Monitoramento das Produções

by Tufan Arslanca, Cihan Fidan, Mine Daggez, Polat Dursun

The coronavirus disease 2019 (COVID-19) outbreak spread to over 100 countries with a total of 100,000 cases during the first week of March 2020. Health care workers, as those on the frontline of the COVID-19 pandemic, are more susceptible to infection. Inadequate related knowledge and preventive behaviors among health care workers might lead to delayed treatment and result in the rapid spread of the infection. Therefore, this study evaluated the knowledge of health care workers with regard to COVID-19. A cross-sectional study was conducted from June 10–18, 2020. Participants were general practitioners, specialists, and nurses working at the forefront of the pandemic. Their knowledge, preventive behaviors, and risk perceptions concerning COVID-19 were evaluated using an online questionnaire created by our medical specialists. The questionnaire consisted of 29, 5, and 4 items about COVID-19 knowledge, preventive behaviors, and risk perceptions, respectively. A total of 251 health care workers completed the questionnaire. The mean age of the participants was 33.88±8.72 years old, and the sample consisted of 68 males (27.08%) and 183 females (72.91%). While there was no difference between the percentage of correct answers given by female and male participants to knowledge-based questions (p>0.05), the percentage of correct answers to the questions on preventive behaviors was significantly higher in female participants than in males (p

by Raiha Browning, Deborah Sulem, Kerrie Mengersen, Vincent Rivoirard, Judith Rousseau

Hawkes processes are a form of self-exciting process that has been used in numerous applications, including neuroscience, seismology, and terrorism. While these self-exciting processes have a simple formulation, they can model incredibly complex phenomena. Traditionally Hawkes processes are a continuous-time process, however we enable these models to be applied to a wider range of problems by considering a discrete-time variant of Hawkes processes. We illustrate this through the novel coronavirus disease (COVID-19) as a substantive case study. While alternative models, such as compartmental and growth curve models, have been widely applied to the COVID-19 epidemic, the use of discrete-time Hawkes processes allows us to gain alternative insights. This paper evaluates the capability of discrete-time Hawkes processes by modelling daily mortality counts as distinct phases in the COVID-19 outbreak. We first consider the initial stage of exponential growth and the subsequent decline as preventative measures become effective. We then explore subsequent phases with more recent data. Various countries that have been adversely affected by the epidemic are considered, namely, Brazil, China, France, Germany, India, Italy, Spain, Sweden, the United Kingdom and the United States. These countries are all unique concerning the spread of the virus and their corresponding response measures. However, we find that this simple model is useful in accurately capturing the dynamics of the process, despite hidden interactions that are not directly modelled due to their complexity, and differences both within and between countries. The utility of this model is not confined to the current COVID-19 epidemic, rather this model could explain many other complex phenomena. It is of interest to have simple models that adequately describe these complex processes with unknown dynamics. As models become more complex, a simpler representation of the process can be desirable for the sake of parsimony.

by Felipe Lima dos Santos, Ludmilla Leidianne Limirio Souza, Alexandre Tadashi Inomata Bruce, Juliane de Almeida Crispim, Luiz Henrique Arroyo, Antônio Carlos Vieira Ramos, Thaís Zamboni Berra, Yan Mathias Alves, Alessandro Rolim Scholze, Fernanda Bruzadelli Paulino da Costa, José Francisco Martoreli Júnior, Ana Carolina Scarpel Moncaio, Ione Carvalho Pinto, Ricardo Alexandre Arcêncio

This study aimed to analyze the discourses of patients who were diagnosed with multidrug-resistant tuberculosis, the perception of why they acquired this health condition and barriers to seeking care in a priority city in Brazil during the COVID-19 pandemic. This was an exploratory qualitative study, which used the theoretical-methodological framework of the Discourse Analysis of French matrix, guided by the Consolidated Criteria for Reporting Qualitative Research. The study was conducted in Ribeirão Preto, São Paulo, Brazil. Seven participants were interviewed who were undergoing treatment at the time of the interview. The analysis of the participants’ discourses allowed the emergence of four discursive blocks: (1) impact of the social determinants in the development of multidrug-resistant tuberculosis, (2) barriers to seeking care and difficulties accessing health services, (3) perceptions of the side effects and their impact on multidrug-resistant tuberculosis treatment, and (4) tuberculosis and COVID-19: a necessary dialogue. Through discursive formations, these revealed the determinants of multidrug-resistant tuberculosis. Considering the complexity involved in the dynamics of multidrug-resistant tuberculosis, advancing in terms of equity in health, that is, in reducing unjust differences, is a challenge for public policies, especially at the current moment in Brazil, which is of accentuated economic, political and social crisis. The importance of psychosocial stressors and the lack of social support should also be highlighted as intermediary determinants of health. The study has also shown the situation of COVID-19, which consists of an important barrier for patients seeking care. Many patients reported fear, insecurity and worry with regard to returning to medical appointments, which might contribute to the worsening of tuberculosis in the scenario under study.

