Learning in Distance Education: Perceptions of 4th Year Portuguese Students

Due to the Covid-19 pandemic, distance learning began to take place. Hence, a questionnaire was conducted to 4th year of Portuguese school about their perceptions on this form of learning, with regard to technological resources and the types of tasks performed, the help provided to students, the obstacles that have arisen and the positive and negative aspects of distance learning. A qualitative research methodology was followed with the application of a questionnaire with open questions to three classes of that grade in three different schools in the north of Portugal. The results showed that there were several technological tools used for distance learning, both for synchronous classes and for carrying out school tasks. The lack of socialization with classmates, malfunctioning of technological resources, work overload and students' anxiety were the most negative aspects mentioned by them.

Research of addition of N95 facial mask fibers, silica fume and marble powder in high performance mortar

The coronavirus pandemic, in addition to the global health crisis, shows damage to the environment due to the high number of disposable face masks, making it necessary to develop research to minimize the environmental risks associated with personal protective equipment used by the population. This research aims to reduce the waste generated by the pandemic, taking advantage of face masks, inserting them in the manufacture of mortars. Processing (grinding) of the masks was carried out and their inclusion in contents of 1.4% and 2.0% in relation to the cement consumption. The products were compared to a reference mix and evaluated for physical and mechanical properties. As a result, it was found that the addition of mask fibers resulting an increase in the water absorption rate, as well as reductions in diametral compression strength and compressive strength, respectively 30% and 50%, due to failures in the matrix/fiber interaction, which may limit the use of the mixture. However, this research contributes to the Brazilian agenda regarding sustainable urban, regional, and national development, through multidisciplinary and innovative approaches, enabling the reduction of environmental degradation by discarding masks and the making of new materials to be employees in the construction sector.

Psychometric properties of the University of California Los Angeles Loneliness Scale version 3: the European Portuguese version

Currently, the gold standard measure to assess loneliness is the University of California, Los Angeles Loneliness scale version 3 (UCLA v3). Objective. The aim of this study was to analyze the psychometric properties of UCLA v3 for the European Portuguese population. Method: A sample of 282 participants was surveyed in Portugal. Results: Confirmatory factor analysis (CFA) supported a model portraying a global loneliness bifactor solution for positive and negative wording items, which achieved optimal fitness. Multi-group CFA indicates scalar and metric invariance across gender. Loneliness test scores (global score, positive items and negative items) correlated with well-established mental health indicators such as psychological stress, depressive and anxiety symptomatology, or psychological inflexibility. Internal consistency of the loneliness test scores was optimal for the global measure (α =.91;ω =.91) as well as for the positive (α =.87;ω =.87) and the negative factors (α =.86;ω =.88). Conclusions: Results support UCLA v3 as a reliable and valid measure of loneliness for future research studies interested in examining the prevalence of loneliness and impact in health in the context of Covid-19 in the Portuguese population and as a health indicator in health promotion and clinical interventions. © 2023 Sociedad Española para el Estudio de la Ansiedad y el Estrés - SEAS. Colegio de la Psicología de Madrid. Todos los derechos reservados.

Determinants of severe COVID-19 infection in Patients with Breast Cancer from a Community Oncology Practice in Brazil

Purpose: The SARS-CoV-2 pandemic was declared a global public health emergency. Determinants of mortality in the general population are now clear, but specific data on patients with breast cancer (BC) remain limited, particularly in developing nations. Material(s) and Method(s): We conducted a longitudinal, multicenter cohort study in patients with BC and confirmed SARS-CoV-2 infection. The primary end point was the proportion of patients on treatment for severe SARS-CoV-2 infection (defined as need for hospitalization) or early death (within 30 days of diagnosis). Data were evaluated sequentially in the following way: i) univariate Fisher's exact test;ii) multivariable logistic regression analysis;and iii) multivariable logistic regression. In items i and ii only those with P< 0.1 are considered significant and in stage iii only those with p< 0.05 were the final significant variables. We divided patients' data into three major variable domains: a) signs and symptoms;b) comorbidities;and c) tumor and treatment characteristics;in item ii each variable domain was tested separately, finally, in item iii the significant variables of all domains were tested together and we called it the integrative step. Result(s): From April 2020 to June 2021, 413 patients with BC and COVID-19 were retrospectively registered, of which 288 (70%) had an identified molecular subtype and 273 (66%) had stage information. Most patients were on active systemic therapy or radiotherapy (73.2%), most of them in the curative setting (69.5%). The overall rate of severe SARS-CoV-2 was 19.7% (95% CI, 15.3-25.1). In the integrative multivariate analysis, factors associated with severe infection were metastatic setting, chronic pain, acute dyspnea, and cardiovascular comorbidities. Recursive partitioning modeling used acute dyspnea, metastatic setting, and cardiovascular comorbidities to predict nonprogression to severe infection, yielding a negative predictive value of 84.9% (95% CI, 78.9%-88.3%). Conclusion(s): The rate of severe COVID-19 in patients with BC is influenced by prognostic factors that partially overlap with those reported in the general population. High-risk patients should be considered candidates to active preventive measures to reduce the risk of infection, close monitoring in the case of exposure or SARS-CoV-2 -related symptoms and prophylactic treatment once infected.

