Monitoramento das Produções

by Christelle Baunez, Mickael Degoulet, Stéphane Luchini, Patrick A. Pintus, Miriam Teschl

An acceleration index is proposed as a novel indicator to track the dynamics of COVID-19 in real-time. Using data on cases and tests in France for the period between the first and second lock-downs—May 13 to October 25, 2020—our acceleration index shows that the pandemic resurgence can be dated to begin around July 7. It uncovers that the pandemic acceleration was stronger than national average for the [59–68] and especially the 69 and older age groups since early September, the latter being associated with the strongest acceleration index, as of October 25. In contrast, acceleration among the [19–28] age group was the lowest and is about half that of the [69–78]. In addition, we propose an algorithm to allocate tests among French “départements” (roughly counties), based on both the acceleration index and the feedback effect of testing. Our acceleration-based allocation differs from the actual distribution over French territories, which is population-based. We argue that both our acceleration index and our allocation algorithm are useful tools to guide public health policies as France might possibly enter a third lock-down period with indeterminate duration.

by Elissa Rennert-May, Jenine Leal, Nguyen Xuan Thanh, Eddy Lang, Shawn Dowling, Braden Manns, Tracy Wasylak, Paul E. Ronksley
Background As a result of the novel coronavirus disease 2019 (COVID-19), there have been widespread changes in healthcare access. We conducted a retrospective population-based study in Alberta, Canada (population 4.4 million), where there have been approximately 1550 hospital admissions for COVID-19, to determine the impact of COVID-19 on hospital admissions and emergency department (ED visits), following initiation of a public health emergency act on March 15, 2020. Methods We used multivariable negative binomial regression models to compare daily numbers of medical/surgical hospital admissions via the ED between March 16-September 23, 2019 (pre COVID-19) and March 16-September 23, 2020 (post COVID-19 public health measures). We compared the most frequent diagnoses for hospital admissions pre/post COVID-19 public health measures. A similar analysis was completed for numbers of daily ED visits for any reason with a particular focus on ambulatory care sensitive conditions (ACSC). Findings There was a significant reduction in both daily medical (incident rate ratio (IRR) 0.86, p

Title: Fiocruz desenvolve novas vacinas para enfrentar Covid-19
Authors: Informe ENSP
Abstract: Com o início da produção da vacina de Oxford/AstraZeneca-Fiocruz em território nacional, e a entrega de lotes ao Ministério da Saúde, esta etapa começa a dar os primeiros resultados à sociedade brasileira. Ainda este ano, o país terá uma vacina produzida totalmente no Brasil e já neste primeiro semestre será iniciada a fabricação dos primeiros lotes do insumo farmacêutico ativo (IFA), que deverá estar disponível para a população no segundo semestre. Será uma vacina 100% produzida no Brasil. Mas a Fiocruz continua, de forma complementar, apoiando o desenvolvimento de outros projetos que levem a novos imunizantes contra a Covid-19. O novo coronavírus é um grande desafio que possivelmente veio para ficar e, até onde a vista alcança, ainda serão necessárias muitas doses da vacina, não apenas em 2021, mas também além. No momento, a Fiocruz desenvolve sete outras vacinas, com parceiros diversos, nacionais e estrangeiros. Segundo o vice-presidente de Produção e Inovação em Saúde da Fundação, Marco Aurélio Krieger, obter o domínio das novas plataformas tecnológicas de desenvolvimento de vacinas dará ao Brasil melhores condições de enfrentar não apenas a atual pandemia mas também novos desafios de saúde pública.
Description: Em colaboração com Ricardo Valverde (Agência Fiocruz de Notícias)

by Chad Artman, Kyle D. Brumfield, Sahil Khanna, Julius Goepp
Background The global pandemic of Coronavirus infectious disease 2019 (COVID-19), caused by SARS-CoV-2, has plunged the world into both social and economic disarray, with vaccines still emerging and a continued paucity of personal protective equipment; the pandemic has also highlighted the potential for rapid emergence of aggressive respiratory pathogens and the need for preparedness. Avian immunoglobulins (IgY) have been previously shown in animal models to protect against new infection and mitigate established infection when applied intranasally. We carried out a proof-of-concept study to address the feasibility of using such antibodies as mucosally-applied prophylaxis against SARS-CoV-2. Methods Hens were immunized with recombinant S1 spike glycoprotein of the virus, and the resulting IgY was evaluated for binding specificity, inhibition of glycoprotein binding to angiotensin converting enzyme-2 (ACE2) protein (the requisite binding site for the virus), and inhibition of viral replication in Vero cell culture. Results Titers of anti-S1 glycoprotein IgY were evident in yolks at 14 days post-immunization, peaking at 21 days, and at peak concentrations of 16.8 mg/ml. IgY showed strong and significant inhibition of S1/ACE2 binding interactions, and significantly inhibited viral replication at a concentration of 16.8 mg/ml. Four weeks’ collection from eggs of two hens produced a total of 1.55 grams of IgY. Conclusions In this proof-of-concept study we showed that avian immunoglobulins (IgY) raised against a key virulence factor of the SARS-CoV-2 virus successfully inhibited the critical initial adhesion of viral spike glycoproteins to human ACE2 protein receptors and inhibited viral replication in vitro, in a short period using only two laying hens. We conclude that production of large amounts of IgY inhibiting viral binding and replication of SARS-CoV-2 is feasible, and that incorporation of this or similar material into an intranasal spray and/or other mucosal protecting products may be effective at reducing infection and spread of COVID-19.

