Monitoramento das Produções

Title: Emissão de comunicação de acidente de trabalho (CAT) para trabalhadores que contraíram o novo coronavirus (COVID-19) em decorrências de suas atividades laboratoriais: Diante da pandemia da doença pelo SARS-CoV-2 (COVID-19)
Authors: Lessa, Flávia; Succi, Isabella; Braga, Isabel; Garbin, Helena; Pacheco, Marcia; Augusta, Marisa; Marinha, Marden; Olivar, Monica; Gertner, Sônia; Pires, Vinicius; Oliveira, Gisele; Cordeiro, Maria Egle

Title: Análise de dimensões do acesso à saúde das crianças com Síndrome Congênita de Zika (SCZ) na Região Metropolitana do Rio de Janeiro
Authors: Peiter, Paulo; Pereira, Rafael; França, Isadora
Abstract: Desde 2015 a população brasileira vive com as
repercussões da epidemia de Zika, levantando o
debate sobre as dificuldades de diagnóstico e acesso
aos cuidados para crianças com Síndrome Congênita
do Zika. As regiões Nordeste e Sudeste foram as
mais atingidas, desafiando-nos a caracterizar
o acesso à saúde das crianças portadoras da
Síndrome Congênita do Zika nessas regiões. O
objetivo deste artigo é analisar a disponibilidade
e a acessibilidade dos serviços de saúde para a
reabilitação das crianças com Síndrome Congênita
do Zika na Região Metropolitana do Rio de Janeiro.
A metodologia consistiu no mapeamento dos
casos de Síndrome Congênita do Zika entre 2015
e 2017 na Região Metropolitana do Rio de Janeiro
por bairros de residência e relacionados com a
localização das unidades de reabilitação indicadas
no Protocolo da Secretaria de Estado de Saúde do
Rio de Janeiro. Como resultado foram identificados
202 casos de Síndrome Congênita do Zika na Região
Metropolitana do Rio de Janeiro no período de
2015 a 2017. A região teve 85% de todos os casos
do estado do Rio de Janeiro, o município do Rio de
Janeiro concentrou 63% dos casos. A acessibilidade
nesse município é a melhor se comparada com os
demais da região metropolitana, dado que é a capital
do estado e concentra grande parte dos serviços
especializados em saúde materno-infantil.
Palavras-chave: Síndrome Congênita de Zika;
Serviços de Saúde; Acessibilidade; Rio de Janeiro.

by Neal Alexander, Audrey Lenhart, Karim Anaya-Izquierdo
Background The ability of cluster-randomized trials to capture mass or indirect effects is one reason for their increasing use to test interventions against vector-borne diseases such as malaria and dengue. For the same reason, however, the independence of clusters may be compromised if the distances between clusters is too small to ensure independence. In other words they may be subject to spillover effects. Methods We distinguish two types of spatial spillover effect: between-cluster dependence in outcomes, or spillover dependence; and modification of the intervention effect according to distance to the intervention arm, or spillover indirect effect. We estimate these effects in trial of insecticide-treated materials against the dengue mosquito vector, Aedes aegypti, in Venezuela, the endpoint being the Breteau index. We use a novel random effects Poisson spatial regression model. Spillover dependence is incorporated via an orthogonalized intrinsic conditional autoregression (ICAR) model. Spillover indirect effects are incorporated via the number of locations within a certain radius, set at 200m, that are in the intervention arm. Results From the model with ICAR spatial dependence, and the degree of surroundedness, the intervention effect is estimated as 0.74—favouring the intervention—with a 95% credible interval of 0.34 to 1.69. The point estimates are stronger with increasing surroundedness within intervention locations. Conclusion In this trial there is some evidence of a spillover indirect effect of the intervention, with the Breteau index tending to be lower in locations which are more surrounded by locations in the intervention arm.

by Natalie Chew, Abdul Muhaimin Noor Azhar, Aida Bustam, Mohamad Shafiq Azanan, Crystal Wang, Lucy C. S. Lum
Background Dengue is a systemic and dynamic disease with symptoms ranging from undifferentiated fever to dengue shock syndrome. Assessment of patients’ severity of dehydration is integral to appropriate care and management. Urine colour has been shown to have a high correlation with overall assessment of hydration status. This study tests the feasibility of measuring dehydration severity in dengue fever patients by comparing urine colour captured by mobile phone cameras to established laboratory parameters. Methodology/Principal findings Photos of urine samples were taken in a customized photo booth, then processed using Adobe Photoshop to index urine colour into the red, green, and blue (RGB) colour space and assigned a unique RGB value. The RGB values were then correlated with patients’ clinical and laboratory hydration indices using Pearson’s correlation and multiple linear regression. There were strong correlations between urine osmolality and the RGB of urine colour, with r = -0.701 (red), r = -0.741 (green), and r = -0.761 (blue) (all p-value

