Monitoramento das Produções

by Andrés Ríos-Gutiérrez, Soledad Torres, Viswanathan Arunachalam

This paper studies the updated estimation method for estimating the transmission rate changes over time. The models for the population dynamics under SEIR epidemic models with stochastic perturbations are analysed the dynamics of the COVID-19 pandemic in Bogotá, Colombia. We performed computational experiments to interpret COVID-19 dynamics using actual data for the proposed models. We estimate the model parameters and updated their estimates for reported infected and recovered data.

by Ana Paula Brioschi dos Santos, Creuza Rachel Vicente, João Paulo Cola, Luana Fiengo Tanaka, Juliana Rodrigues Tovar Garbin, Larissa Soares Dell’Antonio, Cristiano Soares da Silva Dell’Antonio, Angelica Espinosa Miranda
Objective The study aimed to evaluate the risk of maternal death and fetal death among pregnant women infected with SARS-CoV-2. Methods This is a retrospective cohort study among pregnant women with secondary data from the National Live Births System (Sistema Nacional de Nascidos Vivos), National Mortality System (Sistema Nacional de Mortalidade), and e-SUS Health Surveillance System (Sistema e-SUS Vigilância em Saúde). Pregnant women confirmed for COVID-19 had positive RT-PCR between March 2020 and May 2021, pregnant women without COVID-19 were those without notification for disease. Maternal death, fetal death, and stillbirth were assessed as primary outcomes. Results We included 68,673 pregnant women not notified as suspected of COVID-19 and 1,386 with a confirmed diagnosis of COVID-19. Among pregnant women with COVID-19, 1013 (73.0%) were aged 20 to 34 years, 655 (47.2%) were brown, 907 (65.4%) had ≥ 8 years of education, in the third trimester of pregnancy (41.5%), undergoing cesarean section (64.5%). In adjusted analyses, COVID-19 in pregnancy had a higher risk of maternal death (relative risk [RR] 18.73–95% confidence interval [95%CI] 11.07–31.69), fetal death/stillbirth (RR 1.96–95%CI 1.18–3.25), preterm birth [RR 1.18–95%CI 1.01–1.39], cesarean delivery (RR 1.07–95%CI 1.02–1.11), and cesarean delivery occurring before the onset of labor (RR 1.33–95%CI 1.23–1.44). Conclusion COVID-19 may contribute to unfavorable pregnancy outcomes. Results showed that pregnant women infected with SARS-CoV-2 had a higher risk of maternal death, fetal death/stillbirth, preterm birth, cesarean delivery, and cesarean section occurring before the onset of labor.

by Jieun Jang, Hyopin Jeong, Bong-Hwa Kim, Sura An, Hye-Ryun Yang, Sunjoo Kim
Objectives Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine effectiveness in coronavirus disease (COVID-19) patients with breakthrough infections has not been established in South Korea. To address this, we assessed the impact of vaccination on symptom occurrence and viral load. Methods We performed a retrospective cohort study of 9,030 COVID-19 patients enrolled between February and November 2021. The impact of vaccination on the incidence of symptoms and viral load as indicated by cycle threshold (Ct) values of RdRp and E genes was evaluated using relative risks (RRs) and 95% confidence intervals (95% CIs). Results Compared with unvaccinated patients, fully vaccinated patients were associated with a reduced symptom onset of cough, sputum, and myalgia in COVID-19 patients (RR (95% CI) = 0.86 (0.75–0.99) for cough; RR (95% CI) = 0.74 (0.56–0.98) for sputum; RR (95% CI) = 0.65 (0.53–0.79) for myalgia, respectively). Additionally, lower risk of high viral load, Ct value of RdRp gene

by Sudeep R. Bapat, Sreeranjini T. M.

Due to the outbreak of COVID-19, the last couple of years have been drastic in terms of human behavioural patterns. The pandemic has taught us key lessons about crisis, communication and misinformation. People were forced to stay at home for a very long duration because of the strict lockdown measures imposed by governments all over the globe. India was no exception, wherein the Indian government imposed several very strict lockdowns all across the country, which restricted human activities and their social behaviours. However, such restrictions were seen to have a positive impact on environment and ecology. In this paper, we aim to study the changes in House sparrow sightings, as a result of the lockdowns. It is postulated that the lockdowns give rise to increased House sparrow numbers, which we try to argue, using appropriate exploratory analysis and statistical modelling. We apply a specific “zero-inflated Poisson” regression model in this regard.

by Shakera Ahmed, Anwarul Karim, Tanvir Kabir Chowdhury, Orindom Shing Pulock, Nowrin Tamanna, Mastura Akter, Puja Biswas, Fahmida Afroz, Susmita Dey Pinky, Anika Nahrin Alabbi, Tasnuba Raisa Jamil, Zarin Tasnim, Dipa Dev, Mraching Marma, Tasmiah Tahera Aziz, Hafiz Ahmed Nazmul Hakim, A. K. M. Khairul Basher, Nur Hossain Bhuiyan Shahin, Tahmina Banu
Background The COVID-19 pandemic has significantly impacted the surgical practice throughout the world, including elective surgical care. This study investigated the characteristics of patients undergoing elective surgery, the prevalence of COVID-19 infection, the surgical procedures performed, and 30-day mortality in general and pediatric surgical settings in selected tertiary-level hospitals in Bangladesh from November 2020 to August 2021. Methods This serial cross-sectional study included 264 patients scheduled for elective surgeries during the study period. All patients underwent COVID-19 real-time polymerase chain reaction (RT-PCR) testing within 24 hours before surgery. Data on age, sex, common comorbidities, surgical procedures, and 30-day mortality were collected and analyzed. Furthermore, comparisons were made between COVID-19 positive and negative patients. Results The prevalence of COVID-19 infection among patients was 10.6%. Older age, a history of major surgery within the last three months, hypertension, and diabetes mellitus were significantly associated with COVID-19 infection. All COVID-19-negative patients underwent surgery, while only 46.4% of COVID-19-positive patients underwent surgery. The most common surgical procedures were related to the digestive system, breast, and urinary system. Only one patient (0.4%) died within 30 days after surgery among the COVID-19-negative patients, whereas two patients (7.1%) died among the COVID-19-positive patients: one before surgery and one after surgery. Conclusions This study provides valuable insights into the characteristics, burden of COVID-19 infection, and 30-day mortality of patients undergoing elective surgery in tertiary care centers in Bangladesh during the pandemic.

