Monitoramento das Produções

by Zubair Akhtar, Fahmida Chowdhury, Mahmudur Rahman, Probir Kumar Ghosh, Md. Kaousar Ahmmed, Md Ariful Islam, Joshua A. Mott, William Davis
Introduction During the 2019 novel coronavirus infectious disease (COVID-19) pandemic in 2020, limited data from several countries suggested reduced seasonal influenza viruses’ circulation. This was due to community mitigation measures implemented to control the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We used sentinel surveillance data to identify changes in the 2020 influenza season compared with previous seasons in Bangladesh. Methods We used hospital-based influenza surveillance (HBIS) data of Bangladesh that are generated year-round and are population-representative severe acute respiratory infection (SARI) data for all age groups from seven public and two private tertiary care level hospitals data from 2016 to 2019. We applied the moving epidemic method (MEM) by using R language (v4.0.3), and MEM web applications (v2.14) on influenza-positive rates of SARI cases collected weekly to estimate an average seasonal influenza curve and establish epidemic thresholds. Results The 2016–2019 average season started on epi week 18 (95% CI: 15–25) and lasted 12.5 weeks (95% CI: 12–14 weeks) until week 30.5. The 2020 influenza season started on epi week 36 and ended at epi week 41, lasting for only five weeks. Therefore, influenza epidemic started 18 weeks later, was 7.5 weeks shorter, and was less intense than the average epidemic of the four previous years. The 2020 influenza season started on the same week when COVID-19 control measures were halted, and 13 weeks after the measures were relaxed. Conclusion Our findings suggest that seasonal influenza circulation in Bangladesh was delayed and less intense in 2020 than in previous years. Community mitigation measures may have contributed to this reduction of seasonal influenza transmission. These findings contribute to a limited but growing body of evidence that influenza seasons were altered globally in 2020.

by Markus Wolfgang Hermann Spitzer, Sebastian Musslick

The shutdown of schools in response to the rapid spread of COVID-19 poses risks to the education of young children, including a widening education gap. In the present article, we investigate how school closures in 2020 influenced the performance of German students in a curriculum-based online learning software for mathematics. We analyzed data from more than 2,500 K-12 students who computed over 124,000 mathematical problem sets before and during the shutdown, and found that students’ performance increased during the shutdown of schools in 2020 relative to the year before. Our analyses also revealed that low-achieving students showed greater improvements in performance than high-achieving students, suggesting a narrowing gap in performance between low- and high-achieving students. We conclude that online learning environments may be effective in preventing educational losses associated with current and future shutdowns of schools.

by Bernd Kowall, Fabian Standl, Florian Oesterling, Bastian Brune, Marcus Brinkmann, Marcel Dudda, Peter Pflaumer, Karl-Heinz Jöckel, Andreas Stang
Introduction Excess mortality is a suitable indicator of health consequences of COVID-19 because death from any cause is clearly defined contrary to death from Covid-19. We compared the overall mortality in 2020 with the overall mortality in 2016 to 2019 in Germany, Sweden and Spain. Contrary to other studies, we also took the demographic development between 2016 and 2020 and increasing life expectancy into account. Methods Using death and population figures from the EUROSTAT database, we estimated weekly and cumulative Standardized Mortality Ratios (SMR) with 95% confidence intervals (CI) for the year 2020. We applied two approaches to calculate weekly numbers of death expected in 2020: first, we used mean weekly mortality rates from 2016 to 2019 as expected mortality rates for 2020, and, second, to consider increasing life expectancy, we calculated expected mortality rates for 2020 by extrapolation from mortality rates from 2016 to 2019. Results In the first approach, the cumulative SMRs show that in Germany and Sweden there was no or little excess mortality in 2020 (SMR = 0.976 (95% CI: 0.974–0.978), and 1.030 (1.023–1.036), respectively), while in Spain the excess mortality was 14.8% (1.148 (1.144–1.151)). In the second approach, the corresponding SMRs for Germany and Sweden increased to 1.009 (1.007–1.011) and 1.083 (1.076–1.090), respectively, whereas results for Spain were virtually unchanged. Conclusion In 2020, there was barely any excess mortality in Germany for both approaches. In Sweden, excess mortality was 3% without, and 8% with consideration of increasing life expectancy.

by Inés Suárez-García, Isabel Perales-Fraile, Andrés González-García, Arturo Muñoz-Blanco, Luis Manzano, Martín Fabregate, Jesús Díez-Manglano, Eva Fonseca Aizpuru, Francisco Arnalich Fernández, Alejandra García García, Ricardo Gómez-Huelgas, José-Manuel Ramos-Rincón, on behalf of SEMI-COVID-19 Network
Background Whether immunosuppressed (IS) patients have a worse prognosis of COVID-19 compared to non-IS patients is not known. The aim of this study was to evaluate the clinical characteristics and outcome of IS patients hospitalized with COVID-19 compared to non-IS patients. Methods We designed a retrospective cohort study. We included all patients hospitalized with laboratory-confirmed COVID-19 from the SEMI-COVID-19 Registry, a large multicentre national cohort in Spain, from March 27th until June 19th, 2020. We used multivariable logistic regression to assess the adjusted odds ratios (aOR) of in-hospital death among IS compared to non-IS patients. Results Among 13 206 included patients, 2 111 (16.0%) were IS. A total of 166 (1.3%) patients had solid organ (SO) transplant, 1081 (8.2%) had SO neoplasia, 332 (2.5%) had hematologic neoplasia, and 570 (4.3%), 183 (1.4%) and 394 (3.0%) were receiving systemic steroids, biological treatments, and immunosuppressors, respectively. Compared to non-IS patients, the aOR (95% CI) for in-hospital death was 1.60 (1.43–1.79) for all IS patients, 1.39 (1.18–1.63) for patients with SO cancer, 2.31 (1.76–3.03) for patients with haematological cancer and 3.12 (2.23–4.36) for patients with SO transplant. The aOR (95% CI) for death for patients who were receiving systemic steroids, biological treatments and immunosuppressors compared to non-IS patients were 2.16 (1.80–2.61), 1.97 (1.33–2.91) and 2.06 (1.64–2.60), respectively. IS patients had a higher odds than non-IS patients of in-hospital acute respiratory distress syndrome, heart failure, myocarditis, thromboembolic disease and multiorgan failure. Conclusions IS patients hospitalized with COVID-19 have a higher odds of in-hospital complications and death compared to non-IS patients.