by Jiří Mazurek

In the field of machine learning, building models and measuring their performance are two equally important tasks. Currently, measures of precision of regression models’ predictions are usually based on the notion of mean error, where by error we mean a deviation of a prediction from an observation. However, these mean based measures of models’ performance have two drawbacks. Firstly, they ignore the length of the prediction, which is crucial when dealing with chaotic systems, where a small deviation at the beginning grows exponentially with time. Secondly, these measures are not suitable in situations where a prediction is made for a specific point in time (e.g. a date), since they average all errors from the start of the prediction to its end. Therefore, the aim of this paper is to propose a new measure of models’ prediction precision, a divergence exponent, based on the notion of the Lyapunov exponent which overcomes the aforementioned drawbacks. The proposed approach enables the measuring and comparison of models’ prediction precision for time series with unequal length and a given target date in the framework of chaotic phenomena. Application of the divergence exponent to the evaluation of models’ accuracy is demonstrated by two examples and then a set of selected predictions of COVID-19 spread from other studies is evaluated to show its potential.

by The PLOS ONE Staff

by Luke Sy-Cherng Woon, Mohammad Farris Iman Leong Bin Abdullah, Hatta Sidi, Nor Shuhada Mansor, Nik Ruzyanei Nik Jaafar
Background and aims This online cross-sectional study investigated the severity of depressive, anxiety, and stress symptoms among university students and determined the association between various factors and the levels of depressive and anxiety symptoms in response to the coronavirus disease 2019 (COVID-19) pandemic after the movement control order (MCO) was lifted. Methods A total of 316 participants were administered a self-report questionnaire that collected data on sociodemographic attributes, personal characteristics, COVID-19-related stressors, religious coping, and clinical characteristics. In addition, the Multidimensional Scale of Perceived Social Support (MSPSS) and the 21-item Depression, Anxiety and Stress Scale (DASS-21) were administered. Results Regarding depression, 15.5%, 11.7%, and 9.2% of the participants reported mild, moderate, and severe to extremely severe depression, respectively. For anxiety, 7.0%, 16.5%, and 13.2% of the respondents had mild, moderate, and severe to extremely severe anxiety, respectively. Moreover, 26.3% of participants had mild stress, 9.5% had moderate stress, and 6.6% had severe to extremely severe stress. The multiple linear regression model revealed that frustration because of loss of daily routine and study disruption and having preexisting medical, depressive, and anxiety disorders were associated with elevated depressive symptoms, while a greater degree of family and friends social support was associated with less depressive symptoms after adjusting for age, gender, and marital status. It was also found that frustration because of study disruption and having preexisting medical, depressive, and anxiety disorders were associated with elevated anxiety symptoms, while being enrolled in medicine-based courses and having a greater degree of family support were factors associated with less anxiety symptoms after adjusting for age, gender, and marital status. Conclusion There is a need to conduct a longitudinal study in the future to confirm the causal relationship between the significant predictive factors and depression and anxiety identified in this study, and maintenance of a persistent flow of academic activities and social interaction may be of utmost importance to safeguard the mental wellbeing of university students.

by Gabriele Mascherini, Dolores Catelan, Domenico E. Pellegrini-Giampietro, Cristian Petri, Cristina Scaletti, Massimo Gulisano

The confinement and lockdown imposed by the COVID-19 pandemic have produced restrictions in the lifestyle of Italian citizens with variations in their psychological well-being. The aim of the study was to identify changes and relationship with socio-demographic parameters. An online survey was administered to 1383 subjects (1007 females and 307 males) working in the University of Florence, Italy. Three validated questionnaires were used for the survey: the Global Physical Activity Questionnaire, the Med Diet Score and the Psychological General Well-Being Index-A. All the subjects were asked to complete the questionnaires twice, in order to attain a picture of the habits before and a later time point during confinement. Our results show that work-related physical activity was decreased, along with an increase in sedentary behaviour (from 07:22±03:20 to 08:49±03:41 h:min; p

