to assess the prevalence of self-medication to prevent or manage COVID-19. Methods We used different keywords and searched studies published in PubMed, Scopus, Web of Science, Embase, two preprint repositories, Google, and Google Scholar. We included studies that reported original data and assessed self-medication to prevent or manage COVID-19. The risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) modified for cross-sectional studies. Results We identified eight studies, all studies were cross-sectional, and only one detailed the question used to assess self-medication. The recall period was heterogeneous across studies. Of the eight studies, seven assessed self-medication without focusing on a specific symptom: four performed in the general population (self-medication prevalence ranged between

by Justin Elarde, Joon-Seok Kim, Hamdi Kavak, Andreas Züfle, Taylor Anderson

With the onset of COVID-19 and the resulting shelter in place guidelines combined with remote working practices, human mobility in 2020 has been dramatically impacted. Existing studies typically examine whether mobility in specific localities increases or decreases at specific points in time and relate these changes to certain pandemic and policy events. However, a more comprehensive analysis of mobility change over time is needed. In this paper, we study mobility change in the US through a five-step process using mobility footprint data. (Step 1) Propose the Delta Time Spent in Public Places (ΔTSPP) as a measure to quantify daily changes in mobility for each US county from 2019-2020. (Step 2) Conduct Principal Component Analysis (PCA) to reduce the ΔTSPP time series of each county to lower-dimensional latent components of change in mobility. (Step 3) Conduct clustering analysis to find counties that exhibit similar latent components. (Step 4) Investigate local and global spatial autocorrelation for each component. (Step 5) Conduct correlation analysis to investigate how various population characteristics and behavior correlate with mobility patterns. Results show that by describing each county as a linear combination of the three latent components, we can explain 59% of the variation in mobility trends across all US counties. Specifically, change in mobility in 2020 for US counties can be explained as a combination of three latent components: 1) long-term reduction in mobility, 2) no change in mobility, and 3) short-term reduction in mobility. Furthermore, we find that US counties that are geographically close are more likely to exhibit a similar change in mobility. Finally, we observe significant correlations between the three latent components of mobility change and various population characteristics, including political leaning, population, COVID-19 cases and deaths, and unemployment. We find that our analysis provides a comprehensive understanding of mobility change in response to the COVID-19 pandemic.

by Jemima A. Frimpong, Stéphane Helleringer

Exposure notification apps have been developed to assist in notifying individuals of recent exposures to SARS-CoV-2. However, in several countries, such apps have had limited uptake. We assessed whether strategies to increase downloads of exposure notification apps should emphasize improving the accuracy of the apps in recording contacts and exposures, strengthening privacy protections and/or offering financial incentives to potential users. In a discrete choice experiment with potential app users in the US, financial incentives were more than twice as important in decision-making about app downloads, than privacy protections, and app accuracy. The probability that a potential user would download an exposure notification app increased by 40% when offered a $100 reward to download (relative to a reference scenario in which the app is free). Financial incentives might help exposure notification apps reach uptake levels that improve the effectiveness of contact tracing programs and ultimately enhance efforts to control SARS-CoV-2. Rapid, pragmatic trials of financial incentives for app downloads in real-life settings are warranted.

by Ikkoh Yasuda, Nobuo Saito, Motoi Suzuki, Dorcas Valencia Umipig, Rontgene M. Solante, Ferdinand De Guzman, Ana Ria Sayo, Michio Yasunami, Nobuo Koizumi, Emi Kitashoji, Kentaro Sakashita, Chris Fook Sheng Ng, Chris Smith, Koya Ariyoshi