by Madeleine Mant, Asal Aslemand, Andrew Prine, Alyson Jaagumägi Holland
Purpose To investigate university students’ willingness to receive a COVID-19 vaccine when it becomes available to them. Method A multi-methods approach was used—online convenience sample surveys and semi-structured interviews—of young adults attending a large Canadian public university. Two survey samples were collected (June 20-July 28, 2020 and September 22-October 17, 2020). Semi-structured interviews were conducted following each survey, interviewing 20 students in each round. Results In June 77.8% of surveyed students (n = 483) were willing to get the COVID-19 vaccine; in September 79.6% were willing (n = 1269). Multinomial and binary logistic regression analyses found that increasing perception of the severity of COVID-19 predicted the likelihood that a respondent was willing to get the COVID-19 vaccine in both surveys. In the latter survey students who indicated they would be encouraged to get the COVID-19 vaccine if their doctor/pharmacist recommended it were 76 times more likely to be willing to get the vaccine than those who would not be encouraged by medical advice. Interviews revealed concerns about the speed of the vaccine roll out, safety, and efficacy. Conclusions The majority of university students intend to get the COVID-19 vaccine, but there are nuanced concerns about efficacy and safety that must be taken into account by public health authorities as the vaccine becomes available to this group. Ensuring that family doctors, pharmacists, and other front-line healthcare workers have consistent and clear information regarding the benefits of vaccination will be critical to encouraging uptake among young adults.

by Lúcio R. Requião-Moura, Tainá Veras de Sandes-Freitas, Laila Almeida Viana, Marina Pontello Cristelli, Luis Gustavo Modelli de Andrade, Valter Duro Garcia, Claudia Maria Costa de Oliveira, Ronaldo de Matos Esmeraldo, Mario Abbud Filho, Alvaro Pacheco-Silva, Katia Cronemberger Sousa, Alessandra Rosa Vicari, Kellen Micheline Alves Henrique Costa, Denise Rodrigues Simão, Marcos Vinicius de Sousa, Juliana Bastos Campos, Ricardo Augusto Monteiro de Barros Almeida, Luciane Mônica Deboni, Miguel Moysés Neto, Juliana Aparecida Zanocco, Helio Tedesco-Silva, José Medina-Pestana, on behalf of COVID-19-KT Brazil
Background Kidney transplant (KT) recipients are considered a high-risk group for unfavorable outcomes in the course of coronavirus disease 2019 (COVID-19). Aim To describe the clinical aspects and outcomes of COVID-19 among KT recipients. Methods This multicenter cohort study enrolled 1,680 KT recipients diagnosed with COVID-19 between March and November 2020, from 35 Brazilian centers. The main outcome was the 90-day cumulative incidence of death, for the entire cohort and according to acute kidney injury (AKI) and renal replacement therapy (RRT) requirement. Fatality rates were analyzed according to hospitalization, intensive care unit (ICU) admission, and mechanical ventilation (MV) requirement. Multivariable analysis was performed by logistic regression for the probability of hospitalization and death. Results The median age of the recipients was 51.3 years, 60.4% were men and 11.4% were Afro-Brazilian. Comorbidities were reported in 1,489 (88.6%), and the interval between transplantation and infection was 5.9 years. The most frequent symptoms were cough (54%), myalgia (40%), dyspnea (37%), and diarrhea (31%), whereas the clinical signs were fever (61%) and hypoxemia (13%). Hospitalization was required in 65.1%, and immunosuppressive drugs adjustments were made in 74.4% of in-hospital patients. ICU admission was required in 34.6% and MV in 24.9%. In the multivariable modeling, the variables related with the probability of hospitalization were age, hypertension, previous cardiovascular disease, recent use of high dose of steroid, and fever, dyspnea, diarrhea, and nausea or vomiting as COVID-19 symptoms. On the other hand, the variables that reduced the probability of hospitalization were time of COVID-19 symptoms, and nasal congestion, headache, arthralgia and anosmia as COVID-19 symptoms. The overall 90-day cumulative incidence of death was 21.0%. The fatality rates were 31.6%, 58.2%, and 75.5% in those who were hospitalized, admitted to the ICU, and required MV, respectively. At the time of infection, 23.2% had AKI and 23.4% required RRT in the follow-up. The cumulative incidence of death was significantly higher among recipients with AKI (36.0% vs. 19.1%, P 0.0001) and in those who required RRT (70.8% vs. 10.1%, P 0.0001). The variables related with the probability of death within 90 days after COVID-19 were age, time after transplantation, presence of hypertension, previous cardiovascular disease, use of tacrolimus and mycophenolate, recent use of high dose of steroids, and dyspnea as COVID-19 symptom. On the other hand, the variables that reduced the risk of death were time of symptoms, and headache and anosmia as COVID-19 symptoms. Conclusion The patients diagnosed with COVID-19 were long-term KT recipients and most of them had some comorbidities. One in every five patients died, and the rate of death was significantly higher in those with AKI, mainly when RRT was required.

