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Background: Patients (pts) with cancer are at a higher risk of COVID-19 (C19) severe disease. However, our group and others have demonstrated a low prevalence of C19 infection among asymptomatic pts with cancer on active systemic treatment. We hypothesized this phenomenon was due to increased adherence of pts with cancer to anti-C19 protective measures. This study compares adherence and the perceived importance of such measures in oncologic and non-oncologic populations. Methods: This is a cross-sectional study conducted between June and September 2021. A questionnaire was developed to assess how participants perceived and adhered to masking, handwashing, and other anti-C19 protective measures. Demographic information, educational level, and monthly income were also collected. Three groups were included: A) pts with cancer treated at Hospital de Base (HB);B) pts without cancer treated at HB for other medical conditions;C) a healthy outpatient population. Data were summarized in means, medians, and proportions. Chi-squared or Fisher's exact test was used to compare categories;ANOVA was employed to compare means. A multivariable analysis assessing factors associated with adherence to anti-C19 protective measures was performed. Results: A total of 607 people were interrogated (200 in groups A and B, and 207 in C). The mean age of groups A, B, C was significantly different: 60 vs. 52 vs. 35 years old (p < 0.001). Group C had a higher educational level and a higher monthly income than groups A and B (p < 0.001). In cohort A, gastrointestinal, breast, and genitourinary were the most frequent tumors (33%, 31%, 15%);75% of pts had active disease. Pts with cancer were more adherent to anti-C19 protective measures: of 33 points, the mean score of groups A, B, C was respectively 27.8 vs. 25.5 vs. 21.9 (p < 0.001). Regarding the importance of anti-C19 protective measures, pts with cancer also perceived those as more relevant: of 21 points, the mean score of groups A, B, C was respectively 17.8 vs. 17 vs. 16.9 (p < 0.001). For instance, in group A, 95% report consistently wearing a mask when leaving home compared to 90% and 58.2% of groups B and C. In line with our findings, 20.5% vs. 32.5% vs. 35.3% (p < 0.003) of groups A, B, and C reported having C19 before the questionnaire. In multivariable analysis, groups B and C were less likely to adhere to anti-C19 protective measures than group A. Conclusions: Pts with cancer are more adherent to anti- C19 protective measures and perceive them as more important than non-oncologic populations. Our results shed light on the accumulating literature of a low incidence of C19 amongst asymptomatic pts with cancer on systemic treatment even during the surges. Such findings are possibly related to the fact that cancer pts are more vulnerable to hospitalizations and unfavorable outcomes than the general population, prompting a more risk-averse behavior.
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Background: The COVID-19 pandemic had enormous consequences in Brazil and worldwide. Patients with cancer affected by COVID-19 are at a higher risk of developing complications and worse outcomes compared to a non-cancer population, particularly the ones on active systemic treatment. Considering the COVID-19 high transmissibility in asymptomatic and presymptomatic patients, we sought to determine the prevalence of COVID-19 infection in patients with solid cancers receiving systemic therapy in a Brazilian public health hospital. Furthermore, we interrogated if socioeconomic status (SES) was associated with prevalence. Methods: Consecutive asymptomatic patients undergoing treatment for solid tumors at the chemotherapy and infusion center of Hospital de Base were enrolled. Patients were prospectively tested for SARS-CoV2 RNA real-time polymerase chain reaction with nasal and oropharyngeal swabs immediately prior to treatment. A socioeconomic survey was performed prior to testing. Demographic and socioeconomic characteristics were summarized in means, medians, and proportions. Results: From October 6 to 13, 2020, 148 asymptomatic patients were identified. Of those, 41 were excluded (16 had hematological malignancies, 15 declined testing, 10 were not on active systemic treatment) leaving 107 eligible patients. The mean age of the population was 58 years-old (SD± 12.6);55% were female and 90% were self-identified as White. The most common cancer sites were gastrointestinal tract (37%) and breast (25%). Most patients had metastatic disease (62.9%) and were on a anticancer treatment involving chemotherapy (62.9%). Regarding to SES, 70% of our population had either primary school or were illiterate as their highest educational level. In terms of monthly income, 88% had a personal income inferior to U$390 and 92% a household income inferior to U$585. Of 107 patients tested, only one (0.9%) was positive for COVID-19. This is a 48 years-old man living in an urban area, with primary school educational level and a monthly personal income inferior to U$390. Conclusion: Despite a high prevalence of COVID19 in Brazil, our cohort demonstrated a low prevalence of COVID19 (0.9%) amongst asymptomatic patients with cancer. We hypothesize that patients with cancer, independently of their SES, are aware of the increased risk of developing severe disease and are adherent to physical distancing, masking, and hygiene measures. LF and BB are co-senior authors.