by Caleb Arthur, Kathleen Abenes, Marika Waselewski, Samantha A. Chuisano, Tammy Chang
Background Social gatherings are frequent sources of COVID-19 infections, especially among youth. However, little is known about youth testing behaviors before and after gatherings. Our aim was to assess behaviors and perceptions of youth related to testing for COVID-19 before or after social gatherings in order to inform efforts to reduce disease spread. Methods Five open-ended questions were texted to participants aged 14–24 throughout the United States via MyVoice. Using a content analysis approach, two investigators reviewed responses by question, developed a codebook, and independently applied codes. Discrepancies were resolved via discussion. Code frequency and demographic data were summarized using descriptive statistics. Results Of 1204 participants, 989 responded to at least one question (RR = 94.1%). The mean age was 20.2 years (SD: 2.4 years). Most participants (80.7%) reported testing for COVID-19 at least once. Most (70.6%) were likely to test following an event, especially “[i]f someone at the gathering tested positive,” while a smaller number (50.9%) endorsed testing prior to a gathering. Of youth who would not get tested, being vaccinated was the highest reported. Conclusion Youth in our nationwide sample are likely to test for COVID-19 after an event, though less likely if they are vaccinated. Their desire to test is primarily driven by symptoms, exposures, and requirements. Youth are interested in increased access to home testing. Youth-centered communications regarding testing recommendations and increased test availability for youth may reduce COVID-19 spread among young people and inform future pandemic recommendations.

by Arielle Doris Tetgoum Kachie, Lulin Zhou, Prince Ewudzie Quansah, Xinglong Xu, Thomas Martial Epalle, Berty Nsolly Ngajie

The working conditions created by the Covid-19 pandemic have been proven to amplify frontline nurses’ desire to leave their profession in recent years; thus, exploring new causing variables is vital. This cross-sectional study examined role demands’ direct and indirect effects on turnover intention through compassion fatigue and tested the various dimensions of spiritual leadership as moderators on the relationship between compassion fatigue and turnover intention. A total of 527 valid responses were collected from frontline nurses working in designated hospitals across Zhejiang province in China using a survey questionnaire. The outcomes from the hierarchical regression analysis indicated that role demands positively and significantly impacted turnover intention and compassion fatigue. Besides, compassion fatigue significantly and positively affected turnover intention and mediated its relationship with role demands. However, vision and altruistic love moderated the relationship between compassion fatigue and turnover intention, which was not true for the dimension hope/faith. This study’s findings are a steppingstone for medical firms’ managers and policymakers in demonstrating the likelihood of frontline nurses developing turnover thoughts arising from ambiguous and conflicting roles and the emotional strain from patients’ burdens. Furthermore, an exemplary implementation of spiritual leadership could help enhance nurses’ sense of calling and membership, essential in embracing the organization’s vision and achieving its goals.

by Guangli Yang, Liangchen Zhang

The outbreak of the COVID-19 in early 2020 and the recurring epidemic in later years have disturbed China’s economy. Moreover, China’s demographic dividend has been disappearing due to its fastest aging population and declining birth rate. The birth rates in eastern provinces of China are much lower than those of the western provinces. Considering the impacts of the COVID-19 and aging population, this paper focused on the relationship between birth rate and the disposable income and tried to find effective measures to raise China’s birth rate. We discovered through regression analysis that the link between per capita disposable income and birth rate is initially "reverse J" and later "inverted J", indicating that per capita disposable income will influence the birth rate. Women’s employment rate and educational level are negatively correlated with the birth rate. To raise the fertility rate in China, it is necessary to increase the marriage rate and the willingness to have children by raising the per capita disposable income and introducing effective tax relief policies.

by Xuqing Wen, Weiwei Xie, Juan Gao, Dedong Zhang, Mengxin Yang, Zhiqing Zhang, Yingfeng Du, Yiran Jin

Radix Scutellaria-Licorice drug pair (RSLDP), a frequently used herbal pair with the effect of clearing heat and detoxifying, is the commonly employed drug pair in TCM prescriptions for the treatment of COVID-19. Until now, the metabolism feature and anti-COVID-19 mechanism of RSLDP have not been fully elucidated. In this study, a sensitive and rapid method was developed for the separation and identification of the absorbed constituents of RSLDP in the rat plasma by UHPLC-QTOF-MS. Additionally, we optimized the conventional methodologies of network pharmacology and proposed a new concept called target network pharmacology (T-NP). It used the absorbed constituents and the corresponding targets to generate a compound-target network, and compared to conventional network pharmacology, it could reduce false-positive results. A total of 85 absorbed constituents were identified or tentatively characterized in dosed plasma, including 32 components in the group of Radix Scutellaria, 27 components in the group of Licorice, and 65 components in the group of RSLDP. The results showed that the compatibility of Radix Scutellaria and Licorice increased the number of components in vivo. We found that 106 potential targets among the 61 active compounds in RSLDP were related to COVID-19. And 12 targets (STAT3, AKT1, EGFR, HSP9AA1, MAPK3, JUN, IL6, VEGFA, TNF, IL2, RELA, and STAT1) could be core targets for RSLDP in treating COVID-19. Results from these targets indicate that RSLDP treatment of COVID-19 mainly involves response to chemical stress, response to oxygenates, positive regulation of cytokines, PI3K-Akt signaling pathway, AGE-RAGE signaling pathway for diabetic complications, virus-related pathways such as novel coronavirus and human cytomegalovirus infection, inflammatory immune-related pathways, and so on. The metabolism feature of RSLDP in vivo was systematically uncovered. The combined use of the T-NP method could discover potential drug targets and disclose the biological processes of RSLDP, which will clarify the potential mechanisms of RSLDP in the treatment of COVID-19.

