Risk factors for acute kidney injury in patients hospitalized with COVID-19 / Fatores de risco para lesão renal aguda em pacientes hospitalizados com COVID-19

Abstract Introduction: Acute kidney injury (AKI) occurs frequently in COVID-19 patients and is associated with greater morbidity and mortality. Knowing the risks of AKI allows for identification, prevention, and timely treatment. This study aimed to identify the risk factors associated with AKI in hospitalized patients. Methods: A descriptive, retrospective, cross-sectional, and analytical component study of adult patients hospitalized with COVID-19 from March 1 to December 31, 2020 was carried out. AKI was defined by the creatinine criteria of the KDIGO-AKI guidelines. Information, regarding risk factors, was obtained from electronic medical records. Results: Out of the 934 patients, 42.93% developed AKI, 60.59% KDIGO-1, and 9.9% required renal replacement therapy. Patients with AKI had longer hospital stay, higher mortality, and required more intensive care unit (ICU) admission, mechanical ventilation, and vasopressor support. Multivariate analysis showed that age (OR 1.03; 95% CI 1.02-1.04), male sex (OR 2.13; 95% CI 1.49-3.04), diabetes mellitus (DM) (OR 1.55; 95% CI 1.04-2.32), chronic kidney disease (CKD) (OR 2.07; 95% CI 1.06-4.04), C-reactive protein (CRP) (OR 1.02; 95% CI 1.00-1.03), ICU admission (OR 1.81; 95% CI 1.04-3.16), and vasopressor support (OR 7.46; 95% CI 3.34-16.64) were risk factors for AKI, and that bicarbonate (OR 0.89; 95% CI 0.84-0.94) and partial pressure arterial oxygen/inspired oxygen fraction index (OR 0.99; 95% CI 0.98-0.99) could be protective factors. Conclusions: A high frequency of AKI was documented in COVID-19 patients, with several predictors: age, male sex, DM, CKD, CRP, ICU admission, and vasopressor support. AKI occurred more frequently in patients with higher disease severity and was associated with higher mortality and worse outcomes.

RESUMO Introdução: Lesão renal aguda (LRA) ocorre frequentemente em pacientes com COVID-19 e associa-se a maior morbidade e mortalidade. Conhecer riscos da LRA permite a identificação, prevenção e tratamento oportuno. Este estudo teve como objetivo identificar fatores de risco associados à LRA em pacientes hospitalizados. Métodos: Realizou-se estudo descritivo, retrospectivo, transversal e de componente analítico de pacientes adultos hospitalizados com COVID-19 de 1º de março a 31 de dezembro, 2020. Definiu-se a LRA pelos critérios de creatinina das diretrizes KDIGO-LRA. Informações sobre fatores de risco foram obtidas de prontuários eletrônicos. Resultados: Dos 934 pacientes, 42,93% desenvolveram LRA, 60,59% KDIGO-1 e 9,9% necessitaram de terapia renal substitutiva. Pacientes com LRA apresentaram maior tempo de internação, maior mortalidade e necessitaram de mais internações em UTIs, ventilação mecânica e suporte vasopressor. A análise multivariada mostrou que idade (OR 1,03; IC 95% 1,02-1,04), sexo masculino (OR 2,13; IC 95% 1,49-3,04), diabetes mellitus (DM) (OR 1,55; IC 95% 1,04-2,32), doença renal crônica (DRC) (OR 2,07; IC 95% 1,06-4,04), proteína C reativa (PCR) (OR 1,02; IC 95% 1,00-1,03), admissão em UTI (OR 1,81; IC 95% 1,04-3,16) e suporte vasopressor (OR 7,46; IC 95% 3,34-16,64) foram fatores de risco para LRA, e que bicarbonato (OR 0,89; IC 95% 0,84-0,94) e índice de pressão parcial de oxigênio arterial/fração inspirada de oxigênio (OR 0,99; IC 95% 0,98-0,99) poderiam ser fatores de proteção. Conclusões: Documentou-se alta frequência de LRA em pacientes com COVID-19, com diversos preditores: idade, sexo masculino, DM, DRC, PCR, admissão em UTI e suporte vasopressor. LRA ocorreu mais frequentemente em pacientes com maior gravidade da doença e associou-se a maior mortalidade e piores desfechos.

Os reflexos da pandemia do novo coronavírus na judicialização do direito à saúde perante o Supremo Tribunal Federal / The effects of the novel coronavirus pandemic on the judicialization of the right to health before the Federal Supreme Court / Las reflexiones de la pandemia del nuevo coronavirus sobre la judicialización del derecho a la salud ante la Suprema Corte Federal

Objetivo: identificar se a situação pandêmica interferiu na extensão e no modo como as questões referentes ao direito à saúde foram apreciadas pelo Supremo Tribunal Federal. Metodologia: foi realizada pesquisa documental, que, após consulta na base de dados do Supremo Tribunal Federal, com o filtro pelo termo "saúde", retornou um total de 1.178 acórdãos, sendo 447 do período pré-pandêmico e 731 do período pandêmico, os quais foram analisados e classificados conforme a pertinência temática. Após os descartes da etapa de classificação, identificaram-se 70 acórdãos no período pré-pandêmico e 167 acórdãos no pandêmico que versam efetivamente sobre o direito à saúde. Resultados: a pandemia impôs inúmeros desafios ao sistema de saúde, de modo que o Poder Judiciário foi instado a se manifestar ante às controvérsias ora instauradas. Nessas manifestações, identificou-se que houve aumento nas demandas de controle concentrado e no quantitativo absoluto de decisões envolvendo o direito à saúde, bem como que qualitativamente, em geral, o padrão decisório anterior foi mantido, embora novos temas tenham surgido. Conclusão: o estudo concluiu que a tendência da Suprema Corte permanece favorável ao reconhecimento de direitos sanitários, tendo, para tal, argumentos como a não ofensa à separação de poderes e a impossibilidade de arguir a reserva do possível para impedir sua concessão.

Objective: to identify whether the pandemic situation interfered with the extent and way in which issues relating to the right to health were assessed by the Federal Supreme Court. Methodology: documentary research was carried out, which, after consulting the Federal Supreme Court database, with the filter using the term "health", returned a total of 1,178 rulings, 447 from the pre-pandemic period and 731 from the pandemic period, which were analyzed and classified according to thematic relevance. After the classification stage discards, 70 rulings were identified in the pre-pandemic period and 167 rulings in the pandemic that effectively deal with the right to health. Results: the pandemic imposed numerous challenges on the health system, so that the Judiciary was urged to speak out in the face of the now established controversies. In these manifestations, it was identified that there was an increase in demands for concentrated control and in the absolute quantity of decisions involving the right to health, as well as that qualitatively, in general, the previous decision-making pattern was maintained, although new themes have emerged. Conclusion: the study concluded that the Supreme Court's tendency remains in favor of the recognition of health rights, using arguments such as the non-offense of the separation of powers and the impossibility of arguing on the possible reservation to prevent their granting.

