Monitoramento das Produções

Title: Congenital Zika syndrome is associated with maternal protein malnutrition
Authors: Barbeito-Andrés, J.; Pezzuto, P.; Higa, L. M.; Dias, A. A.; Vasconcelos, J. M.; Santos, T. M. P.; Ferreira, J. C. C. G.; Ferreira, R. O.; Dutra, F. F.; Rossi, A. D.; Barbosa, R. V.; Amorim, C. K. N.; Souza, M. P. C. de; Chimelli, L.; Aguiar, R. S.; Gonzalez, P. N.; Lara, F. A.; Castro, M. C.; Molnár, Z.; Lopes, R. T.; Bozza, M. T.; Vianez, J. L. S. G.; Barbeito, C. G.; Cuervo, P.; Bellio, M.; Tanuri, A.; Garcez, P. P.
Description: Acesso aberto em 06/08/2020 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6954064/pdf/aaw6284.pdf

by Elena Loli Piccolomini, Fabiana Zama

Due to the recent evolution of the COVID-19 outbreak, the scientific community is making efforts to analyse models for understanding the present situation and for predicting future scenarios. In this paper, we propose a forced Susceptible-Exposed-Infected-Recovered-Dead (fSEIRD) differential model for the analysis and forecast of the COVID-19 spread in Italian regions, using the data from the Italian Protezione Civile (Italian Civil Protection Department) from 24/02/2020. In this study, we investigate an adaptation of fSEIRD by proposing two different piecewise time-dependent infection rate functions to fit the current epidemic data affected by progressive movement restriction policies put in place by the Italian government. The proposed models are flexible and can be quickly adapted to monitor various epidemic scenarios. Results on the regions of Lombardia and Emilia-Romagna confirm that the proposed models fit the data very accurately and make reliable predictions.

by Thomas G. Kannampallil, Charles W. Goss, Bradley A. Evanoff, Jaime R. Strickland, Rebecca P. McAlister, Jennifer Duncan

The coronavirus disease 2019 (COVID-19) pandemic has put considerable physical and emotional strain on frontline healthcare workers. Among frontline healthcare workers, physician trainees represent a unique group—functioning simultaneously as both learners and caregivers and experiencing considerable challenges during the pandemic. However, we have a limited understanding regarding the emotional effects and vulnerability experienced by trainees during the pandemic. We investigated the effects of trainee exposure to patients being tested for COVID-19 on their depression, anxiety, stress, burnout and professional fulfillment. All physician trainees at an academic medical center (n = 1375) were invited to participate in an online survey. We compared the measures of depression, anxiety, stress, burnout and professional fulfillment among trainees who were exposed to patients being tested for COVID-19 and those that were not, using univariable and multivariable models. We also evaluated perceived life stressors such as childcare, home schooling, personal finances and work-family balance among both groups. 393 trainees completed the survey (29% response rate). Compared to the non-exposed group, the exposed group had a higher prevalence of stress (29.4% vs. 18.9%), and burnout (46.3% vs. 33.7%). The exposed group also experienced moderate to extremely high perceived stress regarding childcare and had a lower work-family balance. Multivariable models indicated that trainees who were exposed to COVID-19 patients reported significantly higher stress (10.96 [95% CI, 9.65 to 12.46] vs 8.44 [95% CI, 7.3 to 9.76]; P = 0.043) and were more likely to be burned out (1.31 [95% CI, 1.21 to1.41] vs 1.07 [95% CI, 0.96 to 1.19]; P = 0.002]. We also found that female trainees were more likely to be stressed (P = 0.043); while unmarried trainees were more likely to be depressed (P = 0.009), and marginally more likely to have anxiety (P = 0.051). To address these challenges, wellness programs should focus on sustaining current programs, develop new and targeted mental health resources that are widely accessible and devise strategies for creating awareness regarding these resources.