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Background: Patients with cancer, both active and previously treated, are at a higher risk of developing severe outcomes from COVID-19. During the pandemic, health care systems (HCS) have adapted the delivery of care, and disparities between private and public systems became even more striking. In Brazil, where 70% of the population depends on the public system, ICU demands largely exceed the capacity in most public centers, whereas in private centers the situation is less challenging. Herein we compare outcomes of patients with cancer and COVID-19 treated in the public and private HCS in Brazil. Methods: We used data from adult patients with solid malignancies who tested positive for COVID-19 and were admitted to two tertiary centers in the state of São Paulo. Patients who tested positive for SARS-CoV2 RNA real-time polymerase chain reaction (RT-PCR) were included. We collected data on baseline clinical conditions, cancer and treatment. Patients were classified by HCS: public system (public) versus (vs) private insurance coverage (private). The co-primary endpoints were all-cause mortality and a composite endpoint consisting of intensive-care-unit (ICU) admission, mechanical ventilation or death (ICU-MV-D). Chi-square, Fisher's exact test and Mann-Whitney U test were used when appropriate. We assessed the association between outcomes and HCS using logistic regression analyses, adjusting for age, sex, current anticancer treatment and comorbidities. Results: From March 16 to October 20 2020, 124 patients were identified. Of those, 90 (72%) were from the public and 34 (28%) from the private HCS. There were no statistical differences in sex, smoking, primary tumor siteand staging between patients from both HCS. Conversely, patients treated in the private system were older [66 (SD 13.8) vs 74 (SD 15.1), p=0.004], had more comorbidities (64.7% vs 37.8% p=0.009), and were on anticancer treatment more frequently (64.7% vs 34.4% p=0.004) compared to public patients. There were no differences in all-cause mortality (public 40% vs private 44.1% p=0.69) between patients treated at the different HCS. Nevertheless, in the composite outcome, private system was significantly associated with increased risk of ICU-MV-D compared to the public system (79.4% and 57.8% p=0.030, respectively). The median time from COVID-19 diagnosis to ICU-MV-D was 13 vs 8 days (p=0.031) and to death was 25 vs 24 days (p=0.24), respectively for public and private HCS patients. In the multivariable logistic regression, HCS was not associated with death [adjusted odds ratio (aOR)=1.16 p=0.75] or ICU-MV-D (aOR=0.55, p=0.27). Conclusion: While patients in the private system were older and had more comorbidities, there were no differences in inpatients all-cause mortality between private and public systems. However, private patients were associated with increased ICU-MV-D. We hypothesize that these findings may reflect disparities in ICU availability, known to be higher in the private system. Further studies investigating this hypothesis are warranted. EDR and DVA co-senior authors.
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Background: As a care tool for the elderly population, caregivers must have knowledge about the prevention of COVID-19 to minimize the transmission of SARS-CoV-2. Objective: Describe the process of construction and validation of educational leaflet content for caregivers of the elderly on covid-19 prevention measures. Methods: Methodological study developed in three stages. The first stage corresponds to the literature review;the second involved the construction of the brochure and the last stage was content validation by a committee of twenty-three experts who judged the objectives, structure/presentation and relevance of the brochure from a validated 3-point Likert scale. Items with positive opinions by more than 80.0% were considered adequate. Results: The leaflet was prepared containing six pages, with information on the new coronavirus, forms of transmission, signs and symptoms, protection of the disease, alteration of the routine of daily care, the importance of hand hygiene, surfaces and food;correct use of mask;care for the caregiver or family member;emotional health and how to proceed in case of suspicion of COVID-19. Only one evaluation round was required;the content validity index was 1.0 and the agreement between judges was statistically significant in all domains of the scale (p<0.006). Conclusion: This study provides an educational leaflet with validated content, configuring a capable component to improve the knowledge of caregivers about prevention measures against COVID-19 in the elderly. © 2021 Faculdade de Medicina de Ribeirao Preto - U.S.P.. All rights reserved.