Title: Falhas do Mercado Farmacêutico na COVID-19: desafios e perspectivas globais
Authors: Leineweber, Fabius Vieira
Abstract: As falhas de mercado revelam ineficiências da economia, que produzem desigualdades em saúde. Recentemente a pandemia amplificou o escopo de confrontos entre economia e saúde. Em particular, a COVID-19 agravou casos em que ocorrem falhas de mercado no setor farmacêutico para lidar com esse desafio de saúde. Com a finalidade de examinar este tópico, a dissertação aborda três categorias principais de falhas de mercado: bens públicos, concorrência e externalidades. Para tanto, esse estudo desenvolve três publicações distintas com uma revisão qualitativa dos aspectos relevantes em cada um dos respectivos temas. Assim, a dissertação resulta em atualização dos desafios de acesso a partir da relação com a cooperação global e investimentos em inovação farmacêutica no horizonte tecnológico. Em conclusão, surge uma oportunidade para um melhor planejamento e coordenação da saúde global no acesso a medicamentos com respeito aos direitos humanos.

by Jonas Schmuck, Nina Hiebel, Milena Rabe, Juliane Schneider, Yesim Erim, Eva Morawa, Lucia Jerg-Bretzke, Petra Beschoner, Christian Albus, Julian Hannemann, Kerstin Weidner, Susann Steudte-Schmiedgen, Lukas Radbruch, Holger Brunsch, Franziska Geiser
Introduction The COVID-19 pandemic resulted in severe detrimental effects on the mental well-being of health care workers (HCW). Consequently, there has been a need to identify health-promoting resources in order to mitigate the psychological impact of the pandemic on HCW. Objective Our objective was to investigate the association of sense of coherence (SOC), social support and religiosity with self-reported mental symptoms and increase of subjective burden during the COVID-19 pandemic in HCW. Methods Our sample comprised 4324 HCW of four professions (physicians, nurses, medical technical assistants (MTA) and pastoral workers) who completed an online survey from 20 April to 5 July 2020. Health-promoting resources were assessed using the Sense of Coherence Scale Short Form (SOC-3), the ENRICHD Social Support Inventory (ESSI) and one item on religiosity derived from the Scale of Transpersonal Trust (TPV). Anxiety and depression symptoms were measured with the PHQ-2 and GAD-2. The increase of subjective burden due to the pandemic was assessed as the retrospective difference between burden during the pandemic and before the pandemic. Results In multiple regressions, higher SOC was strongly associated with fewer anxiety and depression symptoms. Higher social support was also related to less severe mental symptoms, but with a smaller effect size, while religiosity showed minimal to no correlation with anxiety or depression. In professional group analysis, SOC was negatively associated with mental symptoms in all groups, while social support only correlated significantly with mental health outcomes in physicians and MTA. In the total sample and among subgroups, an increase of subjective burden was meaningfully associated only with a weaker SOC. Conclusion Perceived social support and especially higher SOC appeared to be beneficial for mental health of HCW during the COVID-19 pandemic. However, the different importance of the resources in the respective occupations requires further research to identify possible reasons.

by Murielle Mary-Krause, Joel José Herranz Bustamante, Mégane Héron, Astrid Juhl Andersen, Tarik El Aarbaoui, Maria Melchior
Background The outbreak of the COVID-19 epidemic lead to high levels of morbidity and mortality around the globe. Consequences of this outbreak and possible associated infection are an increase in mental health disorders and an increased likelihood of internalizing problems, particularly depression. However, to date few studies have tested this hypothesis while taking into account individuals’ preexisting mental health difficulties. Methods We used longitudinal data collected among 729 persons in the context of the French TEMPO cohort between March and June 2020 (7 waves of data collection). COVID-19-like symptoms as well as anxiety/depression (assessed by the Adult Self Report), were reported at each wave of data collection. To study the relationship between COVID-19-like symptoms and anxiety/depression, we used generalized estimation equation (GEE) models controlled for socio-demographic and health-related characteristics, including anxiety/depression prior to 2020. Results Overall, 27.2% of study participants reported anxiety/depression during lockdown. 17.1% of participants reported COVID-19-like symptoms during the course of follow-up, 7.3% after the beginning of lockdown, with an average number of 2.7 symptoms, and 3.6% reported respiratory distress. In multivariate analyses, nearly all the considered indicators of COVID-19-like symptoms were associated with higher odds of symptoms of anxiety/depression (symptoms Yes/No: OR = 1.66, 95% CI = 1.08–2.55; symptoms after the beginning of lockdown: OR = 1.91, 95% CI = 1.03–3.52; number of symptoms: OR for each additional symptom = 1.19, 95% CI = 1.02–1.39. This relationship exists after taking into account prior symptoms of anxiety/depression, which are associated with a 5-fold increased likelihood of psychological distress. And this impact is stronger among men than women. Conclusions Our study shows higher risk of anxiety/depression among persons who experienced COVID-19-like symptoms, even after accounting for prior mental health difficulties. COVID-19 infection could have both a direct and indirect impact on the occurrence of psychological difficulties, and this association should be studied in greater detail.

by Noa Furth, Shay Shilo, Niv Cohen, Nir Erez, Vadim Fedyuk, Alexander M. Schrager, Adina Weinberger, Amiel A. Dror, Asaf Zigron, Mona Shehadeh, Eyal Sela, Samer Srouji, Sharon Amit, Itzchak Levy, Eran Segal, Rony Dahan, Dan Jones, Daniel C. Douek, Efrat Shema