Business (un)usual: Critical skills for the next normal

The impact of COVID-19 on global human resource (HR) management has been swift, dramatic and has fundamentally changed HR processes. The prompt online migration of business has altered the skills required by employees to succeed in the workplace of the future. This research examines the hard and soft skill gaps that exist in the digital marketing and advertising industry. Through the use of two data collection points in 2019 and 2020, the research identified a renewed importance being placed on soft skills in the wake of the COVID-19 pandemic. Soft skills and the development thereof have become a key focal area of training for new employees as a result of remote working. The identified hard skill gaps are indicative of the future growth areas of the industry, focusing on data analytics, marketing automation and user experience. Future research should consider an expansion to other industry-specific skills and contrast country-level skill gaps. © 2022 The Authors. Thunderbird International Business Review published by Wiley Periodicals LLC.

Hypofractionated radiotherapy for pancreatic cancer

Category: Outcomes of treatment (including chemotherapy, chemo-RT and RT) Purpose: Hypofractionated (5#) radiotherapy for non-metastatic pancreatic cancer was introduced during the COVID-19 pandemic as an alternative to conventional treatment pathways. This study was performed to evaluate clinical outcomes and acute toxicity of 5# radiotherapy. Methods and materials: We retrospectively identified pancreatic cancer patients treated with 5# radiotherapy at Addenbrookes Hospital from March 2020 to September 2021. Patient characteristics, response on follow-up computed tomography (CT) scans, dosimetry and toxicity data were analysed using Excel and SPSS. Result(s): 40 patients were treated with 5# radiotherapy, 60% (n=24) had locally advanced pancreatic cancer, 30% (n=12) operable disease, 7.5% (n=3) postoperative recurrences and 2.5% (n=1) borderline resectable disease. 45% of patients (n=19) had induction chemotherapy. Radiotherapy was delivered as 35 Gy (67.5%, n= 27) and 30 Gy (32.5%, n=13) in 5# in 1.5 weeks using volumetric-modulated arc therapy (VMAT) technique. Median overall survival (mOS) for all patients was 14.2 months (95% CI 10.3-15.6 months). For induction chemotherapy + radiotherapy versus radiotherapy alone, mOS was 14.2 months (95% CI 8.2-17.7 months) versus 13.9 months (95% CI 10.3-15.7 months), p=0.97. Median progression-free survival (mPFS) for all patients was 10.2 months (95% CI 8.0-11.9 months). For induction chemotherapy + radiotherapy versus radiotherapy alone, mPFS was 10.5 months (95% CI 9.5-12.4 months) versus 10.1 months (95% CI 5.5-10.4 months), p=0.99. There were no grade 3 acute toxicities. When compared to 28# radiotherapy, the 5# regimen reduced patient hospital visits by 82%. Conclusion(s): The observed mOS is comparable with mOS of conventional 28# radiotherapy (14.2 versus 15.2 months (SCALOP trial)), 5# radiotherapy for non-metastatic pancreatic cancer is a safe alternative treatment pathway. Copyright © 2022

Relato De Caso: Tromboflebite Superficial Extensa Em Paciente Portador De Hemofilia a Grave Associada a Vacina Para Covid19