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This work is justified by presenting the teacher's office in a context of social distancing, given the health pandemic resulting from COVID-19 that initiated crises in several social institutions. Motivated by questioning - What crises seem to overlap with the reports of teachers in pandemic situations? - we propose to investigate representations of teachers about remote teaching in the transition scenario from face-to-face to remote online classes. Specifically, we recognize as objectives: i) to identify representation(s) of teachers about remote teaching in a context of social distancing;ii) verify reception of teachers about the implementation of remote education in the transition scenario from face-to-face to online teaching. Theoretically, we start from considerations about education mediated by digital technologies, remote teaching, digital literacy, social and professional representations. Methodologically, this study is part of the qualitative paradigm with a netnographic approach. The data were generated through an online form and online focus group sessions. For sampling, we elect the corpus developed in the first session with a teacher Portuguese and a Biology teacher. By identifying that the participants understand remote education as an emergency measure, we found that the transition of the classes did not occur peacefully, because they were surprised by the implementation and did not feel represented by government interventions. The data seem to indicate a crisis established in the condition of the class's performance, since there is an overlap of opaque barriers between professional and family actions. The previously familiar environment is "invaded" by the professional space, constituting a space of deterritorialization/reterritorialization that implies in educational practices.
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The COVID-19 pandemic has affected the whole world since the beginning of 2020. In Brazil, over 70% of the population rely on the Brazil's Unified Health System (SUS). Knowing public opinion related to SUS is very important for the improvement of services and assistance provided by such an entity. Sentiment analysis has been used in several applications including social networks and blogs to extract public opinion. Despite the fact that other papers have already worked with sentiment analysis, none of them have focused on SUS. Therefore, the goal of this paper is to analyse the sentiments shown by Brazillian Twitter users about SUS before and during COVID-19 pandemic. To reach this goal, a database of portuguese tweets regarding SUS posted between december 2019 and october 2020 was created. The tweets were pre-processed, classified and then analysed. The results show that, in most cases, users are in favor of SUS.
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SARS-CoV-2 is the agent causing of COVID-19 and has become the world's largest public health emergency. Initially it was treated as a pneumonia because it affected the lungs of infected individuals, however, with the advance of knowledge about the disease, other pathophysiological manifestations in different organs were noticed and as the studies advance, other conditions are registered. The present study aims to describe the extrapulmonary manifestation of COVID-19, covering different locations such as the stomatognathic system, renal, gastrointestinal, cardiovascular and nervous systems. It is an integrative literature review, carried out in the MEDLINE / pubmed, LILACS and Google Scholar databases, using the descriptors: "Coronavirus Infections", "Cardiovascular System", "Oral Manifestations", "Urinary Tract", " Digestive System Abnormalities "and" Neurologic Manifestations". After applying the inclusion criteria, the search resulted in 31 articles included. Studies have shown that the infection of human cells occurs via the angiotensin-converting enzyme 2 (ACE-2), and this is a possible explanation for the fact that this virus affect several systems. After analyzing the studies, it is clear that the virus can prove complications such as arrhythmias, heart failure, oral ulcerations, proteinuria, renal dysfunction, encephalopathy, stroke, Guillan-Barre syndrome, diarrhea, nausea, vomiting, liver and pancreatic complications. It is necessary that the healthcare team is able to notice signs and symptoms beyond the respiratory tract, since they can be severe and thus guarantee better health care for patients .