by Fabian Ying, Neave O’Clery

Since the outbreak of COVID-19 in early March 2020, supermarkets around the world have implemented different policies to reduce the virus transmission in stores to protect both customers and staff, such as restricting the maximum number of customers in a store, changes to the store layout, or enforcing a mandatory face covering policy. To quantitatively assess these mitigation methods, we formulate an agent-based model of customer movement in a supermarket (which we represent by a network) with a simple virus transmission model based on the amount of time a customer spends in close proximity to infectious customers (which we call the exposure time). We apply our model to synthetic store and shopping data to show how one can use our model to estimate exposure time and thereby the number of infections due to human-to-human contact in stores and how to model different store interventions. The source code is openly available under https://github.com/fabianying/covid19-supermarket-abm. We encourage retailers to use the model to find the most effective store policies that reduce virus transmission in stores and thereby protect both customers and staff.

by Sayaka Horiuchi, Ryoji Shinohara, Sanae Otawa, Yuka Akiyama, Tadao Ooka, Reiji Kojima, Hiroshi Yokomichi, Kunio Miyake, Zentaro Yamagata

by Marko Zdravkovic, Joana Berger-Estilita, Bogdan Zdravkovic, David Berger

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

We evaluated the diagnostic accuracy of two newly developed, point-of-care, rapid antigen tests (RATs) for detecting SARS-CoV-2, the AFIAS COVID-19 Ag and the ichromaTM COVID-19 Ag, and investigated antigen kinetics. A total of 200 serially collected nasopharyngeal (NP) specimens from 38 COVID-19 patients and 122 specimens from negative controls were analyzed. Diagnostic sensitivity and specificity were assessed in comparison to molecular test results and subdivided according to targeted genes (E, RdRP, and N) and days post-symptom onset (PSO). For the kinetics evaluation, cut-off-indices from serial NP specimens were used according to the number of days PSO. Both RATs showed sensitivity of 91.3‒100% for specimens with cycle threshold (Ct) 25. The specificity of AFIAS was 98.7‒98.9% and that of ichromaTM was 100.0%. The kappa values of AFIAS and ichromaTM for the molecular testing of specimens with Ct 25 (RdRP) were 0.97 and 1.00, respectively. The sensitivity of AFIAS and ichromaTM for all genes was lower for specimens collected at 8‒14 PSO than for those collected before 7-days PSO. The kinetics profiles showed that antigen levels gradually decreased from ≤ 7-days PSO to > 22-days PSO. Both RATs showed excellent specificity and acceptable sensitivity for NP specimens with higher viral loads and for specimens collected within 7-days PSO. Hence, they have the potential to become useful tools for the early detection of SARS-CoV-2. However, because of concerns about false negativity, RATs should be used in conjunction with molecular tests.

by Nicola Sweeney, Blair Merrick, Rui Pedro Galão, Suzanne Pickering, Alina Botgros, Harry D. Wilson, Adrian W. Signell, Gilberto Betancor, Mark Kia Ik Tan, John Ramble, Neophytos Kouphou, Sam Acors, Carl Graham, Jeffrey Seow, Eithne MacMahon, Stuart J. D. Neil, Michael H. Malim, Katie Doores, Sam Douthwaite, Rahul Batra, Gaia Nebbia, Jonathan D. Edgeworth

During the first wave of the global COVID-19 pandemic the clinical utility and indications for SARS-CoV-2 serological testing were not clearly defined. The urgency to deploy serological assays required rapid evaluation of their performance characteristics. We undertook an internal validation of a CE marked lateral flow immunoassay (LFIA) (SureScreen Diagnostics) using serum from SARS-CoV-2 RNA positive individuals and pre-pandemic samples. This was followed by the delivery of a same-day named patient SARS-CoV-2 serology service using LFIA on vetted referrals at central London teaching hospital with clinical interpretation of result provided to the direct care team. Assay performance, source and nature of referrals, feasibility and clinical utility of the service, particularly benefit in clinical decision-making, were recorded. Sensitivity and specificity of LFIA were 96.1% and 99.3% respectively. 113 tests were performed on 108 participants during three-week pilot. 44% participants (n = 48) had detectable antibodies. Three main indications were identified for serological testing; new acute presentations potentially triggered by recent COVID-19 e.g. pulmonary embolism (n = 5), potential missed diagnoses in context of a recent COVID-19 compatible illness (n = 40), and making infection control or immunosuppression management decisions in persistently SARS-CoV-2 RNA PCR positive individuals (n = 6). We demonstrate acceptable performance characteristics, feasibility and clinical utility of using a LFIA that detects anti-spike antibodies to deliver SARS-CoV-2 serology service in adults and children. Greatest benefit was seen where there is reasonable pre-test probability and results can be linked with clinical advice or intervention. Experience from this pilot can help inform practicalities and benefits of rapidly implementing new tests such as LFIAs into clinical service as the pandemic evolves.