by William John Robert Thorpe, Leslie Morrison Gutman

Research has demonstrated a disproportionate reduction in the moderate-vigorous physical activity (MVPA) of young UK adults during the initial months of COVID-19. However, previous research has not examined the trajectory of MVPA for this demographic over subsequent phases of the pandemic. The present study investigated the trajectory of MVPA from April 2020 to January 2021 in young UK adults. Data were drawn from 18-29-year-old participants of the Understanding Society COVID-19 Survey (212 males, 542 females). Weekly MVPA was self-reported at three time points (April and September 2020; January 2021) using the International Physical Activity Questionnaire. After controlling for significant covariates, growth curve modelling revealed no variation in weekly MVPA, which remained higher than the UK Physical Activity Guidelines. Female gender; Asian, Black and Mixed ethnicity; lower income,; living with a partner; and no access to a private garden or other outdoor space were associated with lower MVPA in April 2020. Gender, however, was a significant moderator of the trajectory. Males’ MVPA increased between April 2020 to August 2020, followed by a sharp decline; whereas females showed a steady rate of decline from April 2020 to January 2021. Despite the recurrent lockdowns, this study shows that young UK adults, on average, continued to engage in MVPA, above the recommendated amount. Nevertheless, significant variation associated with gender, ethnicity and income highlights the importance of providing accessible spaces for young adults to exercise, especially those with limited access to private gardens.

by L. L. Lima, A. P. F. Atman

In an increasingly interconnected society, preventing epidemics has become a major challenge. Numerous infectious diseases spread between individuals by a vector, creating bipartite networks of infection with the characteristics of complex networks. In the case of dengue, a mosquito-borne disease, these infection networks include a vector—the Aedes aegypti mosquito—which has expanded its endemic area due to climate change. In this scenario, innovative approaches are essential to help public agents in the fight against the disease. Using an agent-based model, we investigated the network morphology of a dengue endemic region considering four different serotypes and a small population. The degree, betweenness, and closeness distributions are evaluated for the bipartite networks, considering the interactions up to the second order for each serotype. We observed scale-free features and heavy tails in the degree distribution and betweenness and quantified the decay of the degree distribution with a q–Gaussian fit function. The simulation results indicate that the spread of dengue is primarily driven by human-to-human and human-to-mosquito interaction, reinforcing the importance of controlling the vector to prevent episodes of epidemic outbreaks.

by Reem Abdelrahim, Zhiwei Gao, Mary Jane Smith, Leigh Anne Newhook
Background Asthma is a highly prevalent chronic inflammatory lung disease and is a frequent cause of hospitalization in children. The COVID-19 pandemic has introduced several challenges that have impacted the delivery of care for vulnerable patients, including asthmatic children. Asthmatic children without immediate access to healthcare services can face severe and fatal consequences. Furthermore, various governmental restrictions and viral mutants have been introduced throughout the pandemic, affecting COVID-19 cases and hospitalization rates. Objectives To investigate the impact of the COVID-19 pandemic on the prevalence of asthma hospitalizations during various stages of the pandemic. We also aim to compare asthma hospital admissions during the pandemic to pre-pandemic periods. Methods and analysis The databases PubMed (MEDLINE), EMBASE, CINAHL, and the Cochrane library will be used to identify relevant articles between the start of the pandemic and the date of the search strategy. Studies will be included if they examine hospital admissions for pediatric (0 to 18 years) asthma patients, regardless of asthma severity, sex, ethnicity or race. Observational retrospective cohort, prospective cohort, and cross-sectional studies will be included. A meta-analysis will be conducted if there are ≥2 articles. Else, a narrative review will be used to report our results. Trial registration PROSPERO registration number: CRD42022337606.

by Somaya Aboelnaga, Katarzyna Czech, Michał Wielechowski, Pavel Kotyza, Lubos Smutka, Kennedy Ndue

Addressing risks and pandemics at a country level is a complex task that requires transdisciplinary approaches. The paper aims to identify groups of the European Union countries characterized by a similar COVID-19 Resilience Index (CRI). Developed in the paper CRI index reflects the countries’ COVID-19 risk and their readiness for a crisis situation, including a pandemic. Moreover, the study detects the factors that significantly differentiate the distinguished groups. According to our research, Bulgaria, Hungary, Malta, and Poland have the lowest COVID-19 Resilience Index score, with Croatia, Greece, Czechia, and Slovakia following close. At the same time, Ireland and Scandinavian countries occupy the top of the leader board, followed by Luxemburg. The Kruskal-Wallis test results indicate four COVID-19 risk indicators that significantly differentiate the countries in the first year of the COVID-19 pandemic. Among the significant factors are not only COVID-19-related factors, i.e., the changes in residential human mobility, the stringency of anti-COVID-19 policy, but also strictly environmental factors, namely pollution and material footprint. It indicates that the most critical global environmental issues might be crucial in the phase of a future pandemic. Moreover, we detect eight readiness factors that significantly differentiate the analysed country groups. Among the significant factors are the economic indicators such as GDP per capita and labour markets, the governance indicators such as Rule of Law, Access to Information, Implementation and Adaptability measures, and social indicators such as Tertiary Attainment and Research, Innovation, and Infrastructure.

by Cameron D. Owens, Camila Bonin Pinto, Peter Mukli, Zsofia Szarvas, Anna Peterfi, Sam Detwiler, Lauren Olay, Ann L. Olson, Guangpu Li, Veronica Galvan, Angelia C. Kirkpatrick, Priya Balasubramanian, Stefano Tarantini, Anna Csiszar, Zoltan Ungvari, Calin I. Prodan, Andriy Yabluchanskiy
Introduction Mild cognitive impairment (MCI) is a prodromal stage to dementia, affecting up to 20% of the aging population worldwide. Patients with MCI have an annual conversion rate to dementia of 15–20%. Thus, conditions that increase the conversion from MCI to dementia are of the utmost public health concern. The COVID-19 pandemic poses a significant impact on our aging population with cognitive decline as one of the leading complications following recovery from acute infection. Recent findings suggest that COVID-19 increases the conversion rate from MCI to dementia in older adults. Hence, we aim to uncover a mechanism for COVID-19 induced cognitive impairment and progression to dementia to pave the way for future therapeutic targets that may mitigate COVID-19 induced cognitive decline. Methodology A prospective longitudinal study is conducted at the University of Oklahoma Health Sciences Center. Patients are screened in the Department of Neurology and must have a formal diagnosis of MCI, and MRI imaging prior to study enrollment. Patients who meet the inclusion criteria are enrolled and followed-up at 18-months after their first visit. Visit one and 18-month follow-up will include an integrated and cohesive battery of vascular and cognitive measurements, including peripheral endothelial function (flow-mediated dilation, laser speckle contrast imaging), retinal and cerebrovascular hemodynamics (dynamic vessel retinal analysis, functional near-infrared spectroscopy), and fluid and crystalized intelligence (NIH-Toolbox, n-back). Multiple logistic regression will be used for primary longitudinal data analysis to determine whether COVID-19 related impairment in neurovascular coupling and increases in white matter hyperintensity burden contribute to progression to dementia.

