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Background: Ventilator-associated pneumonia (VAP) is frequent in critical COVID-19 patients. Its early diagnosis is essential for its prognosis. Aim: To demonstrate the usefulness of the FilmArray Pneumo panel (FAP-P) in confirming or ruling out VAP in these patients. Methods: Retrospective study of 71 critical COVID-19 patients with suspected VAP in whom cultures and FAP-P were performed for diagnostic confirmation. Clinical characteristics, microbiology and mortality are described. The validity and safety of FAP-P is defined. Results: The use of FAP-P and cultures ruled out VAP in 29 patients (40.8%). In 41 patients, VAP was confirmed and the 30-day mortality was 48.8%. Forty-eight samples were studied, the cultures were positive in 30 (62.5%) and 33 bacteria were detected, FAP-P detected 32 of these 33 bacteria;37 bacteria were exclusively detected by PFA-P. The most prevalent bacteria were Klebsiella pneumoniae (31.4%), Pseudomonas aeruginosa (21.4%) and Acinetobacter calcoaceticus-baumannii (14.2%). The sensitivity, specificity, positive predictive value and negative predictive value of FAP-P with respect to cultures were 96.9%, 92.5%, 46.4% and 99.8%, respectively. One patient had VAP due to Burkholderia cepacia bacteria not detected by FAP-P. Conclusions: FAP-P is an effective molecular technique to rule out and diagnose VAP, allowing rapid suspension of antibiotics or early targeted treatment.
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The novel Coronavirus disease of 2019 had an acutely catastrophic effect on almost every tier of emergency medical services in the United States. The Pro Bono EMS Pandemic Response Research Lab led the national effort into the investigation of prehospital pandemic response in the US mainland, interrogating key systemic issues, infectious disease best practices, and provider safety. This chapter - led by Adj. Prof. Christian Ventura, the Co-Principal Investigator of the lab and adjunct lecturer in prehospital resuscitation science and colleagues - serves as a retrospective analysis into how EMS responded to the global pandemic in the critical year of 2020, what we did right, what we can learn, and implications for the urgently warranted paradigm shifts EMS must consider adopting to prevent infrastructural collapse. © 2021 by Nova Science Publishers, Inc.
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Objective: to analyze deaths due to COVID-19 in Brazilian Nursing professionals, with confirmed diagnoses of the disease and in quarantine, hospitalized or deceased, at the Federal Nursing Council Observatory. Method: a cross-sectional study conducted in Brazil between March 2020 and August 2021, via the Federal Nursing Council Observatory. The data were analyzed using descriptive and inferential statistics. Results: the prevalence of death due to COVID-19 in Brazilian Nursing professionals was 2.5% (825/32,560) and 4.9% (109/2,224) in nursing assistants, these latter with a higher mean age (p<0.0001). Although 84.5% (27,508/32,560) of the sample was female, the percentage of deaths was higher in the male gender, with 5.2% (263/5,052) (p<0.0001). The logistic regression analysis showed that gender and professional category can predict deaths due to COVID-19 among Brazilian Nursing workers. Conclusion: the study contributes to evidencing the risks faced by the professional category in coping with COVID-19, as well as to rethinking measures to reduce the harms imposed by the pandemic on this population segment. © 2022, Universidade Federal do Parana. All rights reserved.
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Introduction Information on post-infection and vaccine-induced SARS-CoV-2 seroprevalence is important for public health policies. A 3rd wave of National Serological Survey (ISN3COVID-19) was conducted to measure SARS-CoV-2 seroprevalence and characterize specific antibodies distribution in Portuguese population in September - November 2021, following a mass vaccination campaign. Methods ISN3COVID-19 was a cross-sectional epidemiological study that collected serum samples and questionnaire data on a sample of Portuguese residents aged 1 year or older (n = 4545). SARS-CoV-2 IgG anti-nucleoprotein and anti-spike antibody levels were measured using Abbott Chemiluminescent Microparticle Immunoassays. Seroprevalence was estimated for the overall sample and stratified by age group, sex, region and self-reported chronic conditions. Medians and respective 95% confidence intervals (95%CI) were used to describe the distribution of SARS-CoV-2 antibodies in specific population subgroups. Results The overall seroprevalence of SARS-CoV-2 (post-infection or vaccine-induced) was 86.4% (95%CI: 85.2 to 87.6%), post-infection seroprevalence was 7.5% (95%CI: 6.6 to 8.5). Higher seroprevalence was observed among 50-59 years-old (96.5%), women (88.3%), and those with two or more self-reported chronic conditions (90.8%). Higher IgG (anti-Spike) levels were estimated for individuals vaccinated with the booster dose (median=12601.3 AU/ml;95%CI: 4127.5 to 19089.1) and for those vaccinated with two doses of Spikevax® vaccine (median=7012.7 AU/ml, 95%CI: 5568.8 to 8456.6). Conclusions The SARS-CoV-2 seroprevalence was high and consistent with vaccine coverage in Portugal. Seropositivity was associated with sex, age and previous chronic conditions. The anti-SARS-CoV-2 anti-spike IgG levels varied according to vaccine brand and number of doses. These results show that monitoring seroprevalence and SARS-CoV-2 antibody distribution is of paramount importance to guide public health policies. Key messages • Significant increase in SARS-CoV-2 seroprevalence following the mass vaccination campaign consistent with the high vaccine coverage achieved in Portugal. • Continuous monitoring of the population‐level IgG response after vaccination remains important to guide further public health measures.