The COVID-19 pandemic raises the need for diverse diagnostic approaches to rapidly detect different stages of viral infection. The flexible and quantitative nature of single-molecule imaging technology renders it optimal for development of new diagnostic tools. Here we present a proof-of-concept for a single-molecule based, enzyme-free assay for detection of SARS-CoV-2. The unified platform we developed allows direct detection of the viral genetic material from patients’ samples, as well as their immune response consisting of IgG and IgM antibodies. Thus, it establishes a platform for diagnostics of COVID-19, which could also be adjusted to diagnose additional pathogens.

by Anna Babicka-Wirkus, Lukasz Wirkus, Krzysztof Stasiak, Paweł Kozłowski

The COVID-19 pandemic has changed the functioning of universities worldwide. In Poland, the transfer to online teaching was announced without prior warning, which radically changed students’ daily functioning. This situation clearly showed the students’ helplessness and difficulties with coping with this new, stressful situation, highlighted in many previous studies. A sudden and far-reaching change in daily functioning caused anxiety, depression, and stress in this group. Thus, from a pedagogical and psychological point of view, it is pertinent to examine the students’ strategies of coping with stress caused by the COVID-19 pandemic. To this end, in 2020, a sample of Polish students was anonymously measured using the Mini-COPE questionnaire. Data was gathered from 577 students from 17 universities. The statistical analysis showed that during the coronavirus pandemic, Polish students most often used the coping strategies of: acceptance, planning, and seeking emotional support. Such factors as age, gender, and place of residence influenced the choice of specific strategies of coping with stress during the COVID-19 pandemic. The results also showed that the youngest students had the lowest coping skills. The results allow for concluding that the students’ maladaptive strategies of coping with stress, especially during the pandemic, may result in long-term consequences for their psychophysiological health and academic achievements. Thus, based on the current results and on the participatory model of intervention, a support program for students is proposed which would involve psychological, organizational, and instrumental support.

by Xiaofeng Liu, Zubair Ahmad, Ahmed M. Gemeay, Alanazi Talal Abdulrahman, E. H. Hafez, N. Khalil

Over the past few months, the spread of the current COVID-19 epidemic has caused tremendous damage worldwide, and unstable many countries economically. Detailed scientific analysis of this event is currently underway to come. However, it is very important to have the right facts and figures to take all possible actions that are needed to avoid COVID-19. In the practice and application of big data sciences, it is always of interest to provide the best description of the data under consideration. The recent studies have shown the potential of statistical distributions in modeling data in applied sciences, especially in medical science. In this article, we continue to carry this area of research, and introduce a new statistical model called the arcsine modified Weibull distribution. The proposed model is introduced using the modified Weibull distribution with the arcsine-X approach which is based on the trigonometric strategy. The maximum likelihood estimators of the parameters of the new model are obtained and the performance these estimators are assessed by conducting a Monte Carlo simulation study. Finally, the effectiveness and utility of the arcsine modified Weibull distribution are demonstrated by modeling COVID-19 patients data. The data set represents the survival times of fifty-three patients taken from a hospital in China. The practical application shows that the proposed model out-classed the competitive models and can be chosen as a good candidate distribution for modeling COVID-19, and other related data sets.

by Uday Narayan Yadav, Om Prakash Yadav, Devendra Raj Singh, Saruna Ghimire, Binod Rayamajhee, Sabuj Kanti Mistry, Lal Bahadur Rawal, ARM Mehrab Ali, Man Kumar Tamang, Suresh Mehta
Background Coronavirus disease 2019 (COVID-19) has affected all age groups worldwide, but older adults have been affected greatly with an increased risk of severe illness and mortality. Nepal is struggling with the COVID-19 pandemic. The normal life of older adults, one of the vulnerable populations to COVID-19 infection, has been primarily impacted. The current evidence shows that the COVID-19 virus strains are deadly, and non-compliance to standard protocols can have serious consequences, increasing fear among older adults. This study assessed the perceived fear of COVID-19 and associated factors among older adults in eastern Nepal. Methods A cross-sectional study was conducted between July and September 2020 among 847 older adults (≥60 years) residing in three districts of eastern Nepal. Perceived fear of COVID-19 was measured using the seven-item Fear of COVID-19 Scale (FCV-19S). Multivariate logistic regression identified the factors associated with COVID-19 fear. Results The mean score of the FCV-19S was 18.1 (SD = 5.2), and a sizeable proportion of older adults, ranging between 12%-34%, agreed with the seven items of the fear scale. Increasing age, Dalit ethnicity, remoteness to the health facility, and being concerned or overwhelmed with the COVID-19 were associated with greater fear of COVID-19. In contrast, preexisting health conditions were inversely associated with fear. Conclusion Greater fear of the COVID-19 among the older adults in eastern Nepal suggests that during unprecedented times such as the current pandemic, the psychological needs of older adults should be prioritized. Establishing and integrating community-level mental health support as a part of the COVID-19 preparedness and response plan might help to combat COVID-19 fear among them.

