Impact of the COVID-19 pandemic on compulsory notification of meningitis during the first wave of the pandemic in Brazil: an ecological study using P-score

Abstract BACKGROUND: Meningitis is listed as one of the diseases requiring compulsory notification in Brazil. It can affect all age groups and also has no seasonality. Cases can be recorded in all months of the year and in all states of Brazil. Despite its importance, the obligation of immediate notification may have been compromised by the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: To analyze the immediate impact of the COVID-19 pandemic on compulsory notifications of meningitis in Brazil and its states during the first wave of the pandemic. DESIGN AND SETTING: This was an ecological study involving all confirmed cases of meningitis in Brazil, in its regions and in its states. METHODS: Data for the months from 2015 to 2020 were obtained from the database of the Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação, SINAN), in the Department of Informatics of the National Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS). The P-score was used to obtain the percentage change in the numbers of cases reported in 2020. RESULTS: A 45.7% reduction in notifications of meningitis in Brazil was observed. Regarding the regions and the states, with the exception of Roraima, all of them showed a negative P-score, with decreasing curves each month. CONCLUSION: The pandemic caused a negative impact on meningitis notifications in Brazil.

Duração de sintomas por COVID-19 em pacientes pós-internamento em hospitais terciários no Ceará / Duration of symptoms caused by COVID-19 in patients discharged from tertiary hospitals in Ceará

Apesar do avanço no conhecimento sobre COVID-19, pouco ainda se sabe sobre o percurso da doença e seus desfechos a longo prazo. Assim, surge a investigação pós pandemia centrada nas sequelas e complicações causadas pelo Coronavírus. Desse modo, objetivou-se investigar vestígios sintomatológicos e tempo de duração em pacientes pós internamento por COVID-19 advindos de três hospitais regionais cearenses. Trata-se de um estudo descritivo, analítico do tipo transversal com abordagem quantitativa realizado no período de agosto a outubro de 2021 por meio da telepesquisa. A amostra final foi constituída de 49 pacientes na primeira onda e 153 na segunda, totalizando 202 participantes. Os dados foram tabulados em planilha eletrônica Excel® e analisados conforme estatística descritiva. Apresenta-se uma prevalência de pacientes do sexo masculino, 31 (63,3%) no primeiro período investigado, e 86 (56,2%) no segundo período. Na investigação de sintomas físicos destacou-se fadiga/cansaço, apresentando 23 (46,9%) e 69 (45,1%) conforme onda, seguido de inapetência 13 (26,5%) e (40,5%). Falta de ar teve destaque na segunda onda com 39 (25,5%). Sintomas como perda de memória, tosse e dor no peito aparecem como sendo os mais duradouros, sendo prevalentes por até 4 meses após a alta hospitalar. Enquanto na 2ª onda dor no peito é citada com duração de até 6 meses. Neste contexto, este estudo expõe os principais sintomas relatados, apontando para a necessidade iminente de estratégias públicas de serviços de acompanhamento e intervenção junto a estes pacientes.

Despite advances in knowledge about COVID-19, little is known about the course of the disease and its long-term outcomes. Therefore, post-pandemic research has focused on the sequelae and complications caused by the Coronavirus. Thus, the objective was to investigate symptomatological remains and their duration of discharged patients hospitalized for COVID-19 from three regional hospitals in Ceará. This is a descriptive, analytical cross-sectional study with a quantitative approach carried out from August to October 2021 through telesurvey. The final sample consisted of 49 patients in the first wave of the pandemic and 153 in the second, totaling 202 participants. Data were tabulated in an Excel® spreadsheet and analyzed according to descriptive statistics. There is a prevalence of male patients, 31 (63.3%) in the first period investigated, and 86 (56.2%) in the second wave. In the investigation of physical symptoms, fatigue/tiredness stood out, identified in 23 (46.9%) and 69 (45.1%) individuals according to the wave, followed by a lack of appetite in 13 (26.5%) and (40.5%). Shortness of breath was highlighted in the second period among 39 (25.5%) individuals. Symptoms such as memory loss, cough, and chest pain appear to be the most lasting, and were prevalent for up to 4 months after hospital discharge. While in the 2nd wave chest pain was cited lasting up to 6 months. In this context, this study exposes the main symptoms reported, pointing to the imminent need for public strategies for monitoring and intervention services with these patients.