by Krit Pongpirul, Kanitha Kaewpoungngam, Korn Chotirosniramit, Sinnop Theprugsa
Introduction Coronavirus disease 2019 (COVID-19) pandemic has affected the aviation industry. Existing protocols have relied on scientifically questionable evidence and might not lead to the optimal balance between public health safety and airlines' financial viability. Objective To explore the implementation feasibility of Thai Airways International protocol from the perspectives of passengers and aircrews. Design An online questionnaire survey of passengers and an in-depth interview with aircrews. Setting Two randomly selected repatriation flights operated by Thai Airways International using Boeing 777 aircraft (TG476 from Sydney and TG492 from Auckland to Bangkok) Participants 377 Thai passengers and 35 aircrews. Results The mean age of passengers was 28.14 (95%CI 26.72 to 29.55) years old; 57.03% were female. TG492 passengers were mostly students and significantly younger than that of TG476 (p

by Viet-Thi Tran, Philippe Ravaud
Background To avoid a surge of demand on the healthcare system due to the COVID-19 pandemic, we must reduce transmission to individuals with chronic conditions who are at risk of severe illness with COVID-19. We aimed at understanding the perceptions, context and attitudes of individuals with chronic conditions during the COVID-19 pandemic to clarify their potential risk of infection. Methods A cross-sectional survey was nested in ComPaRe, an e-cohort of adults with chronic conditions, in France. It assessed participants’ perception of their risk of severe illness with COVID-19; their context (i.e., work, household, contacts with external people); and their attitudes in situations involving frequent or occasional contacts with symptomatic or asymptomatic people. Data were collected from March 23 to April 2, 2020, during the lockdown in France. Analyses were weighted to represent the demographic characteristics of French patients with chronic conditions. The subgroup of participants at high risk according to the recommendations of the French High Council for Public Health was examined. Results Among the 7169 recruited participants, 63% patients felt at risk because of severe illness. About one quarter (23.7%) were at risk of infection because they worked outside home, had a household member working outside home or had regular visits from external contacts. Less than 20% participants refused contact with symptomatic people and

Title: Impact of COVID-19 Pandemic on Sexual Minority Populations in Brazil: An Analysis of Social/Racial Disparities in Maintaining Social Distancing and a Description of Sexual Behavior
Authors: Torres, Thiago S.; Hoagland, Brenda; Bezerra, Daniel R. B.; Garner, Alex; Jalil, Emilia M.; Coelho, Lara E.; Benedetti, Marcos; Pimenta, Cristina; Grinsztejn, Beatriz; Veloso, Valdilea G.

Title: O uso de máscaras para a prevenção e controle da COVID-19
Authors: Girardi, Juliana da Motta; Andrade, Aurélio Matos; Silva, Erica Tatiane da
Abstract: Este documento visa informar os gestores, a comunidade científica e a população em geral a respeito do uso dos diferentes tipos de máscaras para proteção contra a COVID-19.
Description: Projeto Gráfico e Fotografia: Sérgio Velho Junior - Fundação Oswaldo Cruz. Fiocruz Brasília. Escola Fiocruz de Governo. Brasília, DF, Brasil. ; Infografico: Fernanda Reis Ribeiro.

by Rendani Mbuvha, Tshilidzi Marwala

The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has highlighted the need for performing accurate inference with limited data. Fundamental to the design of rapid state responses is the ability to perform epidemiological model parameter inference for localised trajectory predictions. In this work, we perform Bayesian parameter inference using Markov Chain Monte Carlo (MCMC) methods on the Susceptible-Infected-Recovered (SIR) and Susceptible-Exposed-Infected-Recovered (SEIR) epidemiological models with time-varying spreading rates for South Africa. The results find two change points in the spreading rate of COVID-19 in South Africa as inferred from the confirmed cases. The first change point coincides with state enactment of a travel ban and the resultant containment of imported infections. The second change point coincides with the start of a state-led mass screening and testing programme which has highlighted community-level disease spread that was not well represented in the initial largely traveller based and private laboratory dominated testing data. The results further suggest that due to the likely effect of the national lockdown, community level transmissions are slower than the original imported case driven spread of the disease.