Title: Dengue Virus and Vaccines: How Can DNA Immunization Contribute to This Challenge?
Authors: Alves, Ada Maria Barcelos; Costa, Simone Morais; PInto, Paolla Beatriz Almeida

by Laia Marques-Fernandez, Swati Sharma, Una Mannu, Hsu Phern Chong
Background Prior studies have demonstrated an increased stillbirth rate. It was suggested that the COVID-19 pandemic may have impacted on attendances for reduced fetal movements. Thus, we sought to ascertain the impact of the pandemic on attendances for reduced fetal movements (RFM) in our unit, ultrasound provision for reduced fetal movements, and the stillbirth rate. Methods This was a single site retrospective cohort study involving all women complaining of a 1st episode of reduced fetal movements between 01/03/2020-30/04/2020 (COVID) to 01/03/2019-30/04/2019 (Pre-COVID). Data were retrieved from computerised hospital records and statistical analyses were performed using GraphPad Prism and SPSS. Results 22% (179/810) of women presented with a 1st episode of reduced fetal movements Pre-COVID compared to 18% (145/803) during COVID (p = 0.047). Primiparous women were significantly over-represented in this population with a 1.4-fold increase in attendances during COVID (67% vs 48%, p = 0.0005). Neither the total stillbirth rate nor the stillbirth rate amongst women who presented with reduced fetal movements changed during COVID. Ultrasound provision was not impacted by COVID with 95% of the scans performed according to local guidelines, compared to Pre-COVID (74%, p = 0.0001). Conclusions There is a significant decrease in 1st attendances for reduced fetal movements during COVID-19 pandemic. Primiparous women were 1.4 times more likely to attend with RFM. Women should be reassured that COVID-19 has not resulted in a decreased provision of care for RFM, and has not impacted on the stillbirth rate.

by Eric O. Yeates, Jeffry Nahmias, Justine Chinn, Brittany Sullivan, Stephen Stopenski, Alpesh N. Amin, Ninh T. Nguyen
Background COVID-19’s pulmonary manifestations are broad, ranging from pneumonia with no supplemental oxygen requirements to acute respiratory distress syndrome (ARDS) with acute respiratory failure (ARF). In response, new oxygenation strategies and therapeutics have been developed, but their large-scale effects on outcomes in severe COVID-19 patients remain unknown. Therefore, we aimed to examine the trends in mortality, mechanical ventilation, and cost over the first six months of the pandemic for adult COVID-19 patients in the US who developed ARDS or ARF. Methods and findings The Vizient Clinical Data Base, a national database comprised of administrative, clinical, and financial data from academic medical centers, was queried for patients ≥ 18-years-old with COVID-19 and either ARDS or ARF admitted between 3/2020-8/2020. Demographics, mechanical ventilation, length of stay, total cost, mortality, and discharge status were collected. Mann-Kendall tests were used to assess for significant monotonic trends in total cost, mechanical ventilation, and mortality over time. Chi-square tests were used to compare mortality rates between March-May and June-August.110,223 adult patients with COVID-19 ARDS or ARF were identified. Mean length of stay was 12.1±13.3 days and mean total cost was $35,991±32,496. Mechanical ventilation rates were 34.1% and in-hospital mortality was 22.5%. Mean cost trended downward over time (p = 0.02) from $55,275 (March) to $18,211 (August). Mechanical ventilation rates trended down (p

by Reza Yousefi Nooraie, Keith Warren, Lisa A. Juckett, Qiuchang A. Cao, Alicia C. Bunger, Michele A. Patak-Pietrafesa
Purpose Worldwide mandates for social distancing and home-quarantine have contributed to loneliness and social isolation. We conducted a systematic scoping review to identify network-building interventions that address loneliness and isolation, describe their components and impact on network structure, and consider their application in the wake of COVID19. Methods We performed forward and backward citation tracking of three seminal publications on network interventions and Bibliographic search of Web of Science and SCOPUS. We developed data charting tables and extracted and synthesized the characteristics of included studies, using an iteratively updating form. Findings From 3390 retrieved titles and abstracts, we included 8 studies. These interventions focused on building networks at either individual- or group-levels. Key elements that were incorporated in the interventions at varying degrees included (a) creating opportunities to build networks; (b) improving social skills; (c) assessing network diagnostics (i.e. using network data or information to inform network strategies); (d) promoting engagement with influential actors; and (e) a process for goal-setting and feedback. The effect of interventions on network structures, or the moderating effect of structure on the intervention effectiveness was rarely assessed. Conclusions As many natural face-to-face opportunities for social connection are limited due to COVID19, groups already at risk for social isolation and loneliness are disproportionately impacted. Network-building interventions include multiple components that address both the structure of individuals’ networks, and their skills and motivation for activating them. These intervention elements could be adapted for delivery via online platforms, and implemented by trained facilitators or novice volunteers, although more rigorous testing is needed.

by Victoria Owens, Htay-Wah Saw
Introduction During public health crises like the COVID-19 pandemic, populations can experience worsening mental health. Prior reports have suggested that Black Americans experienced lower rates of anxiety and depression than White Americans before the pandemic; however, during the pandemic, outcomes may be different as Black Americans have been disproportionately affected in terms of mortality, hospitalization, COVID-19 infection, and job loss. We documented the differential mental health impact of COVID-19 on Black and Non-Black Americans. Methods We analyzed nationally representative longitudinal data from the Understanding America Study COVID-19 Tracking Survey spanning March through November of 2020 to assess differences over time in prevalence of anxiety and depression between Black and non-Black Americans. Results We found that Black Americans were significantly less likely to report symptoms for anxiety, depression, or both during the pandemic. In a given month between March through November of 2020, the odds of Black Americans reporting such symptoms was on average about half that of Non-Black Americans. We also found that in September 2020, the gap in reporting symptoms for depression began to widen gradually. Specifically, since that time, prevalence of depression remained stable among non-Black Americans while it declined gradually among Black Americans. Our main results were robust to adjusting for demographics, risk perceptions, and baseline pre-pandemic mental health status. Conclusions Black Americans maintained significantly better mental health than Non-Black Americans despite their struggle against economic, health, and racial inequalities during the pandemic. We discuss the significance and implications of our results and identify opportunities for future research.