by Teresa López-Castro, Laura Brandt, Nishanthi J. Anthonipillai, Adriana Espinosa, Robert Melara

In March 2020, New York City (NYC) experienced an outbreak of coronavirus disease 2019 (COVID-19) which resulted in a 78-day mass confinement of all residents other than essential workers. The aims of the current study were to (1) document the breadth of COVID-19 experiences and their impacts on college students of a minority-serving academic institution in NYC; (2) explore associations between patterns of COVID-19 experiences and psychosocial functioning during the prolonged lockdown, and (3) explore sex and racial/ethnic differences in COVID-19-related experiences and mental health correlates. A total of 909 ethnically and racially diverse students completed an online survey in May 2020. Findings highlight significant impediments to multiple areas of students’ daily life during this period (i.e., home life, work life, social environment, and emotional and physical health) and a vast majority reported heightened symptoms of depression and generalized anxiety. These life disruptions were significantly related to poorer mental health. Moreover, those who reported the loss of a close friend or loved one from COVID-19 (17%) experienced significantly more psychological distress than counterparts with other types of infection-related histories. Nonetheless, the majority (96%) reported at least one positive experience since the pandemic began. Our findings add to a growing understanding of COVID-19 impacts on psychological health and contribute the important perspective of the North American epicenter of the pandemic during the time frame of this investigation. We discuss how the results may inform best practices to support students’ well-being and serve as a benchmark for future studies of US student populations facing COVID-19 and its aftermath.

by Shana Kushner Gadarian, Sara Wallace Goodman, Thomas B. Pepinsky
Objective To study the U.S. public’s health behaviors, attitudes, and policy opinions about COVID-19 in the earliest weeks of the national health crisis (March 20–23, 2020). Method We designed and fielded an original representative survey of 3,000 American adults between March 20–23, 2020 to collect data on a battery of 38 health-related behaviors, government policy preferences on COVID-19 response and worries about the pandemic. We test for partisan differences COVID-19 related policy attitudes and behaviors, measured in three different ways: party affiliation, intended 2020 Presidential vote, and self-placed ideological positioning. Our multivariate approach adjusts for a wide range of individual demographic and geographic characteristics that might confound the relationship between partisanship and health behaviors, attitudes, and preferences. Results We find that partisanship—measured as party identification, support for President Trump, or left-right ideological positioning—explains differences in Americans across a wide range of health behaviors and policy preferences. We find no consistent evidence that controlling for individual news consumption, the local policy environment, and local pandemic-related deaths erases the observed partisan differences in health behaviors, beliefs, and attitudes. In further analyses, we use a LASSO regression approach to select predictors, and find that a partisanship indicator is the most commonly selected predictor across the 38 dependent variables that we study. Conclusion Our analysis of individual self-reported behavior, attitudes, and policy preferences in response to COVID-19 reveals that partisanship played a central role in shaping individual responses in the earliest months of the COVID-19 pandemic. These results indicate that partisan differences in responding to a national public health emergency were entrenched from the earliest days of the pandemic.

by Maider Muñoz-Culla, Andres Roncancio-Clavijo, Bruno Martínez, Miriam Gorostidi-Aicua, Luis Piñeiro, Arkaitz Azkune, Ainhoa Alberro, Jorge Monge-Ruiz, Tamara Castillo-Trivino, Alvaro Prada, David Otaegui

ABO blood groups have recently been related to COVID19 infection. In the present work, we performed this analysis using data from 412 COVID19 patients and 17796 blood donors, all of them from Gipuzkoa, a region in Northern Spain. The results obtained confirmed this relation, in addition to showing a clear importance of group O as a protective factor in COVID19 disease, with an OR = 0.59 (CI95% 0.481–0.7177, p

