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Objective: Describe the epidemiology of COVID-19 deaths within a hospital in the Amazon region in a period of 64 days, which corresponds to the growth curve of the COVID-19 first-wave pandemic in 2020. Methods: The data were obtained from medical records of 152 deaths registered for adults and elderly hospitalized. The data were also compared with the number of deaths in previous years during the same period studied to assess the impact of the pandemic on this hospital. The study also assesses the impact of intra-hospital transfers, accounting for the number of times patients who died performed transfers between sectors of the hospital. Results: During the period analyzed, there was an increase in deaths compared to the previous years. The majority of dead patients were male, aged between 34 and 96 years. The deaths were associated comorbidities such as arterial hypertension, diabetes mellitus, and kidney disease. The SARS-CoV-2 infection was confirmed in 91 cases. Among them, 15 individuals were admitted without conditions related to SARS-CoV-2 infection; they had a three-fold higher number of hospital transfers than those admitted with SARS-CoV-2 infection symptoms. Sixteen patients with SARS-CoV-2 infection developed respiratory symptoms just after hospitalization. The diagnostic exam for SARS-CoV-2 infection was performed on average 4 (± 6) days after the onset of symptoms and 6 (± 6) days after admission, and the average time from the onset of respiratory symptoms to death was 4 (± 6) days. Conclusions: These data suggest the high presence of hospital infection by SARS-CoV-2 in the Brazilian Amazon region, which may be related to the number of sectorial transfers, delay in confirming the diagnosis, and lack of management. We report a serious public health problem, as it demonstrates the fragility of healthcare institutions in the hospital environmen (AU).
Objetivo: Descrever a epidemiologia de mortes por COVID-19 em um hospital na região da Amazônia em um período de 64 dias, que corresponde à curva de crescimento da primeira onda da pandemia de COVID-19 em 2020. Métodos: Os dados foram obtidos de 152 óbitos registrados em prontuários de adultos e idosos hospitalizados. Os dados foram também comparados com o número de óbitos em anos anteriores, no mesmo período estudado, de forma a avaliar o impacto da pandemia neste hospital. O estudo também avalia o impacto das transferências intra-hospitalares, contabilizando o número de vezes que os pacientes que faleceram realizaram transferências entre setores do hospital. Resultados: No período analisado, houve aumento de óbitos em relação aos anos anteriores. A maioria dos pacientes mortos era do sexo masculino, com idade entre 34 e 96 anos. Os óbitos foram associados a comorbidades como hipertensão arterial, diabetes mellitus e doença renal. A infecção por SARS-CoV-2 foi confirmada em 91 casos. Entre eles, 15 indivíduos foram internados sem condições relacionadas à infecção por SARS-CoV-2; eles tiveram um número três vezes maior de transferências hospitalares do que aqueles admitidos com sintomas de infecção por SARS-CoV-2. Dezesseis pacientes com infecção por SARS-CoV-2 desenvolveram sintomas respiratórios logo após a hospitalização. O exame diagnóstico para infecção por SARS-CoV-2 foi realizado em média 4 (± 6) dias após o início dos sintomas e 6 (± 6) dias após a admissão, e o tempo médio do início dos sintomas respiratórios até o óbito foi de 4 ( ± 6) dias. Conclusões: Esses dados sugerem alta presença de infecção hospitalar por SARS-CoV-2 na região amazônica brasileira, o que pode estar relacionado ao número de transferências setoriais, demora na confirmação do diagnóstico e falta de manejo. Relatamos um grave problema de saúde pública, pois demonstra a fragilidade das instituições de saúde no ambiente hospitalar (AU).
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Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Cross Infection , Amazonian Ecosystem , COVID-19/epidemiologyABSTRACT
ABSTRACT BACKGROUND: Exposure to air pollutants and illness by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection can cause serious pulmonary impairment. OBJECTIVE: To identify a possible association between exposure to air pollutants and hospitalizations due to SARS-Cov-2. DESIGN AND SETTING: Ecological time-series study carried out in Taubaté, Tremembé, and Pindamonhangaba in 2020 and 2021. METHODS: Study with Sars-Cov-2 hospitalizations with information on hospitalization date, sex and age of the subjects, duration of hospitalization, type of discharge, and costs of these hospitalizations. Statistical analysis was performed through a negative binomial regression, with data on pollutant concentrations, temperature, air relative humidity, and hospitalization date. Coefficients obtained by the analysis were transformed into relative risk for hospitalization, which estimated hospitalizations excess according to an increase in pollutant concentrations. RESULTS: There were 1,300 hospitalizations and 368 deaths, with a predominance of men (61.7%). These data represent an incidence rate of 250.4 per 100,000 inhabitants and 28.4% hospital lethality. Significant exposure (P value < 0.05) occurred seven days before hospital admission (lag 7) for nitrogen dioxide (NO2) (relative risk, RR = 1.0124) and two days before hospital admission for PM2.5 (RR = 1.0216). A 10 μg/m3 in NO2 concentration would decrease by 320 hospitalizations and ¼ US $ 240,000 in costs; a 5 μg/m3 in PM2.5 concentration would decrease by 278 hospitalizations and ¼ US $ 190,000 in costs. CONCLUSION: An association between exposure to air pollutants and hospital admission due to Sars-Cov-2 was observed with excess hospitalization and costs for the Brazilian public health system.
