Monitoramento das Produções

by Irene Teo, Junxing Chay, Yin Bun Cheung, Sharon C. Sung, Komal G. Tewani, Li Fang Yeo, Grace Meijuan Yang, Fang Ting Pan, Jin Ying Ng, Fazila Abu Bakar Aloweni, Hui Gek Ang, Tracy Carol Ayre, Crystal Chai-Lim, Robert Chun Chen, Ai Ling Heng, Gayathri Devi Nadarajan, Marcus Eng Hock Ong, Brian See, Chai Rick Soh, Boon Kiat Kenneth Tan, Bien Soo Tan, Kenny Xian Khing Tay, Limin Wijaya, Hiang Khoon Tan
Aim The long-term stress, anxiety and job burnout experienced by healthcare workers (HCWs) are important to consider as the novel coronavirus disease (COVID-19) pandemic stresses healthcare systems globally. The primary objective was to examine the changes in the proportion of HCWs reporting stress, anxiety, and job burnout over six months during the peak of the pandemic in Singapore. The secondary objective was to examine the extent that objective job characteristics, HCW-perceived job factors, and HCW personal resources were associated with stress, anxiety, and job burnout. Method A sample of HCWs (doctors, nurses, allied health professionals, administrative and operations staff; N = 2744) was recruited via invitation to participate in an online survey from four tertiary hospitals. Data were gathered between March-August 2020, which included a 2-month lockdown period. HCWs completed monthly web-based self-reported assessments of stress (Perceived Stress Scale-4), anxiety (Generalized Anxiety Disorder-7), and job burnout (Physician Work Life Scale). Results The majority of the sample consisted of female HCWs (81%) and nurses (60%). Using random-intercept logistic regression models, elevated perceived stress, anxiety and job burnout were reported by 33%, 13%, and 24% of the overall sample at baseline respectively. The proportion of HCWs reporting stress and job burnout increased by approximately 1·0% and 1·2% respectively per month. Anxiety did not significantly increase. Working long hours was associated with higher odds, while teamwork and feeling appreciated at work were associated with lower odds, of stress, anxiety, and job burnout. Conclusions Perceived stress and job burnout showed a mild increase over six months, even after exiting the lockdown. Teamwork and feeling appreciated at work were protective and are targets for developing organizational interventions to mitigate expected poor outcomes among frontline HCWs.

by Zijun Xu, Dexing Zhang, Dong Xu, Xue Li, Yao Jie Xie, Wen Sun, Eric Kam-pui Lee, Benjamin Hon-kei Yip, Shuiyuan Xiao, Samuel Yueng-shan Wong
Objectives This study aims to investigate the potential factors associated with mental health outcomes among Chinese adults during the Coronavirus disease 2019 (COVID-19) epidemic. Methods This is an online cross-sectional survey conducted among Chinese adults in February 2020. Outcome measurements included the three-item UCLA Loneliness Scale (UCLA-3), two-item Patient Health Questionnaire (PHQ-2), two-item Generalized Anxiety Disorder Questionnaire (GAD-2), and two items from the Clinician-Administered Post-traumatic Stress Disorder (PTSD) Scale. COVID-19 related factors, physical health, lifestyle, and self-efficacy were also measured. Univariable and multivariable logistic regressions were performed. Results This study included 1456 participants (age: 33.8±10.5 years; female: 59.1%). The prevalence of depressive symptoms, anxiety symptoms, loneliness, and PTSD symptoms were 11.3%, 7.6%, 38.7%, and 33.9%, respectively. In multivariable analysis, loneliness was associated with being single, separated/divorced/widowed, low level of education, current location, medication, more somatic symptoms, lower self-efficacy, and going out frequently. Depression was associated with fear of infection, binge drinking, more somatic symptoms, lower self-efficacy, and longer screen time. Anxiety was associated with more somatic symptoms and lower self-efficacy. PTSD symptoms were associated with more somatic symptoms, lower self-efficacy, higher perceived risk of infection, fear of infection, and self-rated more negative influence due to the epidemic (p

by Ashutosh Nath Aggarwal, Ritesh Agarwal, Sahajal Dhooria, Kuruswamy Thurai Prasad, Inderpaul Singh Sehgal, Valliappan Muthu
Objective The proportion of COVID-19 patients having active pulmonary tuberculosis, and its impact on COVID-19 related patient outcomes, is not clear. We conducted this systematic review to evaluate the proportion of patients with active pulmonary tuberculosis among COVID-19 patients, and to assess if comorbid pulmonary tuberculosis worsens clinical outcomes in these patients. Methods We queried the PubMed and Embase databases for studies providing data on (a) proportion of COVID-19 patients with active pulmonary tuberculosis or (b) severe disease, hospitalization, or mortality among COVID-19 patients with and without active pulmonary tuberculosis. We calculated the proportion of tuberculosis patients, and the relative risk (RR) for each reported outcome of interest. We used random-effects models to summarize our data. Results We retrieved 3,375 citations, and included 43 studies, in our review. The pooled estimate for proportion of active pulmonary tuberculosis was 1.07% (95% CI 0.81%-1.36%). COVID-19 patients with tuberculosis had a higher risk of mortality (summary RR 1.93, 95% CI 1.56–2.39, from 17 studies) and for severe COVID-19 disease (summary RR 1.46, 95% CI 1.05–2.02, from 20 studies), but not for hospitalization (summary RR 1.86, 95% CI 0.91–3.81, from four studies), as compared to COVID-19 patients without tuberculosis. Conclusion Active pulmonary tuberculosis is relatively common among COVID-19 patients and increases the risk of severe COVID-19 and COVID-19-related mortality.