by Reaz Mahmud, Mohammad Aftab Rassel, Farhana Binte Monayem, S. K. Jakaria Been Sayeed, Md Shahidul Islam, Mohammed Monirul Islam, Mohammad Abdullah Yusuf, Sabrina Rahman, K. M. Nazmul Islam, Imran Mahmud, Mohammad Zaid Hossain, Ahmed Hossain Chowdhury, A. K. M. Humayon Kabir, Kazi Gias Uddin Ahmed, Md. Mujibur Rahman
Background Globally, studies have shown conflicting results regarding the association of blood groups with SARS CoV-2 infection. Objective To observe the association between ABO blood groups and the presentation and outcomes of confirmed COVID-19 cases. Design, setting, and participants This was a prospective cohort study of patients with mild-to-moderately severe COVID-19 infections who presented in the COVID-19 unit of Dhaka Medical College Hospital and were enrolled between 01 June and 25 August, 2020. Patients were followed up for at least 30 days after disease onset. We grouped participants with A-positive and A-negative blood groups into group I and participants with other blood groups into group II. Results The cohort included 438 patients; 52 patients were lost to follow-up, five died, and 381 completed the study. The prevalence of blood group A [144 (32.9%)] was significantly higher among COVID-19 patients than in the general population (p 0.001). The presenting age [mean (SD)] of group I [42.1 (14.5)] was higher than that of group II [38.8 (12.4), p = 0.014]. Sex (p = 0.23) and co-morbidity (hypertension, p = 0.34; diabetes, p = 0.13) did not differ between the patients in groups I and II. No differences were observed regarding important presenting symptoms, including fever (p = 0.72), cough (p = 0.69), and respiratory distress (p = 0.09). There was no significant difference in the median duration of symptoms in the two group (12 days), and conversion to the next level of severity was observed in 26 (20.6%) and 36 patients (13.8%) in group I and II, respectively. However, persistent positivity of RT-PCR at 14 days of initial positivity was more frequent among the patients in group I [24 (19%)] than among those in group II [29 (11.1%)]. Conclusions The prevalence of blood group A was higher among COVID-19 patients. Although ABO blood groups were not associated with the presentation or recovery period of COVID-19, patients with blood group A had delayed seroconversion.

by Md Asiful Islam, Shoumik Kundu, Sayeda Sadia Alam, Tareq Hossan, Mohammad Amjad Kamal, Rosline Hassan
Background Coronavirus disease 2019 (COVID-19), a pandemic disease caused by the severe acute respiratory syndrome coronavirus 2 started to spread globally since December 2019 from Wuhan, China. Fever has been observed as one of the most common clinical manifestations, although the prevalence and characteristics of fever in adult and paediatric COVID-19 patients is inconclusive. We aimed to conduct a systematic review and meta-analysis to estimate the overall pooled prevalence of fever and chills in addition to fever characteristics (low, medium, and high temperature) in both adult and paediatric COVID-19 patients. Methods The protocol of this systematic review and meta-analysis was registered with PROSPERO (CRD42020176327). PubMed, Scopus, ScienceDirect and Google Scholar databases were searched between 1st December 2019 and 3rd April 2020 without language restrictions. Both adult (≥18 years) and paediatric (

by Lisa Mellhammar, Louise Thelaus, Sixten Elén, Jane Fisher, Adam Linder
Background and aims Neutrophil-derived heparin binding protein (HBP; also known as azurocidin or CAP-37) is a key player in bacterial sepsis and a promising biomarker in severe infections.The aims of this study were to assess whether HBP is involved in the pathophysiology of COVID-19 and, if so, whether it can be used to predict severe disease preferably using a point-of-care test. Methods This was a prospective convenience sample study of biomarkers in patients admitted to Skåne University hospital in Sweden with a confirmed COVID-19 diagnosis. Plasma samples and clinical data were collected within 72h after admission, during hospital stay and at discharge. Plasma HBP concentrations samples were measured both with enzyme-linked immunosorbent assay (ELISA) and with a novel dry immunofluorescence analyzer (Joinstar) point-of-care test. Results Thirty-five COVID-19 patients were enrolled in the study. Twenty-nine patients had blood samples taken within 72h after admission. We compared the highest HBP value taken within 72h after admission in patients who eventually developed organ dysfunction (n = 23) compared to those who did not (n = 6), and found that HBP was significantly elevated in those who developed organ dysfunction (25.0 ng/mL (interquartile range (IQR) 16.6–48.5) vs 10.6 ng/mL (IQR 4.8–21.7 ng/mL), p = 0.03). Point-of-care test measurements correlated well with ELISA measurements (R = 0.83). HBP measured by the POC device predicted development of COVID-induced organ dysfunction with an AUC of 0.88 (95% confidence interval (CI) 0.70–1.0). Conclusions HBP is elevated prior to onset of organ dysfunction in patients with severe COVID-19 using a newly developed point-of-care test and hence HBP could be used in a clinical setting as a prognostic marker in COVID-19.

by Makoto Hiki, Yoko Tabe, Tomohiko Ai, Yuya Matsue, Norihiro Harada, Kiichi Sugimoto, Yasushi Matsushita, Masakazu Matsushita, Mitsuru Wakita, Shigeki Misawa, Mayumi Idei, Takashi Miida, Naoto Tamura, Kazuhisa Takahashi, Toshio Naito
Objectives To determine the seroprevalence of anti-SARS-CoV-2 IgG and IgM antibodies in symptomatic Japanese COVID-19 patients. Methods Serum samples (n = 114) from 34 COVID-19 patients with mild to critical clinical manifestations were examined. The presence and titers of IgG antibody for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were determined by a chemiluminescent microparticle immunoassay (CMIA) using Alinity i SARS-CoV-2 IgG and by an immunochromatographic (IC) IgM/IgG antibody assay using the Anti-SARS-CoV-2 Rapid Test. Results IgG was detected by the CMIA in 40%, 88%, and 100% of samples collected within 1 week, 1–2 weeks, and 2 weeks after symptom onset in severe and critical cases, and 0%, 38%, and 100% in mild/moderate cases, respectively. In severe and critical cases, the positive IgG detection rate with the IC assay was 60% within one week and 63% between one and two weeks. In mild/moderate cases, the positive IgG rate was 17% within one week and 63% between one and two weeks; IgM was positive in 80% and 75% of severe and critical cases, and 42% and 88% of mild/moderate cases, respectively. On the CMIA, no anti-SARS-CoV-2 IgG antibodies were detected in COVID-19 outpatients with mild symptoms within 10 days from onset, whereas 50% of samples from severe inpatients were IgG-positive in the same period. The IC assay detected higher IgM positivity earlier from symptom onset in severe and critical cases than in mild/moderate cases. Conclusions A serologic anti-SARS-CoV-2 antibody analysis can complement PCR for diagnosing COVID-19 14 days after symptom onset.

