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Introduction: The development of new diagnostic tests for SARS-CoV-2 is a strategic component for the prevention and control of COVID-19. To regulate the market for SARS-CoV-2 antigen detection self-tests, the regulatory agency issued a resolution that provided for the introduction of self-tests in Brazil. Objective: To perform a comparison between the new technical requirements of antigen self-tests for COVID-19 with data and information available in the literature. Method: This is a systematic literature review to carry out a comparative study between the scientific evidence and the new technical requirements for the commercialization of antigen self-tests for COVID-19 in Brazil. The search was performed in October 2021, and updated in January 2022. Results: Of the 517 studies identified, nine were included. The studies reported adequate sensitivity and specificity results for most self-tests performed in symptomatic people. The studies bring a variety of tests available and one of them was registered for commercialization in Brazil. Based on this outcome, national regulation follows standards that favor the promotion of self-monitoring by the population, which can contribute to a public health policy. Conclusions: The technical requirements contained in the new regulation and at the national level are consistent with the evidence found, which ensures reliability for decision-making by consumers, clinicians and service providers. It is necessary to continue with studies on self-test coverage for new variants, biological material disposal policies and how the use of self-tests can contribute to the role of consumers in health surveillance actions.
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Introduction. The self-test for COVID-19 has been a widely used strategy in some countries, especially in the context of back to face-toface work and educational activities. However, it is necessary to discuss the accuracy of antigen tests for the diagnosis of COVID-19. Methods. A systematic review was carried out. The strategy was defined by the researchers using the terms Covid-19 and Selftesting and their respective synonyms, including studies with data collection from 01/01/2021. Searches were carried out on October 20, 2021, in several databases. Results. A total of 504 studies were identified, four of which were included in this review: two self-tests of nasopharyngeal collection antigen compared to reverse transcriptase polymerase chain reaction (RT-PCR);a supervised and self-collected anterior nasal smear selftest;and a study that evaluated the performance of six self-collected rapid antigen tests against quantitative RT-PCR (gargle, sputum, and spit). Saliva self-tests were found to have low sensitivity (<45%), while anterior nasal or nasopharyngeal swab self-tests had greater than 80 percent sensitivity. In all self-tests, the specificity was less than 85 percent. The diagnostic accuracy of self-tests for the different SARS-CoV-2 variants was not identified. Conclusions. The use of self-tests as a screening strategy is recommended, being a strategy with a significant impact on the surveillance and control of SARS-CoV-2 transmission. Further studies are needed to assess: (i) accuracy considering the concern variants, (ii) safety of tests with self-collection of biological material, and (iii) disposal of biological waste.
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This research review shows how isolation due to the COVID-19 pandemic has affected daily activities such as quality of sleep, physical activity, and work life. This review exercise is developed to provide information that will help different professionals to point out the psychological impact and possible changes presented in the daily activities of people during confinement. Sleep hygiene and quality of sleep were affected due to factors such as age - young, sex - female, history of mental illness, insomnia, anxiety, depression, psychological distress, low back pain, and stress. With regard to physical activity during preventive isolation, it was found that there was a lack of physical exercise, weight gain, increased sedentary life, decreased outdoor activities, increased consumption of cigarettes, alcohol, and the use of electronic devices, as well as increased intake of ultra-processed foods. As for the work activity during COVID-19, there were difficulties in the adaptation and qualification to the management of Tics, and work overload, in addition, it is observed that the predominant gender is female, and there is psychological and mental affectation and emotional exhaustion. © 2022 Academia Nacional de Medicina. All rights reserved.
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Several works have proposed predictive models of the SEIRD (Susceptible, Exposed, Infected, Recovered, and Dead) variables to characterize the pandemic of COVID-19. One of the challenges of these models is to be able to follow the dynamics of the disease to make more precise predictions. In this paper, we propose an approach based on incremental learning to build predictive models of the SEIRD variables for the COVID-19 pandemic. Our incremental learning approach is a dynamic ensemble method based on a bagging scheme that allows the addition of new models or the updating of incremental models. The article proposes an incremental learning architecture composed of two components. The first component carries out an analysis of the interdependencies of the SEIRD variables and the second component is an incremental learning model that builds/updates the predictive models. The paper analyses the quality of the predictive models of our incremental learning approach using data of the COVID-19 from Colombia, and shows interesting results about the predictions of the SEIRD variables. These results are compared with an incremental learning approach based on random forests.
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Background: This study's aims are to assess the current evidence presented in the literature regarding the potential risks of COVID-19 infection among pregnant women and consequent fetal transmission.
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Background: Coagulopathy associated with COVID-19 is one of the main complications, especially in individuals with risk factors. Simultaneously, the use of low molecular weight heparin is the recommended strategy in hospitalized individuals, but the usefulness of other strategies such as DOACs in outpatients is still unknown. Aims: Describe the benefit of the use of rivaroxaban at discharge on the risk of thrombosis in patients discharged from COVID-19.Identify the behavior of Dimero-D at discharge and its modification with anticoagulant therapy. Methods: Randomized 1: 1 study (Rivaroxaban 10mg for 14 days versus observation) at discharge in individuals with COVID-19 who have not required mechanical ventilation. D-dimer was evaluated at 14 and 30 days after discharge in conjunction with a CT angiography at four weeks after hospital discharge. The protocol was developed in the Hospital Regional de Alta Especialidad de Ixtapaluca, authorized by the ethics committee with registration number NR-19-2020. The study is identified in ClinicalTrials.gov with the following registry NCT04508439 Results: Forty individuals were evaluated (20 in each arm) with follow- up greater than 100 days. Gender distribution was equitable in each arm, with a mean age of 50 years (21 to 74 years), 40% (n = 16) were older than 55 years, 27.5% (n = 11) had hypertension and 20% (n = 8) had diabetes. The mean length of hospital stay was 10.5 days (6 to 23 days) treated with oxygen and low molecular weight heparin. At discharge, treatment was started with rivaroxaban 10mg x 14d vs. observation;in the rivaroxaban group, four events were identified (3 hemorrhages / 1 thrombosis), this difference being significant (Log Rank 0.016). Only one thrombosis event (pulmonary embolism) was identified in the rivaroxaban group at eight treatment days. Compared to the diagnosis, DD levels were lower at both 14 and 30 days (p = 0.000, 95% CI, 440.8-1164.9) without finding a difference in those treated with rivaroxaban or observation (p = 0.721, 95% CI, -68.48 to 241.18). Summary/Conclusion: The use of DOACs at discharge does not benefit from an increased risk of hemorrhagic events;the anticoagulant strategy should be individualized, focused only on those patients at very high risk of thrombosis.