by Amanda Caplan, Kelly W. Bates, Carla Brioni, Aileen Santos, Linda M. Sabatini, Karen L. Kaul, Mercedes R. Carnethon, Janardan D. Khandekar, Philip Greenland
Background Studies of outpatients with mild or moderate COVID-19 are uncommon. We studied: 1) association of symptoms with reverse transcriptase polymerase chain reaction (RT-PCR) test results; and 2) association of initial RT-PCR cycle threshold (Ct) in relation to duration of RT-PCR positivity in outpatients with mild or moderate COVID-19. Methods This was a cohort study of outpatients with confirmed COVID-19 and at least one symptom. Participants had repeat nasopharyngeal swabs and symptom checklists every 3–5 days until two consecutive RT-PCR tests were negative. RT-PCR tests were used to assess viral load. Antibody tests for COVID-19 were performed at 2 weeks, 4 weeks, and 8 weeks after symptom onset. Results Twenty-five patients (nine females) were enrolled, ranging in age from 19–58 (median age 28 years). All patients reported at least one symptom, with a median of six symptoms per patient. Symptoms persisted for 6–67 days (median duration 18 days). In all 25 patients, blood samples collected a median of 13 days after symptom onset were positive for SARS-CoV-2 antibodies in 15 (60%). After a median of 28 days following symptom onset, 23/23 patients with available samples tested positive for antibodies. The longest duration of positive RT-PCR test was 49 days from first positive PCR test (Mean = 27.4, SD = 12.5, Median = 24). Initial Ct was significantly associated with longer duration (β = -1.3, SE = 0.3, p

by Bienvenida Austria, Rehana Haque, Sukriti Mittal, Jamie Scott, Aninditha Vengassery, Daniel Maltz, Wentian Li, Blaine Greenwald, Yun Freudenberg-Hua
Objectives Older adults are particularly vulnerable to the negative consequences of antipsychotic exposure and are disproportionally affected by higher mortality from coronavirus disease 2019 (COVID-19). Our goal was to determine whether concurrent antipsychotic medication use was associated with increased COVID-19 mortality in older patients with preexisting behavioral health problems. We also report on findings from post-COVID follow-ups. Design Retrospective observational study. Participants Outpatients at a geriatric psychiatric clinic in New York City. Measurements Demographic and clinical data including medication, diagnosis and Clinical Global Impression Severity (CGI-S) scales on outpatients who had COVID-19 between February 28th and October 1st 2020 were extracted from the electronic health records (EHR) from the hospital. Results A total of 56 patients were diagnosed with COVID-19 (mean age 76 years; median age 75 years) and 13 (23.2%) died. We found an increased mortality risk for patients who were prescribed at least one antipsychotic medication at the time of COVID-19 infection (Fisher’s exact test P = 0.009, OR = 11.1, 95% confidence interval: 1.4–96.0). This result remains significant after adjusting for age, gender, housing context and dementia (Logistic regression P = 0.035, Beta = 2.4). Furthermore, we found that most patients who survived COVID-19 (88.4%) recovered to pre-COVID baseline in terms of psychiatric symptoms. Comparison of pre- and post-COVID assessments of CGI-S for 33 patients who recovered from COVID-19 were not significantly different. Conclusion We observed a higher COVID-19 mortality associated with concurrent antipsychotics use in older patients receiving behavioral health services. The majority of patients in our geriatric clinic who recovered from COVID-19 appeared to return to their pre-COVID psychiatric function. More precise estimates of the risk associated with antipsychotic treatment in older patients with COVID-19 and other underlying factors will come from larger datasets and meta-analyses.

by Imad Al Kassaa, Sarah El Omari, Nada Abbas, Nicolas Papon, Djamel Drider, Issmat I. Kassem, Marwan Osman
Background Coronavirus disease 2019 (COVID-19) has affected millions of lives globally. However, the disease has presented more extreme challenges for developing countries that are experiencing economic crises. Studies on COVID-19 symptoms and gut health are scarce and have not fully analyzed possible associations between gut health and disease pathophysiology. Therefore, this study aimed to demonstrate a potential association between gut health and COVID-19 severity in the Lebanese community, which has been experiencing a severe economic crisis. Methods This cross-sectional study investigated SARS-CoV-2 PCR-positive Lebanese patients. Participants were interviewed and gut health, COVID-19 symptoms, and different metrics were analyzed using simple and multiple logistic regression models. Results Analysis of the data showed that 25% of participants were asymptomatic, while an equal proportion experienced severe symptoms, including dyspnea (22.7%), oxygen need (7.5%), and hospitalization (3.1%). The mean age of the participants was 38.3 ±0.8 years, and the majority were males (63.9%), married (68.2%), and currently employed (66.7%). A negative correlation was found between gut health score and COVID-19 symptoms (Kendall’s tau-b = -0.153, P = 0.004); indicating that low gut health was associated with more severe COVID-19 cases. Additionally, participants who reported unhealthy food intake were more likely to experience severe symptoms (Kendall’s tau-b = 0.118, P = 0.049). When all items were taken into consideration, multiple ordinal logistic regression models showed a significant association between COVID-19 symptoms and each of the following variables: working status, flu-like illness episodes, and gut health score. COVID-19 severe symptoms were more common among patients having poor gut health scores (OR:1.31, 95%CI:1.07–1.61; P = 0.008), experiencing more than one episode of flu-like illness per year (OR:2.85, 95%CI:1.58–5.15; P = 0.001), and owning a job (OR:2.00, 95%CI:1.1–3.65; P = 0.023). Conclusions To our knowledge, this is the first study that showed the impact of gut health and exposure to respiratory viruses on COVID-19 severity in Lebanon. These findings can facilitate combating the pandemic in Lebanon.