by Daniel Kaimann, Ilka Tanneberg

Since January 2020, the COVID-19 outbreak has been progressing at a rapid pace. To keep the pandemic at bay, countries have implemented various measures to interrupt the transmission of the virus from person to person and prevent an overload of their health systems. We analyze the impact of these measures implemented against the COVID-19 pandemic by using a sample of 68 countries, Puerto Rico and the 50 federal states of the United States of America, four federal states of Australia, and eight federal states of Canada, involving 6,941 daily observations. We show that measures are essential for containing the spread of the COVID-19 pandemic. After controlling for daily COVID-19 tests, we find evidence to suggest that school closures, shut-downs of non-essential business, mass gathering bans, travel restrictions in and out of risk areas, national border closures and/or complete entry bans, and nationwide curfews decrease the growth rate of the coronavirus and thus the peak of daily confirmed cases. We also find evidence to suggest that combinations of these measures decrease the daily growth rate at a level outweighing that of individual measures. Consequently, and despite extensive vaccinations, we contend that the implemented measures help contain the spread of the COVID-19 pandemic and ease the overstressed capacity of the healthcare systems.

by Shambel Araya, Mintesnot Aragaw Mamo, Yakob Gebregziabher Tsegay, Asegdew Atlaw, Aschalew Aytenew, Abebe Hordofa, Abebe Edao Negeso, Moges Wordofa, Tirhas Niguse, Mahlet Cheru, Zemenu Tamir
Background Coagulopathy and thromboembolic events are among the complications of Corona Virus disease 2019 (COVID-19). Abnormal coagulation parameters in COVID-19 patients are important prognostic factors of disease severity. The aim of this study was to analyze coagulation profiles of hospitalized COVID-19 patients in Addis Ababa, Ethiopia. Methods This prospective cross-sectional study was conducted among 455 Covid-19 patients admitted at Millennium COVID-19 care and treatment center, Addis Ababa, Ethiopia from July 1- October 23, 2020. Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT) and International normalized ratio (INR) were determined on HUMACLOT DUE PLUS® coagulation analyzer (Wiesbaden, Germany). In all statistical analysis of results, p

Title: Assessing the nationwide impact of COVID-19 mitigation policies on the transmission rate of SARS-CoV-2 in Brazil
Authors: Jorge, Daniel C.P.; Rodrigues, Moreno S.; Silva, Mateus S.; ardim, Luciana L. C; Silva, Nívea B. da; Silveira, Ismael H.; Silva, Vivian A.F.; Pereira, Felipe A.C.; Azevedo, Arthur R. de; Amad, Alan A.S.; Pinho, Suani T.R.; Andrade, Roberto F.S.; Ramos, Pablo I.P.; Oliveira, Juliane F.

by Jiaqing Luo, Lingyun Zhou, Yunyu Feng, Bo Li, Shujin Guo

The global pandemic of COVID-19 poses a huge threat to the health and lives of people all over the world, and brings unprecedented pressure to the medical system. We need to establish a practical method to improve the efficiency of treatment and optimize the allocation of medical resources. Due to the influx of a large number of patients into the hospital and the running of medical resources, blood routine test became the only possible check while COVID-19 patients first go to a fever clinic in a community hospital. This study aims to establish an efficient method to identify key indicators from initial blood routine test results for COVID-19 severity prediction. We determined that age is a key indicator for severity predicting of COVID-19, with an accuracy of 0.77 and an AUC of 0.92. In order to improve the accuracy of prediction, we proposed a Multi Criteria Decision Making (MCDM) algorithm, which combines the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) and Naïve Bayes (NB) classifier, to further select effective indicators from patients’ initial blood test results. The MCDM algorithm selected 3 dominant feature subsets: {Age, WBC, LYMC, NEUT} with a selection rate of 44%, {Age, NEUT, LYMC} with a selection rate of 38%, and {Age, WBC, LYMC} with a selection rate of 9%. Using these feature subsets, the optimized prediction model could achieve an accuracy of 0.82 and an AUC of 0.93. These results indicated that Age, WBC, LYMC, NEUT were the key factors for COVID-19 severity prediction. Using age and the indicators selected by the MCDM algorithm from initial blood routine test results can effectively predict the severity of COVID-19. Our research could not only help medical workers identify patients with severe COVID-19 at an early stage, but also help doctors understand the pathogenesis of COVID-19 through key indicators.

by Lois G. Kim, Michael J. Sweeting, Morag Armer, Jo Jacomelli, Akhtar Nasim, Seamus C. Harrison
Background The National Health Service (NHS) abdominal aortic aneurysm (AAA) screening programme (NAAASP) in England screens 65-year-old men. The programme monitors those with an aneurysm, and early intervention for large aneurysms reduces ruptures and AAA-related mortality. AAA screening services have been disrupted following COVID-19 but it is not known how this may impact AAA-related mortality, or where efforts should be focussed as services resume. Methods We repurposed a previously validated discrete event simulation model to investigate the impact of COVID-19-related service disruption on key outcomes. This model was used to explore the impact of delayed invitation and reduced attendance in men invited to screening. Additionally, we investigated the impact of temporarily suspending scans, increasing the threshold for elective surgery to 7cm and increasing drop-out in the AAA cohort under surveillance, using data from NAAASP to inform the population. Findings Delaying invitation to primary screening up to two years had little impact on key outcomes whereas a 10% reduction in attendance could lead to a 2% lifetime increase in AAA-related deaths. In surveillance patients, a 1-year suspension of surveillance or increase in the elective threshold resulted in a 0.4% increase in excess AAA-related deaths (8% in those 5–5.4cm at the start). Longer suspensions or a doubling of drop-out from surveillance would have a pronounced impact on outcomes. Interpretation Efforts should be directed towards encouraging men to attend AAA screening service appointments post-COVID-19. Those with AAAs on surveillance should be prioritised as the screening programme resumes, as changes to these services beyond one year are likely to have a larger impact on surgical burden and AAA-related mortality.