by Adugna Endale, Daniela Michlmayr, Woldaregay Erku Abegaz, Getahun Asebe, James W. Larrick, Girmay Medhin, Mengistu Legesse
Background Chikungunya (CHIK) and yellow fever (YF) are becoming major public health threats in East African countries including Ethiopia. In Ethiopia, there is no reliable information about the epidemiology of CHIK. This study aimed to assess a community-based sero-prevalence of CHIK and YF in the South Omo Valley, an endemic area for YF. Methods Between February and June 2018, blood samples were collected from study participants and screened for IgG antibody against CHIK virus (CHIKV) and YF virus (YFV) infections using ELISA. Data were computerized using Epi Data Software v.3.1 and analyzed using SPSS. Results A total of 360 participants (51.7% males, age range from 6 to 80, mean age ± SD = 31.95 ± 14.05 years) participated in this study. The overall sero-prevalence of IgG antibody was 43.6% (157/360) against CHIKV, while it was 49.5% (155/313) against YFV. Out of 155 samples which were positive for IgG antibody to YFV, 93 (60.0%) were positive for IgG antibody to CHIKV. Out of 158 samples which were negative for IgG antibody to YFV, 64(40.5%) were positive for IgG antibody to CHIKV. There was a significant positive correlation between IgG antibodies to CHIKV and YFV (sr = 0.82; P

by Anupam Joya Sharma, Malavika A. Subramanyam

The psychological impacts of the lockdown due to the Covid-19 pandemic are widely documented. In India, a family-centric society with a high population density and extreme social stratification, the impact of the lockdown might vary across diverse social groups. However, the patterning in the psychological impact of the lockdown among LGBT adults and persons known to be at higher risk of the complications of Covid-19 (such as persons with comorbidities or a history of mental illness) is not known in the Indian context. We used mixed methods (online survey, n = 282 and in-depth interviews, n = 14) to investigate whether the psychological influence of the lockdown was different across these groups of Indian adults. We fitted linear and logistic regression models adjusted for sociodemographic covariates. Thematic analysis helped us identify emergent themes in our qualitative narratives. Anxiety was found to be higher among LGBT adults (β = 2.44, CI: 0.58, 4.31), the high-risk group (persons with comorbidities) (β = 2.20, CI:0.36, 4.05), and those with a history of depression/loneliness (β = 3.89, CI:2.34, 5.44). Persons belonging to the LGBT group reported a greater usage of pornography than the heterosexuals (β = 2.72, CI: 0.09, 5.36) during the lockdown. Qualitative findings suggested that LGBT adults likely used pornography and masturbation to cope with the lockdown, given the limited physical access to sexual partners in a society that stigmatizes homosexuality. Moreover, both qualitative and quantitative study findings suggested that greater frequency of calling family members during lockdown could strengthen social relationships and increase social empathy. The study thereby urgently calls for the attention of policymakers to take sensitive and inclusive health-related decisions for the marginalized and the vulnerable, both during and after the crisis.

by Alejandro Rodríguez-Molinero, Carlos Pérez-López, César Gálvez-Barrón, Antonio Miñarro, Oscar Macho, Gabriela F. López, Maria Teresa Robles, María Dolores Dapena, Sergi Martínez, Ezequiel Rodríguez, Isabel Collado, on behalf of the COVID-19 research group of CSAPG
Background The rapid spread of the disease caused by the novel SARS-CoV-2 virus has led to the use of multiple therapeutic agents whose efficacy has not been previously demonstrated. The objective of this study was to analyze whether there is an association between the use of azithromycin and the evolution of the pulmonary disease or the time to discharge, in patients hospitalized with COVID-19. Methods This was an observational study on a cohort of 418 patients admitted to three regional hospitals in Catalonia, Spain. As primary outcomes, we studied the evolution of SAFI ratio (oxygen saturation/fraction of inspired oxygen) in the first 48 hours of treatment and the time to discharge. The results were compared between patients treated and untreated with the study drug through subcohort analyses matched for multiple clinical and prognostic factors, as well as through analysis of non-matched subcohorts, using Cox multivariate models adjusted for prognostic factors. Results There were 239 patients treated with azithromycin. Of these, 29 patients treated with azithromycin could be matched with an equivalent number of control patients. In the analysis of these matched subcohorts, SAFI at 48h had no significant changes associated to the use of azithromycin, though azithromycin treatment was associated with a longer time to discharge (10.0 days vs 6.7 days; log rank: p = 0.039). However, in the unmatched cohorts, the increased hospital stay associated to azithromycin use, was no significant after adjustment using Multivariate Cox regression models: hazard ratio 1.45 (IC95%: 0.88–2.41; p = 0.150). This study is limited by its small sample size and its observational nature; despite the strong pairing of the matched subcohorts and the adjustment of the Cox regression for multiple factors, the results may be affected by residual confusion. Conclusions We did not find a clinical benefit associated with the use of azithromycin, in terms of lung function 48 hours after treatment or length of hospital stay.