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Fundamento: la pandemia asociada a la COVID-19 obligó a buscar formas de sostener procesos y servicios. La modalidad de teletrabajo se convirtió en aliada para poder sobrellevar desde los hogares el quehacer laboral. En el año 2022 se inició el proceso de retorno a la presencialidad en la Educación Superior chilena. Objetivo: identificar factores protectores y obstaculizadores que identifican los trabajadores académicos y no académicos de instituciones de Educación Superior chilenas para volver a la presencialidad. Método: se realizó un estudio descriptivo y de corte transversal. Se trabajó con una muestra total de 124 participantes. La muestra se obtuvo de la participación voluntaria de funcionarios académicos y no académicos quienes respondieron una encuesta por formulario. Los datos fueron recogidos entre octubre de 2021 y marzo de 2022. Se aplicó cuestionario acerca de factores protectores y obstaculizadores presentes en el retorno seguro. Se recodificaron los datos, para trabajar con frecuencias y porcentajes de respuestas. Resultados: los mayores obstáculos percibidos para el retorno a la presencialidad laboral se correspondieron con personas que declararon presencia de enfermedad crónica y algún síntoma asociado a salud mental (52-58 %). Las personas menores de 40 años identificaron el factor inmunización y poseer un buen estado de salud como factores facilitadores para el retorno a la presencialidad (54-62 %). Conclusiones: las organizaciones deben desarrollar programas de apoyo para el retorno laboral, de manera que estas acciones favorezcan mejores niveles de bienestar en el trabajo. Se consideran las diferencias de edad, género y presencia de patologías crónicas previas como factores obstaculizadores del retorno.
Background: the pandemic associated with COVID-19 forced the search for ways to sustain processes and services. The teleworking modality became an ally to be able to cope with work from home. In 2022, the process of returning to presence in Chilean Higher Education began. Objective: to identify protective and hindering factors identified by academic and non-academic workers of Chilean Higher Education institutions to return to attendance. Method: a descriptive and cross-sectional study was carried out. We worked with a total sample of 124 participants. The sample was obtained from the voluntary participation of academic and non-academic officials who responded to a survey via form. The data was collected between October 2021 and March 2022. A questionnaire was applied about protective and hindering factors present in safe return. The data was recoded to work with frequencies and percentages of responses. Results: the greatest obstacles perceived for the return to work presence correspond to people who declare the presence of chronic disease and some symptom associated with mental health (52-58 %). People under 40 years of age identified the immunization factor and being in good health as facilitating factors for returning to attendance (54-62 %). Conclusions: organizations must develop support programs for return to work, so that these actions favor better levels of well-being at work. Differences in age, gender and the presence of previous chronic pathologies are considered as factors that hinder return.
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ABSTRACT BACKGROUND: Brazil is facing increasing cycles of numbers of infected people and deaths resulting from coronavirus disease 2019 (COVID-19). This situation involves a series of factors, including the behavior of the population, that can be decisive for controlling the disease. OBJECTIVE: To determine the knowledge, attitudes and practices of the Brazilian population regarding COVID-19. DESIGN AND SETTING: Cross-sectional survey-type study, conducted using a population sample from different Brazilian states. METHODS: A quantitative, descriptive and analytical approach was used. Sampling was done according to convenience and via snowballing. The data collection instrument was a knowledge, attitudes and practices system. RESULTS: 1,655 people from all over Brazil participated in the survey; 80% were living in the southern region and 70.15% were female. More than 90% had knowledge and good attitudes relating to the means of transmission, preventive care and symptoms associated with COVID-19, although their knowledge and attitudes were not fully reflected in daily practices, for which there was lower adherence (80%). Greater knowledge was correlated with older participants, larger number of children, female sex and marital status; better attitude, with female sex and complete higher education; and better practices, with greater age, larger number of children and female sex. CONCLUSION: A large part of the population has general knowledge about COVID-19, but not all knowledge was applied in practice. Older people, females and university graduates stood out as the best informed and most committed to controlling the disease.