by Karien Meier, Toivo Glatz, Mathijs C. Guijt, Marco Piccininni, Merel van der Meulen, Khaled Atmar, Anne-Tess C. Jolink, Tobias Kurth, Jessica L. Rohmann, Amir H. Zamanipoor Najafabadi, on behalf of the COVID-19 Survey Study group
Background The extent to which people implement government-issued protective measures is critical in preventing further spread of coronavirus disease 2019 (COVID-19) caused by coronavirus SARS-CoV-2. Our study aimed to describe the public belief in the effectiveness of protective measures, the reported implementation of these measures, and to identify communication channels used to acquire information on COVID-19 in European countries during the early stage of the pandemic. Methods and findings An online survey available in multiple languages was disseminated starting on March 19th, 2020. After five days, we computed descriptive statistics for countries with more than 500 respondents. Each day, we assessed enacted community containment measures by stage of stringency (I-IV). In total, 9,796 adults responded, of whom 8,611 resided in the Netherlands (stage III), 604 in Germany (stage III), and 581 in Italy (stage IV). To explore possible dynamics as containment strategies intensified, we also included 1,365 responses submitted during the following week. Participants indicated support for governmental measures related to avoiding social gatherings, selective closure of public places, and hand hygiene and respiratory measures (range for all measures: 95.0%-99.7%). Respondents from the Netherlands less frequently considered a complete social lockdown effective (59.2%), compared to respondents in Germany (76.6%) or Italy (87.2%). Italian residents applied enforced social distancing measures more frequently (range: 90.2%-99.3%, German and Dutch residents: 67.5%-97.0%) and self-initiated hygienic and social distancing behaviors (range: 36.3%-96.6%, German and Dutch residents: 28.3%-95.7%). Respondents reported being sufficiently informed about the outbreak and behaviors to avoid infection (range: 90.2%-91.1%). Information channels most commonly reported included television newspapers, official health websites, and social media. One week later, we observed no major differences in submitted responses. Conclusions During the early stage of the COVID-19 pandemic, belief in the effectiveness of protective measures among survey respondents from three European countries was high and participants reported feeling sufficiently informed. In March 2020, implementation of measures differed between countries and were highest among respondents from Italy, who were subjected to the most stringent lockdown measures and greatest COVID-19 burden in Europe during this period.

Title: Boletim Epidemiológico vol.1: situação epidemiológica da COVID-19 entre trabalhadores da Fiocruz
Abstract: Esse primeiro boletim é fruto de um esforço para compatibilizar as informações dessas duas fontes de
informação diferentes no intervalo de um mês (monitoramento do Nust e da plataforma eletrônica). Os
dados foram consolidados e se encontram descritos nos gráficos e tabelas deste boletim. É importante
ressaltar que nem todas as perguntas foram respondidas e que os dados apresentados nesta edição se
referem ao total de informações disponíveis, dispensando a contabilização dos dados faltantes.

by Morgane Verduyn, Nathalie Allou, Virgile Gazaille, Michel Andre, Tannvir Desroche, Marie-Christine Jaffar, Nicolas Traversier, Cecile Levin, Marie Lagrange-Xelot, Marie-Pierre Moiton, Stella Hoang

by Murilo Sena Amaral, Ernesto Goulart, Luiz Carlos Caires-Júnior, David Abraham Morales-Vicente, Alessandra Soares-Schanoski, Roselane Paiva Gomes, Giovanna Gonçalves de Oliveira Olberg, Renato Mancini Astray, Jorge E. Kalil, Mayana Zatz, Sergio Verjovski-Almeida

Zika virus (ZIKV) causes congenital Zika syndrome (CZS), which is characterized by fetal demise, microcephaly and other abnormalities. ZIKV in the pregnant woman circulation must cross the placental barrier that includes fetal endothelial cells and trophoblasts, in order to reach the fetus. CZS occurs in ~1–40% of cases of pregnant women infected by ZIKV, suggesting that mothers’ infection by ZIKV during pregnancy is not deterministic for CZS phenotype in the fetus. Therefore, other susceptibility factors might be involved, including the host genetic background. We have previously shown that in three pairs of dizygotic twins discordant for CZS, neural progenitor cells (NPCs) from the CZS-affected twins presented differential in vitro ZIKV susceptibility compared with NPCs from the non-affected. Here, we analyzed human-induced-pluripotent-stem-cell-derived (hiPSC-derived) trophoblasts from these twins and compared by RNA-Seq the trophoblasts from CZS-affected and non-affected twins. Following in vitro exposure to a Brazilian ZIKV strain (ZIKVBR), trophoblasts from CZS-affected twins were significantly more susceptible to ZIKVBR infection when compared with trophoblasts from the non-affected. Transcriptome profiling revealed no differences in gene expression levels of ZIKV candidate attachment factors, IFN receptors and IFN in the trophoblasts, either before or after ZIKVBR infection. Most importantly, ZIKVBR infection caused, only in the trophoblasts from CZS-affected twins, the downregulation of genes related to extracellular matrix organization and to leukocyte activation, which are important for trophoblast adhesion and immune response activation. In addition, only trophoblasts from non-affected twins secreted significantly increased amounts of chemokines RANTES/CCL5 and IP10 after infection with ZIKVBR. Overall, our results showed that trophoblasts from non-affected twins have the ability to more efficiently activate genes that are known to play important roles in cell adhesion and in triggering the immune response to ZIKV infection in the placenta, and this may contribute to predict protection from ZIKV dissemination into fetuses’ tissues.