by Sinan Trabulus, Cebrail Karaca, Ilker Inanc Balkan, Mevlut Tamer Dincer, Ahmet Murt, Seyda Gul Ozcan, Rıdvan Karaali, Bilgul Mete, Alev Bakir, Mert Ahmet Kuskucu, Mehmet Riza Altiparmak, Fehmi Tabak, Nurhan Seyahi
Background Recent data have suggested the presence of a reciprocal relationship between COVID-19 and kidney function. To date, most studies have focused on the effect of COVID-19 on kidney function, whereas data regarding kidney function on the COVID-19 prognosis is scarce. Therefore, in this study, we aimed to investigate the association between eGFR on admission and the mortality rate of COVID-19. Methods We recruited 336 adult consecutive patients (male: 57.1%, mean age: 55.0±16.0 years) that were hospitalized with the diagnosis of COVID-19 in a tertiary care university hospital. Data were collected from the electronic health records of the hospital. On admission, eGFR was calculated using the CKD-EPI formula. Acute kidney injury was defined according to the KDIGO criteria. Binary logistic regression and Cox regression analyses were used to assess the relationship between eGFR on admission and in-hospital mortality of COVID-19. Results Baseline eGFR was under 60 mL/min/1.73m2 in 61 patients (18.2%). Acute kidney injury occurred in 29.2% of the patients. In-hospital mortality rate was calculated as 12.8%. Age-adjusted and multivariate logistic regression analysis (p: 0.005, odds ratio: 0.974, CI: 0.956–0.992) showed that baseline eGFR was independently associated with mortality. Additionally, age-adjusted Cox regression analysis revealed a higher mortality rate in patients with an eGFR under 60 mL/min/1.73m2. Conclusions On admission eGFR seems to be a prognostic marker for mortality in patients with COVID-19. We recommend that eGFR be measured in all patients on admission and used as an additional tool for risk stratification. Close follow-up should be warranted in patients with a reduced eGFR.

by Xiao Lu, Mao Zhang, Anyu Qian, Luping Tang, Shanxiang Xu
Purpose To investigate the role of lung ultrasound score (LUS) in assessing intubation timing for patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. Materials and methods Seventy-two patients with critical coronavirus disease 2019 (COVID-19) were admitted to a makeshift intensive care unit (ICU). All patients underwent bedside lung ultrasonography one to two times per day. The patients were either intubated, treated with noninvasive ventilation (NIV), or given high-flow nasal cannula (HFNC) after a discussion with the multidisciplinary group after their conditions worsened. Bedside lung ultrasound was performed daily after intubation, and patients received mechanical ventilation. Lung ultrasound was performed on days 1, 2, 3, 5, and 7 after patients were admitted to the ICU; if the patient was intubated, LUS determination was performed before intubation within 24 h (T1) and on days 1, 2, 5, and 7 after intubation (T2, T3, T4, and T5, respectively).The goal of this study was to evaluate the severity of lung aeration loss in intubated and non-intubated patients with SARS-CoV-2 pneumonia by ultrasound at different time points within one week. Results A total of 16 patients were included in this study, including nine who were intubated and mechanically ventilated and seven patients without intubation. The number of elderly individuals in the intubated group was higher than in the non-intubated group (P 0.05). In addition, there were more male than female patients in both groups. Patient characteristics (BMI, SOFA, and PaO2/FiO2 value) were similar between the two groups (P > 0.05). The 28-day mortality rate of intubated patients was higher than that of non-intubated patients; six patients in the intubated group and two patients in the non-intubated group died. Nine intubated patients showed changes in LUS within seven days (n = 9). The mean LUS within 24 h before intubation was 12.8 ± 1.3. LUS was significantly higher on T1 than on T5 (P

Title: Unlike Zika, Chikungunya virus interferes in the viability of Aedes aegypti eggs, regardless of females’ age
Authors: Resck, Maria Eduardo Barreto; Padilha, Karine Pedreira; Cupolillo, Aline Possati; Talyuli, Octávio A. C.; Brito, Anielly Ferreira de; Oliveira, Ricardo Lourenço de; Farnesi, Luana Cristina; Bruno, Rafaela Vieira

Title: Smell dysfunction in COVID-19 patients: More than a yes-no question
Authors: Lima, Marco A.; Silva, Marcus Tulius T.; Oliveira, Raquel V.; Soares, Cristiane N.; Takano, Crissi L.; Azevedo, Anna E.; Moraes, Raissa L.; Rezende, Rafaela B.; Chagas, Ingrid T.; Espíndola, Otávio; Leite, Ana Claudia; Araujo, Abelardo

by Anca Rǎdulescu

We illustrate and study the evolution of reported infections over the month of March in New York State as a whole, as well as in each individual county in the state. We identify piecewise exponential trends, and search for correlations between the timing and dynamics of these trends and statewide mandated measures on testing and social distancing. We conclude that the reports on April 1 may be dramatically under-representing the actual number of statewide infections, an idea which is supported by more recent retroactive estimates based on serological studies. A follow-up study is underway, reassessing data until June 1, using additional measures for validation and monitoring for effects of the PAUSE directive, and of the reopening timeline.

by Alak Paul, Dwaipayan Sikdar, Mohammad Mosharraf Hossain, Md Robed Amin, Farah Deeba, Janardan Mahanta, Md. Akib Jabed, Mohammad Mohaiminul Islam, Sharifa Jahan Noon, Tapan Kumar Nath