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The territorial impact of the COVID-19 pandemic in cities raised several questions. Different studies highlighted that it had a different impact and that it affected more the areas with lower socioeconomic levels. In Latin American cities this was significant, associated with poverty and poor living conditions. Other factors that seemed to influence the spread of the virus were some forms of density, precariousness and residential overcrowding. Based on these questions, this work analyzed the spread of COVID-19 in the Gran Resistencia Metropolitan Area (Argentina), in relation to the population's socio-habitation situations, and with the aim of characterizing the territorial trajectories of the spread of the virus. The research is explanatory, based on a case study that set out to demonstrate and characterize the trajectory of the spread in the first months of the pandemic (March-August 2020), through spatial data analysis of people's residential location affected and the socio-housing situations of the population. The results allowed us to infer that the territorial spread of the virus is associated with precarious socio-habitation situations and that it follows a socioeconomic path from minors to higher levels of social vulnerability.
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Introduction: During the COVID-19 pandemic, mental health problems such as depression have increased in the general population and health care personnel. Objective: Describe the characteristics of publications on depression in the COVID-19 context, with authors affiliated to Ibero-American institutions. Method. The study describes the main characteristics of the publications on depression in the Covid-19 context conduct-ed by authors affiliated to Ibero-American institutions. A retro-spective and descriptive analysis of 1,072 articles indexed in the Scopus database between January 2020 and September 2021 was performed. Results. The results show that original and review articles are the most carried out. Spain is the Ibero-American coun-try that contributes the largest number of scientific articles on depression, representing 33.68% of the Ibero-American production, followed by Brazil and Portugal, countries that exceed 10.00% of the production. The authors are mainly affiliated with institutions in Brazil, Spain and Portugal. Also, International Journal of Environmental Research and Public Health and Frontiers in Psychology are the journals with the largest number of publications. The most cited article is doc-umentary review and was published by authors affiliated with Ibero-American institutions in Brazil and Paraguay. Finally, it was found that the most used keywords were the descriptors depression, mental health, pandemic and Covid-19. Conclusions. The scientific production on depression is un-equal, and it is important to consolidate the scientific literature through collaborative networks between researchers and institutions in Ibero-America.
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Objective: To analyse how testing the population influences the health indicators used to monitor the COVID-19 pandemic in the 50 countries with the highest number of diagnosed cases.
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OBJECTIVE: To analyze the epidemic of COVID-19 in northeastern Brazil, one of the regions most affected by the virus. METHODS: The official data for COVID-19, from March 2020 to March 2021 in the states of the Northeast Region (NE), were used. The analysis of capital cities and states for accumulated weekly cases and confirmed deaths was made using the JoinPoint Trend Analysis application. RESULTS: In one year, the Northeast region reported 22.9% of the cases and 21.5% of the deaths in the country due to C OVID-19. At the beginning of the pandemic, all states showed a growing number of cases, first in the capitals and then in the interior. Following this wave, decreases are observed in all states and their capitals, but with many still reporting a large number of cases. In the middle of the 2nd semester of 2020 the number of cases begins to increase again simultaneously in states and their capitals-some at explosive speed-especially in late 2020 and early 2021. A similar pattern is observed in deaths, which exceed or approach the peak seen in the first wave. In the first wave, all capitals and northeastern states adopted intense isolation measures. Fortaleza, Recife and Teresina reached the highest isolation index of all capitals, close to 0.60. This index decreases, with a slight growth trend until the end of December. With the exception of Fortaleza and Salvador, the other capitals fell to less than 0.40. CONCLUSION: The Brazilian NE and the country are in increasingly complicated health, social and economic situations. It is necessary to speed up vaccinations and maintain nonpharmacological measures: face masks, social distancing measures and hygiene care, in addition to policies to protect workers who have lost their incomes and to subsidize small business owners.