Objetivo: identificar si la situación de pandemia interfirió en el alcance y la forma en que las cuestiones relativas al derecho a la salud fueron evaluadas por el Supremo Tribunal Federal. Metodología: se realizó una investigación documental que, consultada la base de datos del Supremo Tribunal Federal, con el filtro del término "salud", arrojó un total de 1.178 sentencias, 447 del período prepandemia y 731 del período pandémico, que fueron analizados y clasificados según relevancia temática. Descartada la etapa de clasificación, se identificaron 70 sentencias en el período prepandemia y 167 sentencias en la pandemia que abordan efectivamente el derecho a la salud. Resultados: la pandemia impuso numerosos desafíos al sistema de salud, por lo que se instó al Poder Judicial a pronunciarse ante las controversias ahora establecidas. En estas manifestaciones se identificó que hubo un aumento en las demandas de control concentrado y en la cantidad absoluta de decisiones que abordan el derecho a la salud, así como que cualitativamente, en general, se mantuvo el patrón de toma de decisiones anterior, aunque han surgido nuevos temas. Conclusión: el estudio concluyó que se mantiene la tendencia de la Corte Suprema a favor del reconocimiento de los derechos a la salud, utilizando argumentos como la no infracción de la separación de poderes y la imposibilidad de argumentar la reserva de lo posible para impedir su otorgamiento.

Características clínicas e epidemiológicas das internações pediátricas por COVID-19 na Amazônia brasileira: um estudo observacional / Clinical and epidemiological characteristics of pediatric hospitalizations due to COVID-19 in the Brazilian Amazon: an observational study

OBJETIVO: Apontar os aspectos clínicos e epidemiológicos de crianças internadas por COVID-19 em um hospital público situado em um estado da Amazônia Brasileira. MÉTODO: Estudo observacional, descritivo, retrospectivo e documental com uma abordagem quantitativa dos casos de internação pediátrica por COVID-19. RESULTADOS: No Hospital da Criança e Adolescente, foram registrados um total de 5016 casos suspeitos de COVID-19 em crianças. Destes, 666 foram confirmados com a doença e resultaram em 140 internações. Analisamos 136 notificações de crianças internadas por COVID-19. A maioria dos pacientes era lactente (39%) e pré-escolar (36%), com prevalência do sexo masculino (67,6%) e raça/cor preta/parda (86%). Além disso, 83,1% delas residem em área urbana. Quanto ao desfecho, 96,67% evoluíram para a cura e 3,33% resultaram em óbito. CONCLUSÃO: No contexto amazônico, a análise das características clínicas e epidemiológicas deste grupo etário é essencial para orientar os cuidados clínicos, prever a gravidade da doença e determinar o prognóstico.

OBJECTIVE: To determine the clinical and epidemiologic aspects of children hospitalized for COVID-19 in a public hospital located in a state in the Brazilian Amazon. METHODS: Observational, descriptive, retrospective, and documentary study with a quantitative approach to pediatric hospitalization cases due to COVID-19. RESULTS: In the Hospital for Children and Adolescents, a total of 5016 suspected cases of COVID-19 in children were recorded. Of these, 666 were confirmed with the disease, resulting in 140 hospitalizations. We analyzed 136 reports of children hospitalized for COVID-19. Most patients were infants (39%) and preschool children (36%), with a prevalence of males (67.6%) and black/brown race/color (86%). In addition, 83.1% live in urban areas. Regarding the outcome, 96.67% were cured, and 3.33% resulted in death. CONCLUSION: In the Amazonian context, the analysis of this age group's clinical and epidemiologic characteristics is essential to guide clinical care, predict the severity of the disease, and determine the prognosis.

Recent advances in drug screening methods of SARS-CoV-2 spike protein / 药学学报

The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a serious impact on global public health and the economy. SARS-CoV-2 infiltrates host cells via its surface spike protein, which binds to angiotensin-converting enzyme 2 on the host cell membrane. As a result, small molecules targeting spike protein have emerged as a hotspot in anti-SARS-CoV-2 drug research. Activity screening is an important step in seeking small molecule drugs. Therefore, this article aims to review the biological activity evaluation methods of small molecule inhibitors targeting SARS-CoV-2 spike protein, with the goal of laying the foundation for the discovery of new anti-SARS-CoV-2 drugs.

Progress in the epidemiology of COVID-19 infections in children and adolescents / 中国学校卫生

Abstract@#The COVID-19 pandemic has posed a series of complex challenges. COVID-19 in children and adolescents is generally less severe than in adults and the elderly; however, some children and adolescents may experience severe complications and adverse health effects even after mild or asymptomatic COVID-19 infections. The article focuses on gathering the epidemic characteristics, health impact, risk factors, prevention and control measures, and vaccination status of children and adolescents with COVID-19 infection to provide recommendations for protecting children and adolescents in the post COVID-19 era.

Effects of traditional Chinese medicine on treatment outcomes in severe COVID-19 patients: a single-centre study / 中国天然药物

As the search for effective treatments for COVID-19 continues, the high mortality rate among critically ill patients in Intensive Care Units (ICU) presents a profound challenge. This study explores the potential benefits of traditional Chinese medicine (TCM) as a supplementary treatment for severe COVID-19. A total of 110 critically ill COVID-19 patients at the Intensive Care Unit (ICU) of Vulcan Hill Hospital between Feb., 2020, and April, 2020 (Wuhan, China) participated in this observational study. All patients received standard supportive care protocols, with a subset of 81 also receiving TCM as an adjunct treatment. Clinical characteristics during the treatment period and the clinical outcome of each patient were closely monitored and analysed. Our findings indicated that the TCM group exhibited a significantly lower mortality rate compared with the non-TCM group (16 of 81 vs 24 of 29; 0.3 vs 2.3 person/month). In the adjusted Cox proportional hazards models, TCM treatment was associated with improved survival odds (P < 0.001). Furthermore, the analysis also revealed that TCM treatment could partially mitigate inflammatory responses, as evidenced by the reduced levels of proinflammatory cytokines, and contribute to the recovery of multiple organic functions, thereby potentially increasing the survival rate of critically ill COVID-19 patients.