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Humans , Male , Female , Child , Aged , COVID-19 , Brazil/epidemiology , Health Knowledge, Attitudes, Practice , Cross-Sectional Studies , Surveys and QuestionnairesABSTRACT
Objective:To analyze the clinical characteristics of children with 2019 novel coronavirus (2019-nCoV) infection in Putian City, and to provide a reference for the diagnosis and treatment of children with 2019-nCoV infection.Methods:Clinical characteristics, laboratory examination, pulmonary compated tomography findings, treatment, and clinical outcomes of 78 children with 2019-nCoV infection who were admitted to Putian University Affiliated Hospital Medical Group Putian City Children′s Hospital from September 10 to October 20, 2021 were retrospectively collected and analyzed.Results:Of the 78 children included in the analysis, two cases (2.6%) were asymptomatic infection, 36 cases (46.2%) were mild and 40 cases (51.3%) were ordinary. Five children were vaccinated against 2019-nCoV. The main symptoms were fever (24 cases), cough (13 cases), and fatigue (nine cases). A total of 34 cases (43.6%) had neutropenia, 29 cases (37.2%) had lymphopenia, 36 cases (46.2%) had D-dimer increase, 38 cases (48.7%) had hypokalemia, 27 cases (34.6%) had hypoglycemia and 11 cases (14.1%) had elevated creatine kinase isoenzyme. The neutropenia mostly occurred two to four days after admission. Fifty-six cases (71.8%) showed pulmonary computed tomography abnormalities. The cycle threshold of virus open reading frame ( ORF)1 ab was 20.90±7.15 and the cycle threshold of N gene was 20.29±7.78 in the first nucleic acid detection of 78 children after admission. The time of nucleic acid negative conversion of the 78 children was (20.73±6.94) days. IgM antibody titer in five vaccinated children was 0.36 (0.34, 4.89) and IgG antibody was 10.42 (0.50, 19.42). IgM antibody titer was 1.82 (1.66, 8.12) and IgG antibody was 76.63 (16.92, 79.84) in cases with disease duration ≥10 days. Nine children (11.5%) had resurgence of virus and were sent to the isolation site. All the other children were cured and discharged from hospital. Conclusions:Children with 2019-nCoV infection have mild clinical symptoms, and some children have lymphopenia, neutropenia, and D-dimer elevation during the course of the disease. The overall prognosis is good. The children vaccinated against 2019-nCoV have higher antibody levels.
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Objective:To evaluate the effect of 2019 novel coronavirus inactivated vaccine on the disease severity of patients with Delta variant of coronavirus disease 2019.Methods:A retrospective analysis was performed on 704 patients with coronavirus disease 2019 infected with Delta variant who were older than 18 years old and admitted in the coronavirus disease 2019 designated hospital of Yangzhou (Subei Hospital New Area Branch) from July 2021 to September 2021. They were divided into severe (severe, critical) group and non-severe (light, ordinary) group according to the clinical characteristics of patients. According to the vaccination status, they were divided into 0-dose group, 1-dose group and 2-dose group. We evaluated the effects of vaccination on the severity of the disease and the production of antibodies, and analyzed the influencing factors leading to the severe group of coronavirus disease 2019.Results:The proportion of severe group in the 2-dose vaccinated group was significantly lower than that in the 1-dose vaccinated group and 0-dose vaccinated group [3.02% (7/232) vs. 9.48% (22/232), 15.83% (38/240), P < 0.05]. The time from onset to admission (day: 1.97±1.66 vs. 2.66±2.70), age (years: 45.3±12.2 vs. 63.6±17.0), direct bilirubin [DBil (μmol/L): 3.70±1.83 vs. 5.30±5.13], lactate dehydrogenase [LDH (U/L): 240.69±74.29 vs. 256.30±85.18], creatinine [SCr (μmol/L): 63.38±19.86 vs. 70.23±25.43], interleukin-6 [IL-6 (ng/L): 7.32 (1.54, 17.40) vs. 18.38 (8.83, 33.43)], creatine kinase [CK (U/L): 66.00 (43.00, 99.75) vs. 78.00 (54.50, 144.00)] and D-dimer [mg/L: 0.30 (0.08, 0.49) vs. 0.41 (0.23, 0.69)] of patients in the 2-dose group were significantly lower than those in the 0-dose group (all P < 0.05), while platelet [PLT (×10 9/L): 176.69±60.25 vs. 149.25±59.07], white blood cell count [WBC (×10 9/L): 5.43±1.77 vs. 5.03±1.88] and lymphocyte [LYM (×10 9/L): 1.34±0.88 vs. 1.17±0.50] were significantly higher than those in the 0-dose group (all P < 0.05). The titer of immunoglobulin G (IgG) in the 2-dose group was significantly higher than those in the 1-dose group and 0-dose group on the 10th day after admission [U/L: 130.94 (92.23, 326.31), 113.18 (17.62, 136.20), 117.85 (33.52, 156.73), both P < 0.05], and higher than 0-dose group on the 16th day [U/L: 156.12 (120.32, 167.76) vs. 126.52 (61.34, 149.57), P < 0.05]. The proportion of complete 2-dose vaccination [10.45% (7/67) vs. 35.32% (225/637)], LYM (×10 9/L: 1.09±0.32 vs. 1.25±0.56) and PLT (×10 9/L: 138.55±68.03 vs. 166.93±59.70) in the severe group were significantly lower than those in the non-severe group ( P < 0.05), while the time from onset to admission (day: 3.01±2.99 vs. 2.25±2.09), the length of hospital stay (day: 28±18 vs. 16±6), male proportion [77.61% (52/67) vs. 34.54% (220/637)], age (years: 69.13±12.63 vs. 52.28±16.53), DBil [μmol/L: 4.20 (3.18, 6.65) vs. 3.60 (2.80, 4.90], LDH (U/L: 310.61±98.33 vs. 238.19±72.14), SCr (μmol/L: 85.67±38.25 vs. 65.98±18.57), C-reactive protein [CRP (μmol/L): 28.12 (11.32, 42.23) vs. 8.49 (2.61, 17.58)], IL-6 [ng/L: 38.38 (24.67, 81.50) vs. 11.40 (4.60, 22.07)], CK [U/L: 140.00 (66.00, 274.00) vs. 72.80 (53.00, 11.00)] and the D-dimer [mg/L: 0.46 (0.29, 0.67) vs. 0.35 (0.19, 0.57)] in the severe group were significantly higher than those in the non-severe group (all P < 0.05). Multivariate regression analysis showed that the odds ratio ( OR) of severe group was 0.430 ( P = 0.010) in the 1-dose group and the 2-dose group compared with the 0-dose group. However, the risk of severe group was 0.381-fold in the 2-dose group compared with the 0-dose group [ OR = 0.381, 95% confidence interval (95% CI) was 0.121-1.199] which was not statistically significant, when the age was included in the regression analysis ( P > 0.05). PLT ( OR = 0.992, 95% CI was 0.986-0.998) were protective factors, but older than 60 years old ( OR = 3.681, 95% CI was 1.637-8.278), CK ( OR = 1.001, 95% CI was 1.000-1.001), IL-6 ( OR = 1.006, 95% CI was 1.002-1.010), SCr ( OR = 1.020, 95% CI was 1.007-1.033) were risk factors for severe group (all P < 0.05). Conclusions:Compared with the 0-dose vaccinated patients, the coronavirus disease 2019 patients infected with delta variant and fully vaccinated with 2-dose 2019 novel coronavirus inactivated vaccine had lower level of IL-6, SCr, CK and D-dimer, and higher PLT, LYM and IgG titer, who were not easy to develop into the severe condition.