by Carmen Vives-Cases, Daniel La Parra-Casado, Erica Briones-Vozmediano, Sebastià March, Ana María García-Navas, José Miguel Carrasco, Laura Otero-García, Belén Sanz-Barbero

Socioeconomic crisis and humanitarian disasters can cause increased stress for women who experience inter-partner violence (IPV). This study analyzed the impact of the COVID-19 lockdown on this important issue, their related health and social services and working conditions from the perspectives of professionals in different sectors. Forty-three semi-structured interviews were carried out with 47 professionals (44 women and 3 men) from 40 different entities (September 2020—April 2021). This content analysis suggests that the pandemic and its associated prevention measures have had a negative impact on women exposed to IPV and their children, which affected their social wellbeing. Professionals described burnout, difficult and slow administrative processes, and problems with coordination and access to information. These negative impacts were mitigated, in part, by the work of professionals, but this suggests that a series of key strategies are needed to improve the response capacity of the service sector to IPV in situations of crisis. These improvements are related to the availability of human and material resources; an efficient coordination network between the professionals from different sectors; existence of informal support networks in the community; protocols/procedures and prior training for better implementation; and greater flexibility and accessibility of basic services that benefit women who experience IPV.

by Damijana Keržič, Jogymol Kalariparampil Alex, Roxana Pamela Balbontín Alvarado, Denilson da Silva Bezerra, Maria Cheraghi, Beata Dobrowolska, Adeniyi Francis Fagbamigbe, MoezAlIslam Ezzat Faris, Thais França, Belinka González-Fernández, Luz Maria Gonzalez-Robledo, Fany Inasius, Sujita Kumar Kar, Kornélia Lazányi, Florin Lazăr, Juan Daniel Machin-Mastromatteo, João Marôco, Bertil Pires Marques, Oliva Mejía-Rodríguez, Silvia Mariela Méndez Prado, Alpana Mishra, Cristina Mollica, Silvana Guadalupe Navarro Jiménez, Alka Obadić, Daniela Raccanello, Md Mamun Ur Rashid, Dejan Ravšelj, Nina Tomaževič, Chinaza Uleanya, Lan Umek, Giada Vicentini, Özlem Yorulmaz, Ana-Maria Zamfir, Aleksander Aristovnik

The outbreak of the COVID-19 pandemic has dramatically shaped higher education and seen the distinct rise of e-learning as a compulsory element of the modern educational landscape. Accordingly, this study highlights the factors which have influenced how students perceive their academic performance during this emergency changeover to e-learning. The empirical analysis is performed on a sample of 10,092 higher education students from 10 countries across 4 continents during the pandemic’s first wave through an online survey. A structural equation model revealed the quality of e-learning was mainly derived from service quality, the teacher’s active role in the process of online education, and the overall system quality, while the students’ digital competencies and online interactions with their colleagues and teachers were considered to be slightly less important factors. The impact of e-learning quality on the students’ performance was strongly mediated by their satisfaction with e-learning. In general, the model gave quite consistent results across countries, gender, study fields, and levels of study. The findings provide a basis for policy recommendations to support decision-makers incorporate e-learning issues in the current and any new similar circumstances.

by Brooklyn Stanley, Andrew Davis, Rupert Jones, Steven Julious, Dermot Ryan, David Jackson, David Halpin, Hilary Pinnock, Jennifer Quint, Kamlesh Khunti, Liam Heaney, Philip Oliver, Salman Siddiqui, Anu Kemppinen, Francis Appiagyei, Emma-Jane Roberts, Antony Hardjojo, Victoria Carter, Marije van Melle, David Price, on behalf of the Platform C19 committee
Background Data to better understand and manage the COVID-19 pandemic is urgently needed. However, there are gaps in information stored within even the best routinely-collected electronic health records (EHR) including test results, remote consultations for suspected COVID-19, shielding, physical activity, mental health, and undiagnosed or untested COVID-19 patients. Observational and Pragmatic Research Institute (OPRI) Singapore and Optimum Patient Care (OPC) UK established Platform C19, a research database combining EHR data and bespoke patient questionnaire. We describe the demographics, clinical characteristics, patient behavior, and impact of the COVID-19 pandemic using data within Platform C19. Methods EHR data from Platform C19 were extracted from 14 practices across UK participating in the OPC COVID-19 Quality Improvement program on a continuous, monthly basis. Starting 7th August 2020, consenting patients aged 18–85 years were invited in waves to fill an online questionnaire. Descriptive statistics were summarized using all data available up to 22nd January 2021. Findings From 129,978 invitees, 31,033 responded. Respondents were predominantly female (59.6%), white (93.5%), and current or ex-smokers (52.6%). Testing for COVID-19 was received by 23.8% of respondents, of which 7.9% received positive results. COVID-19 symptoms lasted ≥4 weeks in 19.5% of COVID-19 positive respondents. Up to 39% respondents reported a negative impact on questions regarding their mental health. Most (67%-76%) respondents with asthma, Chronic Obstructive Pulmonary Disease (COPD), diabetes, heart, or kidney disease reported no change in the condition of their diseases. Interpretation Platform C19 will enable research on key questions relating to COVID-19 pandemic not possible using EHR data alone.