Enhancing understanding of SARS-CoV-2 infection among individuals with Down syndrome: An integrative review

ABSTRACT BACKGROUND: Down syndrome (DS) is a non-rare genetic condition that affects approximately 1 in every 800 live births worldwide. Further, it is associated with comorbidities, anatomical alterations of the respiratory tract, and immunological dysfunctions that make individuals more susceptible to respiratory infections. OBJECTIVE: To systematize the current scientific knowledge about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among individuals with DS. DESIGN AND SETTING: This integrative review was conducted at the Universidade Federal de São Carlos, São Paulo, Brazil. METHODS: This review was conducted in the following databases: the Virtual Health Library (Biblioteca Virtual em Saúde, BVS), PubMed, and Web of Science, using MeSH descriptors. The search included English or Portuguese studies published between January 1, 2020, and October 14, 2022. RESULTS: A total of 55 articles from 24 countries were selected, comprising 21 case-control or cohort studies, 23 case reports or series, and 11 narrative reviews or opinion studies. The articles were grouped into five categories: previous comorbidities, coronavirus disease 2019 (COVID-19) clinical features and evolution, cytokine storm and interleukins, living in institutions as a risk factor, and behavioral actions as a protective factor against SARS-CoV-2 infection. CONCLUSION: Individuals with DS are more susceptible to COVID-19 infection due to variables such as previous comorbidities, immunological factors, and their habitable environments. These aspects confer a higher risk of infection and an unfavorable clinical course. The precise pathways involved in the pathophysiology of COVID-19 in individuals with DS are not clear, thus requiring further studies. SYSTEMATIC REVIEW REGISTRATION: The Open Science Framework registered the research protocol (https://osf.io/jyb97/).

Hospitalização de idosos por COVID-19 no Paraná: uma análise de fatores associados / Hospitalización de personas mayores por COVID-19 en Paraná: un análisis de factores asociados / Hospitalization of elderly people due to COVID-19 in the State of Paraná, Brazil: analysis of associated factors

Resumo Objetivo Analisar a prevalência e os fatores associados à hospitalização de idosos com COVID-19 no estado do Paraná, PR, Brasil. Métodos Estudo transversal vinculado à coorte "Acompanhamento Longitudinal de adultos e idosos que receberam alta da internação hospitalar por COVID-19", realizado por meio de informações contidas nas fichas de notificação compulsória do Sistema de Informação de Agravos de Notificação. As análises foram realizadas através de frequências relativas e absolutas, com aplicação do teste de qui-quadrado adotado no modelo de regressão logística. A população do estudo englobou pessoas residentes no Estado do Paraná com idade de 60 anos ou mais, hospitalizadas por COVID-19 no período de março de 2020 a setembro de 2021. Resultados Foi identificada maior prevalência de hospitalização entre idosos com escolaridade igual ou maior a oito anos. Indivíduos não vacinados contra COVID-19 apresentaram maior chance de internação. O sexo masculino apresentou mais chance de admissão em Unidade de Terapia Intensiva em comparação com o sexo feminino. Doenças cardiovasculares, pneumopatia e obesidade aumentaram a prevalência da forma grave da doença. Conclusão Fatores tais como escolaridade e não adesão à vacinação contra COVID-19 podem aumentar o risco de hospitalização pela doença. Pessoas idosas do sexo masculino apresentam maior chance de hospitalização na UTI se comparadas às do sexo feminino; além disso, a não utilização de antivirais pode contribuir para o agravamento do estado de saúde.

Resumen Objetivo Analizar la prevalencia y los factores asociados a la hospitalización de personas mayores por COVID-19 en el estado de Paraná. Métodos Estudio transversal vinculado a la cohorte "Seguimiento longitudinal de adultos y personas mayores que recibieron alta de internación hospitalaria por COVID-19", realizado mediante información contenida en las fichas de notificación obligatoria del Sistema de Información de Agravios de Notificación. Los análisis fueron realizados a través de frecuencias relativas y absolutas, con aplicación de la prueba ji cuadrado adoptada en el modelo de regresión logística. La población del estudio incluyó personas residentes del estado de Paraná, de 60 años o más, hospitalizadas por COVID-19 en el período de marzo de 2020 a septiembre de 2021. Resultados Se identificó mayor prevalencia de hospitalización en personas mayores con escolaridad igual o mayor a ocho años. Individuos no vacunados contra COVID-19 presentaron mayor probabilidad de internación. El sexo masculino presentó más probabilidad de admisión en Unidad de Cuidados Intensivos en comparación con el sexo femenino. Enfermedades cardiovasculares, neumopatía y obesidad aumentaron la prevalencia de la forma grave de la enfermedad. Conclusión Factores tales como escolaridad y no adhesión a la vacunación contra COVID-19 pueden aumentar el riesgo de hospitalización por la enfermedad. Personas mayores de sexo masculino presentaron mayor probabilidad de hospitalización en la UCI al compararlas con las de sexo femenino. Además, la no utilización de antivirales puede contribuir al agravamiento del estado de salud.

Abstract Objective To analyze the prevalence and factors associated with hospitalization of elderly people with COVID-19 in the State of Paraná, PR, Brazil. Methods A cross-sectional study linked to the cohort "Longitudinal Monitoring of adults and elderly people who were discharged from hospital admission due to COVID-19", was carried out using information contained in the compulsory notification forms of the Notifiable Diseases Information System. Analyzes were carried out using relative and absolute frequencies, applying the chi-square test adopted in the logistic regression model. The study population included people aged 60 years or over and residing in the State of Paraná, who were hospitalized for COVID-19 from March 2020 to September 2021. Results A higher hospitalization prevalence was identified among elderly people with eight years of education or more. Individuals not vaccinated against COVID-19 had a greater chance of hospitalization. Males had a greater chance of admission to the Intensive Care Unit compared to females. Cardiovascular diseases, lung disease, and obesity have increased the prevalence of the severe form of the disease. Conclusion Factors such as education and non-adherence to vaccination against COVID-19 can increase the risk of hospitalization due to the disease. Elderly people of the male sex have a greater chance of hospitalization in the ICU compared to the female sex. Furthermore, not using antivirals can contribute to worsening health status.

