Can SARS-CoV-2 screening in oral biopsies aid epidemiological surveillance?

BACKGROUND: Three years after the first confirmed COVID-19 case in Brazil, the outcomes of Federal government omissions in managing the crisis and anti-science stance heading into the pandemic have become even more evident. With over 36 million confirmed cases and nearly 700 000 deaths up to January 2023, the country is one of the hardest-hit places in the world. The lack of mass-testing programs was a critical broken pillar responsible for the quick and uncontrolled SARS-CoV-2 spread throughout the Brazilian population. Faced with this situation, we aimed to perform the routine SARS-CoV-2 screening through RT-qPCR of oral biopsies samples to aid in the asymptomatic epidemiological surveillance during the principal outbreak periods. METHODS: We analyzed 649 formalin-fixed paraffin-embedded oral tissue samples from five important oral and maxillofacial pathology laboratories from the north, northeast, and southeast geographic regions of Brazil. We also sequenced the whole viral genome of positive cases to investigate SARS-CoV-2 variants. RESULTS: The virus was detected in 9/649 analyzed samples, of which three harbored the Variant of Concern Alpha (B.1.1.7). CONCLUSION: Although our approach did not value aiding asymptomatic epidemiological surveillance, we could successfully identify a using FFPE tissue samples. Therefore, we suggest using FFPE tissue samples from patients who have confirmed diagnosis of SARS-CoV-2 infection for phylogenetic reconstruction and contraindicate the routine laboratory screening of these samples as a tool for asymptomatic epidemiological surveillance.

Clinical and electrocardiographic outcomes evaluated by telemedicine of outpatients with clinical suspicion of COVID-19 treated with chloroquine compounds in Brazil†.

Aims: To evaluate clinical and electrocardiographic outcomes of patients with COVID-19, comparing those using chloroquine compounds (chloroquine) to individuals without specific treatment. Methods: Outpatients with suspected COVID-19 in Brazil who had at least one tele-electrocardiography (ECG) recorded in a telehealth system were enrolled in two arms (Group 1: chloroquine and Group 2: without specific treatment) and one registry (Group 3: other treatments). Outcomes were assessed through follow-up calls (phone contact, days 3 and 14) and linkage to national mortality and hospitalization databases. The primary outcome was composed of: hospitalization, intensive care admission, mechanical ventilation, and all-cause death, and the ECG outcome was the occurrence of major abnormalities by the Minnesota code. Significant variables in univariable logistic regression were included in 4 models: 1-unadjusted; 2-adjusted for age and sex; 3-model 2 + cardiovascular risk factors and 4-model 3 + COVID-19 symptoms. Results: In 303 days, 712 (10.2%) patients were allocated in group 1, 3,623 (52.1%) in group 2 and 2,622 (37.7%) in group 3; 1,969 had successful phone follow-up (G1: 260, G2: 871, and G3: 838). A late follow-up ECG was obtained for 917 (27.2%) patients [group 1: 81 (11.4%), group 2: 512 (14.1%), group 3: 334 (12.7%)]. In adjusted models, chloroquine was independently associated with greater chance of the composite clinical outcome: phone contact (model 4): OR = 3.24 (95% CI 2.31-4.54), p < 0.001. Chloroquine was also independently associated with higher mortality, assessed by phone + administrative data (model 3): OR = 1.67 (95% CI 1.20-2.28). However, chloroquine did not associate with the occurrence of major ECG abnormalities [model 3; OR = 0.80 (95% CI 0.63-1.02, p = 0.07)]. Abstracts with partial results of this work was accepted in the American Heart Association Scientific Sessions, November 2022, in Chicago, IL, USA. Conclusion: Chloroquine was associated with a higher risk of poor outcomes in patients suspected to have COVID-19 when compared to those who received standard care. Follow-up ECGs were obtained in only 13.2% of patients and did not show any significant differences in major abnormalities amongst the three groups. In the absence of early ECG changes, other side effects, late arrhythmias or deferral of care may be hypothesized to explain the worse outcomes.