by Irena Pilch, Paulina Wardawy, Eryka Probierz

The aim of this study was to evaluate the predictive value of the constructs proposed by two influential theoretical frameworks: the Protection Motivation Theory (PMT) and the Big Five (B5) model of personality in predicting health-related coping behavior during the SARS-CoV-2 pandemic. Both adaptive (i.e., preventive) and maladaptive (i.e., avoidant behavior and wishful thinking) coping behavior was measured. The study was conducted during the first wave of the pandemic. The sample consisted of 397 persons from the general Polish population. The findings provided strong support for the PMT constructs’ predictive value, especially with regard to pandemic-related adaptive behavior. The B5 personality traits accounted for a small proportion of the variability of coping behavior, especially when maladaptive behavior was the outcome. The PMT model showed incremental validity over and above demographic variables and personality traits in predicting preventive behavior, avoidant behavior, and wishful thinking; however, the patterns of relationships differ across the types of coping behavior. According to the current results, to increase adherence to preventive measures during an epidemic, all the PMT constructs should be considered while persuasive communication to the public is formulated.

by Danish A. Ahmed, Ali R. Ansari, Mudassar Imran, Kamal Dingle, Michael B. Bonsall
Background To mitigate the spread of the COVID-19 coronavirus, some countries have adopted more stringent non-pharmaceutical interventions in contrast to those widely used. In addition to standard practices such as enforcing curfews, social distancing, and closure of non-essential service industries, other non-conventional policies also have been implemented, such as the total lockdown of fragmented regions, which are composed of sparsely and highly populated areas. Methods In this paper, we model the movement of a host population using a mechanistic approach based on random walks, which are either diffusive or super-diffusive. Infections are realised through a contact process, whereby a susceptible host is infected if in close spatial proximity of the infectious host with an assigned transmission probability. Our focus is on a short-time scale (∼ 3 days), which is the average time lag time before an infected individual becomes infectious. Results We find that the level of infection remains approximately constant with an increase in population diffusion, and also in the case of faster population dispersal (super-diffusion). Moreover, we demonstrate how the efficacy of imposing a lockdown depends heavily on how susceptible and infectious individuals are distributed over space. Conclusion Our results indicate that on a short-time scale, the type of movement behaviour does not play an important role in rising infection levels. Also, lock-down restrictions are ineffective if the population distribution is homogeneous. However, in the case of a heterogeneous population, lockdowns are effective if a large proportion of infectious carriers are distributed in sparsely populated sub-regions.

Title: Boletim Observatório COVID-19: semanas epidemiológicas 39 e 40: 26 de setembro a 8 de outubro de 2021
Abstract: O Boletim visa apresentar dados, de forma clara e didática, da situação dos estados brasileiros e do Distrito Federal, em relação ao cenário epidemiológico da Síndrome Respiratória Aguda Grave (SRAG) e da Covid-19, assim como da capacidade do sistema de saúde para o enfrentamento da pandemia.
Description: De 26 de setembro a 8 de outubro de 2021.

Title: SAPS-3 performance for hospital mortality prediction in 30,571 patients with COVID-19 admitted to ICUs in Brazil
Authors: Kurtz, Pedro; Bastos, Leonardo S. L.; Salluh, Jorge I. F.; Bozza, Fernando A.; Soares, Marcio

by Maria Gröndal, Karl Ask, Timothy J. Luke, Stefan Winblad

A rapid stream of research confirms that the COVID-19 pandemic is a global threat to mental health and psychological well-being. It is therefore important to identify both hazardous and protective individual factors during the pandemic. The current research explored the relationships between self-reported affective responding, perceived personal consequences of the COVID-19 pandemic, and subjective well-being. An online survey (N = 471) conducted in Sweden between June and September, 2020, showed that higher levels of irritability, impulsivity, and the tendency to experience and express anger were generally associated with more severe personal consequences of the pandemic, particularly in areas related to family life, work/study, and finances. While more severe impacts of the pandemic in these areas of life were directly associated with lower subjective well-being, emotion regulation through cognitive reappraisal appeared to moderate the extent to which consequences of the pandemic in other areas of life (i.e., social, free-time and physical activities) translated into decreased well-being. This suggests that cognitive reappraisal may serve to protect against some of the debilitating effects of the COVID-19 pandemic on mental health. Overall, the results indicate that the perceived consequences of the pandemic are multifaceted and that future research should examine these consequences using a multidimensional approach.