Introducao: A hemofilia A (HA) e uma doenca hemorragica caracterizada pela ocorrencia de sangramentos, principalmente articulares e musculares. Embora esses pacientes sejam considerados relativamente protegidos de eventos tromboticos, existem relatos de trombose venosa, associada a fatores de risco como pos-operatorio ou com reposicao de fator. Relato de caso: Homem, 22 anos, em seguimento no Hemocentro de Ribeirao Preto com diagnostico de HA grave sem inibidor em profilaxia com fator VIII recombinante (FVIIIR). Compareceu para avaliacao em marco de 2022 com queixa de dor e edema difuso na perna direita iniciados ha 10 dias, sem historia de trauma associado. No inicio do quadro clinico, o paciente nao procurou atendimento medico e realizou reposicao de FVIIIR diariamente, com dose superior a habitual (elevacao de FVIII em 50%), conforme julgamento pessoal e sem definicao diagnostica. Como nao apresentou melhora clinica, no decimo primeiro dia de evolucao, procurou atendimento e, apos avaliacao clinica, foi aventada a hipotese de hematoma muscular no compartimento posterior da perna direita, sendo optado pela manutencao do esquema de reposicao diaria, repouso muscular e reavaliacao em 72 horas. Na reavaliacao, paciente mantinha quadro clinico, realizada Tomografia Computadorizada, que nao identificou sangramento muscular. Nesse contexto, foi optado por realizacao de Doppler Venoso de membro inferior direito, que evidenciou tromboflebite de veia safena parva medindo cerca de 10 cm, estendendo-se do terco proximal ate o terco medio da perna, sem acometer o sistema venoso profundo. O hemograma nao evidenciava plaquetopenia. Como potencial fator de risco adicional, o paciente referiu ter recebido a 3degreedose da vacina para COVID19 (AstraZeneca) cerca de 3 semanas antes do inicio dos sintomas. Por se tratar de tromboflebite extensa, com repercussoes clinicas, caracterizadas por comprometimento funcional do membro, o paciente teria indicacao de anticoagulacao terapeutica. Porem, considerando contexto clinico e doenca de base, optamos por manter observacao clinica, repouso, medidas locais, reducao da reposicao de FVIIIR e repeticao do Doppler precocemente. O exame de controle com intervalo de 4 semanas mostrou recanalizacao completa da veia safena parva, bem como houve remissao completa dos sintomas e recuperacao funcional do membro acometido. Discussao: Apesar de ser uma complicacao rara, deve ser considerada, especialmente em casos que apresentem refratariedade clinica, como a situacao apresentada. Particularmente nesse caso, ha de se considerar o fato do paciente ter recebido a vacina para COVID19 anteriormente ao quadro, cuja associacao com quadros de trombose e plaquetopenia vem sendo descrito na populacao em geral, porem os dados sao escassos em paciente com coagulopatias. Ademais, estes pacientes pela "anticoagulacao natural", inerente a patologia de base, podem nao apresentar quadros tao floridos e graves quanto os descritos na literatura. Nao ha como se definir com precisao a contribuicao da reposicao de fator iniciada pelo paciente em regime domiciliar (doses maiores e de forma mais intensa) no desenvolvimento do quadro atual. Conclusao: Eventos tromboticos nessa populacao, apesar de raros, podem ocorrer, e, a decisao quanto a anticoagulacao e desafiadora. E importante avaliar os potenciais fatores de risco associados como traumas, cirurgias e, no contexto atual, a associacao com a vacina para COVID19. Copyright © 2022

Impacts of COVID-19 on physiotherapy care for women with breast cancer

Introduction: COVID-19 has been declared a public health emergency of international concern by the World Health Organization, with a diverse clinical spectrum. Given the coronavirus prevention measures and recommendations from health authorities, there is a concern about how physiotherapy care is provided to women with breast cancer. The discontinuity of care may favor the emergence of complications, and compromise functionality, quality of care and the provision of complementary treatments. Objective: to assess the impacts of the COVID-19 pandemic on the continuity of physiotherapy care for women with breast cancer. Objective: To assess the impacts of the COVID-19 pandemic on the continuity of physiotherapy care for women with breast cancer. Methods: This is a cross-sectional study. Data were collected through an online questionnaire and the population was composed of physiotherapists, of both sexes, who work in Brazil. Results: 20% of the 40 participants reported no change in their work routine, 48% had their workload reduced, 12% had an increased workload, 25% were relocated to provide assistance to patients affected by COVID-19, and 20% of consultations were suspended. The greatest continuity of care was seen in hospital admissions (40%) and outpatient clinics (42%). The number of women cared for before the pandemic compared to during the restriction period declined by 72%. Conclusion: Most consultations were suspended;however, in most cases, continuity of care was guaranteed through telerehabilitation. Nevertheless, the interviewees reported clinical worsening in women after treatment was interrupted © 2022, Fisioterapia em Movimento.All Rights Reserved.