The current novel coronavirus (nCoV) pandemic, COVID-19, was first reported in December 2019 in Wuhan, China, and has spread globally, causing startling loss of life, stalling the global economy, and disrupting social life. One of the challenges to contain COVID-19 is convincing people to adopt personal hygiene, social distancing, and self-quarantine practices that are related to knowledge, attitudes, and practices (KAP) of the residents of respective countries. Bangladesh, a densely populated country with a fast-growing economy and moderate literacy rate, has shown many hiccups in its efforts to implement COVID-19 policies. Understanding KAP may help policy makers produce informed decisions. This study assessed KAP in relation to COVID-19 in Bangladesh. An online survey using a pre-tested questionnaire conducted in late March 2020 attained 1,837 responses across Bangladesh. Ultimately, 1,589 completed responses were included in a statistical analysis to calculate KAP scores and their interrelations with sociodemographic variables. The overall KAP was poor, with only 33% of the participants demonstrating good knowledge, whereas 52.4% and 44.8% of the subjects showed good attitudes and practices, respectively. Sociodemographic factors had strong bearings on the KAP scores. Significantly higher KAP scores were evident in females over males, among aged 45 years and older over younger participants, and among retired workers and homemakers over students and public service employees. This study indicated a panic fuelled by poor understanding of COVID-19 associated facts and the need for the government to ensure more granular and targeted awareness campaigns in a transparent and factual manner to foster public confidence and ensure more meaningful public participation in mitigation measures. This study provides a KAP baseline regarding COVID-19 among Bangladeshis.

Title: Resposta do G20 e da OCDE à COVID-19 - Informes de 6 de abril a 29 de julho de 2020
Authors: Fonseca, L.E.

Title: Nota rápida de evidência: o papel dos transportes públicos na transmissão de COVID 19
Authors: Camargo, Erika Barbosa; Elias, Flávia Tavares Silva
Abstract: Tecnologia: Transportes públicos e a transmissão de COVID-19
Indicação: Servidores que necessitam de transportes públicos para deslocamento em longas distâncias.
Caracterização da tecnologia: A nota rápida de evidência foi elaborada para atualizar as evidências referentes ao papel dos transportes públicos na transmissão de COVID-19. As evidências apresentadas são as que estão atualmente disponíveis e devem ser revisadas com a finalidade de renovar e de tornar público dados de importância para a saúde pública.
Contexto e Pergunta: A Fiocruz Brasília está elaborando proposta de plano de retorno e em reunião entre assessoria da Direção, o Núcleo de Epidemiologia e Vigilância em Saúde (NEVS) e o Programa de Evidencias para Políticas e Tecnologias em Saúde (PEPTS) surgiu a necessidade de uma nota de revisão rápida sobre qual a participação dos transportes públicos na transmissão do COVID-19.
Busca e análise das evidências científicas: As buscas foram realizadas no dia 12/08/2012 via OVID nas seguintes bases de dados: Embase Classic+Embase, Global Health , Joanna Briggs Institute EBP Database, Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions
Resumo dos resultados dos estudos selecionados:
Foram incluídos para análise dois estudos, sendo uma revisão sistemática e um estudo de modelagem de risco. A revisão sistemática de Zhen et al, 20201 incluiu outra revisão sistemática2, um estudo do tipo caso-controle7 e dois estudos de modelagem8,9. O estudo de Browne et al 20162 ( também uma revisão sistemática), incluída no estudo de Zhen et al, 20201 avaliou 4 artigos que tratavam sobre transporte público com evidencias indiretas tomando como base o risco de H1N1, Infecção Respiratória Aguda e Influenza. Dois estudos de casos, uma investigação epidemiológica retrospectiva e um caso controle. O primeiro estudo de caso citou viagem entre a Espanha e a Suíça por mais de 12 horas estimando-se um risco de transmissão por H1N1 de 1,96%3. O segundo estudo de caso encontrou que numa viagem ocorrida na França de mais de 3,5 horas de duração em 2 dias, 84% (21/24) das crianças e 50% (3/5) dos adultos estavam acometidos pelo H1N14. A investigação epidemiológica retrospectiva encontrou que a transmissão de H1N1 aumentou com o tempo de permanência no trem, sendo o menor tempo 13 horas com transmissão de 0,56% e o maior tempo 40 horas com transmissão de 7,68% (χ2 = 23.50, P 0.001) 5. O estudo de caso controle encontrou que pessoas com Infecção Respiratória Aguda (IRA) eram quase seis vezes propensas a terem usado o transporte público nos últimos 5 dias (Odds Ratio OR 5.94; p

Title: Respostas da Ásia Sudeste, Pacífico Ocidental e Oriente Médio à COVID-19: Cenários diplomáticos, políticos, econômicos, de saúde e bem-estar - Informes de 06 de abril a 29 de julho de 2020
Authors: Marques, Lúcia