by Yock Ping Chow, Brenda Huey Zien Chin, Jin Ming Loo, Loshini R. Moorthy, Jamuna Jairaman, Lian Huat Tan, Wendy Wan Ying Tay
Objective This cross-sectional observational study summarized the baseline characteristics of subjects who underwent COVID-19 molecular testing in a private medical centre located in the state of Selangor in Malaysia between 1 Oct 2020 and 31 Jan 2021. We compared the baseline characteristics between subjects who were tested positive and negative of SARS-CoV-2 infection, and identified risk factors which may be predictive of SARS-CoV-2 positivity. Methods and findings A total of 36603 subjects who were tested for COVID-19 infection via molecular assays at Sunway Medical Centre between Oct 1, 2020 and Jan 31, 2021, and consented to participate in this observation study were included for analysis. Descriptive statistics was used to summarize the study cohort, whereas logistic regression analysis was used to identify risk factors associated with SARS-CoV-2 positivity. Among the reasons listed for COVID-19 screening were those who needed clearance for travelling, clearance to return to work, or clearance prior to hospital admission. They accounted for 67.7% of tested subjects, followed by the self-referred group (27.3%). Most of the confirmed cases were asymptomatic (62.6%), had no travel history (99.6%), and had neither exposure to SARS-CoV-2 confirmed cases (61.9%) nor exposure to patients under investigation (82.7%) and disease clusters (89.2%). Those who presented with loss of smell or taste (OR: 26.91; 95% CI: 14.81–48.92, p

by Tiina Savikangas, Timo Törmäkangas, Anna Tirkkonen, Markku Alen, Roger A. Fielding, Miia Kivipelto, Timo Rantalainen, Anna Stigsdotter Neely, Sarianna Sipilä
Background Executive functions underlie self-regulation and are thus important for physical activity and adaptation to new situations. The aim was to investigate, if yearlong physical and cognitive training (PTCT) had greater effects on physical activity among older adults than physical training (PT) alone, and if executive functions predicted physical activity at baseline, after six (6m) and twelve months (12m) of the interventions, one-year post-intervention follow-up and an extended follow-up during COVID-19 lockdown. Methods Data from a single-blinded, parallel-group randomized controlled trial (PASSWORD-study, ISRCTN52388040) were utilized. Participants were 70–85 years old community-dwelling men and women from Jyväskylä, Finland. PT (n = 159) included supervised resistance, walking and balance training, home-exercises and self-administered moderate activity. PTCT (n = 155) included PT and cognitive training targeting executive functions on a computer program. Physical activity was assessed with a one-item, seven-scale question. Executive functions were assessed with color-word Stroop, Trail Making Test (TMT) B-A and Letter Fluency. Changes in physical activity were modeled with multinomial logistic models and the impact of executive functions on physical activity with latent change score models. Results No significant group-by-time interaction was observed for physical activity (p>0.1). The subjects were likely to select an activity category higher than baseline throughout the study (pooled data: B = 0.720–1.614, p

by Adriana Rezende Lopes, Oscar Kenji Nihei
Background The COVID-19 pandemic raises concerns about the mental health of the world population. Protection measures to prevention the disease impacted education and undergraduate students were exposed to additional stressors. Objectives Analyze depression, anxiety and stress symptoms in undergraduates, their respective predictors and the association with satisfaction with life, psychological well-being and coping strategies. Methods An online cross-sectional study was conducted from September 14 to October 19, 2020, involving undergraduate students enrolled in 33 courses from 5 public university campuses in the state of Parana, Brazil, using: questionnaire with sociodemographic, academic, health and pandemic effects variables; Depression, Anxiety and Stress Scale-21 (DASS-21); Satisfaction with Life Scale (SWLS); Psychological Well-Being (PWB); BriefCOPE. The convenience sample was composed of 1,224 participants, with 18 years old or older, that completed all research instruments. Spearman correlation and logistic analysis (univariate and multivariate) were applied to the collected data. Results Most of the undergraduates presented symptoms of depression (60.5%), anxiety (52.5%) and stress (57.5%). Depression, anxiety and stress presented significant correlations in common: negative with satisfaction with life, all dimensions of psychological well-being, and 3 adaptive copings (active coping, planning, positive reframing); positive with 5 maladaptive copings (behavioral disengagement, denial, self-blame, self-distraction, substance use). In addition, there were 7 common predictors for symptoms of depression, anxiety and stress: female; age 18–24 years old; having a chronic disease; lower scores in 2 dimensions of psychological well-being (positive relations with others, self-acceptance); higher scores in 2 maladaptive copings (self-blame, substance use). Conclusions The data indicate a high prevalence of symptoms of depression, anxiety and stress, and suggest that higher scores of satisfaction with life, psychological well-being dimensions and adaptive copings may present protective effects in undergraduates during a pandemic crisis.

by Rhiannon Phillips, Khadijeh Taiyari, Anna Torrens-Burton, Rebecca Cannings-John, Denitza Williams, Sarah Peddle, Susan Campbell, Kathryn Hughes, David Gillespie, Paul Sellars, Bethan Pell, Pauline Ashfield-Watt, Ashley Akbari, Catherine Heidi Seage, Nick Perham, Natalie Joseph-Williams, Emily Harrop, James Blaxland, Fiona Wood, Wouter Poortinga, Karin Wahl-Jorgensen, Delyth H. James, Diane Crone, Emma Thomas-Jones, Britt Hallingberg