Title: Analysis of Humoral Immune Responses in Chikungunya Virus (CHIKV)-Infected Patients and Individuals Vaccinated With a Candidate CHIKV Vaccine
Authors: Henss, Lisa; Yue, Constanze; Von Rhein, Christine; Tschismarov, Roland; Lewis-Ximenez, Lia Laura; Dölle, Albert; Baylis, Sally A.; Schnierle, Barbara S.

Title: Learning from the Italian experience in coping with COVID-19
Authors: Carvalho, Anna Cristina Calçada; Kritski, Afrânio

Title: Boletim Epidemiológico vol.7: situação epidemiológica da COVID-19 entre trabalhadores da Fiocruz: semanas epidemiológicas 10 a 27
Abstract: O sétimo volume do Boletim Epidemiológico (BE) sobre a situação da COVID-19 entre trabalhadores ativos, aposentados e alunos da Fiocruz, com atualizações que incluem as duas últimas semanas epidemiológicas - semana 26 que abrange os dias 21 a 27/06 e a semana 27, de 28/06 a 04/07.

Title: Boletim Epidemiológico vol.8: situação epidemiológica da COVID-19 entre trabalhadores da Fiocruz: semanas epidemiológicas 10 a 29
Abstract: O oitavo volume do Boletim Epidemiológico (BE) sobre a situação da COVID-19 entre trabalhadores ativos, aposentados e alunos da Fiocruz incluem dados das duas últimas semanas epidemiológicas - semana 28 que abrange os dias 05 a 11/07 e a semana 29, de 12 a 18/07.

Title: Covid-19: dados abertos para a ciência
Authors: Campagnucci, Fernanda
Description: Fernanda Campagnucci da Open Knowledge Brasil, palestrante convidada para dar palestra no Evento promovido pela Fiocruz/VPEIC e realizado no dia 18 de junho, em ambiente virtual. A proposta foi aproximar as duas perspectivas - Governo Aberto e Ciência Aberta, que estão impulsionando as instituições da administração pública na direção da transparência, do acesso à informação pública e da participação social.

Title: Webinar: jornalismo e mídias sociais em tempos de Covid
Abstract: A Rede Covida - Ciência, Informação e Solidariedade, uma iniciativa do Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs/Fiocruz Bahia) e da Universidade Federal da Bahia (Ufba), realizou no dia 28 de março de 2020 o Webinar de Jornalismo e Mídias Sociais em Tempos de Covid-19. O encontro virtual visou ajudar os profissionais de comunicação a dar informações de saúde neste contexto da pandemia do Coronavírus.

Title: Covid-19: aspectos e razões da resistência ao distanciamento
Abstract: O webinar “Covid-19: aspectos e razões da resistência ao distanciamento” traz o tema à mesa virtual de debates a partir do olhar de três experientes pesquisadores -- o cientista político André Singer, o psicanalista Christian Dunker e o antropólogo Carl Kendall. Os dois primeiros são professores da Universidade de São Paulo (USP) e o terceiro, da Universidade Tulane, neste momento trabalhando na Universidade Federal do Ceará (UFC). Participam da conversa com eles três jornalistas, Lucas Veloso, da Agência Mural de Jornalismo das Periferias, Sabine Righetti, da Agência Bori e Mariluce Moura, do Ciência na rua, que atuará como mediadora.