Technology Legitimation and User Resistance: The NHS COVID-19 App

Innovative technologies often face acceptance challenges. This is especially true when they constitute disruptive innovations. Disruptive innovations can forcefully alter the way things are done in the economy and society and have differential impacts for social groups. Legitimacy – the fit between an innovation, and society at large – is an important explanatory factor of the success of disruptive technologies. The micro-judgements of legitimacy that individuals make with regards to a technology, can help understand why some innovations succeed or fail. Likewise, users’ actions when using said innovations may indicate how acceptable the technology is to users. This paper analyses how users judge, and use, the NHS COVID-19 Test & Trace app. Preliminary findings suggest that individuals’ micro-legitimacy judgements are strongly related to the decision to use the app or not, and that users have adopted a number of workaround behaviours to resist or compensate for the app’s functionality. © 2022, IFIP International Federation for Information Processing.

Digital Adaptation in Education: A Case Study and Intervention Proposal

Education is one of the most important pillars of our society, thus there is a constant need of adapting to new contexts. The COVID-19 pandemic impacted schools and demanded change in technological literacy. This case study, conducted in a European public school, aims at understanding the context and developing an intervention under the assessment of the pandemic’s impact on such organizations. Hence, a literature review was performed, comprising a framing of the current conditions and relevant constructs to cope with change. Examples of the last are reflexivity, psychological safety and adaptivity. This review led to the diagnosis and the intervention proposal development following Porras’ [23] and Kurt Lewin’s (1947) change models. The diagnosis encompassed the conduction of interviews and focus groups. Hence, several intervention proposals framed by the job demands and resources model by Bakker et al. (Annu Rev Organ Psych Organ Behav 1:389–411, 2014) were developed. All the proposals are presented in this chapter, as well as their desired effects. From the data gathering process and its following analysis, the needs of the school arose, and topics such as exhaustion, the perception of low digital skills, the inability of establishing barriers, lack of digital resources and technologies’ integration, as well as a weak internal communication were mentioned. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Management of acute upper respiratory infections during the COVID-19 pandemic: Challenges for community pharmacies

Background: During the COVID-19 pandemic, the accessibility of health services at community pharmacies for the management of minor ailments became even more relevant, particularly in the case of acute Upper Respiratory Infections (URI) for which symptoms are often similar. Purpose: To provide a clinical pharmacy service to assess and manage symptoms of acute URI and to reaffirm the role of community pharmacies, in these challenging times, as the first line of advice, treatment, and referral, preventing unnecessary visits to emergency rooms. Method: A literature review was carried out to define the appropriate pharmaceutical intervention to assist patients with symptoms of acute URI. Patients were identified by pharmacy teams based on the presence of symptoms suggestive of acute URI or when filling a prescription for an acute URI treatment. The service consisted of an initial assessment and two follow-up contacts (conducted either by phone or face-to-face) 2 and 10 days after initial assessment. A total of 110 pharmacies received training and educational resources to support the service, and surveys to collect data were designed for each contact. Patient registration, task scheduling and surveys were setup and made available through a computer application. Findings: From February 2020 to November 2021, a total of 2239 patients were enrolled in the programme, in 63 participating pharmacies. Most patient were between 31 and 70 years old (n = 1290;56.3%) and 1344 (60.0%) of them were female. At the initial assessment, the top 3 symptoms identified were: runny or itchy nose, and sneezing (23.0%), sore throat (22.9%), unusual cough or worsening of the usual pattern (16.6%). At the initial assessment and during follow-up, the counseling of non-pharmacological measures to alleviate symptoms, along with other pharmaceutical interventions, mostly focused on increasing health literacy, were 3.5 times more frequent than the dispensing of over-the-counter medicines. In addition, there were 346 referrals to the physician. At first follow-up contact, 90.4% of patients reported feeling better, and at the second follow-up contact this percentage was 97.1%. A total of 215 medical consultations were reported by the patients, during follow-up contacts (127 by the first follow-up contact and 88 by the second). As result of these medical appointments, patients were diagnosed with COVID-19 (n = 16), other respiratory illnesses (n = 75), chronic disease decompensation (n = 7), or other diseases (n = 39). Conclusion: During this challenging context for the health care sector, pharmacists play an important role in managing minor ailments, supporting patients throughout their journey, and cooperating with other health care professionals.