Macular perfusion changes in people administered two types of COVID-19 vaccines: optical coherence tomography angiography study

ABSTRACT Purpose: To evaluate macular chorioretinal flow changes on optical coherence tomography angiography, in participants who received inactivated and messenger RNA (mRNA) vaccines to prevent coronavirus disease 2019 (COVID-19). Methods: In this prospective cohort study, healthy participants who received two doses of an inactivated COVID-19 vaccine (CoronaVac) and then one dose of an mRNA vaccine (BNT162b2) were examined before and after each vaccination. Ophthalmologic examination and imaging with optical coherence tomography angiography were performed during each visit. We evaluated vascular densities in the superficial and deep capillary plexuses in foveal, parafoveal, and perifoveal areas; the foveal avascular zone; and choriocapillaris flows (in 1- and 6-mm-diameter areas). Results: One eye in each of the 24 participants was assessed. Superficial capillary plexus vascular densities in the parafoveal area were significantly lower after the second dose of the CoronaVac vaccine than after the first dose. In the deep capillary plexus, vascular attenuation was observed only in the parafoveal region after the first CoronaVac dose. However, in all regions, the deep capillary plexus vascular densities and subfoveal choriocapillaris flow were significantly decreased after the second CoronaVac dose. After the BNT162b2 dose, the superficial capillary plexus vascular densities, the deep capillary plexus vascular densities, and subfoveal choriocapillaris flow of most regions were significantly lower than those before vaccinations. Conclusion: Vascular attenuation, observed particularly after the second dose of the CoronaVac vaccine, may explain the pathogenesis of postvaccine ocular ischemic disorders reported in the literature. However, these disorders are extremely rare, and the incidence of thrombotic events caused by COVID-19 itself is higher.

Is it possible to estimate the number of patients with COVID-19 admitted to intensive care units and general wards using clinical and telemedicine data?

ABSTRACT Objective: To develop and validate predictive models to estimate the number of COVID-19 patients hospitalized in the intensive care units and general wards of a private not-for-profit hospital in São Paulo, Brazil. Methods: Two main models were developed. The first model calculated hospital occupation as the difference between predicted COVID-19 patient admissions, transfers between departments, and discharges, estimating admissions based on their weekly moving averages, segmented by general wards and intensive care units. Patient discharge predictions were based on a length of stay predictive model, assessing the clinical characteristics of patients hospitalized with COVID-19, including age group and usage of mechanical ventilation devices. The second model estimated hospital occupation based on the correlation with the number of telemedicine visits by patients diagnosed with COVID-19, utilizing correlational analysis to define the lag that maximized the correlation between the studied series. Both models were monitored for 365 days, from May 20th, 2021, to May 20th, 2022. Results: The first model predicted the number of hospitalized patients by department within an interval of up to 14 days. The second model estimated the total number of hospitalized patients for the following 8 days, considering calls attended by Hospital Israelita Albert Einstein's telemedicine department. Considering the average daily predicted values for the intensive care unit and general ward across a forecast horizon of 8 days, as limited by the second model, the first and second models obtained R² values of 0.900 and 0.996, respectively and mean absolute errors of 8.885 and 2.524 beds, respectively. The performances of both models were monitored using the mean error, mean absolute error, and root mean squared error as a function of the forecast horizon in days. Conclusion: The model based on telemedicine use was the most accurate in the current analysis and was used to estimate COVID-19 hospital occupancy 8 days in advance, validating predictions of this nature in similar clinical contexts. The results encourage the expansion of this method to other pathologies, aiming to guarantee the standards of hospital care and conscious consumption of resources.

Health and lifestyle parameters in peripheral artery disease at two periods of the COVID-19 pandemic: comparison between men and women

ABSTRACT Objective: This study analyzed the impact of sex on self-reported health and lifestyle parameters in peripheral artery disease patients at two periods of the COVID-19 pandemic. Methods: In this longitudinal study, 99 patients with peripheral artery disease (53 men and 46 women) were evaluated during two periods of the COVID-19 pandemic ( i.e ., at onset: May to August 2020, and on follow-up: May to August 2021). Patients were interviewed via telephone, and information regarding lifestyle and health parameters was obtained. Results: At the onset of the COVID-19 pandemic, health and habit parameters were similar between women and men, with 63.0% and 45.3% indicating frequent fatigue, 73.9% and 84.9% reporting increased sitting time, and 23.9% and 39.6% practicing physical activity, respectively. At follow-up, difficulties in physical mobility (women: from 26.1% to 73.9%, p<0.001; men: from 39.6% to 71.7%, p=0.001) and the frequency of hospitalization for reasons other than COVID-19 increased similarly in women and men (women: from 4.3% to 21.7%, p=0.013; men: from 9.4% to 24.5%, p=0.038). The other parameters were similar between the periods. Conclusion: Self-reported physical mobility difficulties and hospitalization frequency increased in women and men with peripheral artery disease.

Long-term outcomes for epidemic viral pneumonia survivors after discharge from the intensive care unit: a systematic review

ABSTRACT Objective To review the long-term outcomes (functional status and psychological sequelae) of survivors of critical illnesses due to epidemic viral pneumonia before the COVID-19 pandemic and to establish a benchmark for comparison of the COVID-19 long-term outcomes. Methods This systematic review of clinical studies reported the long-term outcomes in adults admitted to intensive care units who were diagnosed with viral epidemic pneumonia. An electronic search was performed using databases: MEDLINE®, Web of Science™, LILACS/IBECS, and EMBASE. Additionally, complementary searches were conducted on the reference lists of eligible studies. The quality of the studies was assessed using the Newcastle-Ottawa Scale. The results were grouped into tables and textual descriptions. Results The final analysis included 15 studies from a total of 243 studies. This review included 771 patients with Influenza A, Middle East Respiratory Syndrome, and Severe Acute Respiratory Syndrome. It analyzed the quality of life, functionality, lung function, mortality, rate of return to work, rehospitalization, and psychiatric symptoms. The follow-up periods ranged from 1 to 144 months. We found that the quality of life, functional capacity, and pulmonary function were below expected standards. Conclusion This review revealed great heterogeneity between studies attributed to different scales, follow-up time points, and methodologies. However, this systematic review identified negative long-term effects on patient outcomes. Given the possibility of future pandemics, it is essential to identify the long-term effects of viral pneumonia outbreaks. This review was not funded. Prospero database registration: (www.crd.york.ac.uk/prospero) under registration ID CRD42021190296.