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This work focuses on social transformations and changes in the communication of knowledge in times of pandemic by COVID-19, using color as an example as a visualizing element of social and technological changes, where the images and the virtual world becomes essential for communication and knowledge. With a qualitative approach, we work from a critical theory by the analysis of texts, images and practical bases, to demonstrate the virtuality effect as a transforming element in learning, communication, knowing and color relationship with the society in the actuality. © 2020, Universidad del Zulia. All rights reserved.
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BACKGROUND: The COVID-19 pandemic may be having many psychological impacts on people, at both an individual and a community level. OBJECTIVE: To ascertain the relationship between the weekly frequency of physical activity and levels of stress among Brazilian adults during social distancing due to the coronavirus (COVID-19), and the interaction of sex in this association. DESIGN AND SETTING: Cross-sectional study with a descriptive approach conducted at a public university in Curitiba (PR), Brazil. METHODS: 2,000 Brazilian adults (average age 36.4 years;59.6% women) were recruited according to convenience through digital media. They filled out a questionnaire in electronic format that asked for sociodemographic information, health data, food consumption data, weekly frequency of physical activity and stress levels on the 10-item Kessler psychological distress scale. Descriptive statistics and regression analyses were used to evaluate the data. RESULTS: Associations were observed for the following correlations: male sex * no physical activity (odds ratio (OR): 4.35;95% confidence interval (CI): 1.14-16.67);female sex * physical activity 4 or 5 times a week (OR: 7.86;95% CI: 2.28-27.05);female sex * physical activity 3 times a week (OR: 7.32;95% CI: 2.09-25.58);female sex * physical activity 1 or 2 times a week (OR: 14.57;95% CI: 4.28-49.57);and female sex * no physical activity (OR: 24.17;95% CI: 7.21-80.97). CONCLUSION: The lower the weekly frequency of physical activity during the period of social distancing was, the greater the chances of having stress levels were, especially for women.
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Objective: To investigate psychosocial effects on health professionals from the frontline activity in the pandemic. Methods: Cross-sectional analysis of entry interviews in a prospective study about the stress and mental health of COVID-19 frontline workers in a public hospital in Southern Brazil. The study has a mixed approach. Results: 123 people interviewed, 76% were nursing professionals and 81% women. A score of seven or more on the Self-Reporting Questionnaire (SRQ-20) was obtained for 40% of the sample, 45% had a score of 25 or more on the Perceived Stress Scale (PSS) and 41% achieved scores compatible with burnout in the Oldenburg Burnout Inventory (OBI). The outcomes were associated with each other (p < 0.05), but no association was found with the independent variables. Long shifts without breaks due to vestments, pressure and fatigue greater than usual, isolation in the hospital itself, risk of contamination itself and fears and guilt related to families were highlighted in the in-depth interviews. The team unity appeared as an aspect that favors performance in COVID-19 coping. Conclusions: Professionals are suffering and it is recommended to prioritize rest and breaks, which may require adjustments to routines and physical spaces, in addition to expanding the offer of emotional support to the teams of health workers. © 2021, Editora Cientifica Nacional Ltda. All rights reserved.
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Objective: To investigate the relationship between the performance of tests to detect COVID-19 and signs of psychological distress, perceived stress and burnout among health professionals on the frontline of the pandemic in a general hospital. Methods: Prospective mixed-approach study using SRQ-20, PSS, OBI and in-depth interviews in a series of 3 interviews throughout 2020. Results: Worrying prevalences of high scores of SRQ20, Burnout and Perceived Stress occurred on the three interviews and the number of tests performed increased during the study period, but there was no association between outcomes and testing to detect COVID-19. Fear of contracting the disease or being a transmitter of the virus appeared as the main stressors for health professionals, maintained despite testing. Conclusion: In this group, tests performed were not sufficient to modify the psychosocial effects of the front line activity on health professionals.
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Objective: To analyze, from the perspective of self-report of antecedents and consequences, how the COVID-19 pandemic decrease the health of men living in Brazil. Methods: Qualitative study, conducted with 200 men living in all regions of Brazil through the application of a semi-structured instrument, hosted on an online platform. The data were analyzed with the Collective Subject Discourse method and anchored in the theoretical framework of Dialectical Historical Materialism. Results: The COVID-19 pandemic decrease men’s mental health because it worsened the history of personal, affective, family, occupational, dysfunctional and/or morbid problems, causing consequences of psychic somatization, family dissolution, end of affective relationship, marital conflicts, social isolation, financial difficulty, vulnerability of the work situation and occupational exhaustion, sudden changes in behavior, barriers in access to health care and impaired experiences of death and grief. Conclusion: Social support networks need to be strengthened in order to minimize the direct and indirect impacts caused by the pandemic materiality for mental health and the various dimensions of life affected.