by Rachel Strodel, Lauren Dayton, Henri M. Garrison-Desany, Gabriel Eber, Chris Beyrer, Joyell Arscott, Leonard Rubenstein, Carolyn Sufrin
Background Carceral facilities are epicenters of the COVID-19 pandemic, placing incarcerated people at an elevated risk of COVID-19 infection. Due to the initial limited availability of COVID-19 vaccines in the United States, all states have developed allocation plans that outline a phased distribution. This study uses document analysis to compare the relative prioritization of incarcerated people, correctional staff, and other groups at increased risk of COVID-19 infection and morbidity. Methods and findings We conducted a document analysis of the vaccine dissemination plans of all 50 US states and the District of Columbia using a triple-coding method. Documents included state COVID-19 vaccination plans and supplemental materials on vaccine prioritization from state health department websites as of December 31, 2020. We found that 22% of states prioritized incarcerated people in Phase 1, 29% of states in Phase 2, and 2% in Phase 3, while 47% of states did not explicitly specify in which phase people who are incarcerated will be eligible for vaccination. Incarcerated people were consistently not prioritized in Phase 1, while other vulnerable groups who shared similar environmental risk received this early prioritization. States’ plans prioritized in Phase 1: prison and jail workers (49%), law enforcement (63%), seniors (65+ years, 59%), and long-term care facility residents (100%). Conclusions This study demonstrates that states’ COVID-19 vaccine allocation plans do not prioritize incarcerated people and provide little to no guidance on vaccination protocols if they fall under other high-risk categories that receive earlier priority. Deprioritizing incarcerated people for vaccination misses a crucial opportunity for COVID-19 mitigation. It also raises ethical and equity concerns. As states move forward with their vaccine distribution, further work must be done to prioritize ethical allocation and distribution of COVID-19 vaccines to incarcerated people.

by Max Carlos Ramírez-Soto, Hugo Arroyo-Hernández, Gutia Ortega-Cáceres
Background There is a worrying lack of epidemiological data on the sex differential in COVID-19 infection and death rates between the regions of Peru. Methods Using cases and death data from the national population-based surveillance system of Peru, we estimated incidence, mortality and fatality, stratified by sex, age and geographic distribution (per 100,000 habitants) from March 16 to November 27, 2020. At the same time, we calculated the risk of COVID-19 death. Results During the study period, 961894 cases and 35913 deaths were reported in Peru. Men had a twofold higher risk of COVID-19 death within the overall population of Peru (odds ratio (OR), 2.11; confidence interval (CI) 95%; 2.06–2.16; p

by Min-Chul Kim, Oh Joo Kweon, Yong Kwan Lim, Seong-Ho Choi, Jin-Won Chung, Mi-Kyung Lee

During the coronavirus disease (COVID-19) pandemic, social distancing was effective in controlling disease spread across South Korea. The impact of national social distancing on the spread of common respiratory virus infections has rarely been investigated. We evaluated the weekly proportion of negative respiratory virus polymerase chain reaction (PCR) test results and weekly positive rates of each respiratory virus during the social distancing period (10th–41st weeks of 2020) and the corresponding period in different years, utilizing the national respiratory virus surveillance dataset reported by the Korean Center for Disease Control and Prevention. The proportions of negative respiratory virus PCR test results increased up to 87.8% and 86.1% during level 3 and level 2 of the social distancing period, respectively. The higher the level of social distancing, the higher the proportion of negative respiratory virus PCR test results. During the social distancing period, the mean weekly positive rates for parainfluenza virus, influenza virus, human coronavirus, and human metapneumovirus were significantly lower than those during the same period in 2015–2019 (0.1% vs. 9.3%, P

by Krueakaew Tiaprapong, Achiraporn Sirikul, Chamawee Krajangmek, Namfon Duangthongkul, Nichaya Pandam, Nitita Piya-amornphan

The COVID-19 global pandemic has had a socioeconomic effect, including many people suffering from stress and mental disorders. Health professional students are at risk of health issues as well when compared to their age-matched counterpart in the population. The present study aimed to find out the impact of COVID-19 awareness on the wellness of Thai health professional students. The awareness of COVID-19 and wellness among Thai health professional students, such as medical, physical therapy, nursing, pharmacy, and medical technology students were surveyed during the early “new normal” informing policy. The participants included 1,001 students, aged 17 to 25 years old, who responded to a Google form questionnaire set by request. The results showed that the prominent health risks among the Thai health professional students included sedentary behavior, obesity, and mental symptoms. A positive rating in attitude towards the COVID-19 epidemic was mostly observed. There was a negative influence on anxiety symptoms (standardized coefficient beta = -0.079, p-value = 0.012), but a positive impact on social well-being (standardized coefficient beta = 0.158, p-value 0.001) and quality of life (standardized coefficient beta = 0.136, p-value 0.001) among the students even when the situation was improving. To relieve the domino effect of the COVID-19 pandemic on students’ wellness, an updated policy for enhancing awareness and providing updated information is continuously required. Improvements on self and situational awareness may help prevent health risk behaviors and promote health among Thai health professional students.