Title: Nota rápida de evidência: o papel dos restaurantes e bares na transmissão de COVID 19
Authors: Camargo, Erika Barbosa; Elias, Flávia Tavares Silva
Abstract: Tecnologia: Restaurantes e bares e a transmissão de COVID-19
Indicação: Cuidado dos servidores que necessitam de utilizar restaurantes e/ou bares durante a pandemia para alimentação.
Caracterização da tecnologia: A nota rápida de evidência foi elaborada para atualizar as evidências referentes ao papel dos restaurantes e restaurantes na transmissão da COVID-19. As evidências apresentadas são as que estão atualmente disponíveis e devem ser revisadas com a finalidade de renovar e de tornar público dados de importância para a saúde pública.
Contexto e Pergunta: A Fiocruz Brasília está elaborando proposta de plano de retorno e em reunião entre assessoria da Direção, o Núcleo de Epidemiologia e Vigilância em Saúde (NEVS) e o Programa de Evidencias para Políticas e Tecnologias em Saúde (PEPTS) surgiu a necessidade de uma nota de revisão rápida sobre qual a participação dos restaurantes e bares na transmissão da COVID-19.
Busca e análise das evidências científicas: As buscas foram realizadas no dia 12/08/2012 via OVID nas seguintes bases de dados: Embase Classic+Embase, Global Health , Joanna Briggs Institute EBP Database, Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions e na literatura cinza.
Resumo dos resultados dos estudos selecionados:
No total 16 artigos foram encontrados na busca nas bases de dados sendo 7 duplicados, ao final, foram lidos na íntegra 9 artigos. Desses, 4 artigos foram inseridos oriundos das bases de dados via OVID e 2 artigos foram extraídos da literatura cinza (Google Scholar).
O estudo de Jianyun Lu et al1 (2020) teve como objetivo investigar um surto de Coronavírus (COVID-19) entre 26 de janeiro de 2020 e 10 fevereiro 2020 que afetou 10 pessoas de 3 famílias que se alimentaram no mesmo restaurante, em que os autores investigaram que a transmissão de gotículas foi induzida por meio da direção do fluxo de ar do ar condicionado. Para evitar a disseminação de COVID-19 em restaurantes, o estudo recomendou monitorar a temperatura dos clientes, aumentar a distância entre as mesas e melhorar a ventilação dentro dos estabelecimentos.
O estudo de Lidia Morawska et al2 (2020) não abordou especificamente o contexto dos restaurantes, masteve como objetivo demostrar como a transmissão de COVID-19 pode ser minimizada em ambientes fechados. As principais recomendações foram: complementar a ventilação existente com purificadores de ar portáteis, com sistemas de filtração mecânica para capturar as microgotículas, fazer a, manutenção e troca dos filtros de ar e evitar superlotação dos ambientes, como por exemplo, em restaurantes, diminuindo o número de mesas, localizando-as com distanciamento adequado, e aumentando a ventilação.
O estudo de Abajo et al4 (2020) teve como objetivo defender o uso de luz UV-C como uma forma de em curto prazo, limitar a disseminação do vírus SARS-CoV-2, concluindo que em espaços menores, como banheiros, elevadores e outros ambientes que são usados de forma intermitente com uma alta rotatividade de pessoas, esses raios UV-C podem ser utilizados s com segurança a uma alta intensidade de radiação enquanto não estiverem em uso..
O estudo de Yuki Furuse et al.5 (2020) teve como objetivo analisar casos de Coronavírus no Japão e identificar 61 case-clusters em unidade de saúde, restaurantes e bares, local de trabalho e de eventos musicais. O estudo investigou a ligação epidemiológica de casos de COVID-19 identificados em 61 clusters em vários contextos, dentre eles, ocorreram 10 casos de COVID-19 (16%) em restaurantes ou bares casos . Nesse estudo de Yuki Furuse et al. 5 (2020) a investigação e a localização ativa de casos foram essenciais para estabelecer ligações com outros casos ou eventos de transmissão. Sendo que a detecção de clusters de casos pode levar à efetiva quarentena dos contatos próximos e à identificação de fatores de risco auxiliando na contenção da transmissão pela vigilância epidemiológica.
O estudo de Mehrabadi et al.6 (2020) avaliou a tendência do interesse público em restaurantes e bares e os casos diários de COVID-19 nos EUA por meio de uma análise com Google Trends. O estudo de Mehrabadi et al.6 (2020) sugeriu que o efeito das pesquisas no google de restaurantes e de bares é maior nas regiões com mais casos novos diários de COVID-19 em comparação com as regiões
que têm um número menor de casos positivos relatados todos os dias, sendo comprovado por modelos de casualidade de Granger e valores mais altos de correlação de Pearson. O Google trends pode, portanto, ser usado como informações adicionais para previsão de casos de COVID-19.
O estudo de Nittayasoot et al.7 (2020) teve como objetivo identificar casos de COVID-19 em restaurante na Tailândia, concluindo sobre a importância das medidas de prevenção e controle para restaurantes e que esses são uma fonte potencial de surtos da doenca. O regulamento para o funcionamento de restaurantes na Tailância baseou-se em 5 pilares: (1) sistema de triagem; (2) rastrear sistemas usando um aplicativo baseado em tecnologia chamado “Thai chana”1 ; (3) distanciamento entre as mesas ≥2 metros ou insercao de uma barreira a cada ≥1,5 metros e uso de equipamento de proteção adequado; (4) ventilação do ar (5) intensificacao de procedimentos de limpeza e desinfecção.
Recomendação: Baseando-se nas escassas evidências disponíveis até o momento, dois estudos que investigaram surtos de COVID-19 em restaurantes citaram espaços confinados que usam ar condicionado, falta de uso de equipamentos de proteção dos funcionários e de medidas de saúde pública como sendo problemas a serem enfrentados. Outro estudo sugere o uso de luz UVC como alternativa para desinfecção de ambientes com circulação intermitente de pessoas. Outro estudo adotou um aplicativo 2 de celulares com o sistema de rastreamento online onde os clientes podem ser rastreados e mensagens de texto podem ser enviadas para eles caso precisem ser testados para auxiliar no monitoramento da COVID-19. Outro estudo usou o Google Trends para identificar cluster de maior circulacao de pessoas e incidencia da COVID-19.
As recomendações para o contexto dos restaurantes e bares está direcionada para sistema de triagem com interlocucao com os orgaos de vigilancia sanitaria e epidemiologica; distanciamento fisico adequado (espaço entre mesas ≥2 metros ou inclusao de barreira a cada ≥1,5 metros), uso de máscaras pelos clinetes e equipamentos de protecao individual (mascaras, viseiras e luvas para funaiconarios); cuidados com ventilação do ar em ambinetes indoor (com preferencia para ambiente outdoor) e intensificacao de procedimentos de limpeza e desinfecção. Essas práticas provavelmente levariam a um controle da tranmissão e melhor acompanhemento da COVID-19 minimizando o número de casos e de contatos.