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Objective:To analyze the clinical characteristics in patients with persistent positive pharyngeal swab of 2019 novel coronavirus Omicron variant and results of nucleic acid testing of anal swabs to provide basis for prevention and control measures.Methods:This study included 93 patients whose pharyngeal swab nucleic acid test were persistent positive and admitted to the ward of Daping Hospital in the National Exhibition and Convention Center (Shanghai) Makeshift Hospital from May 1 to May 24, 2022. The gender, age, underlying diseases, vaccination status, clinical symptoms, interval between infection onset and anal sampling, length of hospital stay, the nucleic acid test result of pharyngeal swabs and anal swabs and the time turning negative were collected and analyzed.Results:The age of 93 patients ranged from 8 to 72 years old with a median of (46.0±16.0) years old. Among them, 30 cases (32.3%) were male and 63 cases (67.7%) were female. Sixty-five patients (69.9%) received 2-3 shots of vaccine, 2 patients (2.1%) received 1 shot, and 26 patients (28.0%) did not receive any vaccination. Twenty patients (21.5%) had underlying diseases, of which hypertension (13 cases, 14.0%) and type 2 diabetes mellitus (6 cases, 6.5%) were the most common. Twenty-four patients (25.8%) had asymptomatic infection and the rest (69 cases, 74.2%) had mild symptoms. Cough (50 cases, 53.8%) and sore throat (28 cases, 30.1%) were the most common clinical manifestations of the upper respiratory tract in these patients. Only 6 patients (6.5%) had gastrointestinal symptoms (including diarrhea in 5 patients and diarrhea with vomiting in 1 patient). Pharyngeal and anal swabs were collected simultaneously from all 93 patients at 8-16th days [(11.55±2.27) days] after 2019 novel coronavirus Omicron variant infection. The pharyngeal swabs were positive in 79 patients (85.0%) and the anal swabs were positive in 5 patients (5.4%). The time of pharyngeal swabs turning negative was (14.7±2.9) days, and that of anal swab turning positive was (14.2±1.9) days. The median length of hospital stay was (16.7±2.9) days.Conclusions:In patients with persistent positive nucleic acid of the 2019 novel coronavirus Omicron variant, there were more mild infection than asymptomatic. The upper respiratory tract symptoms such as cough and sore throat were the most. The likelihood of transmission of 2019 novel coronavirus Omicron variant through the digestive tract may be low. The correlation between gastrointestinal symptoms and 2019 novel coronavirus Omicron variant RNA in the digestive tract is uncertain.
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Resumo A pandemia de COVID-19 teve sério impacto ocupacional em pessoas com transtornos mentais pré-existentes. Para prestar o cuidado nesse contexto, os grupos de telessaúde foram uma opção terapêutica para terapeutas ocupacionais para o cuidado em saúde mental. Este artigo apresenta uma experiência de terapia ocupacional com grupos de telessaúde no Brasil, sustentada pelo Método Terapia Ocupacional Dinâmica, buscando discutir o uso da tecnologia durante a pandemia de Covid-19, além dos limites e das potencialidades do cuidado em terapia ocupacional diante da necessária mudança do trabalho com grupos. Trata-se de análise crítica da prática sustentada por uma perspectiva de produção de evidências baseadas na prática por meio de uma parceria colaborativa entre profissionais e acadêmicos do Brasil e do Reino Unido. Os profissionais refletiram sobre as habilidades necessárias no contexto online, destacando suas preocupações iniciais e suas descobertas neste novo cenário de prática. A prática de cuidado em grupo de terapia ocupacional em telessaúde na prática de saúde mental requer o uso de múltiplas ferramentas digitais. Além disso, a(o) terapeuta ocupacional precisa entender das questões de desigualdade digital (acesso digital e/ou habilidades digitais), aprimorar-se digitalmente para atender às necessidades das pessoas sob seu acompanhamento, além de possuir referenciais teórico-metodológicos claros que permitam sustentar práticas em telessaúde.