by Mariana P. Miranda, Rui Costa-Lopes, Gonçalo Freitas, Catarina L. Carvalho

On the onset of the COVID-19 pandemic, the overcrowding in prisons led to efforts to decarcerate in order to prevent and control outbreaks in prisons. This study analyses how public support for such exceptional measures are determined by cognitive and ideological factors known to create and maintain racial biases in the criminal system. Participants were asked to express their level of agreement with the early-release of hypothetical prisoners. Results showed participants to be less favourable to the early-release of Black compared to White prisoners, when they had committed a stereotypically Black crime. As expected, the congruency between the crime stereotypicality and the colour of the prisoner’s skin did not emerge for White prisoners. Moreover, the difference between the agreement with the release of the Black vs. the White prisoner when both committed a stereotypically Black crime was higher as the level of endorsement of Meritocracy increased. Contrastingly, Anti-egalitarianism only predicted an overall disagreement with prisoners’ early-release. This paper highlights the cumulative explanation by different levels of analysis of this current problem and implications for the development of the public opinion on penal subjects.

Title: Spontaneous Abortion and Chikungunya Infection: Pathological Findings
Authors: Salomão, Natália; Brendolin, Michelle; Rabelo, Kíssila; Wakimoto, Mayumi; Filippis, Ana Maria de; Santos, Flavia dos; Moreira, Maria Elizabeth; Basílio-de-Oliveira, Carlos Alberto; Avvad-Portari, Elyzabeth; Paes, Marciano; Brasil, Patrícia

by Miguel Alejandro Pinzón, Santiago Ortiz, Héctor Holguín, Juan Felipe Betancur, Doris Cardona Arango, Henry Laniado, Carolina Arias Arias, Bernardo Muñoz, Julián Quiceno, Daniel Jaramillo, Zoraida Ramirez
Background There is no effective therapy for the severe acute respiratory syndrome by coronavirus 2 (SARS-CoV2) responsible for the Coronavirus disease 2019 (Covid-19). To date, dexamethasone has shown a decrease in mortality in patients who require oxygen, especially those with invasive mechanical ventilation. However, it is unknown if another corticosteroid can be used, the optimal dose and its duration, to achieve a better clinical outcome. The objective of the study was to compare the differences in clinical outcome and laboratory results in hospitalized patients with severe SARS-CoV2 Pneumonia treated with dexamethasone at 6 mg doses versus patients treated with high-dose methylprednisolone. Materials and methods Ambispective cohort study with survival analysis of 216 patients diagnosed with severe Covid-19 pneumonia confirmed by polymerase chain reaction for SARS-CoV2 by Berlin protocol, who were hospitalized in a high-complexity clinic in Medellín, Colombia. The patients should also have supplementary oxygen and radiological confirmation of Pneumonia by chest tomography. Sample size was not calculated since the total population that met the inclusion criteria was evaluated. 111 patients were treated with the institutional protocol with intravenous dexamethasone 6 mg QD for seven to 10 days if they required oxygen. Since September 15, 2020, the hospitalization protocol of the clinic was modified by the Infectious Diseases and Pulmonology service, recommending a high dose of methylprednisolone of 250 to 500 mg every day for three days with a subsequent change to oral prednisone 50 mg every day for 14 days. The protocol was not applied in the intensive care unit, where dexamethasone continued to be administered. The clinical outcome and differences in laboratory results of the patients who received dexamethasone vs. the prospective cohort that received methylprednisolone from September 15 to October 31, 2020, were evaluated. Follow-up was carried out by outpatient consultation one month after discharge or by telephone, inquiring about readmission or living-dead status. Results 216 patients had Covid-19 pneumonia documented by ground-glass imaging and alveolar pressure / inspired oxygen fraction (PaFi) less than 300. 111 patients received dexamethasone (DXM) and 105 received methylprednisolone (MTP). Patients in the DXM group evolved to severe ARDS in a higher proportion (26.1% vs 17.1% than the MTP group). Upon completion 4 days of treatment with parenteral corticosteroid, laboratory markers of severity decreased significantly in the group that received MTP, CRP 2.85 (2.3–3.8) vs 7.2 (5.4–9.8), (p-value 0.0001), D-dimer 691 (612–847) vs 1083 (740–1565) (p-value = 0.04) and DHL 273 (244–289) vs 355 (270.6–422) (p-value = 0.01). After starting the corticosteroid, transfer to the intensive care unit (4.8% vs. 14.4%) and mortality (9,5% vs. 17.1%) was lower in the group that received MTP. Recovery time was shorter in patients treated with MTP, three days (3–4) vs. DXM 6 days (5–8) (p-value 0.0001). At 30-day follow-up, 88 (92.6%) were alive in MTP vs 58 (63.1%) of those who received dexamethasone. Conclusions In this study, the treatment of severe Covid-19 Pneumonia with high-dose methylprednisolone for three days followed by oral prednisone for 14 days, compared with 6 mg dexamethasone for 7 to 10 days, statistically significantly decreased the recovery time, the need for transfer to intensive care and the severity markers C-reactive protein (CRP), D-dimer and LDH. Randomized controlled studies with methylprednisolone are required to corroborate its effect, and studies in a population hospitalized in intensive care wards.