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Introduction: Cancer patients appear to be at higher risk of complications from sars-cov-2 infection. Specific data regarding lung cancer patients, on active treatment and/or recent diagnosis is limited. Recent data suggests that a bad prognosis is associated with older age (>65 years-old), comorbidities, ECOG2, steroids (>10mg prednisolone), anticoagulants, chemotherapy and chemotherapy-immunotherapy. With this study we aim to investigate the clinical presentation, baseline characteristics and outcomes of patients with lung cancer and Covid-19. Methods: A retrospective case study was carried out at Centro Hospitalar Universitário de São Joao (CHUSJ), a tertiary hospital in the Oporto region of Portugal. Data from all patients from our center was evaluated, and lung cancer patients with covid19 diagnosis during the first 2 months of the Covid-19 pandemic in Portugal (March-April) were included. Results: A total of 5 patients with active lung cancer had a diagnosis of Covid-19 at our center. Adenocarcinoma was the histological type in all patients (n=5, 100%). Most had metastatic stage IV lung cancer (n=3;60,0%). Two patients (40,0%) had relevant comorbidities including HBP, Diabetes and Heart Failure due to heart valvular disease. Of the patients on anti-neoplasic treatment, median time from the last chemotherapy administration to Covid-19 diagnosis was 4 days (min 4;max 39 days). Four patients (80,0%) were receiving corticosteroid therapy. The most common symptoms were cough (n=4, 80,0%) and dyspnea (n=3, 60,0%). Lab results revealed neutrophilia in all patients (n=5, 100%), lymphopenia in 4 patients (80,0%), anemia in 4 patients (80,0%), leukocytosis in 2 patients (40,0%). An example of chest CT scan features is represented in the image attached. All patients (n=5, 100,0%) were admitted to hospital and received oxygen therapy. Two (40,0%) received HFNC with good tolerability and one (20,0%) NIV. Two patients were admitted to Intensive Care Unit, with recovery. No patient received mechanical ventilation or extracorporeal membrane oxygenation. Empirical sars-cov-2 treatment with hydroxychloroquine was administered in most patients (n=4, 80,0%) and antibiotics in three (60,0%). Two of the patients had recent chemotherapy treatment (4 days before diagnosis), and later developed pancytopenia during the next days associated with clinical deterioration. Three patients (60,0%) died after a median time of 5 days since Covid-19 diagnosis (min 2;max 16 days). [Formula presented] Conclusion: This study is one of the first to report outcomes that can be associated with Covid-19 in Lung Cancer patients and highlights the necessity to create protocols to reduce their susceptibility and bad outcomes in future waves of Covid-19. Keywords: lung cancer, Covid19, infection
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The Covid-19 pandemic acts more severely in the lower strata of Brazilian society, where there are recyclable material collectors, who act in an organized manner in associations and cooperatives or individually. To avoid further depletion of their income, recyclable material collectors need to remain collecting for a longer time, at a time when the prices of recyclables are falling, even as their production increases. This leads to greater exposure to the Covid-19 virus because, among recyclable material scavengers, there are many sexagenarians and individuals with pre-existing comorbidities. In addition, it is necessary to discuss the post-pandemic scenario, with the possibility of a substantial increase in new scavengers arising from the economic crisis and an increase in the supply of recyclable material.
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Introduction: Presents notes resulting from an experience about the cataloging of materials in the virtual library CONVIDE-i9, a reliable informational product in the fight against misinformation, fake news and infodemia. Points out characteristics of the library;list the topics covered;quantify the publications registered by category and report the personal performance in the material register. Method: It is characterized as descriptive and bibliographic research, with a quantitative and qualitative approach to data collection in the virtual library CONVIDE-i9, from May to June 2020. Results: Presents CONVIDE-i9 as a collaboration between national information institutions and volunteer librarians, whose aim is to be a source of reliable information within the scope of COVID-19 and related topics;covers eight thematic areas, such as "support for teleworking", "fake news and phishing" and "protocols and recommendations";it has 294 registered materials;lists that personal performance culminated in the registration of 102 items;results in the volunteer who has the largest number of records registered until 01/07/2020;and reports thematic affinities coined from experience in the library, on mental health, eating disorders, guidelines for public libraries before COVID-19, etc. Conclusions: Therefore, it mentions the importance of librarians in providing a digital environment that reaches the largest number of people geographically dispersed, especially in a pandemic scenario, promoting well-being and the dissemination of investigated and subsequently publicized information about COVID-19 in varied perspectives.
