RESUMEN
ABSTRACT Objectives: To verify the association between the ABO blood type and the risk of SARS-CoV-2 infection and COVID-19 disease severity. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using the 2020 PRISMA Checklist and flow diagram, and articles selected for review were analyzed using the Newcastle-Ottawa Quality Rating Scale. The research question was: "Would the ABO blood group influence the risk of infection and clinical course of patients infected with SARS-CoV-2?", The following databases were used: Embase, PubMed, Virtual Health Library (VHL), Web of Science, Science-Direct and Scopus. The protocol for this review was registered in the Prospective Register of Systematic Reviews (PROSPERO), number CRD42021245945. Results: We found 798 articles across PubMed, Embase, Scopus, Web of Science, Science Direct and Virtual Health Library and 54 articles were included in the final analysis. Among 30 studies evaluating the risk of COVID-19 infection, 21 found significant correlations with ABO blood groups, 14 of them revealing an increased risk in blood group A and 15 studies showing a decreased risk in blood group O. Most studies found no significant correlation with disease severity or mortality. Conclusion: The qualitative assessment of available information suggests that blood group A may be a risk factor for COVID-19 infection and that blood group O may have a protective effect. We were unable to determine a clear association between the ABO blood group and mortality. These conclusions are based on highly heterogenous evidence.
RESUMEN
ABSTRACT Objective: To analyze the delay or failure to seek primary health care by the mother-child dyads during the COVID-19 pandemic, a practice that has a high potential to increase maternal and child morbidity and mortality. Methods: Data from three survey rounds of the Iracema-COVID cohort study, collected 6, 12, and 18 months after birth, showed the patterns of postpartum attendance to primary health care consultation of the mother-child dyad. Crude and adjusted multinomial logistic regressions with robust variance were used to assess factors associated with nonattendance. Results: Among the 314 cohort mothers, 25% did not attend any primary health care consultation during the 18-months postpartum, while 30% of the mothers did all three. Regarding the child, 75% had regular primary health care consultations in all three survey rounds, while 4% did not attend any in their first 18 months of life. By the end of the first COVID-19 wave, the proportion of mother and child who attended the consultations had fallen by 23 and 18%, respectively. The main factors associated with nonattendance were mothers aged below 25 years, and mothers with more than one child. Conclusion: An important delay or nonattendance to primary health care consultation by the mother-child dyad was observed during the COVID-19 pandemic. Such practice, with a high potential to increase maternal and child morbidity and mortality, was particularly frequent among younger mothers and those with more than one child.
RESUMO Objetivo: Analisar o retardo ou a não procura por atenção primária à saúde por parte do bionômio mãe-filho durante a pandemia de COVID-19, uma prática que apresenta elevado potencial de aumentar a morbimortalidade materno-infantil. Métodos: Dados de três levantamentos do estudo longitudinal Iracema-COVID, realizados aos seis, 12 e 18 meses após o parto, identificaram padrões de procura por consultas na Atenção Primária à Saúde (APS) por parte do binômio mãe-filho. A regressão multinomial bruta e adjustada com variância robusta foi utilizada para avaliar os fatores associados com a não procura. Resultados: Entre as 314 mães da coorte, 25% não realizaram nenhuma consulta na APS durante o período de 18 meses pós-parto, enquanto 30% das mães o fizeram nos três contatos do seguimento. Com relação à consulta da criança, 75% realizaram consultas de APS nos três momentos, ao passo que 4% não realizaram nenhuma consulta em seus primeiros 18 meses de vida. Ao fim da primeira onda de COVID-19, a proporção de consultas na APS de mães e crianças caiu 23 e 18%, respectivamente. Os principais fatores associados à não procura por APS foram mães com idade abaixo de 25 anos e mães com mais de um filho. Conclusão: Houve importante retardo ou não procura por APS pelo bionômio mãe-filho durante a pandemia de COVID-19. Essa prática, com elevado potencial de aumentar a morbimortalidade materno-infantil, foi mais frequente entre mães mais jovens e com mais de um filho.