Title: Correction to: The infuence of diferent sources of blood meals on the physiology of Aedes aegypti harboring Wolbachia wMel: mouse blood as an alternative for mosquito rearing
Authors: Farnesi, Luana Cristina; Carvalho, Fabiano Duarte; Lacerda, Anna Paula Canuto; Moreira, Luciano Andrade; Bruno, Rafaela Vieira
Description: Correction to: Parasites Vectors (2021) 14:21
https://doi.org/10.1186/s13071-020-04465-9
Following publication of the original article [1] the
authors fagged that the name of one of the authors, Fabi ano Duarte Carvalho, had been wrongly published as
Fabiano Dias Carvalho.
Te authors apologize for this mistake, which has now
been corrected online and in the author list of this cor rection article.

by Yipeng Xi, Anfan Chen, Aaron Ng

Transparency of Chinese media coverage became an international controversy when the COVID-19 outbreak initially emerged in Wuhan, the eventual crisis epicenter in China. Unlike studies characterizing mass media in authoritarian contexts as government mouthpieces during a crisis, this study aims to disaggregate Chinese media practices to uncover differences in when, where, and how the severity of COVID-19 was reported. We examine differences in how media institutions reported the severity of the COVID-19 epidemic in China during the pre-crisis period from 1 January 2020 to 20 January 2020 in terms of both the “vertical” or hierarchical positions of media institutions in the Chinese media ecosystem and the “horizontal” positions of media institutions’ social proximity to Wuhan in terms of geographical human traffic flows. We find that the coverage of crisis severity is negatively associated with the media’s social proximity to Wuhan, but the effect varies depending on the positional prominence of a news article and situation severity. Implications of the institutions’ differentiated reporting strategies on future public health reporting in an authoritarian context are also discussed.

by Janeta Nikolovski, Martin Koldijk, Gerrit Jan Weverling, John Spertus, Mintu Turakhia, Leslie Saxon, Mike Gibson, John Whang, Troy Sarich, Robert Zambon, Nnamdi Ezeanochie, Jennifer Turgiss, Robyn Jones, Jeff Stoddard, Paul Burton, Ann Marie Navar
Background The success of vaccination efforts to curb the COVID-19 pandemic will require broad public uptake of immunization and highlights the importance of understanding factors associated with willingness to receive a vaccine. Methods U.S. adults aged 65 and older enrolled in the HeartlineTM clinical study were invited to complete a COVID-19 vaccine assessment through the HeartlineTM mobile application between November 6–20, 2020. Factors associated with willingness to receive a COVID-19 vaccine were evaluated using an ordered logistic regression as well as a Random Forest classification algorithm. Results Among 9,106 study participants, 81.3% (n = 7402) responded and had available demographic data. The majority (91.3%) reported a willingness to be vaccinated. Factors most strongly associated with vaccine willingness were beliefs about the safety and efficacy of COVID-19 vaccines and vaccines in general. Women and Black or African American respondents reported lower willingness to vaccinate. Among those less willing to get vaccinated, 66.2% said that they would talk with their health provider before making a decision. During the study, positive results from the first COVID-19 vaccine outcome study were released; vaccine willingness increased after this report. Conclusions Even among older adults at high-risk for COVID-19 complications who are participating in a longitudinal clinical study, 1 in 11 reported lack of willingness to receive COVID-19 vaccine in November 2020. Variability in vaccine willingness by gender, race, education, and income suggests the potential for uneven vaccine uptake. Education by health providers directed toward assuaging concerns about vaccine safety and efficacy can help improve vaccine acceptance among those less willing. Trial registration Clinicaltrials.gov NCT04276441.

by Leslie E. Roos, Marlee Salisbury, Lara Penner-Goeke, Emily E. Cameron, Jennifer L. P. Protudjer, Ryan Giuliano, Tracie O. Afifi, Kristin Reynolds
Background Supportive parenting is critical for promoting healthy child development in the face of stressors, such as those occurring during COVID-19. Here, we address a knowledge gap regarding specific household risk factors associated with parenting quality during the pandemic and incorporate first-person accounts of family challenges and needs. Methods Mixed methods were applied to data collected between April 14th - 28th, 2020 from the “Parenting During the Pandemic” survey. Participants included 656 primary caregivers (e.g., mothers, fathers, foster parents) of least one child age 1.5–8 years of which 555 (84.6%) responded to at least one parenting questionnaire. Parenting quality was assessed across stressful, negative, and positive parenting dimensions. Household risk was examined across pandemic- linked (e.g., caregiver depression, unmet childcare needs) and stable factors (i.e., annual income, mental illness history). Significant correlates were examined with regressions in Mplus. Thematic analysis identified caregiver challenges and unmet needs from open-ended questions. Findings Caregiver depression, higher child parity, unmet childcare needs, and relationship distress predicted lower-quality parenting. Caregiver depression was the most significant predictor across every parenting dimension, with analyses indicating medium effect sizes, ds = .39 - .73. Qualitative findings highlighted severe strains on parent capacities including managing psychological distress, limited social supports, and too much unstructured time. Interpretations Lower quality parenting during COVID-19 is associated with multiple household and pandemic risk factors, with caregiver depression consistently linked to parent- child relationship disruptions. Focused efforts are needed to address caregiver mental health to protect child health as part of the pandemic response.