by Linda Larcombe, Laurie Ringaert, Gayle Restall, Albert McLeod, Elizabeth Hydesmith, Ann Favel, Melissa Morris, Michael Payne, Rusty Souleymanov, Yoav Keynan, Kelly MacDonald, Matthew Singer, Jared Star, Pamela Orr
Background The COVID-19 pandemic (March 2020-May 2023) had a profound effect around the world with vulnerable people being particularly affected, including worsening existing health inequalities. This article explores the impact of the pandemic on health services for First Nations people living with HIV (FN-PWLE) in Manitoba, Canada. This study investigated perceptions of both health care providers and FN-PWLE through qualitative interviews occurring between July 2020 and February 2022 to understand their experience and identify lessons learned that could be translated into health system changes. Methods Using a qualitative, participatory-action, intentional decolonizing approach for this study we included an Indigenous knowledge keeper and Indigenous research associates with lived experience as part of the study team. A total of twenty-five [25] in-depth semi-structured interviews were conducted with eleven healthcare providers (HCPs) and fourteen First Nation people with lived HIV experience (FN-PWLE). In total, 18/25 or 72% of the study participants self-identified as First Nation people. Results The COVID-19 pandemic negatively impacted health services access for FN-PWLE, a) disrupted relationships between FN-PWLE and healthcare providers, b) disrupted access to testing, in-person appointments, and medications, and c) intersectional stigma was compounded. Though, the COVID-19 pandemic also led to positive effects, including the creation of innovative solutions for the health system overall. Conclusions The COVID-19 pandemic exaggerated pre-existing barriers and facilitators for Manitoba FN-PWLE accessing and using the healthcare system. COVID-19 impacted health system facilitators such as relationships and supports, particularly for First Nation people who are structurally disadvantaged and needing more wrap-around care to address social determinants of health. Innovations during times of crisis, included novel ways to improve access to care and medications, illustrated how the health system can quickly provide solutions to long-standing barriers, especially for geographical barriers. Lessons learned from the COVID-19 pandemic should be considered for improvements to the health system’s HIV cascade of care for FN-PWLE and other health system improvements for First Nations people with other chronic diseases and conditions. Finally, this study illustrates the value of qualitative and First Nation decolonizing research methods. Further studies are needed, working together with First Nations organizations and communities, to apply these recommendations and innovations to change health care and people’s lives.

by Catherine Washburn, Melinda E. Kantsiper, Rogette Esteve, Ishaan Gupta, Gulzeb Memon, Henry J. Michtalik, Bayview Educational and Academic Research (BEAR) Core Consortium
Background Morale and burnout were concerns for hospitalists prior to the COVID-19 pandemic; these concerns were amplified as COVID-19 spread and hospitals experienced unprecedented stress. In contrast to prior literature, our study assesses both satisfaction and the importance of various factors. This study examines morale of hospitalists early in the COVID-19 pandemic in two settings: conventional hospitals and a COVID-19 Alternate Care site (ACS) in the same geographic region in Maryland. Multiple studies published early in the pandemic show low morale in COVID-19 hospitals. Methods In a cross-sectional survey study, we analyze data from the Hospitalist Morale Index (HMI) administered between September 2020 and March 2021 to determine the pandemic’s impact on hospitalist morale. Results Surprisingly, our study found morale in the ACS was better than morale at the conventional hospitals. ACS hospitalists and conventional hospitalists were demographically similar. Our results show that a significantly higher proportion of conventional hospitalists reported burnout compared to the ACS hospitalists. General quality of life was rated significantly higher in the ACS group than the conventional group. Significantly more ACS hospitalists were invested in making their group outstanding. Five main HMI domains were examined with questions on a 5-point rating scale: Clinical Factors, Workload, Material Rewards, Leadership, and Appreciation/Acknowledgement. ACS hospitalists rated most measures higher than conventional hospitalists; largest differences were observed in Clinical Factors and Appreciation/Acknowledgement domains. Narrative comments from ACS hospitalists revealed strong identification with the mission of the ACS and pride in contributing during a crisis. One key difference between the two groups explains these findings: provider autonomy. The ACS staff chose the position and the assignment, while conventional hospitalists caring for COVID-19 patients could not readily opt out of this work. Conclusion Our data suggest that autonomy in assignments with risk has implications for morale and burnout.

by Esther Castellanos-Torres, Belén Sanz-Barbero, Carmen Vives-Cases, CIBER Program of Violence and Young People team

There is an increasing awareness of the magnitude of different forms of sexual violence (SV), especially in relation to youth. The COVID-19 pandemic has also had a negative impact on different forms of violence against women. In this study, we aim to analyse SV in the COVID-19 lockdown among young people and SV-related services from the perspective of professionals and young people from different sectors in Spain with responsibilities in attending SV and other forms of violence against women-related. A qualitative content analysis was performed on semi-structured interviews with 23 women and men aged 18 to 24 and 15 professionals working with youth and/or in violence against women or sexual violence related services. The sample was from northern, eastern and central regions of Spain. According to the professionals’ experience, the COVID-19 lockdown lessened their ability to work on violence prevention. Both informants perceived that sexual violence had decreased in public spaces whereas it increased in digital ones and noticed the silence surrounding violent situations had deepened. However, they differed regarding its impact on sexual violence within intimate partners, mainly due to the lack of awareness of this problem among young men. In regard to violence against women and sexual violence, our results highlight the need to develop protocols for action and improve resource accessibility in crisis contexts.