Abstract COVID-19 pandemic had a serious occupational impact on people with pre-existing mental disorders. To deliver care in this context, telehealth groups were a therapeutic option for occupational therapists for mental health care. This paper presents an occupational therapy experience with telehealth groups in Brazil, sustained by the Dynamic Occupational Therapy Method, seeking to discuss the use of technology during the COVID-19 outbreak, the limits and potential of occupational therapy in the face of the necessary change in work with groups. The paper is a critical analysis of practice sustained by a practice-based evidence perspective through a collaborative partnership between practitioners and academics from Brazil and the UK. Practitioners reflected on their professional skills in an online context, highlighting their initial concerns and their discoveries within this new practice scenario. The delivery of telehealth groupwork in occupational therapy in mental health practice requires multiple digital tools, and the occupational therapist needs to understand digital inequity issues (digital access or skills), be digitally upskilled to meet client needs, and also be guided by clear occupational therapy theoretical and methodological frameworks that underpin telehealth practices.
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Objective To investigate the clinical features of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant infection and abnormal liver function in Guangdong Province, China. Methods The patients with SARS-CoV-2 Delta variant infection who belonged to the same chain of transmission in Guangdong Province (Guangzhou and Foshan) and were admitted to Guangzhou Eighth People's Hospital, Guangzhou Medical University from May 21 to June 18, 2021 were enrolled in this study, and the judgment criteria for liver function were alanine aminotransferase (male/female) > 50/40 U/L, aspartate aminotransferase > 40 U/L, total bilirubin > 26 μmol/L, gamma-glutamyl transpeptidase > 60 U/L, and alkaline phosphatase (ALK) > 125 U/L. Abnormality in any one item of the above criteria was defined as abnormal liver function, and such patients were included in analysis (the patients, aged < 18 years, who had a mild or moderate increase in ALP alone were not included in analysis). Clinical data were compared between the patients with normal liver function and those with abnormal liver function, and the etiology and prognosis of abnormal liver function were analyzed. The Mann-Whitney U test was used for comparison of continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Results Among the 166 patients with SARS-CoV-2 Delta variant infection, 32 (19.3%) had abnormal liver function with mild-to-moderate increases in liver function parameters, and compared with the normal liver function group, the abnormal liver function group had a significantly higher proportion of critical patients ( χ 2 =38.689, P < 0.001) and significantly higher age and inflammatory cytokines [C-reactive protein type, serum amyloid A, and interleukin-6 (IL-6)](all P < 0.05). Among the 32 patients with abnormal liver function, 13 patients had abnormal liver function on admission (defined as primary group), while 19 patients had normal liver function on admission but were found to have abnormal liver function by reexamination after treatment (defined as secondary group). For the primary group, the evidence of abnormal liver function was not found for 3 patients (3/13, 23.1%), and the possibility of toxic liver injury directly associated with SARS-CoV-2 infection was considered. Among the 19 patients in the secondary group, 9 (47.4%) had mild/common type and 10 (52.6%) had critical type, and all critical patients had the evidence of liver injury indirectly caused by the significant increases in C-reactive protein type, serum amyloid A, and IL-6 and hypoxemia; the evidence of abnormal liver function was not found for only 1 patient (1/19, 5.3%), and the possibility of toxic liver injury directly associated with SARS-CoV-2 infection was considered. All 32 patients with abnormal liver function had [JP2]significant reductions in liver function parameters after treatment including liver protection. Conclusion As for the patients with SARS-CoV-2 Delta variant infection who belong to the same chain of transmission in Guangdong Province, the critical patients show a significantly higher proportion of patients with abnormal liver function than the patients with other clinical types, and other factors except SARS-CoV-2 infection and indirect injury caused by SARS-CoV-2 infection are the main cause of liver injury.
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The pandemic of 2019 novel coronavirus (2019-nCoV) infection since 2020 caused Coronavirus Disease 2019 (COVID-19) leads the serious threaten to global public health. It is urgent to diagnose COVID-19, guide epidemiological measures, control the infection rates, research/develop the antiviral treatment and promote the vaccine research. The application of nano-material based biosensors (the nano-biosensors) has achieved the high-performance detection of a variety of biomarkers due to their small device size, label free detection, high sensitivity, good specificity, short detection time, and has been considered as great potential to become a point-of-care testing tool for detecting 2019-nCoV. Therefore, by summarizing the working principle and classification of nano-biosensors, and focusing on the research progress of nano-biosensors in the detection of 2019-nCoV reported in the recent years, our review provides the challenges and future development prospects of the nano-biosensor in clinical laboratory.