SARS-CoV-2 Post-Infection and Sepsis by Saccharomyces cerevisiae: A Fatal Case Report-Focus on Fungal Susceptibility and Potential Virulence Attributes.

The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been responsible for approximately 6.8 million deaths worldwide, threatening more than 753 million individuals. People with severe coronavirus disease-2019 (COVID-19) infection often exhibit an immunosuppression condition, resulting in greater chances of developing co-infections with bacteria and fungi, including opportunistic yeasts belonging to the Saccharomyces and Candida genera. In the present work, we have reported the case of a 75-year-old woman admitted at a Brazilian university hospital with an arterial ulcer in the left foot, which was being prepared for surgical amputation. The patient presented other underlying diseases and presented positive tests for COVID-19 prior to hospitalization. She received antimicrobial treatment, but her general condition worsened quickly, leading to death by septic shock after 4 days of hospitalization. Blood samples collected on the day she died were positive for yeast-like organisms, which were later identified as Saccharomyces cerevisiae by both biochemical and molecular methods. The fungal strain exhibited low minimal inhibitory concentration values for the antifungal agents tested (amphotericin B, 5-flucytosine, caspofungin, fluconazole and voriconazole), and it was able to produce important virulence factors, such as extracellular bioactive molecules (e.g., aspartic peptidase, phospholipase, esterase, phytase, catalase, hemolysin and siderophore) and biofilm. Despite the activity against planktonic cells, the antifungals were not able to impact the mature biofilm parameters (biomass and viability). Additionally, the S. cerevisiae strain caused the death of Tenebrio molitor larvae, depending on the fungal inoculum, and larvae immunosuppression with corticosteroids increased the larvae mortality rate. In conclusion, the present study highlighted the emergence of S. cerevisiae as an opportunistic fungal pathogen in immunosuppressed patients presenting several severe comorbidities, including COVID-19 infection.

Impact of the COVID-19 pandemic on breast cancer screening and early diagnosis / Impacto da pandemia da COVID-19 no rastreamento e no diagnóstico precoce de câncer de mama

RESUMO Objetivo analisar os impactos da pandemia da COVID-19 no rastreamento e de diagnóstico precoce para o câncer de mama. Métodos estudo ecológico com avaliação retrospectiva dos dados contidos no Departamento de Informática do Sistema Único de Saúde entre os anos de 2016 e 2020. A coleta foi norteada por um roteiro semiestruturado e o impacto da pandemia no rastreamento e no diagnóstico foi realizado por meio da aplicação de fórmula e da comparação com o ano de 2020. Resultados no Brasil, houve uma queda significativa na quantidade de mamografias realizadas durante a pandemia da COVID-19, com diferença de 361.855 de 2016 para 2020. A idade de maior investigação diagnóstica foi entre 50 e 59 anos e a faixa etária com queda expressiva na realização da mamografia foi a de mulheres de 40 anos. Conclusão a pandemia da COVID-19 impactou, negativamente, o rastreamento e o diagnóstico precoce para o câncer de mama devido à redução dos atendimentos. Contribuições para a prática: reforçar a importância de investimentos no campo de políticas públicas diante de um cenário pandêmico para que os protocolos de rastreamento e de tratamento já estejam bem direcionados a fim de garantir uma melhor assistência aos pacientes oncológicos.

ABSTRACT Objective to analyze the impacts of the COVID-19 pandemic on breast cancer screening and early diagnosis. Methods an ecological retrospective study of data from the Department of Informatics of the Unified Health System collected between 2016 and 2020 was carried out. The data collection was guided by a semi-structured script, and the impact of the pandemic on breast cancer screen and diagnosis was established by using a formula and comparing the period of interest to 2020. Results in Brazil, there was a significant drop in mammograms performed during the COVID-19 pandemic, with a decrease of 361,855 exams from 2016 to 2020. Most diagnostic investigations were conducted with patients between 50 and 59 years, and there was a significant drop in mammograms in women aged under 40 years. Conclusion the COVID-19 pandemic has negatively impacted screening and early diagnosis of breast cancer due to reduced availability. Contributions to practice: the study reinforces the importance of investing in public policies to face the pandemic scenario so that screening and treatment protocols be well targeted to guarantee better care for cancer patients.