by Piotr Skórka, Beata Grzywacz, Dawid Moroń, Magdalena Lenda

Severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19), has expanded rapidly throughout the world. Thus, it is important to understand how global factors linked with the functioning of the Anthropocene are responsible for the COVID-19 outbreak. We tested hypotheses that the number of COVID-19 cases, number of deaths and growth rate of recorded infections: (1) are positively associated with population density as well as (2) proportion of the human population living in urban areas as a proxies of interpersonal contact rate, (3) age of the population in a given country as an indication of that population’s susceptibility to COVID-19; (4) net migration rate and (5) number of tourists as proxies of infection pressure, and negatively associated with (5) gross domestic product which is a proxy of health care quality. Data at the country level were compiled from publicly available databases and analysed with gradient boosting regression trees after controlling for confounding factors (e.g. geographic location). We found a positive association between the number of COVID-19 cases in a given country and gross domestic product, number of tourists, and geographic longitude. The number of deaths was positively associated with gross domestic product, number of tourists in a country, and geographic longitude. The effects of gross domestic product and number of tourists were non-linear, with clear thresholds above which the number of COVID-19 cases and deaths increased rapidly. The growth rate of COVID-19 cases was positively linked to the number of tourists and gross domestic product. The growth rate of COVID-19 cases was negatively associated with the mean age of the population and geographic longitude. Growth was slower in less urbanised countries. This study demonstrates that the characteristics of the human population and high mobility, but not population density, may help explain the global spread of the virus. In addition, geography, possibly via climate, may play a role in the pandemic. The unexpected positive and strong association between gross domestic product and number of cases, deaths, and growth rate suggests that COVID-19 may be a new civilisation disease affecting rich economies.

by Daniel J. McGrail, Jianli Dai, Kathleen M. McAndrews, Raghu Kalluri

The outbreak the SARS-CoV-2 (CoV-2) virus has resulted in over 6.5 million cases of COVID19, greatly stressing global healthcare infrastructure. Lacking medical prophylactic measures to combat disease spread, many nations have adopted social distancing policies in order to mitigate transmission of CoV-2. While mathematical models have suggested the efficacy of social distancing to curb the spread of CoV-2, there is a lack of systematic studies to quantify the real-world efficacy of these approaches. Here, we first demonstrate that implementation of social distancing policies in US states corresponded with a reduction in COVID19 spread rates, and that the reduction in spread rate is proportional to the average change in mobility. We validate this observation on a worldwide scale by analyzing COVID19 spread rate in 134 nations with varying social distancing policies. Globally, we find that social distancing policies significantly reduced the COVID19 spread rate, with resulting in an estimated 65% reduction (95% CI = 39–80%) in new COVID19 cases over a two week time period. These data suggest that social distancing policies may be a powerful tool to prevent spread of COVID19 in real-world scenarios.

by Zirun Zhao, Anne Chen, Wei Hou, James M. Graham, Haifang Li, Paul S. Richman, Henry C. Thode, Adam J. Singer, Tim Q. Duong

This study aimed to develop risk scores based on clinical characteristics at presentation to predict intensive care unit (ICU) admission and mortality in COVID-19 patients. 641 hospitalized patients with laboratory-confirmed COVID-19 were selected from 4997 persons under investigation. We performed a retrospective review of medical records of demographics, comorbidities and laboratory tests at the initial presentation. Primary outcomes were ICU admission and death. Logistic regression was used to identify independent clinical variables predicting the two outcomes. The model was validated by splitting the data into 70% for training and 30% for testing. Performance accuracy was evaluated using area under the curve (AUC) of the receiver operating characteristic analysis (ROC). Five significant variables predicting ICU admission were lactate dehydrogenase, procalcitonin, pulse oxygen saturation, smoking history, and lymphocyte count. Seven significant variables predicting mortality were heart failure, procalcitonin, lactate dehydrogenase, chronic obstructive pulmonary disease, pulse oxygen saturation, heart rate, and age. The mortality group uniquely contained cardiopulmonary variables. The risk score model yielded good accuracy with an AUC of 0.74 ([95% CI, 0.63–0.85], p = 0.001) for predicting ICU admission and 0.83 ([95% CI, 0.73–0.92], p

by Rebecca C. Christofferson, Daniel M. Parker, Hans J. Overgaard, Jeffrey Hii, Gregor Devine, Bruce A. Wilcox, Vu Sinh Nam, Sazaly Abubakar, Sebastien Boyer, Kobporn Boonnak, Stephen S. Whitehead, Rekol Huy, Leang Rithea, Tho Sochantha, Thomas E. Wellems, Jesus G. Valenzuela, Jessica E. Manning

by Elnadi Hager, Ismail A. Odetokun, Obasanjo Bolarinwa, Ahmed Zainab, Ochulor Okechukwu, Ahmad I. Al-Mustapha