by Tariku Shimels, Rodas Asrat Kassu, Gelila Bogale, Mahteme Bekele, Melsew Getnet, Abrham Getachew, Zewdneh Shewamene, Mebratu Abraha
Objective This study aims to assess the magnitude and associated factors of poor medication adherence among diabetic and hypertensive patients visiting public health facilities in Addis Ababa, Ethiopia during the COVID-19 pandemic. Methods A multi-site cross-sectional design was conducted from 1st through 30th of August 2020 at public health facilities of the study area. Adult outpatients with T2DM and hypertension visiting hospitals and health centers were included in the study. A proportion to size allocation method was used to determine the required sample size per facility. Data was collected using the 8-item Morisky medication adherence scale. Descriptive statistics and binary logistic regression were used to analyze data. A 95% confidence interval and p≤0.05 statistical significance was considered to determine factors associated with poor medication adherence. Results A total of 409 patients were included in the present study. About 57% of the patients reported that the COVID-19 pandemic has posed negative impacts on either of their follow-up visits, availability of medications, or affordability of prices. And, 21% have reported that they have been affected in all aspects. The overall magnitude of poor medication adherence was 72%. Patients with extreme poverty were more likely to have good medication adherence (AOR: 0.59; 95%C.I: 0.36–0.97), whereas attendance to a health center (AOR: 1.71; 95%C.I: 1.02–2.85), presence of comorbidity (AOR: 2.05; 95%C.I: 1.13–3.71), and current substance use history (AOR: 11.57; 95%C.I: 1.52–88.05) predicted high odds of poor adherence. Conclusion Over a three-fourth of the patients, in the study setting, have poor adherence to their anti-diabetic and antihypertensive medications. Health facility type, income level, comorbidity, and current substance use history showed a statistically significant association with poor adherence to medication. Stakeholders should set alternative strategies as perceived impacts of the COVID-19 pandemic on medication adherence are high in the study area.

by Iman A. Basheti, Qassim N. Mhaidat, Hala N. Mhaidat
Rational During pandemics, including the most recent COVID-19 pandemic, the mental health of university healthcare students’ is expected to be affected negatively, impacting the students’ learning process. Objectives The aim of this study was to assess the level of anxiety and depression of healthcare students living in Jordan, and the effect on their learning process during the COVID-19 pandemic. Methods This descriptive cross-sectional study was conducted via an online survey completed by students studying a healthcare-oriented degree in a university in Jordan. Participants were recruited through social media (Facebook and WhatsApp). The validated previously published Hospital Anxiety and Depression Scale (HADS) questionnaire was used as a part of the online survey to assess students’ anxiety/depression scores. Students’ responses regarding their learning process during the COVID-19 was also assessed. Results The mean age of participants was 21.62 (SD = 4.90), with the majority being females (67.1%). The HADs’ assessment revealed that 43.8% and 40.0% of participants had normal anxiety and depression scores, while 22.4% showed borderline abnormal anxiety/depression scores (33.8%). Many students (33.8%) were classified to have abnormal anxiety scores, while a smaller proportion (26.2%) was classified to have abnormal depression scores. Smoking (p = 0.022), lower family income (p = 0.039), and use of medications (p = 0.032) were positively associated with higher (worse) anxiety scores. Ranking the learning process during COVID-19 showed that 45.8% of the participants believed it was a ‘good/very good/excellent’ process. Conclusions Anxiety and depression levels amongst university healthcare students in Jordan were found to be high when assessed during the COVID-19 pandemic. In addition, the learning process during the pandemic was not accepted by more than half of the students. Implementing psychological interventions for healthcare students during pandemics is strongly recommended in order to optimize students’ mental health and their learning process alike.