The advanced platelet parameters Immature Platelet Fraction and Immature Platelet Fraction Count have been implemented in clinical practice as measures of thrombopoietic activity, mainly in hematologic disorders that cause thrombocytopenia. The purpose of this observational study was to examine thrombopoiesis as reflected by these 2 new CBC parameters in patients infected with dengue. The study was conducted in infectious disease referral hospital in Metro Manila, the Philippines. We enrolled hospitalized patients at admission who were diagnosed with acute dengue or community acquired bacterial infection (CABI). Immature Platelet Fraction (IPF) and Immature Platelet Fraction Count were evaluated at admission and during hospitalization. A total of 606 patients were enrolled from May 1, 2017 to June 1, 2018. The participants consisted of 152 patients with dengue infection, 180 confirmed CABI, and 274 suspected CABI patients. At admission, the percent IPF (IPF%) of the patients with dengue was significantly higher than that of the confirmed CABI patients (median 3.7% versus 1.9%; p

by Carol Y. Rao, Tashina Robinson, Karin Huster, Rebecca L. Laws, Ryan Keating, Farrell A. Tobolowsky, Temet M. McMichael, Elysia Gonzales, Emily Mosites
Objective To describe the work environment and COVID-19 mitigation measures for homeless shelter workers and assess occupational risk factors for COVID-19. Methods Between June 9-August 10, 2020, we conducted a self-administered survey among homeless shelter workers in Washington, Massachusetts, Utah, Maryland, and Georgia. We calculated frequencies for work environment, personal protective equipment use, and SARS-CoV-2 testing history. We used generalized linear models to produce unadjusted prevalence ratios (PR) to assess risk factors for SARS-CoV-2 infection. Results Of the 106 respondents, 43.4% reported frequent close contact with clients; 75% were worried about work-related SARS-CoV-2 infections; 15% reported testing positive. Close contact with clients was associated with testing positive for SARS-CoV-2 (PR 3.97, 95%CI 1.06, 14.93). Conclusions Homeless shelter workers may be at risk of being exposed to individuals with COVID-19 during the course of their work. Frequent close contact with clients was associated with SARS-CoV-2 infection. Protecting these critical essential workers by implementing mitigation measures and prioritizing for COVID-19 vaccination is imperative during the pandemic.

by Bianca Dekel, Naeemah Abrahams
Background In April 2020, the United Nations predicted that the COVID-19 pandemic will have a ‘calamitous’ impact on the lives of women. This was based on concerns about an upsurge in Intimate Partner Violence (IPV) arising from increased opportunities for relational conflict due to forced co-existence and therefore additional time spent with abusive partners. Aim Research has shown an increase in IPV during times of crisis. The COVID-19 pandemic has generated unprecedented circumstances and stress, and opportunities to do research to understand whether the COVID-19 pandemic impacted on IPV experiences were limited. Thus, the present study aimed to understand women’s experiences of being in and leaving an abusive relationship during the COVID-19 pandemic. Methods Individual, telephonic interviews were conducted with 16 women living in domestic violence shelters within three Provinces during South Africa’s lockdown period. Results Findings reveal that the public health measures implemented by the South African Government to curb the spread of the virus, may have placed vulnerable groups at increased risk of violence. Specifically, lockdown likely magnified the risk for escalation of abuse in families already experiencing IPV prior to COVID-19. The study highlights an IPV and COVID-19 relationship, showing that the gender insensitive pandemic control measures, such as stay at home orders and travel restrictions, likely placed women at risk of increased abuse. Given the recurrency of COVID-19 epidemic waves, attention must be given to gender disparities or many South African women may experience worse outcomes. Conclusion This study reminds us that being ordered to stay at home is not always the safest option for women and thus, in a country with one of the highest levels of GBV, it becomes imperative to ensure that IPV safeguards are integrated into COVID-19 measures. It also becomes evident that COVID-19 requires enhanced ways of responding by paying attention to gender disparities.

by M. Rubaiyat Hossain Mondal, Subrato Bharati, Prajoy Podder

This paper focuses on the application of deep learning (DL) in the diagnosis of coronavirus disease (COVID-19). The novelty of this work is in the introduction of optimized InceptionResNetV2 for COVID-19 (CO-IRv2) method. A part of the CO-IRv2 scheme is derived from the concepts of InceptionNet and ResNet with hyperparameter tuning, while the remaining part is a new architecture consisting of a global average pooling layer, batch normalization, dense layers, and dropout layers. The proposed CO-IRv2 is applied to a new dataset of 2481 computed tomography (CT) images formed by collecting two independent datasets. Data resizing and normalization are performed, and the evaluation is run up to 25 epochs. Various performance metrics, including precision, recall, accuracy, F1-score, area under the receiver operating characteristics (AUC) curve are used as performance metrics. The effectiveness of three optimizers known as Adam, Nadam and RMSProp are evaluated in classifying suspected COVID-19 patients and normal people. Results show that for CO-IRv2 and for CT images, the obtained accuracies of Adam, Nadam and RMSProp optimizers are 94.97%, 96.18% and 96.18%, respectively. Furthermore, it is shown here that for the case of CT images, CO-IRv2 with Nadam optimizer has better performance than existing DL algorithms in the diagnosis of COVID-19 patients. Finally, CO-IRv2 is applied to an X-ray dataset of 1662 images resulting in a classification accuracy of 99.40%.