Brazilian emergency benefit: implementation and control to compared to Lowi's distributive theory

Purpose: The present study aims to evidence the origin of resources, the implementation and distribution processes of the emergency benefit destined to the popular classes, comparing with Lowi's distributive theory, and justify the control and accountability. Methodology: A literature review was conducted regarding Lowi's approach to distributive theory and a documentary research in federal executive transparency sites for the construction of this theoretical essay. Results: The results point to the existence of a mere mutation of the origins of resources in education and health, for the Ministry of Citizenship leaving doubts about whether there was effectiveness of investments. The emergency benefit immediately serves the most disadvantaged people but does not repair the permanent damage of the trajectory of vulnerability and sub citizenship of the population of the popular classes. The control action and accountability of resources by the Federal Court of Auditors shows that there was a lack of focus on social policy, as predicted by Lowi's distributive theory (Marcuso & Moreira, 2013). Contributions of the Study: In the academic and scientific sphere, this study contributes to the debate of Lowi's distributive theory applied in contingency situations, such as in the context of covid's pandemic 19. For society, its contributions permeate the need for more transparent, reliable information and greater comprehensibility of the use and origins of public resources to avoid budgetary manipulations. And the need for intervention of controlling institutions to ensure the proper use of the public office.

3D printed devices to avoid hand contact with commonly shared surfaces

In the context of the COVID-19 pandemic, public spaces had to be quickly adapted to the new circumstances especially under the uncertainty of the pandemic development. Door handles are some of the most touched surfaces and so, this point of contagion was chosen to be tackled and two solutions were developed that would prevent direct touch with the handle: a portable and a fixed device. The portable device (HYHOOK + HYTIP) is a hook-like device holding a finger cover, which permits to open doors and push buttons safely. The fixed device (HANDGENIC) is meant to be assembled in door handles to equip buildings, such as universities or schools. With the fixed device, the user can open the door using their forearm which makes them less likely to transfer any particles to eyes, nose or mouth. The 3D printing Fused Filament Fabrication (FFF) process was selected as manufacturing technique, which allows the fast production of prototypes. This work portrays the development process and design iterations taking into consideration the concerns about the functioning of the devices and possible failures or alternative uses. To assure structural integrity of the parts, finite element (FE) analysis was used to verify its mechanical response. As conclusion, it was found that FE analysis indicate that the devices are structurally sound to be used in public spaces and that 3D printing is a useful way to rapidly develop devices while testing several design possibilities.