Alternative therapies for viral infections caused by SARS-Cov-2 / Terapias alternativas para infecções virais causadas pelo SARS-Cov-2

Abstract Introduction The relevance of the studied topic lies in the complexity of the treatment of infection caused by SARS-CoV-2. Objective To discuss the potential advantages and disadvantages of alternative treatments compared to conventional medical approaches, and to highlight the importance of collaborative communication between patients and healthcare providers in making informed decisions about alternative treatments of the SARS-CoV-2 virus. Methods The research methodology employed literature analysis methods, including bibliographic and bibliosemantic approaches. The study used theoretical, systematic, and statistical methods, including analysis, synthesis, generalization, interpretation, classification, and meta-analysis to explore alternative treatments for SARS-CoV-2 infections, their interrelationships, and statistical trends in incidence. Results The study identifies diverse alternative therapies for treating SARS-CoV-2 infections, highlighting herbal medicine, acupuncture, reflexology, biohacking, homoeopathy, and magnetotherapy. It underscores the potential benefits of herbal remedies like garlic, ginger, chamomile, and honeysuckle, as well as vitamins (C, D, B12) and minerals (zinc, selenium) in managing COVID-19 symptoms. Conclusion While of-fering holistic benefits, these therapies warrant cautious consideration due to limited scientific backing and potential interactions. Cultural understanding, patient-provider dialogue, and informed choices are key in harnessing the potential of alternative medicine along-side conventional approaches for managing COVID-19 challenges.

Resumo Introdução A relevância do tema estudado reside na comple-xidade do tratamento da infeção causada pelo SARS-CoV-2. Objetivo Discutir as potenciais vantagens e desvantagens dos tratamentos alternativos em comparação com as abordagens médicas convencionais e realçar a importância da comunicação colaborativa entre os doentes e os prestadores de cuidados de saúde na tomada de decisões informadas sobre os tratamentos alternativos do vírus SARS-CoV-2. Métodos A metodologia de investigação utilizou métodos de análise da literatura, incluindo abordagens bibliográficas e bibliosemânticas. O estudo utilizou métodos teóricos, sistemáticos e estatísticos, incluindo análise, síntese, generalização, interpretação, classificação e meta-aná-lise para explorar tratamentos alternativos para as infecções por SARS-CoV-2, suas inter-relações e tendências estatísticas da incidência. Resultados O estudo identifica diversas terapias alternativas para o tratamento das infecções por SARS-CoV-2, destacando a fitoterapia, a acupunctura, a reflexologia, o biohacking, a homeopatia e a magnetoterapia. Sublinha os potenciais benefícios dos remédios à base de plantas como o alho, o gengibre, a camomila e a madressilva, bem como das vitaminas (C, D, B12) e dos minerais (zinco, selénio) na gestão dos sintomas da COVID-19. Conclusão Embora ofereçam benefícios holísticos, estas terapias devem ser consideradas com cautela devido ao apoio científico limitado e às potenciais interações. A compreensão cultural, o diálogo paciente-prove-dor e as escolhas informadas são fundamentais para aproveitar o potencial da medicina alternativa juntamente às abordagens convencionais para gerir os desafios da COVID-19.

Children in the pandemic: Contributions of the National Course on Mental Health and Psychosocial Care in COVID-19 / Crianças na pandemia: contribuições do Curso Nacional de Saúde Mental e Atenção Psicossocial na COVID-19

Objective Considering the psychosocial repercussions of the COVID-19 pandemic on children, this case study aims to describe the work process involved in the construction and execution of the Children in the COVID-19 Pandemic module, which comprised the National Course on Mental Health and Psychosocial Care in COVID-19, hosted by the Fundação Oswaldo Cruz. Method Data from the materials that made up the module (booklet, video lesson, forum, and live broadcast), the profile of those enrolled, as well as emerging themes from participants' questions and comments (forum and live broadcast) were analyzed. Results Thirty-one percent of the course participants, who were predominantly female psychologists, completed the module. The booklet, developed with an accessible language, met the general guidelines for the development of manuals aimed at providing guidance on health care, seeking to address emerging demands in order to qualify the care for children in the context of COVID-19. Conclusion There was a great diversity of themes addressed in the material resulting from the forum and the live broadcast, which were discussed in order to contribute to the planning of psychosocial care strategies aimed at mitigating the negative repercussions of the pandemic on child development, as well as to offer a space for sharing knowledge and experiences on professional practice during this major public health emergency.

Objetivo Considerando as repercussões psicossociais da pandemia de COVID-19 às crianças, este estudo de caso tem o objetivo de descrever o processo de trabalho envolvido na construção e execução do módulo Crianças na Pandemia COVID-19, que compôs o Curso Nacional de Saúde Mental e Atenção Psicossocial na COVID-19, promovido pela Fundação Oswaldo Cruz. Método Analisaram-se dados provenientes dos materiais que compuseram o módulo (cartilha, videoaula, fórum e live), o perfil dos inscritos, bem como as temáticas emergentes em questionamentos e comentários dos participantes (fórum e live). Resultados Concluíram o módulo 31% dos participantes do Curso, os quais eram, predominantemente, mulheres psicólogas. A cartilha, desenvolvida em linguagem acessível, atendeu às diretrizes gerais para elaboração de manuais voltados à orientação sobre cuidados em saúde, buscando abordar demandas emergentes, no sentido de qualificar a atenção às crianças no contexto da COVID-19. Conclusão Houve grande diversidade de temáticas abordadas no material decorrente do fórum e da live, as quais foram discutidas com vista a contribuir para o planejamento de estratégias de atenção psicossocial voltadas a mitigar repercussões negativas da pandemia para o desenvolvimento infantil, bem como oferecer um espaço para compartilhamento de conhecimentos e experiências de atuação profissional frente a essa grave emergência de saúde pública.

Como a pandemia de COVID-19 afetou a notificação de acidentes do trabalho em diferentes atividades econômicas e ocupações no Brasil? Um estudo ecológico usando o p-score / How did the COVID-19 pandemic affect occupational accident notification in different economic activities and occupations in Brazil? An ecological study using p-score

Resumo Objetivo: mensurar o impacto da pandemia de COVID-19 nas notificações de acidentes do trabalho (AT) no Brasil, por atividade econômica e ocupação. Métodos: estudo ecológico que utilizou os casos de AT registrados entre 2015 e 2020 no Anuário Estatístico da Previdência Social. Os AT foram analisados por setor de atividade econômica, ocupação e códigos da 10ª revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-10). Uma adaptação do p-score foi aplicada para comparar os casos de AT pré-pandemia com os do primeiro ano da pandemia. Resultados: os p-scores variaram de -60,2%, para AT por nexo técnico epidemiológico, a -13,9%, para AT típico. As doenças do trabalho apresentaram p-score de 151,1%. Houve aumento notável nos casos de doenças ocupacionais dos capítulos I e X da CID-10. As notificações de AT diminuíram em todas as categorias de atividades econômicas, exceto nas de saúde humana e serviços sociais (p-score = 8,0%). Na maioria das categorias, os valores foram negativos, exceto nos subgrupos forças de segurança e profissionais de saúde de nível superior, técnico e gestores. Conclusão: houve redução geral na notificação de AT durante a pandemia de COVID-19 no Brasil, que evidenciou desigualdades entre diferentes setores de atividades e ocupações, além de mudança no perfil de adoecimento dos trabalhadores.