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Background/Case Studies: In the past months, convalescent plasma (CP) has been used as an alternative therapy to treat COVID-19 patients. Previous studies highlighted the role of neutralizing antibody titers (NAbs) on clinical improvements. We analysed a series of cases of COVID patients treated with CP transfusion and associations between transfused NAbs and patient NAbs on respiratory outcomes. Study Design/Methods: Thirty patients diagnosed with SARS-CoV-2 by RT PCR and severe pneumonia were prospectively analysed at a single center in Brazil. Doses of 300-600ml of CP were transfused. To assess respiratory outcomes, PaO2/FiO2 ratios were determined at Day 0 (day of CP transfusion), Day 5 and by discharge and duration of ventilation support were analysed. Improvements were determined by variations of PaO2/ FiO2 ratios from Day 0 through day 5 (V0-5) and from Day 0 through discharge (V0-D). Neutralizing antibodies from patients prior to transfusion (NAbsP) and neutralizing antibodies of CP units transfused (NAbsCP) were analysed. NAbsCP considers the total amount of antibodies transfused to account for volume differences. We performed a generalized estimating equations (GEE) approach with logit link for binary data to model the effect of Nabs CP and variations on PaO2/FiO2 ratios between Day 0-Day 5 and Day 0-discharge. Regression models were performed to determine the predictive variables associated to improvements on PaO2/FiO2 ratios and duration of ventilation support. Results/Findings: Variations of PaO2/FiO2 ratios from day 0 through Day 5 and day 0 through discharge are displayed on Table 1. Significant improvements on PaO2/ FiO2 ratios were observed from Day 0 through discharge (p<0.001). NAbsP were associated to higher improvements on PaO2/FiO2 on V0-D (mean difference (MD)): 2.8 CI 95% -1.0-4.6 p 0.003), NAbsCP, however, were associated to minor variations in PaO2/FiO2 (MD -4.8 CI95% -7.9;-1.7 p 0.002) on the same interval. At each 100 unit increase in NAbs CP, variations on PaO2/FiO2 on V0-D were expected to be 4.8 units lower. When analysing V0-5, NAbsCP were again associated to minor improvements of PaO2/FiO2 ratios from D0 through D5 (MD -3.6 95%CI -7.2;-0.003 p 0.05). Other variables did not show statistical significance. When considering duration of ventilation support neither NabsP (Mean Ratio MR 0.985 CI 95% 0.962-1.007 p 0.185) nor NAbsCP (MR 0.967 CI95% 0.918 1.018 p 0.198) showed significant statistical differences. Conclusions: In our analysis, NAbs produced from the patient prior to CP transfusion are associated to better improvements on respiratory outcomes when compared to NAbs from transfused units. Regarding duration of mechanical ventilation, neither NAbsP nor Nabs CP had impact on outcomes.
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Background/Case Studies: Convalescent plasma (CP) has emerged in the past months as an alternative treatment for COVID-19. We prospectively analysed the outcomes of critically ill COVID-19 patients treated with CP in order to investigate predictive factors of intensive care unit (ICU) length of stay at a single center in Brazil. Study Design/Methods: Thirty COVID-19 patients laboratory-confirmed by RTPCR with severe pneumonia were recruited at a single center in Brazil. Doses of 300-600ml of CP were administered. Primary outcomes were ICU length of stay and duration of mechanical ventilation support.The following variables were analysed: Severity organ failure assessment score(SOFA) at day 0 (day of CP transfusion), patient ABO blood group, concomitant use of any other therapies (hydroxychloroquine, azythromicin, tocilizumab, immunoglobulin), neutralizing antibody titers of the patients prior to transfusion (NAbsP) and total titers of neutralizing antibody from CP units transfused (NAbsCP). NAbsCP considers the total amount of antibodies transfused to account for volume differences. Multivariate logistic regression was performed. Results/Findings: In our case series, SOFA at day 0, ABO group, and both NAbs P and NAbsCP were predictive factors of ICU length of stay. At each point increased in SOFA, ICU length of stay was 38.7% longer (MR: 1.387 CI 95% 1.254-1.534, p<0.001). Group A had36.1% longer ICU length of stay (MR: 0.639 CI 95% 0.417-0.980, p 0.04). Increases of 100 units in NAbsP resulted in 1% reduction of ICU lenght of stay (MR 0.990 CI 95% 0.982-0.998, p 0.017). Similar results were obtained with NAbs-CP, with 2% reduction in ICU length of stay (MR 0.980 CI95% 0.968-0.993, p 0.002) at each 100 unit increase. Use of other therapies did not influence ICU lenght of stay (p 0.373). We perform the same analysis for duration of mechanical ventilation support, and all the variables failed to demonstrate any association Conclusions: Our findings suggest that severity of disease prior to transfusion, ABO group, patient capacity to produce neutralizing antibodies and transfusion of CP with high titer NAbs are significant predictive factors for ICU length of stay. High titer NAbs CP may add benefit to these patients. No association was found between these same variables and duration of mechanical ventilation.