Title: Vertical transmission of chikungunya virus: A systematic review
Authors: Ferreira, Fátima Cristiane Pinho de Almeida Di Maio; Silva, Anamaria Szrajbman Vaz da; Recht, Judith; Guaraldo, Lusiele; Moreira, Maria Elisabeth Lopes; Siqueira, André Machado de; Gerardin, Patrick; Brasil, Patrícia

by Daniele Proverbio, Françoise Kemp, Stefano Magni, Andreas Husch, Atte Aalto, Laurent Mombaerts, Alexander Skupin, Jorge Gonçalves, Jose Ameijeiras-Alonso, Christophe Ley

Against the current COVID-19 pandemic, governments worldwide have devised a variety of non-pharmaceutical interventions to mitigate it. However, it is generally difficult to estimate the joint impact of different control strategies. In this paper, we tackle this question with an extended epidemic SEIR model, informed by a socio-political classification of different interventions. First, we inquire the conceptual effect of mitigation parameters on the infection curve. Then, we illustrate the potential of our model to reproduce and explain empirical data from a number of countries, to perform cross-country comparisons. This gives information on the best synergies of interventions to control epidemic outbreaks while minimising impact on socio-economic needs. For instance, our results suggest that, while rapid and strong lockdown is an effective pandemic mitigation measure, a combination of social distancing and early contact tracing can achieve similar mitigation synergistically, while keeping lower isolation rates. This quantitative understanding can support the establishment of mid- and long-term interventions, to prepare containment strategies against further outbreaks. This paper also provides an online tool that allows researchers and decision makers to interactively simulate diverse scenarios with our model.

by Zsófia Benedek, Imre Fertő, Cristina Galamba Marreiros, Pâmela Mossmann de Aguiar, Cristina Bianca Pocol, Lukáš Čechura, Anne Põder, Piia Pääso, Zoltán Bakucs

This paper explores to what extent product and marketing channel diversification contributed to the economic success of small-scale agricultural producers involved in short food supply chains after the outbreak of the COVID-19 pandemic. A survey was conducted between April and July 2020 in four countries of the European Union–Estonia, Hungary, Portugal and Romania,–resulting in a relatively large sample of farmers (N = 421). The analysis was built on a semi-nonparametric approach. Approximately 19 percent of small-scale producers were able to increase sales during the first wave of the pandemic, although country-level variation was significant. Fruits and vegetables were by far the most popular products. The importance of specific channels varied across countries, but farm gate sales were among the most important marketing channels both before and during the first wave. The importance of channels that were based on digital resources and home delivery increased. Our evidence indicates that diversification was a strategy that paid off, both in terms of marketing channels and different product categories. However, the impact appears to be nonlinear; the initial advantage generated by diversification rapidly tapered off, either temporarily (in the case of products), or permanently (in the case of marketing channels). Later research may clarify whether these findings are generalizable in other socio-economic contexts, as well as in a non-COVID situation.

by Cristian Aragón-Benedí, Pablo Oliver-Forniés, Felice Galluccio, Ece Yamak Altinpulluk, Tolga Ergonenc, Abdallah El Sayed Allam, Carlos Salazar, Mario Fajardo-Pérez

by Stefano Crabu, Paolo Giardullo, Andrea Sciandra, Federico Neresini

The SARS-CoV-2 pandemic has emerged as one of the most dramatic health crises of recent decades. This paper treats mainstream news about the current pandemic as a valuable entry point for analyzing the relationship between science and politics in the public sphere, where the outbreak must be both understood and confronted through appropriate public-health policy decisions. In doing so, the paper aims to examine which actors, institutions, and experts dominate the SARS-CoV-2 media narratives, with particular attention to the roles of political, medical, and scientific actors and institutions within the pandemic crisis. The study relies on a large dataset consisting of all SARS-CoV-2 articles published by eight major Italian national newspapers between January 1, 2020 and June 15, 2020. These articles underwent a quantitative analysis based on a topic modeling technique. The topic modeling outputs were further analyzed by innovatively combining ad-hoc metrics and a classifier based on the stacking ensemble method (combining regularized logistic regression and linear stochastic gradient descent) for quantifying scientific salience. This enabled the identification of relevant topics and the analysis of the roles that different actors and institutions engaged in making sense of the pandemic. The results show how the health emergency has been addressed primarily in terms of political regulation and concerns and only marginally as a scientific matter. Hence, science has been overwhelmed by politics, which, in media narratives, exerts a moral as well as regulatory authority. Media narratives exclude neither scientific issues nor scientific experts; rather, they configure them as a subsidiary body of knowledge and expertise to be mobilized as an ancillary, impersonal institution useful for legitimizing the expansion of political jurisdiction over the governance of the emergency.