by Ak Narayan Poudel, Shihua Zhu, Nicola Cooper, Paul Roderick, Nisreen Alwan, Carolyn Tarrant, Nida Ziauddeen, Guiqing Lily Yao
Introduction Coronavirus disease (Covid-19) has led to a global pandemic since its emergence in December 2019. The majority of research into Covid-19 has focused on transmission, and mortality and morbidity associated with the virus. However, less attention has been given to its impact on health-related quality of life (HRQoL) of patients with Covid-19. Methods We searched for original studies published between December 2019 and Jan 2021 in PubMed, Scopus and Medline databases using a specific search strategy. We also explored literature on websites of distinguished public health organisations and hand-searched reference lists of eligible studies. The studies were screened by two reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flowchart using pre-determined eligibility criteria. Data were synthesised, analysed descriptively and reported in line with PRISMA guidelines. Results In total, 1276 studies were identified through the search strategy. Of these, 77 studies were selected for full-text reading after screening the studies. After reading full-text, 12 eligible studies were included in this review. The majority of the studies used a generic HRQoL assessment tool; five studies used SF-36, five studies used EQ-5D-5L, and three used pulmonary disease-specific HRQoL tools (two studies used two tools each). The impact of Covid-19 on HRQoL was found to be considerable in both Acute Covid and Long Covid patients. Higher impact on HRQoL was reported in Acute Covid, females, older ages, patients with more severe disease and patients from low-income countries. Conclusion The impact of Covid-19 on HRQoL of Acute and Long Covid patients is substantial. There was disproportional impact on patients by gender, age, severity of illness and study country. The long-term impact of Covid-19 is still in its initial stage. The findings of the review may be useful to researchers, policymakers, and clinicians caring for people following Covid-19 infection.

Title: Dengue na Infância
Authors: Fundação Oswaldo Cruz, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira
Abstract: A dengue é uma doença única, dinâmica e sistêmica. Avaliação, observação e intervenções oportunas são fundamentais para que os óbitos não ocorram. Mas sua principal profilaxia é o controle do ambiente.

by Ahmed S. Doghish, Walid F. Elkhatib, Essam A. Hassan, Ahmed F. Elkhateeb, Eman E. Mahmoud, Mona I. Ahmed, Mahmoud A. F. Khalil

by David C. Rettew, Ellen W. McGinnis, William Copeland, Hilary Y. Nardone, Yang Bai, Jeff Rettew, Vinay Devadanam, James J. Hudziak

Title: Hélio Fraga iniciará inquérito sobre Covid-19 em pacientes com tuberculose resistente
Authors: Vargas, Tatiane
Abstract: O Centro de Referência Professor Hélio Fraga (CRPHF/ENSP) – instituição nacional de referência no atendimento de pacientes com tuberculose e tuberculose multirresistente – dará início, no mês de agosto, à realização de um inquérito sorológico e do diagnóstico molecular da Covid-19 nos pacientes atendidos pelo ambulatório. O inquérito sorológico permitirá avaliar quantos de seus pacientes já tiveram contato com o novo coronavírus, enquanto a realização da testagem RT-PCR possibilitará o acesso mais rápido ao diagnóstico de casos suspeitos. Segundo a coordenadora do estudo, a pesquisadora Karen Gomes, a pesquisa trará um retrato do impacto da Covid-19 dentro de uma população fortemente vulnerável. “Com a realização do inquérito, temos o objetivo de verificar a porcentagem de pacientes com tuberculose resistente já infectados pelo novo coronavírus e correlacionar com a gravidade e desfecho desses casos.”