Facilitating access to pneumococcal vaccine for people living with HIV: an experience report.

OBJECTIVE: The article describes a strategy to facilitate access to pneumococcal conjugate vaccine 13 (PCV-13) for people living with HIV/AIDS (PLHIV) during the COVID-19 pandemic. METHOD: report on the experience regarding the organization of a care service for PLHIV in the city of São Paulo to facilitate access to PCV-13 in the framework of the 2020 influenza vaccination campaign during the COVID-19 pandemic. RESULTS: through the integration between a PLHIV care service and an Immunization Center (CRIE in Portuguese), it was possible to offer PCV-13 to PLHIV at the point of care, reducing physical barriers to access to immunization. Thus, of the 1,906 PLHIV who passed through the service during the period March 23-July 31, 2020, 84.4% (1,609) received the influenza vaccine, PCV-13 or both. Of the 1609 vaccinated, 50.6% (814) were eligible and received PCV-13. CONCLUSION: offering the vaccine at the point of care and orienting PLHIV on the importance of vaccination as a disease prevention strategy, identifying those eligible to receive it, was an important action carried out by the institution together with the nursing team, as a strategy to facilitate access to vaccination.

Post-viral fatigue in COVID-19: A review of symptom assessment methods, mental, cognitive, and physical impairment.

Coronavirus 2 is responsible for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), and the main sequela is persistent fatigue. Post-viral fatigue is common and affects patients with mild, asymptomatic coronavirus disease-2019 (COVID-19). However, the exact mechanisms involved in developing post-COVID-19 fatigue remain unclear. Furthermore, physical and cognitive impairments in these individuals have been widely described. Therefore, this review aims to summarize and propose tools from a multifaceted perspective to assess COVID-19 infection. Herein, we point out the instruments that can be used to assess fatigue in long-term COVID-19: fatigue in a subjective manner or fatigability in an objective manner. For physical and mental fatigue, structured questionnaires were used to assess perceived symptoms, and physical and cognitive performance assessment tests were used to measure fatigability using reduced performance.

ANÁLISE DA POSITIVIDADE E TÍTULOS DE NEUTRALIZAÇÃO EM PVHIV E CONTROLES NÃO VACINADOS COM IGG POSITIVO PARA SARS-COV-2

Introdução Testes de neutralização têm se tornado a principal referência para avaliar proteção após exposição ao SARS-CoV-2 ou após a vacinação. Alguns estudos sugerem que pessoas que vivem com HIV (PVHIV) têm menor probabilidade de soroconversão após a vacinação para COVID-19, porém a resposta humoral após infecção natural é pouco conhecida. Objetivo Avaliar a positividade e títulos de anticorpos neutralizantes em PVHIV e controles com IgG positivo identificados no Estudo Prevent, realizado antes da implementação das vacinas para COVID-19 no Brasil. Método O Estudo Prevent incluiu PVHIV sob tratamento ARV e contactantes próximos sem diagnóstico de infecção por HIV acompanhados por 120 dias com avaliação clínica semanal e avaliação sorológica (IgM/IgG) ao início (TS1) e final (TS2) do seguimento, entre abril/2020 e janeiro/2021. Todas as amostras com IgG reagente (+) foram submetidas a um teste correlato de anticorpos neutralizantes (TCAN). Resultados Um total de 74 amostras tiveram IgG reagente;entre PVHIV, 9 tiveram TS1+ e TS2 não reagente (NR);14 tiveram TS1+ e TS2+;e 18 tiveram TS1 NR e TS2+. No grupo controle, 6 tiveram TS1+/TS2 NR;5 tiveram TS1+ e TS2+ e apenas 2 tiveram TS1 NR e TS2+. Quanto à avaliação do TCAN, houve positividade em 39/56 (69%;IC95% 56-81) amostras de PVHIV, e em 14/18 (78%;IC95% 52-94) amostras de controles. 21 amostras foram positivas no TS e negativas no TCAN (17 PVHIV e 4 controles) além de 1 amostra TNeutrAc indeterminada após TS positivo (PVHIV). Embora as medianas de porcentagens de neutralização tenham sido mais altas entre controles em relação a PVHIV tanto nas amostras iniciais quanto ao término do estudo, essa diferença não atingiu significância estatística. Conclusão Testes de neutralização para SARS-CoV-2 ainda possuem aplicabilidade e interpretação controversos. Entretanto, até o momento consistem na metodologia mais aceita para avaliar níveis de proteção contra o vírus. Nossos resultados sugerem tendência a resposta neutralizante inferior entre PVHIV comparadas com controles.