by Filippo Pieralli, Fulvio Pomero, Margherita Giampieri, Rossella Marcucci, Domenico Prisco, Fabio Luise, Antonio Mancini, Alessandro Milia, Lucia Sammicheli, Irene Tassinari, Francesca Caldi, Francesca Innocenti, Antonio Faraone, Chiara Beltrame, Riccardo Pini, Andrea Ungar, Alberto Fortini
Objective The aim of this study was to assess the incidence of deep vein thrombosis (DVT) of the lower limbs, using serial compression ultrasound (CUS) surveillance, in acutely ill patients with COVID-19 pneumonia admitted to a non-ICU setting. Methods Multicenter, prospective study of patients with COVID-19 pneumonia admitted to Internal Medicine units. All patients were screened for DVT of the lower limbs with serial CUS. Anticoagulation was defined as: low dose (enoxaparin 20–40 mg/day or fondaparinux 1.5–2.5 mg/day); intermediate dose (enoxaparin 60–80 mg/day); high dose (enoxaparin 120–160 mg or fondaparinux 5–10 mg/day or oral anticoagulation). The primary end-point of the study was the diagnosis of DVT by CUS. Results Over a two-month period, 227 consecutive patients with moderate-severe COVID-19 pneumonia were enrolled. The incidence of DVT was 13.7% (6.2% proximal, 7.5% distal), mostly asymptomatic. All patients received anticoagulation (enoxaparin 95.6%) at the following doses: low 57.3%, intermediate 22.9%, high 19.8%. Patients with and without DVT had similar characteristics, and no difference in anticoagulant regimen was observed. DVT patients were older (mean 77±9.6 vs 71±13.1 years; p = 0.042) and had higher peak D-dimer levels (5403 vs 1723 ng/mL; p = 0.004). At ROC analysis peak D-dimer level >2000 ng/mL (AUC 0.703; 95% CI 0.572–0.834; p = 0.004) was the most accurate cut-off value able to predict DVT (RR 3.74; 95%CI 1.27–10, p = 0.016). Conclusions The incidence of DVT in acutely ill patients with COVID-19 pneumonia is relevant. A surveillance protocol by serial CUS of the lower limbs is useful to timely identify DVT that would go otherwise largely undetected.

by Marta Rorat, Tomasz Jurek, Krzysztof Simon, Maciej Guziński
Introduction Quantitative computed tomography (QCT) is used to objectively assess the degree of parenchymal impairment in COVID-19 pneumonia. Materials and methods Retrospective study on 61 COVID-19 patients (severe and non-severe; 33 men, age 63+/-15 years) who underwent a CT scan due to tachypnea, dyspnoea or desaturation. QCT was performed using VCAR software. Patients’ clinical data was collected, including laboratory results and oxygenation support. The optimal cut-off point for CT parameters for predicting death and respiratory support was performed by maximizing the Youden Index in a receiver operating characteristic (ROC) curve analysis. Results The analysis revealed significantly greater progression of changes: ground-glass opacities (GGO) (31,42% v 13,89%, p

Title: Conexões entre a pandemia da Covid19 e a soberania e segurança alimentar e nutricional
Abstract: Neste grave momento em que a sociedade brasileira enfrenta um alto número de óbitos em decorrência da pandemia da Covid 19, a Revista de Segurança Alimentar e Nutricional vem apresentar aos seus leitores o Dossiê: Conexões entre a pandemia da Covid19 e a Soberania e Segurança Alimentar e Nutricional. Neste Dossiê, que abre o volume 28, você encontrará artigos originais com reflexões acadêmicas sobre a temática da Soberania e a Segurança Alimentar e Nutricional em suas múltiplas dimensões.