by Shengyang He, Wenlong Liu, Mingyan Jiang, Peng Huang, Zhi Xiang, Dingding Deng, Ping Chen, Lihua Xie
Objective To understand the clinical characteristics of COVID-19 patients with clinically diagnosed bacterial co-infection (CDBC), and therefore contributing to their early identification and prognosis estimation. Method 905 COVID-19 patients from 7 different centers were enrolled. The demography data, clinical manifestations, laboratory results, and treatments were collected accordingly for further analyses. Results Around 9.5% of the enrolled COVID-19 patients were diagnosed with CDBC. Older patients or patients with cardiovascular comorbidities have increased CDBC probability. Increased body temperature, longer fever duration, anhelation, gastrointestinal symptoms, illness severity, intensive care unit attending, ventilation treatment, glucocorticoid therapy, longer hospitalization time are correlated to CDBC. Among laboratory results, increased white blood cell counting (mainly neutrophil), lymphocytopenia, increased procalcitonin, erythrocyte sedimentation rate, C-reaction protein, D-dimer, blood urea nitrogen, lactate dehydrogenase, brain natriuretic peptide, myoglobin, blood sugar and decreased albumin are also observed, indicating multiple system functional damage. Radiology results suggested ground glass opacity mixed with high density effusion opacities and even pleural effusion. Conclusion The aged COVID-19 patients with increased inflammatory indicators, worse lymphopenia and cardiovascular comorbidities are more likely to have clinically diagnosed bacterial co-infection. Moreover, they tend to have severer clinical manifestations and increased probability of multiple system functional damage.

Title: Contact System Activation in Plasma from Dengue Patients Might Harness Endothelial Virus Replication through the Signaling of Bradykinin Receptors
Authors: Coelho, Sharton V. A.; Rusr, Naiara M.; Vellasco, Lucas; Papa, Michelle P.; Pereira, Aline S. G.; Palazzo, Matheus Ferreira da Silva; Juliano, Maria Aparecida; Costa, Simone M.; Alves, Ada M. B.; Cordeiro, Marli T.; Marques, Ernesto T. A.; Scharfstein, Júlio; Arruda, Luciana B. de

by Alexander Kreh, Rachele Brancaleoni, Sabina Chiara Magalini, Daniela Pia Rosaria Chieffo, Barbara Flad, Nils Ellebrecht, Barbara Juen

This study aims at investigating the nature of resilience and stress experience of health care workers during the COVID-19 pandemic. Thirteen healthcare workers from Italian and Austrian hospitals specifically dealing with COVID-19 patients during the first phase of the pandemic were interviewed. Data was analysed using grounded theory methodology. Psychosocial effects on stress experience, stressors and resilience factors were identified. We generated three hypotheses. Hypothesis one is that moral distress and moral injury are main stressors experienced by healthcare workers. Hypothesis two states that organisational resilience plays an important part in how healthcare workers experience the crisis. Organisational justice and decentralized decision making are essential elements of staff wellbeing. Hypothesis three refers to effective psychosocial support: Basic on scene psychosocial support based on the Hobfoll principles given by trusted and well-known mental health professionals and peers in an integrated approach works best during the pandemic.

by Indy Man Kit Ho, Kai Yuen Cheong, Anthony Weldon

Despite the wide adoption of emergency remote learning (ERL) in higher education during the COVID-19 pandemic, there is insufficient understanding of influencing factors predicting student satisfaction for this novel learning environment in crisis. The present study investigated important predictors in determining the satisfaction of undergraduate students (N = 425) from multiple departments in using ERL at a self-funded university in Hong Kong while Moodle and Microsoft Team are the key learning tools. By comparing the predictive accuracy between multiple regression and machine learning models before and after the use of random forest recursive feature elimination, all multiple regression, and machine learning models showed improved accuracy while the most accurate model was the elastic net regression with 65.2% explained variance. The results show only neutral (4.11 on a 7-point Likert scale) regarding the overall satisfaction score on ERL. Even majority of students are competent in technology and have no obvious issue in accessing learning devices or Wi-Fi, face-to-face learning is more preferable compared to ERL and this is found to be the most important predictor. Besides, the level of efforts made by instructors, the agreement on the appropriateness of the adjusted assessment methods, and the perception of online learning being well delivered are shown to be highly important in determining the satisfaction scores. The results suggest that the need of reviewing the quality and quantity of modified assessment accommodated for ERL and structured class delivery with the suitable amount of interactive learning according to the learning culture and program nature.