Investigation of obesity, eating behaviors and physical activity levels living in rural and urban areas during the covid-19 pandemic era: a study of Turkish adolescent.

BACKGROUND: The purpose of this study was to determine the eating behaviors, obesity and physical activity status of children of similar ages living in rural and urban areas and to examine these relationships during the coronavirus disease (COVID-19) pandemic process. METHOD: The research was conducted using the scanning model. The research group consists of children living in rural and urban areas in Turkey. The sample of the study consists of a total of 733 adolescent participants, 351 females (47.9%) and 382 males (52.1%). After anthropometric measurements were made, the Physical Activity Questionnaire for older children and the Yale Food Addiction Scale for children 2.0 were used to determine the food addiction and physical activity status of children during the COVID19 pandemic process. Since the groups were homogeneously distributed, independent samples t-test and Pearson correlation test were used. RESULT: In terms of food addiction and physical activity levels, children living in the urban have higher scores than children living in rural areas. In addition, children living in the urban were taller and have higher body mass values than those in rural areas. In terms of physical activity level and food addiction levels, while girls living in the urban had higher activity levels than those living in rural areas, no statistically significant difference was found between the physical activity levels of boys. When evaluated in terms of general and gender, it was determined that children living in rural areas were overweight and obese at a higher rate. Obese children had higher levels of food addiction and lower physical activity levels than non-obese children. CONCLUSION: In order to prevent childhood obesity, the level of food addiction should be reduced as well as increasing the level of physical activity. This study is limited in terms of cross-sectional evaluation. Future research can experimentally reveal how much obesity is reduced by methods such as exercise and diet interventions.

A Institucionalização das Redes Sociais On-Line pela Polícia Militar: ameaça ou oportunidade?

Este caso para ensino em administração pública estimula reflexões e debates sobre a gestão na condução de políticas públicas de segurança em uma cidade de médio porte no interior do Brasil, denominada aqui pelo nome fictício de Gotatina. Para além do anseio por serviços públicos de qualidade e participação social, incluiu-se, desde março de 2020, o regime de isolamento social no combate à pandemia do Covid-19, que trouxe às práticas de policiamento comunitário enorme desafios. Ao articular os pressupostos da Polícia Comunitária e os temas relacionados à gestão pública, o caso potencializa um espaço para o debate de ideias relacionadas à cidadania e à democracia das instituições policiais, em cursos de graduação e pós-graduação em Administração e Administração Pública, especialmente em disciplinas que envolvam e-Governo, Negociação, Gestão participativa.Alternate :This teaching case to public administration stimulates reflections and debates about the management in conducting public security policies in a medium-sized city in the interior of Brazil, whose fictitious name is Gotatina. In addition to the desire for quality public services and social participation, the regime of social isolation, since 2020, in the fight against the Covid-19 pandemic brought enormous challenges to community policing practices. By articulating the assumptions of Community Police and issues related to public management, the case enhances a space for the debate of ideas related to citizenship and democracy of police institutions, in undergraduate and graduate courses in Administration and Public Administration, especially in subjects involving e-Government, Negotiation, Participatory management.