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The main target organ of 2019 novel coronavirus(2019-nCoV)was the lung and acute respiratory distress syndrome, a life-threatening condition, could happen in severe cases.The main receptor of 2019-nCoV is angiotensin-converting enzyme 2(ACE2). Other receptors reported included CD147, tyrosine protein kinase receptor UFO, Neuropilin-1, Kidney injury molecule-1, et al.When 2019-nCoV is bound with ACE2, the expression of ACE2 would be down-regulated, which causes an increased angiotensin level and consequent lung injury through downstream signals.In addition, 2019-nCoV infection can induce inflammatory cytokine storm, cause coagulation dysfunction, trigger lung epithelial cell apoptosis, et al, which collaboratively contribute to lung injury.The clinical symptoms of 2019-nCoV infection in children are mild, which is thought due to the advantages of children in innate immune response and the low level of adaptive immune response.The fundamental means to prevent and treat lung injury was inhibiting the proliferation and replication of the 2019-nCoV virus, but so far, there are no specific antiviral drugs found yet.Approaches like recombinant human soluble ACE2 protein, neutralizing antibody against protein S, inhibiting angiotensinⅡ, contradicting inflammation factors, or stem cell infusion may be helpful to prevent and alleviate lung injury.
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Resumen En marzo de 2020, la Organización Mundial de la Salud (OMS) hizo un llamado a mantener la vacunación programática siempre que se pudieran garantizar condiciones seguras frente a la circulación de SARS-CoV-2. Asimismo, advirtió sobre el riesgo de interrupción de la vacunación programática secundaria a la pandemia por SARS-CoV-2. La interrupción de la vacunación genera un aumento en el número de personas susceptibles a las enfermedades que se busca prevenir y, así, de la probabilidad de uno o más brotes epidémicos. Estos, junto con incrementar la morbilidad y mortalidad en los grupos de riesgo, significarían una carga adicional al ya demandado sistema de salud por COVID-19. En agosto 2020, la OMS reportó interrupción de los servicios de salud esenciales en distintos países a raíz de la pandemia de SARS-CoV-2, afectando con mayor frecuencia a la vacunación de rutina y extramural. En Chile, la vacunación programática durante el 2020 disminuyó respecto del promedio del período 2015-2019, con la menor caída en la vacunación de los 2 meses de edad con hexavalente (0,39%) y la mayor a los 18 meses también con hexavalente (12,02%). La excepción fue la vacunación antineumocócica del adulto, con un incremento de 0,8% respecto del período 2015-2019.
Abstract In March 2020, the World Health Organization (WHO) recommended that vaccination not be interrupted as long as countries could safely maintain this service in the context of the SARS-CoV-2 pandemic. WHO also warned about the risk of interruption of programmatic vaccination that generates an increase in the number of people susceptible to infections that are sought to be prevented with the use of vaccines and, therefore, an increase in the probability of disease outbreak. Along with increased morbidity and mortality in risk groups, vaccine-preventable disease outbreaks would put additional demand on the health system already burdened by COVID-19. In August 2020, WHO reported the interruption of essential health services in different countries as a result of the SARS-CoV-2 pandemic, which mainly affected routine and extramural vaccination. In Chile, routine vaccination coverage decreased during 2020 compared to the average coverage for the 2015-2019 period. The smallest decline was 0.39% for the hexavalent vaccine at 2 months of age and the largest decrease was 12.02% at 18 months for the same vaccine. The exception to the fall in coverage in 2020 was adult pneumococcal vaccination, which showed an increase of 0.8% compared to 2015-2019.
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Humans , Adult , Vaccination/statistics & numerical data , Immunization Programs/statistics & numerical data , COVID-19 , Chile/epidemiology , Vaccination Coverage , Pandemics/prevention & control , SARS-CoV-2ABSTRACT
ABSTRACT SARS-CoV-2 has a high risk of outbreak in long-term skilled nursing facilities (SNF). Coronavirus disease (COVID-19) has high mortality rates among the elderly with chronic health conditions. Following identification of COVID-19 index case in a SNF, serial point-prevalence was implemented with reverse transcription-polymerase chain reaction (RT-PCR) and immunochromatographic assays. Active surveillance and early isolation of infected patients were implemented. Out of 23 SNF residents and 26 healthcare workers (HCW), 18 (78%) and 12 (46%) tested positive for SARS-CoV-2, respectively. High proportion (38%) of positive patients were asymptomatic and RT-PCR was positive up to six days before symptoms. Five (21.74%) residents were hospitalized with COVID-19, and 2 (9%) died; only 1 (4%) HCW needed to be hospitalized and no staff members died. Active surveillance helped COVID-19 control and management in a SNF. Testing symptomatic individuals only may fail to identify and isolate all persons contributing to transmission. In high-risk elderly, only symptoms screening may not be enough for outbreak control.