Title: Covid-19: preservar a vida é a melhor maneira de celebrar a Páscoa: a forma mais segura de celebrar a Páscoa é ficar em casa apenas com as pessoas que moram com você
Abstract: A cartilha traz informações sobre o preparo e manuseio de alimentos, limite de pessoas e ventilação nos ambientes, descarte de lixo e disponibilização de álcool em gel. As recomendações sobre lavagem das mãos permanecem. No fim da cartilha, estão listadas as situações e as condições de saúde que impedem as pessoas de participarem de confraternizações. A principal mensagem é: a forma mais segura de celebrar a Páscoa é ficar em casa, apenas com as pessoas que moram com você. Nenhuma medida é capaz de impedir totalmente a transmissão da Covid-19.

by Matthew Jenkins, Janet Hoek, Gabrielle Jenkin, Philip Gendall, James Stanley, Ben Beaglehole, Caroline Bell, Charlene Rapsey, Susanna Every-Palmer

The COVID-19 pandemic has caused significant disruption, distress, and loss of life around the world. While negative health, economic, and social consequences are being extensively studied, there has been less research on the resilience and post-traumatic growth that people show in the face of adversity. We investigated New Zealanders’ experiences of benefit-finding during the COVID-19 pandemic and analysed qualitative responses to a survey examining mental well-being during the New Zealand lockdown. A total of 1175 of 2010 eligible participants responded to an open-ended question probing ‘silver linings’ (i.e., positive aspects) they may have experienced during this period. We analysed these qualitative responses using a thematic analysis approach. Two thirds of participants identified silver linings from the lockdown and we developed two overarching themes: Surviving (coping well, meeting basic needs, and maintaining health) and thriving (self-development, reflection, and growth). Assessing positive as well as negative consequences of the pandemic provides more nuanced insights into the impact that New Zealand’s response had on mental well-being.

by Kok-Siang Yow, Joel Aik, Eugene Yong-Meng Tan, Lee-Ching Ng, Yee-Ling Lai
Introduction Early and rapid confirmation of dengue infections strengthens disease surveillance program and are critical to the success of vector control measures. Rapid diagnostics tests (RDTs) are increasingly used to confirm recent dengue infections due to their ease of use and short turnaround time for results. Several studies undertaken in dengue-endemic Southeast Asia have reported the performance of RDTs against enzyme-linked immunosorbent assay (ELISA), reverse transcriptase polymerase chain reaction (RT-PCR) and virus isolation methods. However, few studies have compared multiple RDTs for the detection of dengue NS1 antigen and IgM antibody in a single combo cassette. We evaluated six RDTs in Singapore for their utility in routine clinical testing to detect recent dengue infections. Methods The evaluation comprised two phases. The first phase sought to determine each RDT’s specificity to dengue NS1 and IgM using zika and chikungunya virus supernatant and zika convalescent samples. RDTs that cross-reacted with zika or chikungunya were not further tested in phase 2. The second phase sought to determine the sensitivity and specificity of the remaining RDTs to dengue NS1 and IgM using pre-characterised dengue specimens and non-dengue/chikungunya febrile clinical specimens. Results None of the RDTs cross-reacted with zika IgM in Phase 1. Truquick and Quickprofile cross reacted with zika and chikungunya viruses and were not evaluated thereafter. Standard Q had the highest dengue NS1 and IgM sensitivity at 87.0% and 84.3% respectively whereas Bioline (68.5%) and Multisure (58.3%) had the lowest dengue NS1 and IgM sensitivity respectively. Combining dengue NS1/IgM detection results greatly improved the RDT ability to detect recent dengue infection; Standard Q had the highest sensitivity at 99.1% while Multisure had the lowest at 92.6%. All the RDTs were highly specific for dengue NS1 and IgM (96.7% to 100%). All the RDTs had high positive predictive values (98.4% to 100%) for NS1, IgM and combined NS1/IgM parameters whereas Standard Q had the highest negative predictive values at 68.2% (NS1), 63.8% (IgM) and 96.8% (NS1/IgM). For the RDTs, detection of NS1 declined from acute to convalescent phase of illness whereas IgM detection rate gradually increased over time. Conclusion In our study, several RDTs were evaluated for their diagnostic accuracy and capability in detecting recent dengue infection. Standard Q demonstrated a high degree of diagnostic accuracy and capability in the detection of NS1 and IgM biomarkers. RDTs can provide rapid and accurate confirmation of recent dengue infections and augment dengue surveillance and control programmes. Further studies are required to assess the usefulness of these RDTs in other epidemiology settings.

by Lisa Fourniol, Yoann Madec, Laurence Mousson, Marie Vazeille, Anna-Bella Failloux

Mosquito control is implemented when arboviruses are detected in patients or in field-collected mosquitoes. However, mass screening of mosquitoes is usually laborious and expensive, requiring specialized expertise and equipment. Detection of virus in mosquito saliva using honey-impregnated filter papers seems to be a promising method as it is non-destructive and allows monitoring the viral excretion dynamics over time from the same mosquito. Here we test the use of filter papers to detect chikungunya virus in mosquito saliva in laboratory conditions, before proposing this method in large-scale mosquito surveillance programs. We found that 0.9 cm2 cards impregnated with a 50% honey solution could replace the forced salivation technique as they offered a viral RNA detection until 7 days after oral infection of Aedes aegypti and Aedes albopictus mosquitoes with CHIKV.