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Background/Case Studies: We describe the COVID- 19 Convalescent Plasma (CCP) program from two Brazilian hospitals for treatment of severe/critical patients Study Design/Methods: Mild/moderate COVID-19 convalescents were selected as CCP donors after RT-PCR confirmed SARS-CoV-2 infection and absence of symptoms for ≥14 days plus: 1) age (18-60yrs), body weight >55kg;2) immunohematological studies;3) no infectious markers of HBV, HCV, HIV, HTLV1-2, Chagas and syphilis infection;4) no HLA antibodies (multiparous);5) Second RT-PCR (nasopharyngeal swab and/or blood) negativity;6) virus neutralization test (CPE-based VNT nAb) and anti-nucleocapsid (NP) SARS-CoV-2 IgM, IgG and IgA ELISAs. Results/Findings: Among 271 donors (41 females, 230 males), 250 presented with nAb. Final RT-PCR was negative on swab (77.0%) or blood (88.4%;p= 0.46). Final definition of RT-PCR was only defined at>28days after full recovery in 59/174 (33.9%) RT-PCR-ve, and 25/69 RT-PCR+ve (36.2%;13 between 35-48 days). NAb titers ≥160 was found in 63.6%. Correlation between IgG signal/ cut-off ≥5.0 and nAb ≥160 was 82.4%. Combination of final RT-PCR-ve with nAb ≥160 was 41.3% (112/271). Serial plasma collection showed decline in nAb titers and IgA levels (p<0.05), probably denoting a “golden period” for CCP collection (≤ 28 days after joining the program);IgA might have an important role as nAb. Donor's weight, days between disease onset and serial plasma collection, IgG and IgM levels are important predictors for nAb titer. Conclusions: RT-PCR+ve cases are still detected in 36.2% within 28-48 days after recovery. High anti-NP IgG levels may be used as surrogate marker to nAb.
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Background/Case Studies: COVID-19 convalescent plasma (CCP) has been used for therapy in severely affected COVID-19 patients. The rational relies on the presence of nAb in convalescent's bloodstream, which might suppress patient's viremia. Little is known about the nAb kinetics in CCP donors. Study Design/Methods: A cohort of previously RTPCR+ ve, male, volunteer, non-remunerated, mild convalescent donors has been studied, based on serial virus neutralization tests (CPE-based VNT, GenBank: MT MT350282, transformed in natural log) and specific IgM, IgG and IgA anti-nucleocapsid protein (NP) SARS-CoV-2 ELISA, depicted as signal/cutoff (S/CO). Results/Findings: A total of 63 donors were evaluated within a period ranging from 14-97 days after full recovery of symptoms (DARS). There was initially a decline in nAb and IgA anti-NP from the first to third collection (median = 45days), followed by an unexpected rise in two additional collections. No differences were seen for IgM and IgG anti-NP. Data are shown below, with statistical values between subsequent samples. Conclusions: There is a great variability in nAb titers, with a declining trend over time. Although this was clear during the first three collections, the sudden rise could be explained by biological nAb fluctuation or by viral re-exposure after recovery, due to contact with infected people (pandemic still active in our region). Although IgA anti-NP shows a wide range, its declining trend could be signaling a possible role of IgA as an important component of nAb. Further studies are required to better understand the kinetic behavior of these antibodies.