by Pierre-julien Coulaud, Julie Jesson, Naseeb Bolduc, Olivier Ferlatte, Karine Bertrand, Travis Salway, Marie Jauffret-Roustide, Rod Knight
Background While compliance with preventive measures remains central to limit the spread of COVID-19, these measures critically affected mental health of young adults. We therefore investigated the association between the level of compliance with COVID-19 preventive measures and depressive symptoms among young adults in Canada and France. Methods From October to December 2020, we conducted a cross-sectional online survey of young adults ages 18–29 years in Canada (n = 3246) and France (n = 2680) to collect demographic data, experiences with COVID-19 preventive measures, and mental health. Depressive symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9). Compliance profiles were built using cluster analysis. Weighted multivariable logistic regression was used to estimate associations between compliance level and major depressive symptoms (PHQ-9 score≥15) in each country. Results One third of respondents reported major depressive symptoms (Canada: 36.4%, France: 23.4%). Four compliance profiles were identified: high (42.5%), medium-high (21.7%), medium-low (18.1%), and low (17.7%), with high levels more frequently observed in Canada compared to France. In both countries, participants in low compliance profile (Canada: Adjusted Odds Ratio (AOR) [95% Confidence Interval] 0.75 [0.58, 0.98], France: AOR 0.60 [0.46, 0.75]), in the medium-low (Canada: AOR 0.58 [0.48, 0.72], France: AOR 0.81 [0.66, 1.01]), and medium-high compliance profiles (Canada: AOR 0.78 [0.65, 0.93], France: AOR 0.77 [0.63, 0.93]) were less likely to report major depressive symptoms compared to the high compliance profile. Ethno-racial minorities, sexual and gender minority, and unemployed young adults had higher odds of reporting such symptoms. Conclusions Major depressive symptoms were associated with high compliance with COVID-19 preventive measures among young adults. The implementation of socially-isolating measures should be coupled with mental health interventions to address mental health needs of young adults, with enhanced supports for sub-groups who are structurally disadvantaged (e.g., racialized, unemployed, sexual and gender minority).

by Phyo Zin Winn, Thein Hlaing, Kyaw Myo Tun, Seim Lei Lei
Background The life quality of about two-thirds of patients with COVID-19 is affected by related olfactory dysfunctions. The negative impact of olfactory dysfunction ranged from the decreased pleasure of eating to impaired quality of life. This research aimed to provide a comprehensive understanding of the effects of corticosteroid treatments by comparing that to other currently available treatments and interventions. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist’s 27-point checklist was used to conduct this review. PubMed (Public/Publisher MEDLINE), PubMed Central and EMBASE (Excerpta Medica Database) databases were conveniently selected and Boolean search commands were used for a comprehensive literature search. Five core search terms were "effects of treatments", " COVID-19-related olfactory dysfunction", "corticosteroids", "treatments" and "interventions". The reporting qualities of the included studies were appraised using JBI (Joanna Briggs Institute) appraisal tools. The characteristics of the 21 experimental studies with a total sample (of 130,550) were aggregated using frequencies and percentages and presented descriptively. The main interventions and their effects on the duration of the COVID-19-related olfactory dysfunction were narratively analyzed. Results Among patients with COVID-19, the normal functions of the olfactory lobe were about 23 days earlier to gain with the treatments of fluticasone and triamcinolone acetonide nasal spray compared with that of mometasone furoate nasal spray and oral corticosteroid. The smell loss duration was reduced by fluticasone and triamcinolone acetonide nasal spray 9 days earlier than the inflawell syrup and 16 days earlier than the lavender syrup. The nasal spray of corticosteroids ended the COVID-19-related smell loss symptoms 2 days earlier than the zinc supplementation, about 47 days earlier than carbamazepine treatment and was more effective than palmitoylethanolamide (PEA) and luteolin and omega-3 supplementations and olfactory training. Treatment with oral corticosteroid plus olfactory training significantly improved Threshold, Discrimination and Identification (TDI) scores compared with olfactory training alone. A full dose of the COVID-19 vaccination was not uncertain to reduce the COVID-19-related smell loss duration. Conclusion Corticosteroid treatment is effective in reducing the duration of COVID-19-related smell loss and olfactory training, the basic, essential and effective intervention, should be used as a combination therapy.

by Lauren E. Parmley, Tepa Nkumbula, Lophina Chilukutu, Lazarus Chelu, Chipili Mulemfwe, Brave Hanunka, John Mwale, Joyce Neal, Ray Handema, Prisca Kasonde, Kennedy Mutale, Henry M. Sakala, Maria Lahuerta
Background Despite achievements in the HIV response, social and structural barriers impede access to HIV services for key populations (KP) including men who have sex with men (MSM), transgender women (TGW), and people who inject drugs (PWID). This may be worsened by the COVID-19 pandemic or future pandemic threats. We explored the impact of COVID-19 on HIV services and sexual and substance use behaviors among MSM/TGW and PWID in Zambia as part of a formative assessment for two biobehavioral surveys. Methods From November-December 2020, 3 focus groups and 15 in-depth interviews (IDIs) with KP were conducted in Lusaka, Livingstone, Ndola, Solwezi, and Kitwe, Zambia. Overall, 45 PWID and 60 MSM/TGW participated in IDIs and 70 PWID and 89 MSM/TGW participated in focus groups. Qualitative data were analyzed using framework matrices according to deductive themes outlined in interview guides. Results KP reported barriers to HIV testing and HIV treatment due to COVID-19-related disruptions and fear of SARS-CoV-2 exposure at the health facility. MSM/TGW participants reported limited supply of condoms and lubricants at health facilities; limited access to condoms led to increased engagements in condomless sex. Restrictions in movement and closure of meet-up spots due to COVID-19 impeded opportunities to meet sex partners for MSM/TGW and clients for those who sold sex. COVID-19 restrictions led to unemployment and loss of income as well as to shortages and increased price of drugs, needles, and syringes for PWID. Due to COVID-19 economic effects, PWID reported increased needle-sharing and re-use of needles. Conclusions Participants experienced barriers accessing HIV services due to COVID-19 and PWID attributed unsafe needle use and sharing to loss of income and lack of affordable needles during pandemic-related restrictions. To maintain gains in the HIV response in this context, strengthening harm reduction strategies and improvements in access to HIV services are necessary.