Safety and immunogenicity of CoronaVac in people living with HIV: a prospective cohort study.

BACKGROUND: People living with HIV might have a poor or delayed response to vaccines, mainly when CD4 cell counts are low, and data concerning COVID-19 vaccines in this population are scarce. This prospective cohort study assessed the safety and immunogenicity of the inactivated SARS-CoV-2 vaccine CoronaVac in people with HIV compared with people with no known immunosuppression. METHODS: In this prospective cohort study, adults (aged ≥18 years) living with HIV who were regularly followed up at the University of Sao Paulo HIV/AIDS outpatient clinic in Sao Paulo, Brazil, were included in the study. Eligibility for people with HIV was independent of antiretroviral use, HIV viral load, or CD4 cell count. Adults with no known immunosuppression with CoronaVac vaccination history were included as a control group. CoronaVac was given intramuscularly in a two-dose regimen, 28 days apart. Blood was collected before vaccine administration and 6 weeks after the second dose (day 69). Immunogenicity was assessed at baseline (day 0), before second vaccine (day 28), and 6 weeks after second vaccine dose (day 69) through SARS-CoV-2 IgG titre and seroconversion, neutralising antibody (NAb) positivity and percentage activity, and factor increase in IgG geometric mean titres (FI-GMT). We investigated whether HIV status and CD4 count (<500 or ≥500 cells per µL) were associated with CoronaVac immunogenicity by use of multivariable models adjusted for age and sex. FINDINGS: Between Feb 9, 2021, and March 4, 2021, 776 participants were recruited. Of 511 participants included, 215 (42%) were people with HIV and 296 (58%) were people with no known immunosuppression. At 6 weeks after the second vaccine dose (day 69), 185 (91%) of 204 participants with HIV and 265 (97%) of 274 participants with no known immunosuppression had seroconversion (p=0·0055). 143 (71%) of 202 participants with HIV were NAb positive compared with 229 (84%) of 274 participants with no known immunosuppression (p=0·0008). Median IgG titres were 48·7 AU/mL (IQR 26·6-88·2) in people with HIV compared with 75·2 AU/mL (50·3-112·0) in people with no known immunosuppression (p<0·0001); and median NAb activity was 46·2% (26·9-69·7) compared with 60·8% (39·8-79·9; p<0·0001). In people with HIV who had CD4 counts less than 500 cells per µL seroconversion rates, NAb positivity, and NAb activity were lower than in those with CD4 counts of at least 500 cells per µL. In multivariable models for seroconversion, NAb positivity, IgG concentration, and NAb activity after a complete two-dose regimen, adjusted for age and sex, people with HIV who had CD4 counts of at least 500 cells per µL and people with no known immunosuppression had higher immunogenicity than did people with HIV with CD4 counts less than 500 cells per µL. No serious adverse reactions were reported during the study. INTERPRETATION: Immunogenicity following CoronaVac in people with HIV seems strong but reduced compared with people with no known immunosuppression. Our findings highlight the need for strategies to improve vaccine immunogenicity in people with HIV. FUNDING: Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), and B3-Bolsa de Valores do Brasil.

The Mediating Role of Resilience and Life Satisfaction in the Relationship between Stress and Burnout in Medical Students during the COVID-19 Pandemic.

Following the WHO's declaration of a public health emergency due to the COVID-19 outbreak, the subsequent quarantine and confinement measures that were adopted, including distance learning measures, were shown to have caused a significant deterioration in the mental health of medical students. The goal of this study was to explore the mediating role of resilience and life satisfaction in the relationship between perceived stress and burnout among medical students in the context of COVID-19. A transversal assessment was performed using an online questionnaire, to which 462 students responded. The instruments applied were the Perceived Stress Scale-10, the Resilience Scale-25 items, the Satisfaction with Life Scale (SWLS), and the Burnout Scale (Oldenburg Inventory). A regression model was estimated for each dimension of burnout. The results revealed that resilience and life satisfaction play a mediating role in the association between stress and the dimensions of burnout. This suggests that measures of promoting mental health based on resilience and improving perceptions of life should be implemented.