Public perceptions of pandemic viral threats and government policies can influence adherence to containment, delay, and mitigation policies such as physical distancing, hygienic practices, use of physical barriers, uptake of testing, contact tracing, and vaccination programs. The UK COVID-19 Public Experiences (COPE) study aims to identify determinants of health behaviour using the Capability, Opportunity, Motivation (COM-B) model using a longitudinal mixed-methods approach. Here, we provide a detailed description of the demographic and self-reported health characteristics of the COPE cohort at baseline assessment, an overview of data collected, and plans for follow-up of the cohort. The COPE baseline survey was completed by 11,113 UK adult residents (18+ years of age). Baseline data collection started on the 13th of March 2020 (10-days before the introduction of the first national COVID-19 lockdown in the UK) and finished on the 13th of April 2020. Participants were recruited via the HealthWise Wales (HWW) research registry and through social media snowballing and advertising (Facebook®, Twitter®, Instagram®). Participants were predominantly female (69%), over 50 years of age (68%), identified as white (98%), and were living with their partner (68%). A large proportion (67%) had a college/university level education, and half reported a pre-existing health condition (50%). Initial follow-up plans for the cohort included in-depth surveys at 3-months and 12-months after the first UK national lockdown to assess short and medium-term effects of the pandemic on health behaviour and subjective health and well-being. Additional consent will be sought from participants at follow-up for data linkage and surveys at 18 and 24-months after the initial UK national lockdown. A large non-random sample was recruited to the COPE cohort during the early stages of the COVID-19 pandemic, which will enable longitudinal analysis of the determinants of health behaviour and changes in subjective health and well-being over the course of the pandemic.

by Javier Barbero, Juan José de Lucio, Ernesto Rodríguez-Crespo

This paper examines the impact of COVID-19 on bilateral trade flows using a state-of-the-art gravity model of trade. Using the monthly trade data of 68 countries exporting across 222 destinations between January 2019 and October 2020, our results are threefold. First, we find a greater negative impact of COVID-19 on bilateral trade for those countries that were members of regional trade agreements before the pandemic. Second, we find that the impact of COVID-19 is negative and significant when we consider indicators related to governmental actions. Finally, this negative effect is more intense when exporter and importer country share identical income levels. In the latter case, the highest negative impact is found for exports between high-income countries.

Title: Morphological Aspects and Viremia Analysis of BALB/c Murine Model Experimentally Infected with Dengue Virus Serotype 4
Authors: Rasinhas, Arthur da Costa; Jácome, Fernanda Cunha; Caldas, Gabriela Cardoso; Almeida, Ana Luisa Teixeira de; Silva, Marcos Alexandre Nunes da; Souza, Daniel Dias Coutinho de; Paulino, Amanda Carlos; Bandeira, Derick Mendes; Leonardo, Raphael; Nunes, Priscila Conrado Guerra; Borges, Ronaldo Mohana; Barth, Otrud Monika; Santos, Flavia Barreto dos; Vieira, Debora Ferreira Barreto

by Elyssa M. Barrick, Mark A. Thornton, Diana I. Tamir

Faces are one of the key ways that we obtain social information about others. They allow people to identify individuals, understand conversational cues, and make judgements about others’ mental states. When the COVID-19 pandemic hit the United States, widespread mask-wearing practices were implemented, causing a shift in the way Americans typically interact. This introduction of masks into social exchanges posed a potential challenge—how would people make these important inferences about others when a large source of information was no longer available? We conducted two studies that investigated the impact of mask exposure on emotion perception. In particular, we measured how participants used facial landmarks (visual cues) and the expressed valence and arousal (affective cues), to make similarity judgements about pairs of emotion faces. Study 1 found that in August 2020, participants with higher levels of mask exposure used cues from the eyes to a greater extent when judging emotion similarity than participants with less mask exposure. Study 2 measured participants’ emotion perception in both April and September 2020 –before and after widespread mask adoption—in the same group of participants to examine changes in the use of facial cues over time. Results revealed an overall increase in the use of visual cues from April to September. Further, as mask exposure increased, people with the most social interaction showed the largest increase in the use of visual facial cues. These results provide evidence that a shift has occurred in how people process faces such that the more people are interacting with others that are wearing masks, the more they have learned to focus on visual cues from the eye area of the face.

by Fredrikke Christie Knudtzen, Thøger Gorm Jensen, Susan Olaf Lindvig, Line Dahlerup Rasmussen, Lone Wulff Madsen, Silje Vermedal Hoegh, Malene Bek-Thomsen, Christian B. Laursen, Stig Lønberg Nielsen, Isik Somuncu Johansen
Introduction We aimed to examine if severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) cycle quantification (Cq) value, as a surrogate for SARS-CoV-2 viral load, could predict hospitalisation and disease severity in adult patients with coronavirus disease 2019 (COVID-19). Methods We performed a prospective cohort study of adult patients with PCR positive SARS-CoV-2 airway samples including all out-patients registered at the Department of Infectious Diseases, Odense University Hospital (OUH) March 9-March 17 2020, and all hospitalised patients at OUH March 10-April 21 2020. To identify associations between Cq-values and a) hospital admission and b) a severe outcome, logistic regression analyses were used to compute odds ratios (OR) and 95% Confidence Intervals (CI), adjusting for confounding factors (aOR). Results We included 87 non-hospitalised and 82 hospitalised patients. The median baseline Cq-value was 25.5 (interquartile range 22.3–29.0). We found a significant association between increasing Cq-value and hospital-admission in univariate analysis (OR 1.11, 95% CI 1.04–1.19). However, this was due to an association between time from symptom onset to testing and Cq-values, and no association was found in the adjusted analysis (aOR 1.08, 95% CI 0.94–1.23). In hospitalised patients, a significant association between lower Cq-values and higher risk of severe disease was found (aOR 0.89, 95% CI 0.81–0.98), independent of timing of testing. Conclusions SARS-CoV-2 PCR Cq-values in outpatients correlated with time after symptom onset, but was not a predictor of hospitalisation. However, in hospitalised patients lower Cq-values were associated with higher risk of severe disease.