Corpos e cura na cidade: categorizações nosológicas relacionadas ao Covid-19 entre moradores de uma comunidade Tikuna de Manaus, Amazonas, Brasil.
Santos, Fabiane Vinente; Menezes, Kátia Maria Lima de; Florentino, Yang Alfredo; Rodrigues, Clayton; Castro, Fabiola Sabino
A emergência sanitária representada pela pandemia de Covid-19 foi particularmente desafiadora para indígenas que residem nas cidades brasileiras da Amazônia. Tendo como base um projeto de intervenção, o artigo alia o referencial da epidemiologia e da antropologia na busca por construir um inventário cultural das categorias nosológicas relacionadas ao processo de adoecimento por Covid-19, bem como os aspectos fisiológicos e os fluxos e práticas terapêuticas relacionadas a este agravo em uma comunidade indígena de Manaus, Amazonas, a partir da compreensão de que, a despeito de seu aspecto biológico, a pandemia foi compreendida a partir de filtros culturais e sociais. Tal conhecimento sistematizado permitirá construir abordagens mais sensíveis às necessidades de acesso dos indígenas nas cidades.

by Doan Hoang Phu, Sarunya Maneerattanasak, Shamarina Shohaimi, Le Thanh Thao Trang, Truong Thanh Nam, Muminah Kuning, Aunchalee Like, Hameedah Torpor, Charuai Suwanbamrung

Mental health disorders have become a growing public health concern among individuals recovering from COVID-19. Long COVID, a condition where symptoms persist for an extended period, can predict psychological problems among COVID-19 patients. This study aimed to investigate the prevalence of long COVID and mental health status among Thai adults who had recovered from COVID-19, identify the association between the mental health status and long COVID symptoms, and investigate the risk factors associated with the correlation between long COVID and mental health outcomes. A cross-sectional study was conducted among 939 randomly selected participants in Nakhon Si Thammarat province, southern Thailand. The Depression, Anxiety, and Stress Scale-21 was used to investigate mental health symptoms, and a checklist comprised of thirteen common symptoms was used to identify the long COVID among participants. Logistic regression models were used to investigate the risk factors associated with mental health status and long COVID symptoms among participants. Among the 939 participants, 104 (11.1%) had depression, 179 (19.1%) had anxiety, and 42 (4.8%) were stressed. A total of 745 participants (79.3%) reported experiencing at least one symptom of long COVID, with fatigue (72.9%, SE±0.02), cough (66.0%, SE±0.02), and muscle pain (54.1%, SE±0.02) being the most frequently reported symptoms. All long COVID symptoms were significantly associated with mental health status. Shortness of breath, fatigue, and chest tightness were the highest risk factors for mental health status among COVID-19 patients. The final multivariable model indicated that female patients (OR = 1.89), medical history (OR = 1.92), and monthly income lower than 5,000 Thai baht (OR = 2.09) were associated with developing long COVID symptoms and mental health status (all p

by Lexy Sorrell, Valentina Leta, Anton Barnett, Kara Stevens, Angela King, Jemma Inches, Christopher Kobylecki, Richard Walker, K. Ray Chaudhuri, Hannah Martin, Jane Rideout, J. Robert Sneyd, Sarah Campbell, Camille Carroll, on behalf of the COVID-19 PD UK study team
Background Parkinson’s disease has been identified as a risk factor for severe Coronavirus disease 2019 (COVID-19) outcomes. However, whether the significant high risk of death from COVID-19 in people with Parkinson’s disease is specific to the disease itself or driven by other concomitant and known risk factors such as comorbidities, age, and frailty remains unclear. Objective To investigate clinical profiles and outcomes of people with Parkinson’s disease and atypical parkinsonian syndromes who tested positive for COVID-19 in the hospital setting in a multicentre UK-based study. Methods A retrospective cohort study of Parkinson’s disease patients with a positive SARS-CoV-2 test admitted to hospital between February 2020 and July 2021. An online survey was used to collect data from clinical care records, recording patient, Parkinson’s disease and COVID-19 characteristics. Associations with time-to-mortality and severe outcomes were analysed using either the Cox proportional hazards model or logistic regression models, as appropriate. Results Data from 552 admissions were collected: 365 (66%) male; median (inter-quartile range) age 80 (74–85) years. The 34-day all-cause mortality rate was 38.4%; male sex, increased age and frailty, Parkinson’s dementia syndrome, requirement for respiratory support and no vaccination were associated with increased mortality risk. Community-acquired COVID-19 and co-morbid chronic neurological disorder were associated with increased odds of requiring respiratory support. Hospital-acquired COVID-19 and delirium were associated with requiring an increase in care level post-discharge. Conclusions This first, multicentre, UK-based study on people with Parkinson’s disease or atypical parkinsonian syndromes, hospitalised with COVID-19, adds and expands previous findings on clinical profiles and outcomes in this population.

by Wijnand van den Boom, Mart van Dijk, Bianca Snijders, Guus Luijben, Jan van der Laan, Saskia Euser, Jet G. Sanders, Anne H. Buitenhuis, Pita Spruijt, Floor Kroese, Mattijs Lambooij, Yvette Muhren, Nannah Tak, Koen van der Swaluw, Caroline van Rossum, Thijs Nielen, Janneke Elberse, Reint Jan Renes, Mariken Leurs, Marijn de Bruin