Response of patients with acute respiratory failure caused by COVID-19 to awake-prone position outside the intensive care unit based on pulmonary involvement.

OBJECTIVES: Since there are difficulties in establishing effective treatments for COVID-19, a vital way to reduce mortality is an early intervention to prevent disease progression. This study aimed to evaluate the performance of patients with COVID-19 with acute hypoxic respiratory failure according to pulmonary impairment in the awake-prone position, outside of the intensive care unit (ICU). METHODS: A prospective observational cohort study was conducted on COVID-19 patients under noninvasive respiratory support. Clinical and laboratory data were obtained for each patient before the treatment and after they were placed in the awake-prone position. To identify responders and non-responders after the first prone maneuver, receiver operating characteristic curves with sensitivity and specificity of the PaO2/FiO2 and SpO2/FiO2 indices were analyzed. The maneuver was considered positive if the patient did not require endotracheal intubation for ventilatory assistance. RESULTS: Forty-eight patients were included, and 64.6% were categorized as responders. The SpO2/FiO2 index was effective for predicting endotracheal intubation in COVID-19 patients regardless of lung parenchymal damage (area under the curve 0.84, cutoff point 165, sensitivity 85%, specificity 75%). Responders had better outcomes with lower hospital mortality (hazard ratio [HR]=0.107, 95% confidence interval [CI]: 0.012-0.93) and a shorter length of stay (median difference 6 days, HR=0.30, 95% CI: 0.13-0.66) after adjusting for age, body mass index, sex, and comorbidities. CONCLUSIONS: The awake-prone position for COVID-19 patients outside the ICU can improve oxygenation and clinical outcomes regardless of the extent of pulmonary impairment. Furthermore, the SpO2/FiO2 index discriminates responders from non-responders to the prone maneuver predicting endotracheal intubation with a cutoff under or below 165.

How can biophotonics help dentistry to avoid or minimize cross infection by SARS-CoV-2?

Biophotonics is defined as the combination of biology and photonics (the physical science of the light). It is a general term for all techniques that deal with the interaction between biological tissues/cells and photons (light). Biophotonics offers a great variety of techniques that can facilitate the early detection of diseases and promote innovative theragnostic approaches. As the COVID-19 infection can be transmitted due to the face-to-face communication, droplets and aerosol inhalation and the exposure to saliva, blood, and other body fluids, as well as the handling of sharp instruments, dental practices are at increased risk of infection. In this paper, a literature review was performed to explore the application of Biophotonics approaches in Dentistry focusing on the COVID-19 pandemic and how they can contribute to avoid or minimize the risks of infection in a dental setting. For this, search-related papers were retrieved from PubMED, Scielo, Google Schoolar, and American Dental Association and Centers for Disease Control and Prevention databases. The body of evidence currently available showed that Biophotonics approaches can reduce microorganism load, decontaminate surfaces, air, tissues, and minimize the generation of aerosol and virus spreading by minimally invasive, time-saving, and alternative techniques in general. However, each clinical situation must be individually evaluated regarding the benefits and drawbacks of these approaches, but always pursuing less-invasive and less aerosol-generating procedures, especially during the COVID-19 pandemic.

Retrospective cohort of children and adolescents hospitalized by COVID-19 in Brazil from the beginning of the pandemic to August 1st, 2020. / Coorte retrospectiva de crianças e adolescentes hospitalizados por COVID-19 no Brasil do início da pandemia a 1º de agosto de 2020.