Abstract Objective: to assess the COVID-19 pandemic impact on Occupational Accident (OA) notifications in Brazil by economic activity and occupation. Methods: an ecological study was conducted using OA cases recorded in the Statistical Yearbook of Social Security from 2015 to 2020. Accidents were analyzed by sector of economic activity, occupation, and ICD-10 codes. Pre-pandemic cases were compared with the first year of the public health emergency scenario caused by Sars-Cov-2 using an adapted p-score. Results: p-scores ranged from -60.2% for technical-epidemiological Occupational Accidents to -13.9% for typical OA. Occupational diseases had a p-score of 151.1%. Cases of occupational diseases from ICD-10 chapters I and X showed a significant increase. OA notifications decreased in all CNAE sections, except for human health and social services activities (p-score = 8.0%). P-score values were negative in most CBO categories, except in subgroups such as security forces and high-level health professionals, technicians, and managers. Conclusion: Brazil registered a general reduction in OA notifications due to the pandemic, which evinced inequalities in different sectors and occupations, as well as changes in the illness profile of workers.

Índice de massa corporal e desfechos clínicos: um estudo retrospectivo durante a pandemia de Covid-19 / Body mass index and clinical outcomes: a retrospective study in Covid-19 / Índice de masa corporal y resultado clínico: un estudio retrospectivo durante la pandemia de Covid-19

A COVID-19 é uma doença respiratória aguda provocada pela infecção do vírus SARS-CoV-2, que pode causar uma grave insuficiência respiratória hipoxêmica, complicações e mortes, principalmente na população com condições crônicas de saúde. Os mecanismos pelos quais a obesidade pode aumentar a gravidade da COVID-19 incluem mecanismos físicos, inflamação crônica e uma função imunológica prejudicada. Além disso, o índice de massa corporal elevado é um fator de risco para várias condições médicas que têm sido sugeridas para aumentar o risco de gravidade da COVID-19. Objetivo: analisar a associação entre o índice de massa corporal e desfechos clínicos dos casos confirmados de COVID-19. Metodologia: Estudo transversal, com coleta de dados de prontuários, conduzido de março de 2020 a dezembro 2021. Foram analisados os registros de prontuários, exames bioquímicos e de imagem de pacientes internados com COVID-19 em três hospitais da cidade de Francisco Beltrão (PR). As variáveis analisadas foram o diagnóstico nutricional, idade, sexo, necessidade de internação em UTI, comorbidades, dias de hospitalização, complicações, exames laboratoriais e desfecho. Os critérios para inclusão no estudo foram, pacientes hospitalizados com diagnóstico para COVID-19, com presença de diagnóstico nutricional relatado. Resultados: No ano de 2020 foram analisados 292 prontuários e no ano de 2021 foram 860 prontuários. Destes, somente 413 possuíam diagnóstico nutricional, sendo assim incluídos no presente estudo. Foram classificados como peso normal 78 (18,9%), com sobrepeso 153 (37%)e como obeso 182 (44,1%) participantes. A maior prevalência de obesidade foi encontrada no sexo feminino (52,5%), portadores de diabetes (27,6%), pacientes com estado geral comprometido (67,9%), que apresentaram complicações pulmonares (54,5%) e arritmias (23%). A média de idade encontrada em pacientes com obesidade foi mais jovem (55,54) em comparação com os classificados com sobrepeso (59,08) e normal (62,51). Observou-se que quanto maior o IMC menor foram os valores encontrados para idade (rho = -0,190), leucócitos (rho = -0,109), ureia (rho = -0,145) e D-dímero (rho = -0,155). Conclusão: Este estudo fornece evidências de que o sobrepeso e/ou obesidade então associadas a um pior quadro clínico durante a internação dos pacientes com COVID-19. Em relação a frequência de óbito, não houve diferença estatística em relação ao diagnóstico nutricional.

COVID-19 is an acute respiratory disease caused by SARS-CoV-2 virus infection, which can cause severe hypoxemic respiratory failure, complications, and deaths, especially in the population with chronic health conditions. The mechanisms by which obesity may increase the severity of COVID-19 include physical mechanisms, chronic inflammation, and impaired immune function. In addition, high body mass index is a risk factor for several medical conditions that have been suggested to increase the risk of COVID-19 severity. Objective: to analyze the association between body mass index and clinical outcomes of confirmed cases of COVID-19. Methodology: Cross-sectional study, with data collection from medical records, conducted from March 2020 to December 2021. The records of medical records, biochemical and imaging tests of patients hospitalized with COVID-19 in three hospitals in the city of Francisco Beltrão (PR) were analyzed. The variables analyzed were nutritional diagnosis, age, gender, need for ICU admission, comorbidities, days of hospitalization, complications, laboratory tests and outcome. The inclusion criteria for the study were, hospitalized patients with diagnosis for COVID-19, with presence of nutritional diagnosis reported. Results: In the year 2020, 292 medical records were analyzed and in the year 2021 there were 860 medical records. Of these, only 413 had nutritional diagnosis, thus being included in this study. Were classified as normal weight 78 (18.9%), overweight 153 (37%), and obese 182 (44.1%) participants. The highest prevalence of obesity was found in females (52.5%), patients with diabetes (27.6%), patients with impaired general condition (67.9%), who presented pulmonary complications (54.5%) and arrhythmias (23%). The mean age found in obese patients was younger (55.54) compared to those classified as overweight (59.08) and normal (62.51). It was observed that the higher the BMI the lower were the values found for age (rho = -0.190), leukocytes (rho = -0.109), urea (rho = -0.145) and D-dimer (rho = -0.155). Conclusion: This study provides evidence that overweight and/or obesity then associated with a worse clinical picture during hospitalization of patients with COVID-19. Regarding the frequency of death, there was no statistical difference in relation to nutritional diagnosis.