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Humans , Aged , Skilled Nursing Facilities , COVID-19 , Mass Screening , Disease Outbreaks , SARS-CoV-2ABSTRACT
Este estudo objetiva analisar questões da educação médica evidenciadas pelas medidas de distanciamento social provocadas pela pandemia do coronavírus19 associadas às percepções de professores de medicina sobre esses mesmos aspectos, em um momento prévio à eclosão da crise sanitária. Realizamos um recorte de resultados de uma pesquisa de natureza qualitativa e conduzimos a discussão com base na triangulação de dados entre observações de campo e entrevistas com professores. A pandemia reacendeu debates sobre a relevância de conteúdos, a utilização de tecnologias digitais para fins pedagógicos e o valor do trabalho colaborativo. Além disso, resgatou questões que envolvem habilidades de comunicação e a saúde de estudantes nas práticas do cuidado. Discutiremos a experiência passada articulando-a às experiências recentes e o que poderemos recolher para (re)construirmos os rumos da formação dos médicos.(AU)
El objetivo de este estudio es analizar cuestiones de la educación médica puestas en evidencia por las medidas de distancia social adoptadas por la pandemia del coronavirus 19, asociadas a las percepciones de profesores de medicina sobres esos mismos aspectos, en un momento previo a la eclosión de la crisis sanitaria. Realizamos un recorte de resultados de una investigación de naturaleza cualitativa y dirigimos la discusión a partir de la triangulación de datos entre observaciones de campo y entrevistas con profesores. La pandemia reencendió debates sobre la relevancia de contenidos, la utilización de tecnologías digitales para fines pedagógicos y el valor del trabajo colaborativo. Además, rescató cuestiones que envuelven habilidades de comunicación y la salud de estudiantes en las prácticas del cuidado. Discutiremos la experiencia pasada articulándola con las experiencias recientes y lo que podremos recoger para (re)construir los rumbos de formación de los médicos.(AU)
This study aims to analyze medical education issues evidenced by the measures of social distancing due to the coronavirus pandemic19, associated with the perceptions of medical professors about these same aspects, in a moment prior to the outbreak of the health crisis. We focused in the results of a qualitative research and conducted a discussion based on the triangulation of data between field observations and interviews with professors. The pandemic has rekindled debates about the relevance of contents, the use of digital technologies for educational purposes and the value of collaborative work. Additionally, it provoked the emergence of issues involving communication skills and the health of students in care practices. We discuss past experiences articulating them with recent experiences and what we can collect to (re)build the direction of medical training.(AU)
Subject(s)
Humans , Male , Female , Perception , Education, Medical/trends , Faculty/psychology , COVID-19 , Curriculum/trends , Information Technology/trends , Physical DistancingABSTRACT
Objective:To analyze the evolutionary characteristics and variations of 2019 novel coronavirus (2019-nCoV) strains imported from abroad in Henan Province.Methods:A total of 16 imported cases of coronavirus disease 2019 (COVID-19) reported in Henan Province from May to December 2020 were enrolled. The throat swab specimens from the patients were collected and sent to the Henan Provincial Center for Disease Control and Prevention for whole genome sequencing. Taking SARS-CoV-2 Wuhan-Hu-1 published in Global Initiative on Sharing All Influenza Data (GISAID) as the reference sequence, the sequences were aligned and analyzed by MEGA X, and the phylogenetic tree was constructed by the maximum likelihood method.Results:Among 16 cases, 13 cases were imported from Russia, two cases were imported from Myanmar, and one case was imported from Ukraine. A total of 16 strains of 2019-nCoV genomes with the lengths of 29 804 bp to 29 882 bp were obtained. A total of 145 nucleotide mutations and 80 amino acid mutations were detected. Nucleotide variations of C241T, C3037T, C14408T, A23403G and the amino acid variation of D614G in spike protein were detected in all sequences. Meanwhile, insertion A at the site of 29704 was found in BetaCov/HEN02/Human/2020, BetaCov/HEN04/Human/2020 and BetaCov/HEN05/Human/2020. Deletion variation was not found. Phylogenetic analysis showed that there was no correlation between the 16 strains and currently epidemic variants of concern (VOC) .Conclusion:From May to December 2020, the detection of viral genome mutations in the imported cases of Henan Province shows randomness and diversity, while the strains are not VOC.
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Objective:To investigate the viral molecular mutations of 2019 novel coronavirus (2019-nCoV) and host adaptability in Suzhou City.Methods:The throat swab specimens from nine local cases and six imported cases with 2019-nCoV viral nucleic acid test positive in Suzhou City were sequenced for the whole genome of the virus, and the Wuhan-Hu-1 strain was used as the reference sequence for alignment and analysis. The phylogenetic tree of the viral whole genome sequence was constructed by MEGA 7.0 software.Results:According to the Chinese typing method, Nextstrain typing method, Pangolin classification method and Global Initiative on Sharing All Influenza Data (GISAID) typing method, the 15 2019-nCoV genome sequences could be divided into seven types, six types, eight types and five subtypes, respectively. Compared with Wuhan-Hu-1 strain, the median number of amino acid sequence mutation sites based on nucleotide translation was three (ranging from 0 to 12). D614G mutation of spike protein was identified from all six imported viral strains, which could enhance the transmissibility. No Alpha, Beta, or Gamma mutants, which also could enhance the transmissibility, was found in the genomic sequences of the imported cases. The median number of nucleotide mutation sites in 15 sequences was eight (ranging from three to 23).Conclusions:2019-nCoV is constantly mutating, and a variety of evolutionary lineages/genotypes have been derived. All imported viruses in Suzhou City carry mutations that can increase infectivity.
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2019 novel coronavirus (2019-nCoV) Delta variant of concern (VOC) is one of the variants of 2019-nCoV, which has the characteristics of strong transmission, high pathogenicity, and rapid progression. 2019-nCoV Delta VOC has caused a global pandemic. Understanding the characteristics of 2019-nCoV Delta VOC and implementing targeted control measures are important aspects of controlling the pandemic. In this paper, the characteristics and control measures of 2019-nCoV Delta VOC were reviewed.