OBJECTIVES: To characterize the study population, estimating the in-hospital lethality rate by state and analysing associated factors with COVID-19-related deaths. METHODS: A retrospective cohort study was carried out of hospitalised children and adolescents diagnosed with COVID-19, confirmed by RT-PCR, whose outcome was death by COVID-19 or recovery, from 2020 March 1 to August 1. The data source was the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe in Brazilian acronym), where patients with Severe Acute Respiratory Syndrome (SARS) are notified. Children were defined as those between the ages of 0 and 11, and adolescents those between 12 and 18. A bi and multivariate analysis were performed using Poisson Regression with robust variance, with adjusted Relative Risk as the final association measure. RESULTS: A total of 4,930 cases were analysed; 2,553 (51.8%) were males, 2,335 (47.4%) were brown-skinned. The Federative Unit of Roraima presented the highest in-hospital case-fatality rate, with 68.8% (11/16). Multivariate analysis showed that belonging to the age group adolescent (RR = 1.59; 95%CI 1.12 - 2.25; p = 0.009), SARS-critical patient (RR = 4.56; 95%CI 2, 77 - 7.51; p < 0.001) and presenting immunological disorders (RR = 2.24; 95%CI 1.58 - 3.17; p < 0.001) as comorbidities were statistically associated factors with death by COVID-19. CONCLUSION: It was observed that adolescents, SARS-critical patients, and presence of immunological disorders were important factors associated with death. Active surveillance and differentiated care are recommended for patients with chronic diseases and special immunological conditions.

OBJETIVOS: Caracterizar a população do estudo, estimar a taxa de letalidade intra-hospitalar por estado e analisar fatores associados aos óbitos por COVID-19. MÉTODOS: Foi realizado estudo de coorte retrospectiva de crianças e adolescentes hospitalizados com diagnóstico de COVID-19 confirmado por transcrição reversa seguida de reação em cadeia da polimerase (RT-PCR), tendo como desfecho óbito por COVID-19 ou recuperação, entre 1º de março e 1º de agosto de 2020. A fonte de dados foi o Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe), ao qual são notificados pacientes internados com Síndrome Respiratória Aguda Grave (SRAG). Consideraram-se crianças os pacientes com idade entre 0 e 11 anos completos e adolescentes aqueles com idade entre 12 e 18 anos completos. Realizou-se análise bi e multivariável por meio de Regressão de Poisson com variância robusta, utilizando-se como medida de associação final o Risco Relativo ajustado (RRa). RESULTADOS: Dos 4.930 casos analisados, 2.553 (51,8%) eram do sexo masculino. A raça/cor autodeclarada parda foi a mais frequente, com 2.335 (47,4%). A unidade federativa de Roraima apresentou a maior taxa de letalidade intra-hospitalar, com 68,8% (n = 11/16). A análise multivariada mostrou que pertencer ao grupo etário adolescente (RR = 1,59; IC95% 1,12 - 2,25; p = 0,009), ter sido classificado como SRAG-crítico (RR = 4,56; IC95% 2,77 - 7,51; p < 0,001) e apresentar imunopatia (RR = 2,24; IC95% 1,58 - 3,17; p < 0,001) como comorbidade configuraram-se como fatores associados ao óbito pela COVID-19. CONCLUSÃO: Observou-se que ser adolescente, ter classificação de SRAG-crítico e imunopatia como comorbidade foram importantes fatores associados ao óbito. Recomenda-se vigilância ativa e cuidados diferenciados a portadores de doenças crônicas e condições imunológicas especiais.

Description of COVID-19 hospitalized health worker cases in the first nine weeks of the pandemic, Brazil, 2020. / Descrição dos casos hospitalizados pela COVID-19 em profissionais de saúde nas primeiras nove semanas da pandemia, Brasil, 2020.