Title: Parecer sobre proposta de protocolo de embarque e testagem para COVID-19 nos petroleiros
Authors: Larentis, Ariane Leites; Carvalho, Leandro Vargas B. de; Teixeira, Liliane Reis; Correa, Maria Juliana Moura; Santos, Marcus Vinicius Corrêa dos
Abstract: O documento preparado pelas duas federações (Federação Única dos Petroleiros - FUP e Federação Nacional dos Petroleiros - FNP) aborda duas questões importantes: o protocolo de testagem para Covid-19 e a saúde mental dos trabalhadores.
O protocolo de testagem para Covid-19 está adequado. Entretanto, é importante
acrescentar o teste sorológico sanguíneo, que é realizado através de imunoensaio
automatizado em metodologias de quimioluminescência, eletroquimioluminescência ou
ELISA. Este teste deve ocorrer uma única vez, na primeira coleta sanguínea, antes
do primeiro embarque, pelo novo protocolo sugerido. Desta forma, ele irá detectar
anticorpos que podem levar de 1 a 3 semanas após a infecção para serem produzidos
pelo sistema imunológico.

by Pedro Nascimento de Lima, Robert Lempert, Raffaele Vardavas, Lawrence Baker, Jeanne Ringel, Carolyn M. Rutter, Jonathan Ozik, Nicholson Collier

The COVID-19 pandemic required significant public health interventions from local governments. Although nonpharmaceutical interventions often were implemented as decision rules, few studies evaluated the robustness of those reopening plans under a wide range of uncertainties. This paper uses the Robust Decision Making approach to stress-test 78 alternative reopening strategies, using California as an example. This study uniquely considers a wide range of uncertainties and demonstrates that seemingly sensible reopening plans can lead to both unnecessary COVID-19 deaths and days of interventions. We find that plans using fixed COVID-19 case thresholds might be less effective than strategies with time-varying reopening thresholds. While we use California as an example, our results are particularly relevant for jurisdictions where vaccination roll-out has been slower. The approach used in this paper could also prove useful for other public health policy problems in which policymakers need to make robust decisions in the face of deep uncertainty.

by Paolo Miguel Manalang Vicerra

The efficacy of the public health measures to mitigate COVID-19 is influenced by health literacy which includes the level of knowledge about the disease and the preventive behaviours adopted by individuals. Thailand, being a low- and middle-income country with an ageing society, has to consider both the challenges that its health system has in disseminating information and the disparities in health literacy among its older population. This study investigated the knowledge and behaviour of older adults in Thailand regarding COVID-19 using the Impact of COVID-19 on Older Persons in Thailand, a cross-sectional survey. The data was primarily collected online and included 1,230 adults aged at least 60 years from nine provinces of the five regions of the country. The associated factors with the health literacy outcomes were tested using bivariate logistic regression analyses. It was observed that 43% of the older adults in the sample had proper knowledge of the disease and 33% adopted preventive behaviours. Knowledge about the disease was not associated with preventive behaviour. The associated factors common between the increased levels of knowledge and adoption of behaviours were rural area residence and higher educational attainment levels. Obtaining information from the internet was observed to increase knowledge while having the television and radio as sources of information had negative relationship. Many older adults continued to be employed during the lockdown period and this was associated with decreased adoption of preventive behaviour. The context of vulnerable populations, particularly older adults, is different with regard to their access to information and concern about income. Health information has to be tailored for targeted populations. Their needs also have to be addressed as they have increased risks because of financial and health susceptibilities.