by Jeffrey Clement, Maura Jacobi, Brad N. Greenwood

Patient access and adherence to chronic medications is critical. In this work, we evaluate whether disruptions related to Covid-19 have affected new and existing patients’ access to pharmacological therapies without interruption. We do so by performing a retrospective analysis on a dataset of 9.4 billion US prescription drug claims from 252 million patients from May, 2019 through August, 2020 (about 93% of prescriptions dispensed within those months). Using fixed effect (conditional likelihood) linear models, we evaluate continuity of care, how many days of supply patients received, and the likelihood of discontinuing therapy for drugs from classes with significant population health impacts. Findings indicate that more prescriptions were filled in March 2020 than in any prior month, followed by a significant drop in monthly dispensing. Compared to the pre-Covid era, a patient’s likelihood of discontinuing some medications increased after the spread of Covid: norgestrel-ethinyl estradiol (hormonal contraceptive) discontinuation increased 0.62% (95% CI: 0.59% to 0.65%, p

by Chang Hee Han, Misuk Kim, Jin Tae Kwak

Coronavirus disease 2019 (COVID-19) has been spread out all over the world. Although a real-time reverse-transcription polymerase chain reaction (RT-PCR) test has been used as a primary diagnostic tool for COVID-19, the utility of CT based diagnostic tools have been suggested to improve the diagnostic accuracy and reliability. Herein we propose a semi-supervised deep neural network for an improved detection of COVID-19. The proposed method utilizes CT images in a supervised and unsupervised manner to improve the accuracy and robustness of COVID-19 diagnosis. Both labeled and unlabeled CT images are employed. Labeled CT images are used for supervised leaning. Unlabeled CT images are utilized for unsupervised learning in a way that the feature representations are invariant to perturbations in CT images. To systematically evaluate the proposed method, two COVID-19 CT datasets and three public CT datasets with no COVID-19 CT images are employed. In distinguishing COVID-19 from non-COVID-19 CT images, the proposed method achieves an overall accuracy of 99.83%, sensitivity of 0.9286, specificity of 0.9832, and positive predictive value (PPV) of 0.9192. The results are consistent between the COVID-19 challenge dataset and the public CT datasets. For discriminating between COVID-19 and common pneumonia CT images, the proposed method obtains 97.32% accuracy, 0.9971 sensitivity, 0.9598 specificity, and 0.9326 PPV. Moreover, the comparative experiments with respect to supervised learning and training strategies demonstrate that the proposed method is able to improve the diagnostic accuracy and robustness without exhaustive labeling. The proposed semi-supervised method, exploiting both supervised and unsupervised learning, facilitates an accurate and reliable diagnosis for COVID-19, leading to an improved patient care and management.

by Shelby M. Scott, Louis J. Gross

In response to the pandemic in early 2020, cities implemented states of emergency and stay at home orders to reduce virus spread. Changes in social dynamics due to local restrictions impacted human behavior and led to a shift in crime dynamics. We analyze shifts in crime types by comparing crimes before the implementation of stay at home orders and the time period shortly after these orders were put in place across three cities. We find consistent changes across Chicago, Baltimore, and Baton Rouge with significant declines in total crimes during the time period immediately following stay at home orders. The starkest differences occurred in Chicago, but in all three cities the crime types contributing to these declines were related to property crime and statutory crime rather than interpersonal crimes.

Title: Oviposition behavior of wild yellow fever vector mosquitoes (Diptera: Culicidae) in an Atlantic Forest fragment, Rio de Janeiro state, Brazil
Authors: Silva, Shayenne Olsson Freitas; Mello, Cecilia Ferreira de; Figueiró, Ronaldo; Docile, Tatiana; Serdeiro, Michele; Fumian, Fabiana Fagundes; Alencar, Jeronimo

by Oriol Aspachs, Ruben Durante, Alberto Graziano, Josep Mestres, Marta Reynal-Querol, Jose G. Montalvo

Pandemics have historically had a significant impact on economic inequality. However, official inequality statistics are only available at low frequency and with considerable delay, which challenges policymakers in their objective to mitigate inequality and fine-tune public policies. We show that using data from bank records it is possible to measure economic inequality at high frequency. The approach proposed in this paper allows measuring, timely and accurately, the impact on inequality of fast-unfolding crises, like the COVID-19 pandemic. Applying this approach to data from a representative sample of over three million residents of Spain we find that, absent government intervention, inequality would have increased by almost 30% in just one month. The granularity of the data allows analyzing with great detail the sources of the increases in inequality. In the Spanish case we find that it is primarily driven by job losses and wage cuts experienced by low-wage earners. Government support, in particular extended unemployment insurance and benefits for furloughed workers, were generally effective at mitigating the increase in inequality, though less so among young people and foreign-born workers. Therefore, our approach provides knowledge on the evolution of inequality at high frequency, the effectiveness of public policies in mitigating the increase of inequality and the subgroups of the population most affected by the changes in inequality. This information is fundamental to fine-tune public policies on the wake of a fast-moving pandemic like the COVID-19.