TRAINING FOR THE MOTHERS OF CHILDREN WITH CLEFT USING INSTRUCTIONAL MANUALS

Background/Purpose: Infants with cleft lip and/or palate require special care from birth in order to adapt to the cleft and overcome insufficient suction, difficulties in breastfeeding, insufficient food intake, and malnutrition. Early nutritional intervention, as well as nutritional care and guidance, are extremely important for them to achieve their potential in terms of growth, development, and preparation for surgery. Mothers should receive training and have access to appropriate feeding assistance to optimize their children's nutrition, health, and survival rate. The purpose is to provide feeding assistance by training mothers, using the manuals prepared by our specialized multidisciplinary team. Methods/Description: Planning, preparation and dissemination of instruction/educational manuals that are accessible and easy to understand, by the team of otolaryngologists, pediatricians, nurses, nutritionists, speech-language therapist, dental professionals, and lactation specialists who prepared straightforward and fun manuals that have been used since May 2021, in treatment centers all over Brazil. Results: Breastfeeding Manual: the importance of breast milk;breast physiology, latching;various breastfeeding positions;expressing breast milk manually or using a pump;best nipple for each cleft, breastfeeding position;burping (eructation);types of milk formulas and dilution, hygiene, and preparation techniques. Manual on Introducing Food and Feeding in the Post-Surgical Feeding and Foods: introducing additional foods, food quality and quantity;techniques to offer food;child positioning;food consistency;care after lip surgery (cheiloplasty) and after palate surgery (palatoplasty), such as: raising the crib;using bracelets to prevent the child from touching his/ her mouth and thus hindering the healing process;when to change the food consistency;weaning from the bottle and pacifier, and the use of glasses and spoons;recipes. Manual Guide to Anthropometric Measurements: teaching mothers to check their children's weight, height, head, thoracic, and brachial circumference and to send this information to nutritionists/pediatricians, for monitoring and interventions, as needed. Conclusions: Since the onset of the COVID-19 pandemic, the need to provide training to the parents of patients with cleft has become increasingly evident, so as to provide nutritional care at home needed for the appropriate growth and development of infants, even with less frequent in-person appointments. Considering that cleft babies begin to be submitted to surgical procedures at 3 months old, nutritional care must include growth, development, and preparation for these surgeries. Providing support for the mothers is essential for them to overcome challenges and to adopt best practices in feeding their children. Training them to do that is certainly the best way. This work was supported by Smile Train, Inc.

Business (un)usual: Critical skills for the next normal

The impact of COVID-19 on global human resource (HR) management has been swift, dramatic and has fundamentally changed HR processes. The prompt online migration of business has altered the skills required by employees to succeed in the workplace of the future. This research examines the hard and soft skill gaps that exist in the digital marketing and advertising industry. Through the use of two data collection points in 2019 and 2020, the research identified a renewed importance being placed on soft skills in the wake of the COVID-19 pandemic. Soft skills and the development thereof have become a key focal area of training for new employees as a result of remote working. The identified hard skill gaps are indicative of the future growth areas of the industry, focusing on data analytics, marketing automation and user experience. Future research should consider an expansion to other industry-specific skills and contrast country-level skill gaps. © 2022 The Authors. Thunderbird International Business Review published by Wiley Periodicals LLC.

Challenges, burden and emotional impact on Portuguese athletes during COVID-19 pandemic

This study aimed to explore how contextual variables associated with the period of confinement during pandemic can differentiate symptoms of anxiety, depression, and stress. It also intended to understand the concerns that were experienced by athletes when resuming their sport practice and how these could be associated with psychopathological indicators. The sample comprised 265 athletes who completed self-reported questionnaires. Results demonstrated that there were differences in psychopathological indicators in terms of hours of training per week, and the type of contact that athletes have with their coach. Athletes reported concerns regarding the resumption of sport practice, and that were associated with anxiety, depression, and stress symptoms. This study may contribute in warning the sports community about the impact of contextual variables-related to critical moments of this pandemic. Sports communities should encourage the preservation of the athlete's physical activities, as well as supporting coaches in continuing to guide athlete's training.

The Impact of Visual Communication in COVID-19's Prevention and Risk Mitigation

This study aims to analyse the visual and graphical elements used in health communication during the coronavirus pandemic, with the purpose of identifying its characteristics at a global level and understanding the impact and efficacy of the materials in COVID-19 prevention and risk mitigation. A total of 264 materials have been examined and submitted to a coding system with variables regarding the message and graphic representations in the information presented about coronavirus by the health departments and ministries of ten countries. The results show that health communication should walk alongside visual communication, particularly when communicating risks during public health emergencies once that materials combining both text and pictures have been highlighted as the greatest in improving understanding and comprehension.