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Coronavirus disease 2019(COVID-19) refers to the pneumonia caused by novel coronavirus(2019-nCoV) infection in 2019. It is highly infectious, with quick spreading and a wide range of impact. It has been broken out in many countries around the world and has become a public health emergency of international concern. Chinese medicine has a long history in treating plague, and viral disease is the clinical advantage in Chinese medicine. Under the premise that there is currently no specific drug treatment, Chinese medicine has achieved certain effects in the treatment of COVID-19, which has attracted much attention and has been upgraded to a national strategy. Regarding the treatment of COVID-19 with Chinese medicine, it is believed that in terms of the name of Chinese medicine, the modern connotation of "uniform of typhoid and febrile disease" should be re-recognized, and it is advisable to use drugs based on specific clinical prescriptions and indications. In terms of pathogenesis, the COVID-19 has the pathogenesis rules including from the mild to severe conditions, from the surface to the inside, from the excess syndrome to the deficiency syndrome. We should pay attention to the Taiyang syndrome damaged by wet disease in initial stage, Shaoyang syndrome complicated with Yangming syndrome in the middle stage, phlegm-heat obstructing lung in critical period, lung and spleen deficiency in the recovery stage. In terms of clinical treatment strategies, Dayuan Yin is recommended to induce sweat and disperse the stasis in early stage. Xiaochaihu Decoction and Maxing Shigan Decoction is used to relieve both exterior and interior symptoms in middle stage. In critical stage, Tingli Dazao Xiefei Decoction, Weijing Decoction, Xuanbai Chengqi Decoction, Xiaoxianxiong Decoction, and Sanzi Yangqin Decoction are considered to reduce phlegm and clear heat. We should pay attention to nourishing Qi and strengthening the spleen by Zhuye Shigao Decoction, Sha-shen Maidong Decoction, and Liujunzi Decoction in the later recovery period. It shall be noted that, no matter in the initial mild stage, the middle and critical stages, or in the later recovery stage, Chinese medicine plays an important role, including preventing mild to severe disease, shortening the fever time, improving cough symptoms, increasing blood oxygen saturation and reducing mortality. Many studies have shown that the classical herbal formulae can alleviate the cytokine storm, regulate the immune imbalance, and produce the potential effect of synergistic treatment for COVID-19 through multiple components, multiple targets, and multiple pathways.
Subject(s)
Humans , COVID-19 , Drugs, Chinese Herbal/therapeutic use , Medicine, Chinese Traditional , SARS-CoV-2 , SyndromeABSTRACT
Objective:To conduct epidemiological investigation of a family cluster of coronavirus disease 2019 （COVID-19） in Fangshan District， Beijing， so as to provide reference and scientific basis for the strategy of prevention and control. Methods:Based on the "Prevention and Control Plan for COVID-19 （Third Edition）"issued by the National Health Commission of China， two cases from the same family were studied by field epidemiological investigation method. Sputum and/or throat swab specimens were collected and sent to the laboratory of Fangshan District Center for Disease Control and Prevention （CDC） for nucleic acid detection of 2019 novel coronavirus （2019-nCoV）. Tracking close contacts and isolation observation were conducted. Results:Both sputum and throat swab specimens of case 1 were positive for 2019-nCoV nucleic acid on February 3rd， 2020. Case 2 （wife of case 1） received screening as a close contact， and throat swab specimen was positive on February 4th， 2020. Therefore， it was determined to be a family cluster. The epidemic was effectively controlled after a series of measures， including isolation treatment， medical observation according to management of close contact and terminal disinfection of residence. Conclusion:The CDC professionals should strengthen monitoring of new findings， comprehensively analyze case data based on the latest research trends， improve professional sensitivity， and conduct timely screening to detect cases as soon as possible for the prevention of further epidemic spreading.
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ABSTRACT BACKGROUND: Since February 2020, data on the clinical features of patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and their clinical evolution have been gathered and intensively discussed, especially in countries with dramatic dissemination of this disease. OBJECTIVE: To assess the clinical features of Brazilian patients with SARS-CoV-2 and analyze its local epidemiological features. DESIGN AND SETTING: Observational retrospective study conducted using data from an official electronic platform for recording confirmed SARS-CoV-2 cases. METHODS: We extracted data from patients based in the state of Pernambuco who were registered on the platform of the Center for Strategic Health Surveillance Information, between February 26 and May 25, 2020. Clinical signs/symptoms, case evolution over time, distribution of confirmed, recovered and fatal cases and relationship between age group and gender were assessed. RESULTS: We included 28,854 patients who were positive for SARS-CoV-2 (56.13% females), of median age 44.18 years. SARS-CoV-2 infection was most frequent among adults aged 30-39 years. Among cases that progressed to death, the most frequent age range was 70-79 years. Overall, the mortality rate in the cohort was 8.06%; recovery rate, 30.7%; and hospital admission rate (up to the end of follow-up), 17.3%. The average length of time between symptom onset and death was 10.3 days. The most commonly reported symptoms were coughing (42.39%), fever (38.03%) and dyspnea/respiratory distress with oxygen saturation < 95% (30.98%). CONCLUSION: Coughing, fever and dyspnea/respiratory distress with oxygen saturation < 95% were the commonest symptoms. The case-fatality rate was 8.06% and the hospitalization rate, 17.3%.