Title: Classification algorithm for congenital Zika Syndrome: characterizations, diagnosis and validation
Authors: Veiga, Rafael V.; Faccini, Lavinia Schuler; França, Giovanny V. A.; Andrade, Roberto F. S.; Teixeira, Maria Glória; Costa, Larissa C.; Paixão, Enny S.; Costa, Maria da Conceição N.; Barreto, Maurício Lima; Oliveira, Juliane F.; Oliveira, Wanderson K.; Cardim, Luciana L.; Rodrigues, Moreno S.

by Yanguang Chen, Yajing Li, Shuo Feng, Xiaoming Man, Yuqing Long

The spatial diffusion of epidemic disease follows distance decay law in geography and social physics, but the mathematical models of distance decay depend on concrete spatio-temporal conditions. This paper is devoted to modeling spatial diffusion patterns of COVID-19 stemming from Wuhan city to Hubei province, China. The modeling approach is to integrate analytical method and experimental method. The local gravity model is derived from allometric scaling and global gravity model, and then the parameters of the local gravity model are estimated by observational data and least squares calculation. The main results are as below. The local gravity model based on power law decay can effectively describe the diffusion patterns and process of COVID-19 in Hubei Province, and the goodness of fit of the gravity model based on negative exponential decay to the observational data is not satisfactory. Further, the goodness of fit of the model to data entirely became better and better over time, the size elasticity coefficient increases first and then decreases, and the distance attenuation exponent decreases first and then increases. Moreover, the significance of spatial autoregressive coefficient in the model is low, and the confidence level is less than 80%. The conclusions can be reached as follows. (1) The spatial diffusion of COVID-19 of Hubei bears long range effect, and the size of a city and the distance of the city to Wuhan affect the total number of confirmed cases. (2) Wuhan direct transmission is the main process in the spatial diffusion of COVID-19 in Hubei at the early stage, and the horizontal transmission between regions is not significant. (3) The effect of spatial lockdown and isolation measures taken by Chinese government against the transmission of COVID-19 is obvious. This study suggests that the role of urban gravity (size and distance) should be taken into account to prevent and control epidemic disease.

Title: Tríplice epidemia de zika, dengue e chikungunya em municípios brasileiros: difusão espacial e fatores de risco individual
Authors: Dalvi, Ana Paula Razal
Abstract: Diversos fatores são atribuídos à propagação de patógenos como fatores climáticos, sociodemográficos e de mobilidade humana. Diferentes países, principalmente o Brasil, que desde então enfrentavam epidemias recorrentes de dengue e, a partir de 2014, chikungunya, precisaram reorganizar os serviços de saúde para o enfrentamento de uma tríplice epidemia de arboviroses causadas por um mesmo vetor. Fatores sociodemográficos e características do domicílio e seu entorno merecem atenção dentre os fatores associados às três arboviroses. Pouco se sabe sobre essas relações entre adolescentes que apresentam relações com o ambiente social diversas das populações economicamente ativa, implicando em locais, tipos e graus de exposições ao vetor potencialmente distintos. Diversos esforços têm sido empregados para o maior conhecimento das doenças citadas na área da pesquisa epidemiológica, tendo a análise espacial um papel importante no conhecimento da dinâmica de doenças. O primeiro estudo deste projeto busca identificar o padrão de difusão espacial da epidemia de Zika, dengue e chikungunya em 2015-2016 no município do Rio de Janeiro, Brasil. Dois desenhos de estudo foram utilizados: a) Estudo transversal, e b) Estudo Ecológico. Mapas sequenciais de Kernel, variação da razão do vizinho mais próximo calculada cumulativamente em relação ao tempo, correlogramas de autocorrelação global utilizando o I de Moran e frequência das mudanças da autocorrelação local (LISA) no tempo foram utilizados para a identificação do padrão de difusão espacial. Seus resultados sugerem o padrão de difusão por expansão para as três arboviroses durante os anos de 2015-2016 no município do Rio de Janeiro. O segundo estudo de desenho caso-controle teve como objetivo identificar fatores sociodemográficos associados com o adoecimento pelo vírus Zika, dengue vírus e pelo vírus chikungunya em adolescentes participantes do Estudo de Riscos Cardiovasculares em Adolescentes \2013 ERICA \2013 nos municípios do Rio de Janeiro/RJ e Fortaleza/CE em 2015-2019. Uma análise de regressão logística multinível foi aplicada para o município de Fortaleza e uma regressão logística para o município do Rio de Janeiro para estimar razões de chances (RC) como medida de associação, com respectivos intervalos de 95% de confiança (IC95%). Em comparação com adolescentes vivendo em melhores condições socioeconômicas, a chance de adoecer por alguma das 3 arboviroses estudadas foi maior entre aqueles vivendo em condições socioeconômicas precárias (Baixo (RC=6,62; IC 95%: 1,12-38,46)) e foi menor nos residiam em domicílios com ausência de esgoto a céu aberto no entorno do domicílio (RC=0,38: IC 95%: (0,15-0,98)) em Fortaleza. O índice de Infestação Predial também influencia positivamente na chance de ocorrência de arboviroses em Fortaleza (RC=1,91; IC95%: 1,20-3,05). A chance de adoecer por Zika, dengue e chikungunya também foi maior entre os que vivem em domicílios com ausência de rede de abastecimento de água no Rio de Janeiro (RC=2,93; IC 95%: 1,08-8,16). Esses achados indicam que condições socioeconômicas mais precárias, a presença de esgoto a céu aberto e um índice de infestação predial de A. aegypti alto podem contribuir para uma maior chance de infecção de Zika, dengue ou chikungunya em adolescentes. A identificação de áreas com base nessas variáveis pode contribuir para a implementação de medidas de controle em grupos populacionais e locais prioritários.