The current Coronavirus (COVID-19) pandemic has impacted and changed lives on a global scale since its emergence and spread from China in late 2019. It has caused millions of infections, and thousands of deaths worldwide. However, the control of this pandemic still remains unachievable in many African countries including Egypt and Nigeria, despite the application of some strict preventive and control measures. Therefore, this study assessed the knowledge, attitude, and perceptions of Egyptians and Nigerians towards the COVID-19 pandemic. This study was designed as a cross-sectional community-based questionnaire survey in both countries. Participants’ demography, knowledge, attitude, and perceptions towards the COVID-19 outbreak were obtained using a convenience sampling technique. Data collected were subjected to descriptive statistics and logistic regression analysis. A total of 1437 respondents were included in this preliminary report. The mean knowledge score was 14.7±2.3. The majority of the respondents (61.6%) had a satisfactory knowledge of the disease. Age (18–39 years), education (College/bachelors), and background of respondents were factors influencing knowledge levels. The attitude of most respondents (68.9%) towards instituted preventive measures was satisfactory with an average attitude score of 6.9 ± 1.2. The majority of the respondents (96%) practiced self-isolation and social-distancing but only 36% follow all health recommendations. The perception of most respondents (62.1%) on the global efforts at controlling the virus and preventing further spread was satisfactory with an average score of 10.9 ± 2.7. Only 22% of the respondents were satisfied with their country’s handling of the pandemic. An apprehensive understanding of the current status in Africa through studies like KAP is crucial to avoid Africa being the next epicenter of the pandemic. For the populace to follow standard infection prevention and control measures adequately, governments need to gain the trust of citizens by strengthening the health systems and improving surveillance activities in detecting cases, to offer the optimum health services to their communities.

by Se Yoon Lee, Bowen Lei, Bani Mallick

Currently, novel coronavirus disease 2019 (COVID-19) is a big threat to global health. The rapid spread of the virus has created pandemic, and countries all over the world are struggling with a surge in COVID-19 infected cases. There are no drugs or other therapeutics approved by the US Food and Drug Administration to prevent or treat COVID-19: information on the disease is very limited and scattered even if it exists. This motivates the use of data integration, combining data from diverse sources and eliciting useful information with a unified view of them. In this paper, we propose a Bayesian hierarchical model that integrates global data for real-time prediction of infection trajectory for multiple countries. Because the proposed model takes advantage of borrowing information across multiple countries, it outperforms an existing individual country-based model. As fully Bayesian way has been adopted, the model provides a powerful predictive tool endowed with uncertainty quantification. Additionally, a joint variable selection technique has been integrated into the proposed modeling scheme, which aimed to identify possible country-level risk factors for severe disease due to COVID-19.

by Camila Alves dos Santos Siqueira, Yan Nogueira Leite de Freitas, Marianna de Camargo Cancela, Monica Carvalho, Albert Oliveras-Fabregas, Dyego Leandro Bezerra de Souza

It is paramount to expand the knowledge base and minimize the consequences of the pandemic caused by the new Coronavirus (SARS-Cov2). Spain is among the most affected countries that declared a countrywide lockdown. An ecological study is presented herein, assessing the trends for incidence, mortality, hospitalizations, Intensive Care Unit admissions, and recoveries per autonomous community in Spain. Trends were evaluated by the Joinpoint software. The timeframe employed was when the lockdown was declared on March 14, 2020. Daily percentage changes were also calculated, with CI = 95% and p