This ‘cohort profile’ aims to provide a description of the study design, methodology, and baseline characteristics of the participants in the Corona Behavioral Unit cohort. This cohort was established in response to the COVID-19 pandemic by the Dutch National Institute for Public Health and the Environment (RIVM) and the regional public health services. The aim was to investigate adherence of and support for COVID-19 prevention measures, psychosocial determinants of COVID-19 behaviors, well-being, COVID-19 vaccination, and media use. The cohort also examined specific motivations and beliefs, such as for vaccination, which were collected through either closed-ended items or open text responses. In April 2020, 89,943 participants aged 16 years and older were recruited from existing nation-wide panels. Between May 2020 and September 2022, 99,676 additional participants were recruited through online social media platforms and mailing lists of higher education organizations. Participants who consented were initially invited every three weeks (5 rounds), then every six weeks (13 rounds), and since the summer of 2022 every 12 weeks (3 rounds). To date, 66% of participants were female, 30% were 39 years and younger, and 54% completed two or more questionnaires, with an average of 9.2 (SD = 5.7) questionnaires. The Corona Behavioral Unit COVID-19 cohort has published detailed insights into longitudinal patterns of COVID-19 related behaviors, support of COVID-19 preventive measures, as well as peoples’ mental wellbeing in relation to the stringency of these measures. The results have informed COVID-19 policy making and pandemic communication in the Netherlands throughout the COVID-19 pandemic. The cohort data will continuously be used to examine COVID-19 related outcomes for scientific analyses, as well as to inform future pandemic preparedness plans.

by Omar B. Ahmed, Atif H. Asghar, Majid Bamaga, Fayez S. Bahwerth, Mutasim E. Ibrahim

Since the peak of the coronavirus disease 2019 (COVID-19) pandemic, concerns around multidrug-resistant (MDR) bacterial pathogens have increased. This study aimed to characterize aminoglycoside resistance genes in MDR Klebsiella pneumoniae (K. pneumoniae) collected during the COVID-19 pandemic. A total of 220 clinical isolates of gram-negative bacteria were collected from tertiary hospitals in Makkah, Saudi Arabia, between April 2020 and January 2021. The prevalence of K. pneumoniae was 40.5%; of the 89 K. pneumoniae isolates, MDR patterns were found among 51 (57.3%) strains. The MDR isolates showed elevated resistance rates to aminoglycoside agents, including amikacin (100%), gentamicin (98%), and tobramycin (98%). PCR assays detected one or more aminoglycoside genes in 42 (82.3%) MDR K. pneumoniae strains. The rmtD gene was the most predominant gene (66.7%; 34/51), followed by aac(6′)-Ib and aph(3′)-Ia (45.1%; 23/51). The aac(3)-II gene was the least frequent gene (7.8%; 4/51) produced by our isolates. The rmtC gene was not detected in the studied isolates. Our findings indicated a high risk of MDR bacterial infections through the COVID-19 outbreak. Therefore, there is a need for continuous implementation of effective infection prevention control (IPC) measures to monitor the occurrence of MDR pathogens and the emergence of MDR bacterial infections through the COVID-19 outbreak.

by Eustes Kigongo, Amir Kabunga, Raymond Tumwesigye, Marvin Musinguzi, Ronald Izaruku, Walter Acup
Background The COVID-19 vaccination is regarded as an effective intervention for controlling the pandemic. However, COVID-19 vaccine hesitancy is hampering efforts geared towards reducing the burden of the pandemic. Therefore, examining COVID-19 hesitancy and its predictors among healthcare workers is essential to improving COVID-19 uptake. In sub-Saharan Africa, the pooled proportion of COVID-19 vaccine hesitancy is yet to be known. Purpose The present study was to estimate the pooled proportion of COVID-19 vaccine hesitancy and its predictors among healthcare workers in Sub-Saharan Africa. Methods A systematic search of articles was conducted in PubMed, Science Direct, African Journal Online, and Google Scholar. Data was extracted with the help of Excel. Data analysis was conducted using STATA 17. Heterogeneity in the studies was assessed using Cochrane Q and 12 tests. A random effects model was used to examine the pooled estimates to determine if heterogeneity was exhibited. Results A total of 15 studies involving 7498 participants were included in the final analysis. The pooled prevalence of COVID-19 vaccination hesitancy among healthcare workers was 46%, 95% CI (0.38–0.54). The predictors of COVID-19 hesitancy were negative beliefs towards vaccine 14.0% (OR = 1.05, 95% CI: 1.04, 1.06), perceived low risk of COVID-19 infection 24.0% (OR = 1.25, 95% CI: 1.23, 1.28), and vaccine side effects 25.0% (OR = 1.23, 95% CI: 1.21, 1.24). Conclusion The data revealed generally high hesitancy of COVID-19 vaccine among health workers in Sub-Saharan Africa. Future COVID-19 adoption and uptake should be improved by national and individual level efforts. In Sub-Saharan Africa, it is crucial to address the myths and obstacles preventing healthcare professionals from accepting the COVID-19 vaccination as soon as feasible since their willingness to get the vaccine serves as an important example for the broader public.

by Madalo Mukoka, Euphemia Sibanda, Constancia Watadzaushe, Moses Kumwenda, Florence Abok, Elizabeth L. Corbett, Elena Ivanova, Augustine Talumba Choko
Background COVID-19 testing is critical for identifying cases to prevent transmission. COVID-19 self-testing has the potential to increase diagnostic testing capacity and to expand access to hard-to-reach areas in low-and-middle-income countries. We investigated the feasibility and acceptability of COVID-19 self-sampling and self-testing using SARS-CoV-2 Antigen-Rapid Diagnostic Tests (Ag-RDTs). Methods From July 2021 to February 2022, we conducted a mixed-methods cross-sectional study examining self-sampling and self-testing using Standard Q and Panbio COVID-19 Ag Rapid Test Device in Urban and rural Blantyre, Malawi. Health care workers and adults (18y+) in the general population were non-randomly sampled. Results Overall, 1,330 participants were enrolled of whom 674 (56.0%) were female and 656 (54.0%) were male with 664 for self-sampling and 666 for self-testing. Mean age was 30.7y (standard deviation [SD] 9.6). Self-sampling usability threshold for Standard Q was 273/333 (82.0%: 95% CI 77.4% to 86.0%) and 261/331 (78.8%: 95% CI 74.1% to 83.1%) for Panbio. Self-testing threshold was 276/335 (82.4%: 95% CI 77.9% to 86.3%) and 300/332 (90.4%: 95% CI 86.7% to 93.3%) for Standard Q and Panbio, respectively. Agreement between self-sample results and professional test results was 325/325 (100%) and 322/322 (100%) for Standard Q and Panbio, respectively. For self-testing, agreement was 332/333 (99.7%: 95% CI 98.3 to 100%) for Standard Q and 330/330 (100%: 95% CI 99.8 to 100%) for Panbio. Odds of achieving self-sampling threshold increased if the participant was recruited from an urban site (odds ratio [OR] 2.15 95% CI 1.44 to 3.23, P .01. Compared to participants with primary school education those with secondary and tertiary achieved higher self-testing threshold OR 1.88 (95% CI 1.17 to 3.01), P = .01 and 4.05 (95% CI 1.20 to13.63), P = .02, respectively. Conclusions One of the first studies to demonstrate high feasibility and acceptability of self-testing using SARS-CoV-2 Ag-RDTs among general and health-care worker populations in low- and middle-income countries potentially supporting large scale-up. Further research is warranted to provide optimal delivery strategies of self-testing.