Title: Clinical and laboratory diagnosis of SARS-CoV-2, the virus causing COVID-19
Authors: Silva, Severino Jefferson Ribeiro da; Silva, Caroline Targino Alves da; Guarines, Klarissa Miranda; Mendes, Renata Pessôa Germano; Pardee, Keith; Kohl, Alain; Pena, Lindomar José

Title: Planned Yellow Fever Primary Vaccination Is Safe and Immunogenic in Patients With Autoimmune Diseases: A Prospective Non-interventional Study
Authors: Valim, Valéria; Machado, Ketty Lysie Libardi Lira; Miyamoto, Samira Tatiyama; Pinto, Arthur Dalmaso; Rocha, Priscila Costa Martins; Serrano, Erica Vieira; Dinis, Valquiria Garcia; Gouvêa, Sônia Alves; Dias, João Gabriel Fragoso; Azevedo, Ana Carolina Campi; Carvalho, Andréa Teixeira de; Paschoal, Vanessa Peruhype Magalhães; Rocha, Ismael Artur da Costa; Lima, Sheila Maria Barbosa de; Miranda, Emily Hime; Trindade, Gisela Freitas; Maia, Maria de Lourdes de Sousa; Gavi, Maria Bernadete Renoldi de Oliveira; Silva, Lidia Balarini da; Duque, Ruben Horst; Gianordoli, Ana Paula Espíndula; Casagrande, Thays Zanon; Oliveira, Karine Gadioli; Moura, Bruna Costa da Mata; Batista, Fernanda Nicole; Rodrigues, Luiza Correa; Clemente, Thalles Brandão; Magalhães, Enan Sales; Bissoli, Maria de Fatima; Gouvea, Maria da Penha Gomes; Pinto Neto, Lauro Ferreira da Silva; Costa, Carolina Zorzanelli; Giovelli, Raquel Altoé; Brandão, Leticia Resende; Polito, Elizandra Tomazela Laurenti; Koehlert, Ingrid de Oliveira; Borjaille, Brunela Passos; Pereira, Daniela Bergamim; Dias, Laiza Hombre; Merlo, Daniela Linhares; Genelhu, Luiz Fellipe Favoreto; Pretti, Flavia Zon; Giacomin, Maryella dos Santos; Burian, Ana Paula Neves; Fantinato, Francieli Fontana Sutile Tardetti; Pileggi, Gecilmara Salviato; Mota, Lícia Maria Henrique da; Martins Filho, Olindo Assis

Title: The coronavirus and the História, Ciências, Saúde – Manguinhos blog
Authors: Cueto, Marcos

Title: Cadernos CRIS-Fiocruz: Panorama da Resposta Global à COVID-19 - Informe 10 - Junho - 2020
Description: Informe produzido pelo CRIS-Fiocruz, sobre a semana de 17 a 24 de junho de 2020
Projeto Gráfico: Antonio Augusto Farah de Mesquita

Title: Association Between Antenatal Exposure to Zika Virus and Anatomical and Neurodevelopmental Abnormalities in Children
Authors: Cranston, Jessica S.; Tiene, Sophia Finn; Nielsen-Saines, Karin; Vasconcelos, Zilton; Pone, Marcos V.; Pone, Sheila; Zin, Andrea; Salles, Tania Saad; Pereira, Jose Paulo; Orofino, Dulce; Brasil, Patricia; Kerin, Tara; Adachi, Kristina; Soares, Fernanda Mendes; Abranches, Andrea Dunshee de; Costa, Ana Carolina C.; Lopes Moreira, Maria Elisabeth

by Wen-Quan Liu, Si-Qi Chen, Hao-Qiang Bai, Qi-Mei Wei, Sheng-Nan Zhang, Chen Chen, Yi-Han Zhu, Tang-Wei Yi, Xiao-Pu Guo, Si-Yuan Chen, Meng-Jie Yin, Chen-Feng Sun, Shao-Hui Liang

Aedes mosquitoes can transmit dengue and several other severe vector-borne viral diseases, thereby influencing millions of people worldwide. Insects primarily control and clear the viral infections via their innate immune systems. Mitogen-Activated Protein Kinases (MAPKs) and antimicrobial peptides (AMPs) are both evolutionarily conserved components of the innate immune systems. In this study, we investigated the role of MAPKs in Aedes mosquitoes following DENV infection by using genetic and pharmacological approaches. We demonstrated that knockdown of ERK, but not of JNK or p38, significantly enhances the viral replication in Aedes mosquito cells. The Ras/ERK signaling is activated in both the cells and midguts of Aedes mosquitoes following DENV infection, and thus plays a role in restricting the viral infection, as both genetic and pharmacological activation of the Ras/ERK pathway significantly decreases the viral titers. In contrast, inhibition of the Ras/ERK pathway enhances DENV infection. In addition, we identified a signaling crosstalk between the Ras/ERK pathway and DENV-induced AMPs in which defensin C participates in restricting DENV infection in Aedes mosquitoes. Our results reveal that the Ras/ERK signaling pathway couples AMPs to mediate the resistance of Aedes mosquitoes to DENV infection, which provides a new insight into understanding the crosstalk between MAPKs and AMPs in the innate immunity of mosquito vectors during the viral infection.