by Peter J. Hotez, Maria Elena Bottazzi

Title: Yellow fever epizootics in non‑human primates, Southeast and Northeast Brazil (2017 and 2018)
Authors: Mares-Guia, Maria Angélica Monteiro de Mello; Horta, Marco A.; Romano, Alessandro; Rodrigues, Cintia D. S.; Mendonça, Marcos C. L.; Santos, Carolina C. dos; Torres, Maria C.; Araujo, Eliane S. M.; Fabri, Allison; Souza, Everton R. de; Ribeiro, Roberta O. R; Lucena, Fabiana P.; Junior, Luiz C. A.; Cunha, Rivaldo V, da; Nogueira, Rita Maria Ribeiro; Sequeira, Patricia C. S; Fillipis, Ana Maria Bispo de

by Jocelyn Zhu, Beiyi Shen, Almas Abbasi, Mahsa Hoshmand-Kochi, Haifang Li, Tim Q. Duong

This study employed deep-learning convolutional neural networks to stage lung disease severity of Coronavirus Disease 2019 (COVID-19) infection on portable chest x-ray (CXR) with radiologist score of disease severity as ground truth. This study consisted of 131 portable CXR from 84 COVID-19 patients (51M 55.1±14.9yo; 29F 60.1±14.3yo; 4 missing information). Three expert chest radiologists scored the left and right lung separately based on the degree of opacity (0–3) and geographic extent (0–4). Deep-learning convolutional neural network (CNN) was used to predict lung disease severity scores. Data were split into 80% training and 20% testing datasets. Correlation analysis between AI-predicted versus radiologist scores were analyzed. Comparison was made with traditional and transfer learning. The average opacity score was 2.52 (range: 0–6) with a standard deviation of 0.25 (9.9%) across three readers. The average geographic extent score was 3.42 (range: 0–8) with a standard deviation of 0.57 (16.7%) across three readers. The inter-rater agreement yielded a Fleiss’ Kappa of 0.45 for opacity score and 0.71 for extent score. AI-predicted scores strongly correlated with radiologist scores, with the top model yielding a correlation coefficient (R2) of 0.90 (range: 0.73–0.90 for traditional learning and 0.83–0.90 for transfer learning) and a mean absolute error of 8.5% (ranges: 17.2–21.0% and 8.5%-15.5, respectively). Transfer learning generally performed better. In conclusion, deep-learning CNN accurately stages disease severity on portable chest x-ray of COVID-19 lung infection. This approach may prove useful to stage lung disease severity, prognosticate, and predict treatment response and survival, thereby informing risk management and resource allocation.

by Jill M. Newby, Kathleen O’Moore, Samantha Tang, Helen Christensen, Kate Faasse

The acute and long-term mental health impacts of the COVID-19 pandemic are unknown. The current study examined the acute mental health responses to the COVID-19 pandemic in 5070 adult participants in Australia, using an online survey administered during the peak of the outbreak in Australia (27th March to 7th April 2020). Self-report questionnaires examined COVID-19 fears and behavioural responses to COVID-19, as well as the severity of psychological distress (depression, anxiety and stress), health anxiety, contamination fears, alcohol use, and physical activity. 78% of respondents reported that their mental health had worsened since the outbreak, one quarter (25.9%) were very or extremely worried about contracting COVID-19, and half (52.7%) were worried about family and friends contracting COVID-19. Uncertainty, loneliness and financial worries (50%) were common. Rates of elevated psychological distress were higher than expected, with 62%, 50%, and 64% of respondents reporting elevated depression, anxiety and stress levels respectively, and one in four reporting elevated health anxiety in the past week. Participants with self-reported history of a mental health diagnosis had significantly higher distress, health anxiety, and COVID-19 fears than those without a prior mental health diagnosis. Demographic (e.g., non-binary or different gender identity; Aboriginal and Torres Strait Islander status), occupational (e.g., being a carer or stay at home parent), and psychological (e.g., perceived risk of contracting COVID-19) factors were associated with distress. Results revealed that precautionary behaviours (e.g., washing hands, using hand sanitiser, avoiding social events) were common, although in contrast to previous research, higher engagement in hygiene behaviours was associated with higher stress and anxiety levels. These results highlight the serious acute impact of COVID-19 on the mental health of respondents, and the need for proactive, accessible digital mental health services to address these mental health needs, particularly for those most vulnerable, including people with prior history of mental health problems. Longitudinal research is needed to explore long-term predictors of poor mental health from the COVID-19 pandemic.