PROJETO SENTINELA COVID-19: ESTUDO DE VIABILIDADE DA DETECÇÃO VIRAL EM ASSINTOMÁTICOS UTILIZANDO O TESTE POINT OF CARE PARA DETECÇÃO DO ANTÍGENO DO SARS-COV-2 E RESULTADOS EM MEIO À EXPANSÃO DA VARIANTE DELTA NO BRASIL

A OMS estabelece como métricas para avaliação da transmissão comunitária da COVID-19 a ocorrência de casos novos, mortes, internações e positividade da testagem sentinela. A testagem sentinela por razões econômicas e logísticas não ocorreu no Brasil e sempre atuamos sob indicadores já ocorridos. Considerando a relevância da transmissão assintomática, sobretudo com a expansão da vacina, e a necessidade de aprimorar a vigilância sobre a circulação viral implementamos um projeto sentinela na cidade de Cubatão na região da Baixada Santista em São Paulo. Realizamos semanalmente, aos sábados, dois testes para cada 1000 habitantes em todas as regiões do município, incluindo as mais socialmente desafiadoras, respeitando as bases e divisões dos setores censitários do IBGE. Aplicamos o TCLE e coletamos um questionário em meio digital com dados demográficos, clínicos e epidemiológicos. Entre 31/07 e 25/09/21 foram realizados 2185 testes (Panbio-AbbottR). Foram identificados 6 casos positivos no período (0,3%). A mediana de idade dos testadas foi de 49 anos, sendo 51,8% do sexo feminino. Em média, ao longo do período de testagem, 51,1% da amostra avaliada havia tomado 2 doses de vacinas dentro do prazo e foi possível avaliar a evolução da cobertura vacinal no período. Na última data de inquérito no período (25/09/2021), 75,59% da amostra estava plenamente vacinada e quase a totalidade com uma dose ao menos. Os resultados de baixa positividade alinham-se com a redução na demanda por consultas em PA por COVID (menos 70%), por internações (menos 97%) e por vagas em UTI (menos 98%) comparando-se os meses entre março (pico) e agosto de 2021. Alinham-se ainda à redução de positividade do RT-PCR entre sintomáticos de 88% para o mesmo período (de 43,6 para 4,9%). Entre 30/08 e 08/09/21 100% das variantes isoladas no município são delta e nenhum dos pacientes teve evolução desfavorável com necessidade de internação. O uso da testagem sentinela mostrou-se uma ferramenta útil no processo da gestão dos leitos e decisões estratégicas da secretaria de saúde, teve excelente aceitação e performance sem nenhuma perda, foi sensível e esteve em linha com os dados compilados pela gestão. Seu uso deve ser realizado como ferramenta útil no monitoramento precoce e antes que desfechos clínicos mais severos estejam concretizados. Por fim, está evidente a performance da vacina como ferramenta essencial na proteção contra formas graves da COVID e na contenção da expansão da variante delta.

COVID 19 Infection in Children in Colombia, Experience from a Nationwide Network (CORONARED)

Background. Worldwide SARS-CoV-2 infections increase every day. Despite the infection is less severe in children, it can be severe and associated with complications. However, local data remain scarce. We sought to describe epidemiological and clinical characteristics of COVID-19 infection in this population across different age groups. Methods. Observational, multicenter study across 23 Colombian hospitals from 22 different territories. We included all patients from 0 months to 17 years with confirmed SARS-CoV-2 infection by either antigen or RT-PCR testing. Results. From March 1, 2020, to October 31, 2021, we identified 1,186 patients: neonates (88), 1 to 3 months (130), 4 to 23 months (306), 2 to 4 years (169), 5 to 11 years (229) and 12 to 18 years (226) with confirmed COVID-19 infection. Of those,77(6.2%) were asymptomatic, 631(53.2%) hospitalized, 132(11.2%) required PICU. 58 cases met WHO definition of MIS-C. Patients less than 24 months of age were characterized by fever (74%) and more respiratory distress (30.1%) compared to other groups. Patients >5yo seemed to have a more severe presentation. They had more gastrointestinal (GI) symptoms (31% vs 37.8%), had more need for ICU care given presentation with shock increased with age ( >5yo 9.5%;5-12yo 10.6%;12-18yo 11.5%). Lab markers including thrombocytopenia and Lymphopenia were more common on this age group. Antibiotic treatment was common (%%) especially in neonates (40.9%), despite bacterial coinfection was rare (8.7%), length of hospitalization was longer in older than 2-year-old groups. 23(1.9%) patients died, similar across different age groups. Conclusion. COVID-19 infection in Colombian children presented differently across different age groups. Children older than 5 years had a more severe clinical course and prolonged hospital stays. Clinical findings according to age groups could help clinicians in characterizing and identifying COVID 19 infections in Children.