by Titouan Launay, Cécile Souty, Ana-Maria Vilcu, Clément Turbelin, Thierry Blanchon, Caroline Guerrisi, Thomas Hanslik, Vittoria Colizza, Isabelle Bardoulat, Magali Lemaître, Pierre-Yves Boëlle

In France, social distancing measures have been adopted to contain the spread of COVID-19, culminating in national Lockdowns. The use of hand washing, hydro-alcoholic rubs and mask-wearing also increased over time. As these measures are likely to impact the transmission of many communicable diseases, we studied the changes in common infectious diseases incidence in France during the first year of COVID-19 circulation. We examined the weekly incidence of acute gastroenteritis, chickenpox, acute respiratory infections and bronchiolitis reported in general practitioner networks since January 2016. We obtained search engine query volume for French terms related to these diseases and sales data for relevant drugs over the same period. A periodic regression model was fit to disease incidence, drug sales and search query volume before the COVID-19 period and extrapolated afterwards. We compared the expected values with observations made in 2020. During the first lockdown period, incidence dropped by 67% for gastroenteritis, by 79% for bronchiolitis, by 49% for acute respiratory infection and 90% for chickenpox compared to the past years. Reductions with respect to the expected incidence reflected the strength of implemented measures. Incidence in children was impacted the most. Reduction in primary care consultations dropped during a short period at the beginning of the first lockdown period but remained more than 95% of the expected value afterwards. In primary care, the large decrease in reported gastroenteritis, chickenpox or bronchiolitis observed during the period where many barrier measures were implemented imply that the circulation of common viruses was reduced and informs on the overall effect of these measures.

by Weiyu Luo, Wei Guo, Songhua Hu, Mofeng Yang, Xinyuan Hu, Chenfeng Xiong

During the outbreak of the COVID-19 pandemic, Non-Pharmaceutical and Pharmaceutical treatments were alternative strategies for governments to intervene. Though many of these intervention methods proved to be effective to stop the spread of COVID-19, i.e., lockdown and curfew, they also posed risk to the economy; in such a scenario, an analysis on how to strike a balance becomes urgent. Our research leverages the mobility big data from the University of Maryland COVID-19 Impact Analysis Platform and employs the Generalized Additive Model (GAM), to understand how the social demographic variables, NPTs (Non-Pharmaceutical Treatments) and PTs (Pharmaceutical Treatments) affect the New Death Rate (NDR) at county-level. We also portray the mutual and interactive effects of NPTs and PTs on NDR. Our results show that there exists a specific usage rate of PTs where its marginal effect starts to suppress the NDR growth, and this specific rate can be reduced through implementing the NPTs.

by Scott E. Bokemper, Maria Cucciniello, Tiziano Rotesi, Paolo Pin, Amyn A. Malik, Kathryn Willebrand, Elliott E. Paintsil, Saad B. Omer, Gregory A. Huber, Alessia Melegaro

In the absence of widespread vaccination for COVID-19, governments and public health officials have advocated for the public to wear masks during the pandemic. The decision to wear a mask in public is likely affected by both beliefs about its efficacy and the prevalence of the behavior. Greater mask use in the community may encourage others to follow this norm, but it also creates an incentive for individuals to free ride on the protection afforded to them by others. We report the results of two vignette-based experiments conducted in the United States (n = 3,100) and Italy (n = 2,659) to examine the causal relationship between beliefs, social norms, and reported intentions to engage in mask promoting behavior. In both countries, survey respondents were quota sampled to be representative of the country’s population on key demographics. We find that providing information about how masks protect others increases the likelihood that someone would wear a mask or encourage others to do so in the United States, but not in Italy. There is no effect of providing information about how masks protect the wearer in either country. Additionally, greater mask use increases intentions to wear a mask and encourage someone else to wear theirs properly in both the United States and Italy. Thus, community mask use may be self-reinforcing.

Title: Boletim Observatório COVID-19: boletim extraordinário: 6 de outubro de 2021
Abstract: Esta edição do Boletim ratifica um cenário otimista com relação à pandemia, quando comparado à fase
de colapso do sistema de saúde vivida entre março e abril de 2021. Os valores atuais de mortalidade se
apresentam estáveis, em torno de 500 óbitos diários, o que revela uma queda expressiva em relação ao pico observado em abril, quando foram notificados mais de 3 mil por dia. No entanto, são valores ainda preocupantes, que demonstram a permanência da transmissão e a incidência de casos graves
que exigem cuidados intensivos e podem gerar milhares de mortes nos próximos meses. Esses novos dados representam a estabilização da epidemia no Brasil, ainda com níveis que necessitam atenção, pois a circulação de pessoas nas ruas e a positividade de testes permanecem altas.