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Background/Case Studies: COVID-19 Convalescent plasma (CCP) has been used for therapy in severely symptomatic COVID-19 patients. Pathogen reduction (PR) has been proposed to mitigate the risk of transfusion-transmitted infectious agents. We investigate the impact of A/UVA on nAbs and anti-NP (IgM, IgG and IgA) PR treatment of CCP units. Study Design/Methods: Plasmapheresis CCP units (600 mL) were collected from a cohort of previously confirmed male RT-PCR positive [+ve] COVID-19 mild/ moderate convalescent patients, all first-time and nonremunerated volunteers, with >14 days after full recovery of symptoms. CCP units were treated with INTERCEPT Blood System (Cerus Corporation, Concord, USA) according to manufacturer's instructions, either individually or pooled two by two. After treatment, units were separated into 200 mL doses. Pre- and post-PR treatment samples were harvested and kept at 4oC for 3-5 days prior to testing for nAb titers using a CPE-based virus neutralization assay (GenBank: MT MT350282), and specific IgM, IgG and IgA anti-NP antibodies by ELISA. Results/Findings: A total of 16 individual and 94 pooled units were treated (n =110 CCP donations), rendering 330 x 200 mL treated CCP therapeutic doses. There were no statistical differences in samples harvested before versus after A/UVA treatment (all p>0.05, Wilcoxon test) for nAb titers or IgM, IgG and IgA anti-NP absorbance levels, as shown in the table. Conclusions: Anti-NP IgM, IgG, IgA, and nAbs are not adversely impacted by A/UVA treatment, suggesting this PR technology can be employed to mitigate the risk of transfusion-transmitted infections after collection of CCP donors, who are often first time blood donors. With most CCP units destined to treat older, immunosuppressed patients with several comorbidities, the use of A/UVA PR treatment is not only safe and recommended, while preserving anti-SARSCoV- 2 antibodies in CCP units.
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Background/Case Studies: It is not clear which individual characteristics can determine susceptibility and intensity of symptoms, however, age, sex, ethnicity, hypertension and some haematological biomarkers, as Ddimer, thrombocytopenia and lymphopenia were associated with a worse outcome. Recently, it has been hypothesized that ABO blood groups can be related to susceptibility to the SARS-CoV-2 infection. Considering that the first studies reported A group as a risk factor and O group as a protection, some authors have been suggesting that the anti-A antibodies, and not the blood group, could be responsible for the findings. Study Design/Methods: A retrospective study with 430 COVID-19 individuals (268 COVID-19 convalescent plasma donors-CCPD and 162 COVID-19 inpatients-CIP) from two Brazilian reference hospitals, confirmed by RTPCR, and 2,212 healthy volunteer blood donors (VBD) as control group, that were evaluated and divided into two groups: one with anti-A (O/B blood groups) and one without anti-A group (A/AB blood groups). Immunoglobulins and neutralizing antibody titres were measured for CCPD and CIP. Multivariate logistic regression and nonparametric tests were performed. Results/Findings: Although O blood group was the most frequent ABO group among VBD, A blood group was more frequent among COVID-19 individuals (CCPD 47.8%, CIP 43.2%, VBD 35.5%, p<0.001). There was no statistical difference in blood groups distribution between CCPD and CIP (p=0.268). In our cohort, for each increased age year there was 6% more chance for COVID-19 (OR: 1.06;CI 95%: 1.05-1.06, p<0.001), males showed 27% more chance for the disease (OR: 1.27;CI 95%:1.02-1.59, p=0.035) and O/B blood groups showed 38% less infection prevalence (OR: 0.62;CI 95%: 0.5-0.7, p<0.001). Considering the fact that higher anti-A is usually described in the O blood group, data from O versus B blood groups individuals were analysed and the former showed 34% less chance for COVID-19 (OR: 0.66;CI 95%:0.46-0.95, p=0.026). There was no difference regarding ABO group found when COVID-19 inpatients of all blood types were analysed. Immunoglobulins A, M and G (IgA, IgM and IgG) and neutralizing antibodies (NAbs) for SARS-CoV-2 were lower in COVID-19 individuals O/B blood groups (NAbs p=0.008, IgM p=0.03, IgG p=0.02, IgA p=0.03). Conclusions: In our retrospective cohort, the COVID-19 individuals O/B blood groups (which produces anti-A) had 38% less chance to have a diagnosis of COVID-19 (p<0.001) and the same groups showed lower titers of neutralizing antibodies, IgM, IgG and IgA. Groups O/B showed a protective factor against the SARS-CoV-2 infection, but it was not associated to COVID-19 inpatients (versus COVID-19 convalescent plasma donors) suggesting that blood type is not associated to SARSCoV- 2 infection severity.