by Ayenew Kassie Tesema, Kegnie Shitu, Asmamaw Adugna, Simegnew Handebo
Background The Ethiopian Federal government has locked down schools as one measure to contain Covid-19 pandemic. Psychological effect of COVID-19 on students is increased due to the reopening of schools. The psychological effect of the pandemic is increasing along with physical aspect of health. Therefore, this study aimed to assess the psychological impact of Covid-19 and its contributing factors of students’ behavior in Ethiopia. Methods A cross sectional design was conducted from November to December 2020. Data were collected using pre tested self- administered questionnaire from secondary school students in Gondar city North West Ethiopia. Stratified simple random sampling technique was used to select 403 secondary school students. Data were entered and cleaned with Epidata version 4.62 and exported for analysis STATA version 14. Multivariable logistic regression and multiple linear regression were used to show the association of dependent and independent variables. Independent variables in relation to dependent variable measured using odd ratios and B coefficient with 95% confidence interval for Covid-19 anxiety and preventive behavior of Covid-19 respectively were used. Results A total of 370 students were participated giving response rate of 92%. The prevalence of Covid-19 anxiety and obsession among secondary school students were 38.1% and 40.27% respectively. Being 11thgrade 54% (AOR = 0.46; 95%CI:0.22, 0.95) and increased knowledge16% (AOR = 0.84;95%CI: 0.77, 0.89) score associated with decreased COVID-19 anxiety while Covid-19 obsession, 14.51 times (AOR = 14.51;95%CI: 8.05, 26.17), and being female 1.6 times (AOR = 1.6; 95%CI: 1.01, 2.51) increased Covid-19 Anxiety. Furthermore, increased self-efficacy 0.5 times (B = 0.5; 95%CI: 0.28, 0.62), and increased cues to action 0.4 times (B = 0.4; 95% CI: 0.19, 0.69) increased preventive behavior of Covid-19 while perceived barrier 0.1 times (B = -0.1; 95%CI:-0.22, 0.01) decrease preventive behavior of Covid-19. Conclusion Almost two individuals of five participants developed COVID-19 anxiety and COVID-19 obsession. Being grade 11th and knowledge were negatively associated with anxiety while being female and being obsessed with COVID-19 were positively associated with anxiety. No variable was associated with obsession of Covid-19. Intervention is needed to reduce anxiety among females. Furthermore, perceived barrier, self-efficacy and cues to action were significant factors of preventive behaviour of Covid-19. Therefore, to increase preventive behaviour of Covid-19, information, education and communication and behavioural change communication should be targeted on reducing barriers and increasing motivations and confidences.

by Rea Antoniou, Heather Romero-Kornblum, J. Clayton Young, Michelle You, Joel H. Kramer, Winston Chiong

The COVID-19 pandemic poses many real-world moral dilemmas, which can pit the needs and rights of the many against the needs and rights of the few. We investigated moral judgments in the context of the contemporary global crisis among older adults, who are at greatest personal risk from the pandemic. We hypothesized that during this pandemic, individuals would give fewer utilitarian responses to hypothetical dilemmas, accompanied by higher levels of confidence and emotion elicitation. Our pre-registered analysis (https://osf.io/g2wtp) involved two waves of data collection, before (2014) and during (2020) the COVID-19 pandemic, regarding three categories of moral dilemmas (personal rights, agent-centered permissions, and special obligations). While utilitarian responses considered across all categories of dilemma did not differ, participants during the 2020 wave gave fewer utilitarian responses to dilemmas involving personal rights; that is, they were less willing to violate the personal rights of others to produce the best overall outcomes.

by Jin Young Kim, Keum Ji Jung, Seung-Jin Yoo, Soon Ho Yoon
Objective This study aimed to stratify the early pneumonia trajectory on chest radiographs and compare patient characteristics in dyspneic patients with coronavirus disease 2019 (COVID-19). Materials and methods We retrospectively included 139 COVID-19 patients with dyspnea (87 men, 62.7±16.3 years) and serial chest radiographs from January to September 2020. Radiographic pneumonia extent was quantified as a percentage using a previously-developed deep learning algorithm. A group-based trajectory model was used to categorize the pneumonia trajectory after symptom onset during hospitalization. Clinical findings, and outcomes were compared, and Cox regression was performed for survival analysis. Results Radiographic pneumonia trajectories were categorized into four groups. Group 1 (n = 83, 59.7%) had negligible pneumonia, and group 2 (n = 29, 20.9%) had mild pneumonia. Group 3 (n = 13, 9.4%) and group 4 (n = 14, 10.1%) showed similar considerable pneumonia extents at baseline, but group 3 had decreasing pneumonia extent at 1–2 weeks, while group 4 had increasing pneumonia extent. Intensive care unit admission and mortality were significantly more frequent in groups 3 and 4 than in groups 1 and 2 (P .05). Groups 3 and 4 shared similar clinical and laboratory findings, but thrombocytopenia (