COVID-19 es una enfermedad respiratoria aguda causada por la infección por el virus SARS-CoV-2, que puede provocar insuficiencia respiratoria hipoxémica grave, complicaciones y muertes, especialmente en poblaciones con enfermedades crónicas. Los mecanismos por los cuales la obesidad puede aumentar la gravedad de la COVID-19 incluyen mecanismos físicos, inflamación crónica y función inmune deteriorada. Además, un índice de masa corporal alto es un factor de riesgo para varias afecciones médicas que, según se ha sugerido, aumentan el riesgo de gravedad del COVID-19. Objetivo: analizar la asociación entre el índice de masa corporal y los resultados clínicos de casos confirmados de COVID-19. Metodología: Estudio transversal, con recolección de datos de historias clínicas, realizado de marzo de 2020 a diciembre de 2021. Se analizaron historias clínicas, exámenes bioquímicos y de imagen de pacientes hospitalizados con COVID-19 en tres hospitales de la ciudad de Francisco Beltrão (PR). Las variables analizadas fueron diagnóstico nutricional, edad, sexo, necesidad de ingreso a UCI, comorbilidades, días de internación, complicaciones, exámenes de laboratorio y evolución. Los criterios de inclusión en el estudio fueron pacientes hospitalizados con diagnóstico de COVID-19, con presencia de diagnóstico nutricional informado. Resultados: En 2020 se analizaron 292 historias clínicas y en 2021 se analizaron 860 historias clínicas. De ellos, sólo 413 tenían diagnóstico nutricional, por lo que fueron incluidos en el presente estudio. 78 (18,9%) participantes fueron clasificados como normopeso, 153 (37%) como sobrepeso y 182 (44,1%) como obesidad. La mayor prevalencia de obesidad se encontró en el sexo femenino (52,5%), pacientes con diabetes (27,6%), pacientes con estado general comprometido (67,9%), quienes presentaron complicaciones pulmonares (54,5%) y arritmias (23%). La edad promedio encontrada en los pacientes con obesidad fue menor (55,54) en comparación con los clasificados como con sobrepeso (59,08) y normales (62,51). Se observó que a mayor IMC, menores son los valores encontrados para edad (rho = -0,190), leucocitos (rho = -0,109), urea (rho = -0,145) y dímero D (rho = -0,155). Conclusión: Este estudio proporciona evidencia de que el sobrepeso y/u obesidad se asocia con una peor condición clínica durante la hospitalización de pacientes con COVID-19. En cuanto a la frecuencia de muerte, no hubo diferencia estadística en relación al diagnóstico nutricional.

Comportamento preventivo contra covid-19 e sua relação com as condições sociais e de saúde de pessoas idosas / Preventive behavior against covid-19 and its relationship with the social and health conditions of older adults

Resumo Objetivo Descrever o perfil de comportamento preventivo contra covid-19 adotado pelas pessoas idosas e verificar sua relação com as condições sociais e de saúde. Método Estudo transversal e analítico realizado com 72 indivíduos (≥ 60 anos) cadastrados em uma Universidade Aberta para Pessoas Idosas, no município de Campinas, São Paulo, Brasil. Os participantes foram contatados por meio de ligações telefônicas, no período de novembro de 2020 a junho de 2021. Um total de 11 medidas preventivas foram analisadas para a identificação dos comportamentos adotados pelas pessoas idosas contra covid-19. Para a análise dos dados, utilizaram-se análise de componentes principais, testes qui-quadrado de Pearson e Exato de Fisher, com 95% de confiança. Resultados A adoção de comportamentos preventivos foi avaliada por meio das atividades de: higienização das mãos com água e sabão, uso do álcool em gel, uso de máscara facial e distanciamento social. A maioria dos indivíduos mencionou a adoção de comportamentos preventivos (79,2%), e verificou-se que aqueles com renda inferior a quatro salários-mínimos apresentaram maiores proporções de comportamento (87,5%) quando comparados aos indivíduos de renda superior a 10 salários-mínimos (46,2%) (p=0,038). Conclusão Houve adoção às medidas preventivas para covid-19 pelos idosos, influenciada pela renda. Os achados ressaltam a importância de estratégias educativas para promoção de comportamentos preventivos em saúde, considerando o contexto social.

Abstract Objective To delineate the profile of preventive behavior against covid-19 adopted by older adults and investigate its correlation with social and health conditions. Method A cross-sectional and analytical study conducted with 72 individuals (≥ 60 years) enrolled in an Open University for Older Adults in the municipality of Campinas, São Paulo, Brazil. Participants were contacted via telephone from November 2020 to June 2021. A total of 11 preventive measures were scrutinized to identify the behaviors adopted by older adults against covid-19. Data analysis employed principal component analysis, Pearson's chi-square tests, and Fisher's exact tests, with a confidence level of 95%. Results The adoption of preventive behaviors was assessed through activities such as hand hygiene with soap and water, use of hand sanitizer, wearing facial masks, and practicing social distancing. The majority of individuals reported the adoption of preventive behaviors (79.2%), and it was observed that those with incomes below four minimum wages exhibited higher proportions of compliance (87.5%) compared to individuals with incomes exceeding 10 minimum wages (46.2%) (p=0.038). Conclusion Preventive measures against covid-19 were embraced by the older adults, influenced by income. The findings underscore the significance of educational strategies for fostering health preventive behaviors, taking into account the social context.

Lesão renal aguda e COVID-19 em adultos jovens na terapia intensiva / Lesión renal aguda y COVID-19 en adultos jóvenes en cuidados intensivos / Acute kidney injury and COVID-19 in young adults in intensive care

Resumo Objetivo Descrever a prevalência de lesão renal aguda em adultos jovens com diagnóstico da COVID-19 admitidos em unidade terapia intensiva. Métodos Estudo retrospectivo, quantitativo e analítico. A amostra foi de adultos jovens (20 a 40 anos) admitidos em unidades de terapia intensiva, com diagnóstico de infecção por SARS-CoV-2 entre março e dezembro de 2020. Os dados foram obtidos por meio do prontuário eletrônico, e a lesão renal aguda foi definida pelo valor da creatinina, segundo critérios das diretrizes da Kidney Disease Improving Global Outcomes. A significância estatística foi de p≤0,05. Resultados Foram internados 58 adultos jovens, sendo 63,8% do sexo masculino. A hipertensão arterial sistêmica esteve presente em 39,6%, a obesidade em 18,9% e o diabetes mellitus em 8,6%. A lesão renal aguda foi identificada em 55,1%, sendo o estágio 3 predominante em 43,1% deles. Nesses pacientes, o uso de ventilação mecânica e de drogas vasoativas foi significativo em 92%, assim como a disfunção orgânica respiratória (80%), seguida da renal (76%). Fatores de risco, como transplante renal ou doença renal crônica e obesidade, aumentaram em 12,3 e 9,0 vezes, respectivamente, a chance de desenvolver lesão renal aguda. Conclusão Este estudo demonstrou alta prevalência de lesão renal em adultos jovens e sua associação com comorbidades prévias. Obesidade, transplante renal e doença renal crônica elevaram a chance de o adulto jovem desenvolver lesão renal aguda, resultando em desfechos a favor da morbimortalidade.