OBJECTIVE: To describe COVID-19 hospitalized health worker cases in Brazil. METHODS: This was a descriptive case series study; it included cases that became ill between February 21st and April 15th, 2020 registered on the Influenza Surveillance Information System (SIVEP-Gripe, acronym in Portuguese). RESULTS: Of the 184 cases, 110 (59.8%) were female and median age was 44 years (min-max: 23-85); 89 (48.4%) were nursing professionals and 50 (27.2%) were doctors. Ninety-two (50.0%) presented comorbidity, with heart disease predominating (n=37; 40.2%). Of the 112 professionals with a record of case progression, 85 (75.9%) were cured and 27 (24.1%) died, 18 of whom were male. CONCLUSION: The profile of COVID-19 hospitalized health workers is similar to that of the general population with regard to age and comorbidities, but different in relation to sex. The most affected areas were nursing and medicine.

Descripción de los casos hospitalizados por COVID-19 en profesionales de salud en las primeras nueve semanas de la pandemia, Brasil, 2020 Description of COVID-19 hospitalized health worker cases in the first nine weeks of the pandemic, Brazil, 2020

Resumo Objetivo: Descrever os casos hospitalizados pela COVID-19 em profissionais de saúde no Brasil. Métodos: Estudo descritivo de tipo série de casos;foram incluídos aqueles com adoecimento entre 21 de fevereiro e 15 de abril de 2020, registrados no Sistema de Informação de Vigilância da Gripe (SIVEP-Gripe). Resultados: Dos 184 casos, 110 (59,8%) eram do sexo feminino, com mediana de idade de 44 anos (mínima-máxima: 23-85);89 (48,4%) eram profissionais da enfermagem e 50 (27,2%) eram médicos. Ainda, 92 (50,0%) apresentavam comorbidade, predominando cardiopatias (n=37;40,2%). Dos 112 profissionais com registro de evolução, 85 (75,9%) alcançaram cura e 27 (24,1%) foram a óbito, 18 destes do sexo masculino. Conclusão: O perfil dos profissionais de saúde hospitalizados por COVID-19 é semelhante ao da população quanto à idade e comorbidades;porém, diferente quanto ao sexo. As áreas profissionais mais acometidas foram a enfermagem e a medicina. Resumen Objetivo: Describir los casos hospitalizados por COVID-19 en profesionales de salud, en Brasil. Métodos: Estudio descriptivo del tipo serie de casos;se incluyeron aquellos que enfermaron entre el 21 de febrero y el 15 de abril de 2020, registrados en el Sistema de Información de Vigilancia de la Gripe (SIVEP-Gripe). Resultados: De los 184 (1,76%) casos 110 (59,8%) eran del sexo femenino, con promedio de edad de 44 años (mínima-máxima: 23-85), 89 (48,4%) eran profesionales de enfermería y 50 (27,2%) médicos. Además, 92 (50,0%) presentaron comorbilidad, predominando las cardiopatías (n=37;40,2%). De los 112 profesionales con un historial de evolución, 85 (75,9%) fueron curados y 27 (24,1%) murieron, 18 de los cuales era de sexo masculino. Conclusión: El perfil de los hospitalizados por COVID-19 es similar al de la población en edad y comorbilidades, aunque diferente con relación a sexo. Las áreas más afectadas fueron la enfermería y la medicina. Objective: To describe COVID-19 hospitalized health worker cases in Brazil. Methods: This was a descriptive case series study;it included cases that became ill between February 21st and April 15th, 2020 registered on the Influenza Surveillance Information System (SIVEP-Gripe, acronym in Portuguese). Results: Of the 184 cases, 110 (59.8%) were female and median age was 44 years (min-max: 23-85);89 (48.4%) were nursing professionals and 50 (27.2%) were doctors. Ninety-two (50.0%) presented comorbidity, with heart disease predominating (n=37;40.2%). Of the 112 professionals with a record of case progression, 85 (75.9%) were cured and 27 (24.1%) died, 18 of whom were male. Conclusion: The profile of COVID-19 hospitalized health workers is similar to that of the general population with regard to age and comorbidities, but different in relation to sex. The most affected areas were nursing and medicine.