by Shanchita Ghosh, Teddy Salan, Jessica Riotti, Amrutha Ramachandran, Ivan A. Gonzalez, Emmalee S. Bandstra, Fiama L. Reyes, Samita S. Andreansky, Varan Govind, Gaurav Saigal
Background Infants with congenital Zika syndrome (CZS) are known to exhibit characteristic brain abnormalities. However, the brain anatomy of Zika virus (ZIKV)-exposed infants, born to ZIKV-positive pregnant mothers, who have normal-appearing head characteristics at birth, has not been evaluated in detail. The aim of this prospective study is, therefore, to compare the cortical and subcortical brain structural volume measures of ZIKV-exposed normocephalic infants to age-matched healthy controls. Methods and findings We acquired T2-MRI of the whole brain of 18 ZIKV-exposed infants and 8 normal controls on a 3T MRI scanner. The MR images were auto-segmented into eight tissue types and anatomical regions including the white matter, cortical grey matter, deep nuclear grey matter, corticospinal fluid, amygdala, hippocampus, cerebellum, and brainstem. We determined the volumes of these regions and calculated the total intracranial volume (TICV) and head circumference (HC). We compared these measurements between the two groups, controlling for infant age at scan, by first comparing results for all subjects in each group and secondly performing a subgroup analysis for subjects below 8 weeks of postnatal age at scan. ZIKV-exposed infants demonstrated a significant decrease in amygdala volume compared to the control group in both the group and subgroup comparisons (p

by Soo Jung Kim, Yin Min Aye, Danipa Panyarachun, Seo Ah Hong, Yan-Shing Chang
Background Social support for postpartum women helps mothers to recover from childbirth and fosters healthy infant development. However, the impacts of reduced interpersonal interactions inflicted by the COVID-19 outbreak on available social support for postpartum women have received little attention. Therefore, this study aimed to examine the levels of social support provided to postpartum women and associated factors in Thailand during the COVID-19 pandemic. Methods A cross-sectional study was conducted from July to October 2021 using an anonymous online questionnaire. The responses of 840 eligible women up to six months postpartum in Thailand were obtained. The maternity social support scale was used to measure social support. Multivariate logistic regression was used to analyse the factors associated with social support among postpartum women. Results About 57% of women reported to receive high support. Women in the high social support group were more likely to be married (aOR:2.70; 95% CI:1.57–4.66), have a university education or above (1.88; 1.35–2.64), have an intended pregnancy (2.06; 1.34–3.16), good health (2.01; 1.44–2.81), good sleep quality (1.62; 1.14–2.31), receive counsel from peers or family (1.56; 1.13–2.16), and use internet or social media to reduce stress and depression (1.51; 1.08–2.11). Meanwhile, women in the high social support group were significantly less likely to feed complementary foods to infants within 24 hours of completing the survey (0.28; 0.15–0.52). Conclusions The results of this study indicated that more than half of the women reported high support and illustrated the important role played by family, peers, and professionals as well as online and remote channels in providing postpartum informational and emotional support during the pandemic. Online platforms and remote support may be considered to provide social support to postpartum women during a pandemic such as COVID-19.

by Peter Samuel Smith, Aos Alaa, Eva Riboli Sasco, Emmanouil Bagkeris, Austen El-Osta
Background The COVID-19 pandemic fundamentally changed the way services are delivered. Self-care, including good hygiene practices and avoidance of risk was emphasised as the key measure to tackle the pandemic in the early stages. Objective To understand how self-reported professional attitudes, perceptions and practices of self-care have changed as a result of the COVID-19 pandemic. Design Cross-sectional online survey and semi-structured qualitative interview. Setting Health care. Participants 304 healthcare professionals (HCPs). Methods A wide range of HCPs, including pharmacists, nurses, doctors, social prescribers and other designations took part in a 27-item anonymous online survey. Semi-structured qualitative interviews with nine healthcare professionals explored attitudes to and practices of self-care before and during the pandemic. Views were sought on the permanence and implications of changes. Data were analysed using routine statistics and thematic analysis to identify major themes. Results A total of 304 HCPs responded to the survey fully. Nine participated in a semi-structured interview. There was agreement that the importance of self-care has increased markedly during the pandemic. The percentage of respondents who felt that self-care was ’very’ important to their clients increased from 54.3% to 86.6% since the pandemic. Personal empowerment and capacity of service users to self-care increased significantly during the pandemic. Willingness of patients to engage (74%) and poor understanding of self-care (71%) were cited as the two main barriers to self-care. A close third was digital exclusion (71%), though 86% of respondents recommended online resources and 77% the use of smartphone apps. Survey respondents believed the changes to be permanent and positive. Interviewees reported a major, and positive move to self-care with the pandemic seen as an opportunity to be grasped, but professional education would have to be aligned to make the most of it. They raised concerns as to whether the shift to self-care was perceived by users as ’abandonment’ rather than ’empowerment’ and whether problems had been stored rather than dealt with through self-care and therefore whether the positive changes would continue after the pandemic. Conclusion Reporting their views before the pandemic, barely more than half of the professionals surveyed saw self-care as fundamentally important to the individuals they served. This changed to 86% as a result of the pandemic. Patient/client engagement with and understanding of self-care were reported as major barriers, as was digital exclusion, though increased technological solutions were used by all respondents. Concerns were raised that the permanence of the changes depended upon continued encouragement and empowerment of individuals to self-care and on its inclusion in professional education as a substantive subject.