Title: Comensalidade em Tempos de Pandemia por Covid -19
Abstract: Anelise Rizzolo (professora da Universidade de Brasília e Pesquisadora associada do Observatório de Políticas de Segurança Alimentar e Nutricional – OPSAN/UnB) compartilha conosco os resultados da pesquisa “Comensalidade em Tempos de Pandemia por Covid -19".
Description: Vídeo publicado no canal do Youtube Fiocruz Brasília (Fundação Oswaldo Cruz - Brasília) no dia 7 de mai. de 2021. Está disponível pelo link: https://www.youtube.com/watch?v=uhx5D5yFHI0&list=PLPyO8qVoPmBRLFJ03lmSUM...

by Alessio Gori, Eleonora Topino, Letizia Palazzeschi, Annamaria Di Fabio

The COVID-19 pandemic has had a significant influence on the lives of people around the world and could be a risk factor for mental health diseases. This study aimed to explore the psychological impact of the COVID-19 pandemic by identifying patterns related to post-traumatic symptoms by considering personality and defensive styles. Specifically, it was hypothesized that neuroticism was negatively associated with impact of event, as opposed to extraversion, agreeableness, conscientiousness, and openness traits. The mediation role of mature, neurotic, and immature defenses in these relationships was also investigated. This study involved 557 Italian individuals (71.3% women, 28.7% men; Mage = 34.65, SD = 12.05), who completed an online survey including the Impact of Event Scale—Revised, Forty Item Defense Style Questionnaire (DSQ-40) and Ten Item Personality Inventory. Results showed a nonsignificant effect for extraversion and openness on impact of event. The negative influence of neuroticism was instead confirmed in a partial parallel mediation involving significant effects from immature and neurotic defenses in the indirect path. Finally, agreeableness and conscientiousness delineated two protective pathways regarding impact of event, determining two total parallel mediation models in which both these personality traits were negatively associated with immature defensive styles, and conscientiousness was also positively related to mature defenses. These findings provide an exploration post-traumatic symptom patterns during the COVID-19 pandemic, involving the big five personality traits and defense mechanisms. These results may be useful for developing interventions, treatments, and prevention activities.

by Erika Cione, Antonio Siniscalchi, Pietro Gangemi, Lucio Cosco, Manuela Colosimo, Federico Longhini, Filippo Luciani, Giovambattista De Sarro, G&SP Working Group , Liberato Berrino, Bruno D’Agostino, Luca Gallelli

The multifunctional role of neuron-specific enolase (NSE) in lung diseases is well established. As the lungs are greatly affected in COVID-19, we evaluated serum NSE levels in COVID-19 patients with and without dyspnea. In this study, we evaluated both SARS-CoV-2-infected and uninfected patients aged >18 years who were referred to hospitals in Catanzaro, Italy from March 30 to July 30, 2020. Epidemiological, clinical, and radiological characteristics, treatment, and outcome data were recorded and reviewed by a trained team of physicians. In total, 323 patients (178 men, 55.1% and 145 women, 44.9%) were enrolled; of these, 128 were COVID-19 patients (39.6%) and 195 were control patients (60.4%). Westergren’s method was used to determine erythroid sedimentation rate. A chemiluminescence assay was used for measurement of interleukin-6, procalcitonin, C-reactive protein, and NSE. We detected significantly higher NSE values (P

by Zoe M. Volenec, Joel O. Abraham, Alexander D. Becker, Andy P. Dobson

Public parks serve an important societal function as recreational spaces for diverse communities of people, with well documented physical and mental health benefits. As such, parks may be crucial for how people have handled effects of the COVID-19 pandemic, particularly the increasingly limited recreational opportunities, widespread financial uncertainty, and consequent heightened anxiety. Despite the documented benefits of parks, however, many states have instituted park shutdown orders due to fears that public parks could facilitate SARS-CoV-2 transmission. Here we use geotagged social media data from state, county, and local parks throughout New Jersey to examine whether park visitation increased when the COVID-19 pandemic began and whether park shutdown orders were effective at deterring park usage. We compare park usage during four discrete stages of spring 2020: (1) before the pandemic began, (2) during the beginning of the pandemic, (3) during the New Jersey governor’s state-wide park shutdown order, and (4) following the lifting of the shutdown. We find that park visitation increased by 63.4% with the onset of the pandemic. The subsequent park shutdown order caused visitation in closed parks to decline by 76.1% while parks that remained open continued to experience elevated visitation levels. Visitation then returned to elevated pre-shutdown levels when closed parks were allowed to reopen. Altogether, our results indicate that parks continue to provide crucial services to society, particularly in stressful times when opportunities for recreation are limited. Furthermore, our results suggest that policies targeting human behavior can be effective and are largely reversible. As such, we should continue to invest in public parks and to explore the role of parks in managing public health and psychological well-being.