Resumen Objetivo Describir la prevalencia de lesión renal aguda en adultos jóvenes con diagnóstico de COVID-19 admitidos en unidad de cuidados intensivos. Métodos Estudio retrospectivo, cuantitativo y analítico. La muestra fue de adultos jóvenes (20 a 40 años) admitidos en unidades de cuidados intensivos, con diagnóstico de infección por SARS-CoV-2 entre marzo y diciembre de 2020. Los datos se obtuvieron por medio de historias clínicas electrónicas, y la lesión renal aguda fue definida por el valor de la creatinina, de acuerdo con criterios de las directrices de la Kidney Disease Improving Global Outcomes. La significación estadística fue de p≤0,05. Resultados Hubo 58 adultos jóvenes internados, el 63,8 % de sexo masculino. La hipertensión arterial sistémica estuvo presente en el 39,6 %, la obesidad en el 18,9 % y la diabetes mellitus en el 8,6 %. Se identificó lesión renal aguda en el 55,1 %, de nivel 3 como predominante en el 43,1 % de los casos. En esos pacientes, el uso de ventilación mecánica y de drogas vasoactivas fue significativo en el 92 %, así como también la disfunción orgánica respiratoria (80 %), seguida de la renal (76 %). Los factores de riesgo, como trasplante renal o enfermedad renal crónica y obesidad, aumentaron 12,3 y 9,0 veces respectivamente la probabilidad de presentar lesión renal aguda. Conclusión Este estudio demostró alta prevalencia de lesión renal en adultos jóvenes y su asociación con comorbilidades previas. La obesidad, el trasplante renal y la enfermedad renal crónica aumentaron la probabilidad de que los adultos jóvenes presenten lesión renal aguda, lo que da como resultado desenlaces a favor de la morbimortalidad.

Abstract Objective To describe acute kidney injury prevalence in young adults diagnosed with COVID-19 admitted to the Intensive Care Unit. Methods This is a retrospective, quantitative and analytical study. The sample consisted of young adults (20 to 40 years old) admitted to Intensive Care Units, diagnosed with SARS-CoV-2 infection between March and December 2020. Data were obtained through electronic medical records, and kidney injury acute was defined by the creatinine value, according to the Kidney Disease Improving Global Outcomes guidelines criteria. Statistical significance was p≤0.05. Results A total of 58 young adults were hospitalized, 63.8% of whom were male. Hypertension was present in 39.6%, obesity in 18.9%, and diabetes mellitus in 8.6%. Acute kidney injury was identified in 55.1%, with stage 3 predominating in 43.1% of them. In these patients, the use of mechanical ventilation and vasoactive drugs was significant in 92% as well as respiratory organ dysfunction (80%), followed by renal organ dysfunction (76%). Risk factors such as kidney transplantation or chronic kidney disease and obesity increased by 12.3 and 9.0 times, respectively, the chances of developing acute kidney injury. Conclusion This study demonstrated a high kidney injury prevalence in young adults and its association with previous comorbidities. Obesity, kidney transplantation and chronic kidney disease increased the chance of young adults to develop acute kidney injury, resulting in outcomes in favor of morbidity and mortality.

Impacts caused by the use of screens during the COVID-19 pandemic in children and adolescents: an integrative review / Impactos causados pelo uso de telas durante a pandemia da COVID-19 em crianças e adolescentes: uma revisão integrativa

ABSTRACT Objective: To identify the scientific evidence on the impacts caused by the use of screens during the COVID-19 pandemic in children and adolescents, raising reflections for future interventions with this public. Data source: This is an integrative literature review, conducted in the databases Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), United States National Library of Medicine (PubMed), Scopus, Web of Science, and Embase, published from March 2020 to January 2022, in Portuguese, English and Spanish. Data synthesis: The search strategies allowed retrieving 418 articles, of which 218 were duplicates. The analysis of titles and abstracts resulted in the maintenance of 62 studies. Of these, 31 were excluded from the reading of the full text, since they did not clearly present the phenomenon investigated. Thirty-one were eligible, resulting in five categories: eye consequences; increased sedentary behavior and weight; change in eating habits; implications for sleep quality and impacts on mental health. Conclusions: The excessive use of screens during the pandemic led to numerous consequences for children and adolescents, with a higher incidence of visual damage, sedentary lifestyle, inadequate eating habit and increased weight gain, in addition to impaired sleep quality and mental health. This study provides subsidy for health professionals to carry out continuing education focused on this theme, and elaborate effective interventions for this public in this transition to the post-pandemic period.

RESUMO Objetivo: Identificar as evidências científicas sobre os impactos causados pelo uso de telas durante a pandemia da COVID-19 em crianças e adolescentes, almejando reflexões para futuras intervenções com esse público. Fontes de dados: Trata-se de uma revisão integrativa da literatura, realizada nas bases de dados Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), United States National Library of Medicine (PubMed), Scopus, Web of Science e Embase, publicados de março de 2020 a janeiro de 2022, em português, inglês e espanhol. Síntese dos dados: As estratégias de busca possibilitaram recuperar 418 artigos, sendo 218 duplicados. A análise de títulos e resumos resultou na manutenção de 62 estudos. Destes, após a leitura do texto integral foram excluídos 31, uma vez que não apresentavam com clareza o fenômeno investigado. Foram elegíveis 31 estudos, emergindo cinco categorias: consequências oculares; aumento do comportamento sedentário e do peso; alteração dos hábitos alimentares; implicações na qualidade do sono e impactos na saúde mental. Conclusões: Percebe-se que o uso telas em excesso durante a pandemia trouxe inúmeras consequências para o público infantojuvenil, com maior incidência de acometimentos visuais, sedentarismo, alimentação inadequada e, por consequência, maior ganho de peso, além de prejuízos à qualidade do sono e à saúde mental. Este estudo fornece subsídios para que os profissionais da saúde realizem educação continuada voltada para essa temática e elaborem intervenções efetivas para esse público nesta transição para o período pós-pandêmico.