by Jiazhen Zheng, Rui Zhou, Fengjuan Chen, Guofang Tang, Keyi Wu, Furong Li, Huamin Liu, Jianyun Lu, Jiyuan Zhou, Ziying Yang, Yuxin Yuan, Chunliang Lei, Xianbo Wu

The phenomenon of COVID-19 patients tested positive for SARS-CoV-2 after discharge (redetectable as positive, RP) emerged globally. The data of incidence rate and risk factors for RP event and the clinical features of RP patients may provide recommendations for virus containment and cases management for COVID-19. We prospectively collected and analyzed the epidemiological, clinical and virological data from 285 adult patients with COVID-19 and acquired their definite clinical outcome (getting PCR positive or not during post-discharge surveillance). By March 10, 27 (9.5%) discharged patients had tested positive for SARS-CoV-2 in their nasopharyngeal swab after a median duration of 7·0 days (IQR 5·0–8·0). Compared to first admission, RP patients generally had milder clinical symptoms, lower viral load, shorter length of stay and improved pulmonary conditions at readmission (p0.05). A prolonged duration of viral shedding (>10 days) during the first hospitalization [adjusted odds ratio [aOR]: 5.82, 95% confidence interval [CI]: 2.50–13.57 for N gene; aOR: 9.64, 95% CI: 3.91–23.73 for ORF gene] and higher Ct value (ORF) in the third week of the first hospitalization (aOR: 0.69; 95% CI: 0.50–0.95) were associated with RP events. In conclusion, RP events occurred in nearly 10% of COVID-19 patients shortly after the negative tests, were not associated with worsening symptoms and unlikely reflect reinfection. Patients’ lack of efficiency in virus clearance was a risk factor for RP result. It is noteworthy that elder RP patients (≥ 60 years old) were more susceptible to clinical symptoms at readmission.

by Frederik Seelig, Haroldo Bezerra, Mary Cameron, Jeffrey Hii, Alexandra Hiscox, Seth Irish, Robert T. Jones, Trudie Lang, Steven W. Lindsay, Rachel Lowe, Tanaka Manikidza Nyoni, Grace M. Power, Juliana Quintero, Anna M. Stewart-Ibarra, Lucy S. Tusting, Scott Tytheridge, James G. Logan

by Khai Lone Lim, Nur Alia Johari, Siew Tung Wong, Loke Tim Khaw, Boon Keat Tan, Kok Keong Chan, Shew Fung Wong, Wan Ling Elaine Chan, Nurul Hanis Ramzi, Patricia Kim Chooi Lim, Sulaiman Lokman Hakim, Kenny Voon

The rapid global spread of the coronavirus disease (COVID-19) has inflicted significant health and socioeconomic burden on affected countries. As positive cases continued to rise in Malaysia, public health laboratories experienced an overwhelming demand for COVID-19 screening. The confirmation of positive cases of COVID-19 has solely been based on the detection of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) using real-time reverse transcription polymerase chain reaction (qRT-PCR). In efforts to increase the cost-effectiveness and efficiency of COVID-19 screening, we evaluated the feasibility of pooling clinical Nasopharyngeal/Oropharyngeal (NP/OP) swab specimens during nucleic acid extraction without a reduction in sensitivity of qRT-PCR. Pools of 10 specimens were extracted and subsequently tested by qRT-PCR according to the WHO-Charité protocol. We demonstrated that the sample pooling method showed no loss of sensitivity. The effectiveness of the pooled testing strategy was evaluated on both retrospective and prospective samples, and the results showed a similar detection sensitivity compared to testing individual sample alone. This study demonstrates the feasibility of using a pooled testing strategy to increase testing capacity and conserve resources, especially when there is a high demand for disease testing.

by Ling-Ling Dai, Xi Wang, Tian-Ci Jiang, Peng-Fei Li, Yu Wang, Shu-Jun Wu, Liu-Qun Jia, Meng Liu, Lin An, Zhe Cheng

Fangcang shelter hospitals were established in China during the coronavirus disease 2019 (COVID-19) pandemic as a countermeasure to stop the spread of the disease. To our knowledge, no research has been conducted on mental health problems among patients in Fangcang shelter hospitals. This study aimed to determine the prevalence and major influencing factors of anxiety and depressive symptoms among COVID-19 patients admitted to Fangcang shelter hospitals. From February 23, 2020, to February 26, 2020, we obtained sociodemographic and clinical characteristics information of COVID-19 patients in Jianghan Fangcang Shelter Hospital (Wuhan, China) and assessed their mental health status and sleep quality. Data were obtained with an online questionnaire. The questionnaire consisted of a set of items on demographic characteristics, a set of items on clinical characteristics, the Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Pittsburgh Sleep Quality Index. Three hundred seven COVID-19 patients who were admitted to Jianghan Fangcang Shelter Hospital participated in this study. The prevalence of anxiety and depressive symptoms were 18.6% and 13.4%, respectively. Poor sleep quality and having ≥ two current physical symptoms were independent risk factors for anxiety symptoms. Female sex, having a family member with confirmed COVID-19, and having ≥ two current physical symptoms were independent risk factors for depressive symptoms. Anxiety and depressive symptoms were found to be common among COVID-19 patients in Fangcang Shelter Hospital, with some patients being at high risk.