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The COVID-19 was first reported in China at late December 2019 and was listed as a pandemic on March 19, 2020 by the WHO. The virus protein S, which mediates the entry and fusion process, has been reported to require ACE-2, the angiotensin converting enzyme-2 as an anchoring receptor. ACE-2 is expressed in oral and gingival tissue, epithelial cells and fibroblast in the oral mucosa, making it a high-risk factor for infectious virus susceptibility. On the other hands, the importance of saliva has been reported for its role as a vehicle for the transmission of viral particles, which allows it to be considered as an instrument of potential diagnostic value in the detection of COVID-19. To know the etiology of SARS-CoV-2 and its impact at the oral level, as well as to recognize and execute biosecurity measures for the management of patients in dental clinical practice is the fundamental object of this review, for this reason, a retrospective cross-sectional study with electronic search was carried out through NCBI, Virtual Health Library, Scielo, LILACS and Redalyc. The reports given by the WHO, CDC and Ministries of Health in Latin America are analyzed. The dissemination of information and the adaptation of knowledge in time of pandemic by COVID-19, will protect the health conditions of both, dentist and patient, which is why it is necessary to put biosafety protocols into practice and constantly update them regarding to health care at the clinical and hospital level.
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OBJECTIVE: To analyse how testing the population influences the health indicators used to monitor the COVID-19 pandemic in the 50 countries with the highest number of diagnosed cases. METHODS: This was an ecological study using secondary data retrieved on 8/19/2020. Cumulative incidence, mortality rate, case-fatality rate, and proportion of positive tests were calculated. The data were described and presented graphically, with their respective Spearman Correlation Coefficients. RESULTS: The testing rate varied enormously between countries. Cumulative incidence and the proportion of positive tests were correlated with the number of tests, while the mortality rate and case-fatality rate showed low correlation with this indicator. CONCLUSION: Most countries do not test enough to ensure adequate monitoring of the pandemic, and this is reflected in the quality of the indicators. Expanding the number of tests is essential, but it needs to be accompanied by other measures, such as isolation of diagnosed cases and contact tracing.
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OBJECTIVE: To know the perception of health professionals and their families about fake news related to the COVID-19 pandemic. METHOD: Descriptive-exploratory study with a qualitative approach. Twenty-eight individuals participated, including seven physicians, seven nurses, and 14 family members. Data collection took place between August and October 2020, with audio-recorded interviews. After transcription, the content was analyzed using Content Analysis, thematic modality. RESULTS: Three categories were identified: "Context of the occurrence and dissemination of fake news in times of pandemic";"Consequences of fake news on the experience of the pandemic";and "Coping strategies to contain/combat fake news". CONCLUSION: Sociocultural, political, educational, and technological aspects influence the occurrence and dissemination of fake news, which have consequences such as: misinformation, self-medication, worsening in the professional-patient relationship, increased need for additional research, and fear in the population. To face the current situation, greater control by the State is required, with investigation and punishment of people who disseminate fake news, as well as greater awareness among the population on the subject.
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Objective: to map the scientific production on interprofessional relationships in health in the first year of the COVID-19 pandemic. Method: this is a scoping review performed in PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar and Science Direct databases, covering the period of publication in 2020, using the acronym PCC (Population = health professionals;Concept = interprofessional relationships;Context = health services) and respective search strategies. Results: fourteen scientific articles were selected and the content discussed in the manuscripts was standardized, analyzed and organized into categories of affinities and similarities of their results: 1 - Interprofessional collaboration;2 - Collaborative practice;3 - Interprofessional work;4 - Interactive and interprofessional learning. Conclusion: the pandemic demanded quick and effective responses that were only possible through collaboration and interprofessionalism dimensions. Interprofessional work in health during the first year of the COVID-19 pandemic confirms the importance of interprofessional work and its dimensions for the provision of more comprehensive, resolute and safer health services.
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Objective: to describe experiences of nurses and doctors of Emergency Care Units in coping with the Covid-19 pandemic. Method: descriptive-exploratory study with a qualitative approach, conducted with seven doctors and seven nurses working in two Emergency Care Units, reference for Covid-19. The interviews took place between September and November 2020 and were guided by a semi-structured questionnaire. The statements were recorded, transcribed and submitted to Content Analysis. Results: two categories of analysis emerged: "We feel exhausted": the experience of nurses and doctors and Strategies to face the mishaps in the pandemic context. Final considerations: the professionals experienced several challenges, such as lack of institutional protocol, lack of physical structure, material, human resources and training, difficulty in sensitizing the population and concern to contaminate oneself and the family. However, they relied on different strategies, such as preventive self-isolation, family support, exchange of experiences with other professionals and keeping up to date on the disease. © 2021 Universidade Federal da Bahia. All rights reserved.