by Anick Bérard, Odile Sheehy, Jin-Ping Zhao, Evelyne Vinet, Caroline Quach, Behrouz Kassai, Sasha Bernatsky
Background Medications already available to treat other conditions are presently being studied in clinical trials as potential treatments for COVID-19. Given that pregnant women are excluded from these trials, we aimed to investigate their safety when used during pregnancy within a unique population source. Methods Using the population-based Quebec Pregnancy Cohort, we identified women who delivered a singleton liveborn (1998–2015). Taking potential confounders into account including indications for use, the risk of prematurity, low birth weight (LBW), small for gestational age (SGA), and major congenital malformation (MCM) associated with COVID-19 repurposed drug use during pregnancy were quantified using generalized estimation equations. Results Of the 231,075 eligible pregnancies, 107 were exposed to dexamethasone (0.05%), 31 to interferons (0.01%), 1,398 to heparins (0.60%), 24 to angiotensin-receptor blockers (ARB) (0.01%), 182 to chloroquine (0.08%), 103 to hydroxychloroquine (0.05%), 6,206 to azithromycin (2.70%), 230 to oseltamivir (0.10%), and 114 to HIV medications (0.05%). Adjusting for potential confounders, we observed an increased risk of prematurity related to dexamethasone (aOR 1.92, 95%CI 1.11–3.33; 15 exposed cases), anti-thrombotics (aOR 1.58, 95%CI 1.31–1.91; 177 exposed cases), and HIV medications (aOR 2.04, 95%CI 1.01–4.11; 20 exposed cases) use. An increased risk for LBW associated with anti-thrombotics (aOR 1.72, 95%CI 1.41–2.11; 152 exposed cases), and HIV medications (aOR 2.48, 95%CI 1.25–4.90; 21 exposed cases) use were also found. Gestational exposure to anti-thrombotics (aOR 1.20, 95%CI 1.00–1.44; 176 exposed cases), and HIV medications (aOR 2.61, 95%CI 1.51–4.51; 30 exposed cases) were associated with SGA. First-trimester dexamethasone (aOR 1.66, 95%CI 1.02–2.69; 20 exposed cases) and azithromycin (aOR 1.10, 95%CI 1.02–1.19; 747 exposed cases) exposures were associated with MCM. Conclusions Many available medications considered as treatments for COVID-19 are associated with adverse pregnancy outcomes. Caution is warranted when considering these medications during the gestational period.

by Liat Ayalon, Ella Cohn-Schwartz

Worries associated with COVID-19 health consequences are well-justified. They may motivate people to take safety precautions, but may hinder if they become too intense. Current research has examined mainly age and gender as potential correlates associated with worries. This study instead, is focused on self-perceptions of aging (SPA) and perceived age discrimination as potential predictors of worry, in the light of the ageism pandemic which has co-occurred with the COVID-19 outbreak. The study is based on a national sample of 1,092 adults aged 50 and above in Israel. Phone interviews were conducted between March 29 2020 and May 3 2020, when Israel gradually moved from strict to partial lockdown. Respondents were queried about their worries related to COVID-19 health consequences, demographic characteristics, known-risk factors, SPA and perceived age-based discrimination in the healthcare system. Our findings show that in addition, to sex, financial status and chronic illness, SPA and age-based discrimination in the healthcare were significant predictors of worries and explained additional 8% of the variance. The findings point to the potentially negative impact of the ageism pandemic in an area that has not received much attention, thus far, namely people’s worries. Interventions that address ageism directed by self or others might alleviate worries in the midst of the COVID-19 pandemic.

by Lis Campos Ferreira, Rívia Siqueira Amorim, Fellipe Matos Melo Campos, Rosana Cipolotti

Introduction: SARS-Cov-2 virus pandemic causes serious emotional consequences. It has occurred widespread medical courses suspension, and graduations were anticipated. Field hospitals, set up to treat patients with mild to moderate COVID-19, were the main workplaces of newly graduated doctors. Objective: To assess the impact of SARS-Cov-2/COVID-19 pandemic on mental health of medical interns and newly graduated doctors. Method: This is a cross-sectional study performed using a digital platform. Links to forms were sent in two moments: moment 1 (M1), at the beginning of the pandemic, in the first half of April/2020 and moment 2 (M2), after six months of pandemic, in the second half of September/2020. All students from the medical internship and all doctors graduated since 2018 from the three medical schools in Sergipe-NE-Brazil were invited. Results: 335 forms were answered in April and 148 in September. In M1 88.9% considered themselves exposed to excess of information about COVID-19, which was associated with anxiety symptoms (p = 0.04). Long family physical distance was also associated with these symptoms, as increased appetite (p = 0.01), feeling shortness of breath (p = 0.003) and sweating (p = 0.007). Fear of acquire COVID-19 was reported as intense by almost half of participants, and of transmitting by 85.7% in M1. In M2 41.2% reported the death of friends or relatives. Psychiatric illness was described by 38.5% and psychotropic drugs use by 30.1% in M1, especially those who lived alone (p = 0.03) and the single ones (p = 0.01). Alcohol intake was reported by 54.3%, and among doctors graduated in 2020 it increased from 50% in M1 to 85% in M2 (p = 0.04). Conclusion: The pandemic had a negative impact on the mental health of medical students and newly graduated doctors. Exposure to excessive COVID-19 information and family physical distance were associated to anxiety symptoms. Among doctors graduated in 2020, alcohol intake increased during pandemic evolution.