Title: Boletim Epidemiológico vol.20: situação epidemiológica da COVID-19 entre trabalhadores da Fiocruz: período analisado - 13/03/2020 a 31/08/2021
Abstract: Nessa vigésima edição do Boletim Epidemiológico (BE) atualizamos o panorama mensal da situação da COVID-19 na Fiocruz, no período entre 13 março de 2020 e 31 de agosto de 2021. Além disso, acompanha a evolução da cobertura vacinal ao longo do tempo na Instituição.

Title: CoronaFatos: Entrevista - Esporte e Covid
Authors: Figueira, Ana Cristina
Abstract: Na entrevista de hoje do CoronaFatos, conversamos sobre Esporte e Covid com o Superintendente de Vigilância em Saúde da Secretaria Municipal de Saúde do Rio de Janeiro, Márcio Garcia; e o Presidente do Instituto Municipal de Vigilância Sanitária, Vigilância de Zoonoses e de Inspeção Agropecuária da Prefeitura do Rio de Janeiro (IVISA - Rio), Rodrigo Prado.
Description: Ficha técnica: Apresentação: Ana Cristina Figueira | Produção e Direção: Valéria Mauro | Edição e Finalização: Marcelo Louro | Arte: Marcelo Vianna.

by Courtney M. Lattimore, William J. Kane, Mark A. Fleming II, Allison N. Martin, J. Hunter Mehaffey, Mark E. Smolkin, Sarah J. Ratcliffe, Victor M. Zaydfudim, Shayna L. Showalter, Traci L. Hedrick
Background Telemedicine has been rapidly adopted in the wake of the COVID-19 pandemic. There is limited work surrounding demographic and socioeconomic disparities that may exist in telemedicine utilization. This study aimed to examine demographic and socioeconomic differences in surgical patient telemedicine usage during the COVID-19 pandemic. Methods Department of Surgery outpatients seen from July 1, 2019 to May 31, 2020 were stratified into three visit groups: pre-COVID-19 in-person, COVID-19 in-person, or COVID-19 telemedicine. Generalized linear models were used to examine associations of sex, race/ethnicity, Distressed Communities Index (DCI) scores, MyChart activation, and insurance status with telemedicine usage during the COVID-19 pandemic. Results 14,792 patients (median age 60, female [57.0%], non-Hispanic White [76.4%]) contributed to 21,980 visits. Compared to visits before the pandemic, telemedicine visits during COVID-19 were more likely to be with patients from the least socioeconomically distressed communities (OR, 1.31; 95% CI, 1.08,1.58; P = 0.005), with an activated MyChart (OR, 1.38; 95% CI, 1.17–1.64; P .001), and with non-government or commercial insurance (OR, 2.33; 95% CI, 1.84–2.94; P .001). Adjusted comparison of telemedicine visits to in person visits during COVID-19 revealed telemedicine users were more likely to be female (OR, 1.38, 95% CI, 1.10–1.73; P = 0.005) and pay with non-government or commercial insurance (OR, 2.77; 95% CI, 1.85–4.16; P .001). Conclusions During the first three months of the COVID-19 pandemic, telemedicine was more likely utilized by female patients and those without government or commercial insurance compared to patients who used in-person visits. Interventions using telemedicine to improve health care access might consider such differences in utilization.

by Chathurani Sigera, Chaturaka Rodrigo, Nipun L. de Silva, Praveen Weeratunga, Deepika Fernando, Senaka Rajapakse
Introduction The cost in managing hospitalised dengue patients varies across countries depending on access to healthcare, management guidelines, and state sponsored subsidies. For health budget planning, locally relevant, accurate costing data from prospective studies, is essential. Objective To characterise the direct costs of managing hospitalised patients with suspected dengue infection in Sri Lanka. Methods Colombo Dengue Study is a prospective single centre cohort study in Sri Lanka recruiting suspected hospitalised dengue fever patients in the first three days of fever and following them up until discharge. The diagnosis of dengue is retrospectively confirmed and the cohort therefore has a group of non-dengue fever patients with a phenotypically similar illness, managed as dengue while in hospital. The direct costs of hospital admission (base and investigation costs, excluding medication) were calculated for all recruited patients and compared between dengue and non-dengue categories as well as across subgroups (demographic, clinical or temporal) within each of these categories. We also explored if excluding dengue upfront, would lead to an overall cost saving in several hypothetical scenarios. Results From October 2017 to February 2020, 431 adult dengue patients and 256 non-dengue fever patients were recruited. The hospitalisation costs were USD 18.02 (SD: 4.42) and USD 17.55 (SD: 4.09) per patient per day for dengue and non-dengue patients respectively (p>0.05). Laboratory investigations (haematological, biochemical and imaging) accounted for more than 50% of the total cost. The costs were largely homogenous in all subgroups within or across dengue and non-dengue categories. Excluding dengue upfront by subsidised viral genomic testing may yield overall cost savings for non-dengue patients. Conclusion As non-dengue patients incur a similar cost per day as the dengue patients, confirming dengue diagnosis using subsidised tests for patients presenting in the first three days of fever may be cost-efficient.