Immunogenicity after CoronaVac vaccination

SUMMARY OBJECTIVE: This study aimed to investigate the seropositivity of CoronaVac-SinoVac vaccination in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) risk factors and comorbidities. METHODS: Immunoglobulin (IgG) antibody responses were examined on the 21st day after the second dose of CoronaVac-SinoVac 6 μg vaccine on the 28th day. SARS-CoV-2 IgG antibody levels were measured by using the enzyme-linked immunosorbent assay method in vaccinated health care workers (n=134) (Group I), vaccinated polymerase chain reaction (PCR) (+) who had coronavirus-19 (COVID-19) disease (n=21) (Group II), and unvaccinated PCR (+) (n=28) (Group III) participants. Subgroups were formed in Group I according to the presence of COVID-19 risk factors and comorbidities (diabetes mellitus, cardiovascular disease, and asthma/allergy) and demographic data. RESULTS: Seropositivity rates were 95.5, 100, and 89.3% for Groups I, II, and III, respectively. IgG antibody levels were found significantly higher in the group between the ages of 20-30 in group I compared to those aged 31-50 and over 50 (both p<0.01). It was found significantly higher in normal-weight individuals than in the overweight and obese group (both p<0.01). IgG antibody levels were found significantly lower in people with cardiovascular disease and diabetes mellitus compared with those who did not (p<0.05 and p<0.001, respectively). There was a negative correlation between IgG antibody response values and body mass index and age in Group I (r= −0.336, p<0.001 and r= −0.307, p<0.001, respectively). CONCLUSION: IgG antibody values decrease with age and with increasing body mass index. The presence of comorbidities (i.e., diabetes mellitus and cardiovascular disease) decreased COVID-19 IgG antibody values.

Estimating Brazilian states demands for intensive care unit and clinical hospital beds during the COVID-19 pandemic: development of a predictive model

ABSTRACT BACKGROUND: The fragility of healthcare systems worldwide had not been exposed by any pandemic until now. The lack of integrated methods for bed capacity planning compromises the effectiveness of public and private hospitals' services. OBJECTIVES: To estimate the impact of the COVID-19 pandemic on the provision of intensive care unit and clinical beds for Brazilian states, using an integrated model. DESIGN AND SETTING: Experimental study applying healthcare informatics to data on COVID-19 cases from the official electronic platform of the Brazilian Ministry of Health. METHODS: A predictive model based on the historical records of Brazilian states was developed to estimate the need for hospital beds during the COVID-19 pandemic. RESULTS: The proposed model projected in advance that there was a lack of 22,771 hospital beds for Brazilian states, of which 38.95% were ICU beds, and 61.05% were clinical beds. CONCLUSIONS: The proposed approach provides valuable information to help hospital managers anticipate actions for improving healthcare system capacity.

Investigation of mental health among hospital workers in the COVID-19 pandemic: a cross-sectional study

ABSTRACT BACKGROUND: The rapid spread of the COVID-19 epidemic has led to extraordinary measures taken worldwide, and has led to serious psychological disorders. Healthcare professionals face greater severity of stress burden, due both to their direct contact with patients with the virus and to the isolation dimension of this outbreak. OBJECTIVE: To examine psychiatric disorders such as anxiety, depression and sleep disorders among healthcare professionals working in an emergency department and a COVID-19 clinic. DESIGN AND SETTING: Cross-sectional study including healthcare professionals in the emergency department and other units serving patients with COVID-19, of a training and research hospital in Turkey. METHODS: 210 volunteers, including 105 healthcare professionals in the emergency department and 105 healthcare professionals working in other departments rendering services for COVID-19 patients, were included in this study. A sociodemographic data form and the Hospital Anxiety Depression Scale (HAD), Pittsburg Sleep Quality Index (PSQI), World Health Organization Quality of Life scale (WHOQOL-BREF-TR) and Religious Orientation Scale were applied to the volunteers. RESULTS: The perceived stress levels and PSQI subscores were found to be significantly higher among the volunteers working in the emergency department than among those in other departments. The risk of development of anxiety among women was 16.6 times higher than among men. CONCLUSIONS: Healthcare professionals on the frontline need systematic regular psychosocial support mechanisms. Anxiety due to fear of infecting family members can be prevented through precautions such as isolation. However, it should be remembered that loneliness and feelings of missing family members consequent to isolation may increase the risk of depression.

Evaluation of patients undergoing emergency surgery in a COVID-19 pandemic hospital: a cross-sectional study

ABSTRACT BACKGROUND: The COVID-19 pandemic is threatening healthcare systems and hospital operations on a global scale. Treatment algorithms have changed in general surgery clinics, as in other medical disciplines providing emergency services, with greater changes seen especially in pandemic hospitals. OBJECTIVES: To evaluate the follow-up of patients undergoing emergency surgery in our hospital during the COVID-19 pandemic. DESIGN AND SETTING: Cross-sectional study conducted in a tertiary-level public hospital. METHODS: The emergency surgeries carried out between March 11 and April 2, 2020, in the general surgery clinic of a tertiary-care hospital that has also taken on the functions of a pandemic hospital, were retrospectively examined. RESULTS: A total of 25 patients were included, among whom 20 were discharged without event, one remained in the surgical intensive care unit, two are under follow-up by the surgery service and two died. Upon developing postoperative fever and shortness of breath, two patients underwent thoracic computed tomography (CT), although no characteristics indicating COVID-19 were found. The discharged patients had no COVID-19 positivity at follow-up. CONCLUSION: The data that we obtained were not surgical results from patients with COVID-19 infection. They were the results from emergency surgeries on patients who were not infected with COVID-19 but were in a hospital largely dealing with the pandemic. Analysis on the cases in this study showed that both the patients with emergency surgery and the patients with COVİD infection were successfully treated, without influencing each other, through appropriate isolation measures, although managed in the same hospital. In addition, these successful results were supported by 14-day follow-up after discharge.