by Belayneh Ayanaw Kassie, Aynishet Adane, Yared Tadesse Tilahun, Eskeziaw Abebe Kassahun, Amare Simegn Ayele, Aysheshim Kassahun Belew
Background COVID-19 has a devastating effect on social, economic, and political crises that will leave deep pockmarks on victims of the virus. Having poor knowledge and attitude of the disease among health care providers could bring in impeded effect in the supportive treatment and, it increases the spread of the pandemic. Objective The study aims to assess the knowledge and attitude towards COVID-19, and associated factors among health care providers in Northwest Ethiopia in 2020. Methods Institution based cross-sectional study was conducted from the mid of March to the end of April 2020 among 408 participants who were selected by a simple random sampling technique. Pretested and structured self-administered questionnaire was used to collect data. The data were entered using EPI-info v. 7, and were exported to SPSS version 20 for further analysis. Bivariate and multivariable logistic regression analyses were used to identify factors associated with Knowledge and Attitude towards COVID-19. Variables having p-value 0.05 were taken as variables which were significantly associated with the dependent variable. Result A total of 408(97.1%) participants have participated in the study. Most of the participants (67.3%) were males. One-third (35.5%) of the participants were nurses. About 62% of the health care providers were Bachelor degree holders. The prevalence of Knowledge and attitude towards COVID-19 found to be 73.8% (95%CI: 69.9, 77.9) and 65.7% (95%CI: 61.5, 70.1) respectively. Master degree level of education (AOR = 2.85; 95% CI: 1.25, 6.00) was associated with knowledge of the participants. Similarly, having good knowledge (AOR = 3.17; 95%CI: 1.97, 5.06) was positively associated with the attitude of health care providers towards COVID-19. Conclusion and recommendation Health care providers found to have good knowledge and attitude towards COVID-19. Being Master’s Degree holder and having good knowledge are associated with the knowledge and attitude of the respondents towards COVID-19 respectively. Thus, improving awareness through health education is a significant approach to address the global agenda of COVID-19 Pandemic.

by Tailai Peng, Xinhao Liu, Hefeng Ni, Zhe Cui, Lei Du
Background In December 2019, an outbreak of COVID-19 epidemic occurred in Wuhan, China and infection spread rapidly around the world. To limit the rapid spread locally and nationwide, the Chinese government locked down Wuhan city on January 23 and began implementing nationwide intensive community screening on February 16. Method To assess the effectiveness of city lockdown and intensive community screening, we built a modified SIR model by introducing an α value into the classic SIR model. The α value represents the proportion of infected individuals who are not effectively isolated from susceptible individuals at a given time point. Results The accuracy of the modified SIR model was validated using data from Guangdong and Zhejiang provinces. The lockdown of Wuhan city substantially reduced the α value for the rest of China excluding Hubei province, while only slightly reducing the α value for the city itself. Intensive community screening rapidly reduced the α value for Wuhan. Conclusion City lockdown was efficient in controlling the spread of the epidemic from Wuhan to the rest of the country. Nationwide intensive community screening was extremely effective in suppressing the spread locally within Wuhan city. These experiences should urgently be shared with other countries to help halt the progressing worldwide pandemic.

by Kirsti Riiser, Sølvi Helseth, Kristin Haraldstad, Astrid Torbjørnsen, Kåre Rønn Richardsen
Purpose First, to describe adolescents’ health information sources and knowledge, health literacy (HL), health protective measures, and health-related quality of life (HRQoL) during the initial phase of the Covid-19 pandemic in Norway. Second, to investigate the association between HL and the knowledge and behavior relevant for preventing spread of the virus. Third, to explore variables associated with HRQoL in a pandemic environment. Methods This cross-sectional study includes survey data from 2,205 Norwegian adolescents 16–19 years of age. The participants reported on their health information sources, HL, handwashing knowledge and behavior, number of social interactions, and HRQoL. Associations between study variables and specified outcomes were explored using multiple linear and logistic regression analyses. Results Television (TV) and family were indicated to be the main sources for pandemic-related health information. Handwashing, physical distancing, and limiting the number of social contacts were the most frequently reported measures. HL and handwashing knowledge and HL and handwashing behavior were significantly associated. For each unit increase on the HL scale, the participants were 5% more likely to socialize less with friends in comparison to normal. The mean HRQoL was very poor compared to European norms. Being quarantined or isolated and having confirmed or suspected Covid-19 were significantly negatively associated with HRQoL, but seeing less friends than normal was not associated. HL was significantly positively associated with HRQoL, albeit of minor clinical importance. Conclusion Adolescents follow the health authorities’ guidelines and appear highly literate. However, high fidelity requires great sacrifice because the required measures seem to collide with certain aspects that are important for the adolescents’ HRQoL.