Risk for Severe Illness and Death among Pediatric Patients with Down Syndrome Hospitalized for COVID-19, Brazil.

Down syndrome is the most common human chromosomal disorder. Whether Down syndrome is a risk factor for severe COVID-19 outcomes in pediatric patients remains unclear, especially in low-to-middle income countries. We gathered data on patients <18 years of age with SARS-CoV-2 infection from a national registry in Brazil to assess the risk for severe outcomes among patients with Down syndrome. We included data from 14,684 hospitalized patients, 261 of whom had Down syndrome. After adjustments for sociodemographic and medical factors, patients with Down syndrome had 1.8 times higher odds of dying from COVID-19 (odds ratio 1.82, 95% CI 1.22-2.68) and 27% longer recovery times (hazard ratio 0.73, 95% CI 0.61-0.86) than patients without Down syndrome. We found Down syndrome was associated with increased risk for severe illness and death among COVID-19 patients. Guidelines for managing COVID-19 among pediatric patients with Down syndrome could improve outcomes for this population.

Prevalence and Associated Factors of SARS by Covid-19 in Adults and Aged People with Chronic Cardiovascular Disease. / Prevalência e Fatores Associados à SRAG por COVID-19 em Adultos e Idosos com Doença Cardiovascular Crônica.

BACKGROUND: The presence of Cardiovascular Disease (CVD) in individuals infected with COVID-19 may imply a worse prognosis. OBJECTIVE: To describe the prevalence of Severe Acute Respiratory Syndrome (SARS) by COVID-19 and to analyze the factors associated with this condition in adults and the elderly with cardiovascular disease in Brazil until the 30th Epidemiological Week of 2020. METHODS: Cross-sectional study conducted with data from the Influenza Epidemiological Surveillance Information System (Sistema de Informação de Vigilância Epidemiológica da Gripe - SIVEP-Gripe), referring to the SARS notification forms of hospitalized individuals in Brazil, between the 1st and 30th Epidemiological Week of 2020. Adults and the aged (≥ 18 years old) with CVD. The dependent variable was SRAG confirmation by COVID-19 and factors related to sociodemographic characteristics, signs and symptoms, and clinical factors were analyzed. Poisson regression with robust variance was applied. The level of significance adopted was 5%. RESULTS: Notifications from 116,343 individuals were analyzed. Of these, 61.9% were diagnosed with SARS by COVID-19. The prevalence of the outcome was 4% lower in women (95%CI: 0.94-0.99) and 18% lower in rural areas (95%CI: 0.77-0.87). There was a higher prevalence in the 50 to 59 age group (95%CI: 1.09-1.48) and in the northeast region (95%CI: 1.72-1.91). Fever, cough, admission to the ICU, use of ventilatory support, and nosocomial cases were also significantly associated with a higher probability of SRAS by COVID-19 in these individuals. CONCLUSION: There is a high prevalence of SARS by COVID-19 in adults and aged people with CVD in Brazil. Factors associated with sociodemographic and clinical characteristics, signs, and symptoms were associated.

FUNDAMENTO: A presença de Doença Cardiovascular (DCV) em indivíduos infectados pela COVID-19 pode implicar em um pior prognóstico. OBJETIVO: Descrever a prevalência da Síndrome Respiratória Aguda Grave (SRAG) por COVID-19 e analisar os fatores associados a essa condição em adultos e idosos com doença cardiovascular no Brasil até a 30ª Semana Epidemiológica de 2020. MÉTODOS: Estudo transversal realizado com dados do Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe), referente às fichas de notificação de SRAG de indivíduos hospitalizados no Brasil, entre a 1a e 30a Semana Epidemiológica de 2020. Foram incluídos adultos e idosos (≥ 18 anos) com DCV. A variável dependente foi a confirmação de SRAG por COVID-19 e foram analisados fatores relacionados a características sociodemográficas, sinais e sintomas e fatores clínicos. Aplicou-se a regressão de Poisson com variância robusta. O nível de significância adotado foi de 5%. RESULTADOS: Foram analisadas as notificações de 116.343 indivíduos. Destes, 61,9% obtiveram diagnóstico de SRAG por COVID-19. A prevalência do desfecho foi 4% menor nas mulheres (IC95%: 0,94­0,99) e 18% menor em zonas rurais (IC95%: 0,77­0,87). Observou-se prevalência maior na faixa etária de 50 a 59 anos (IC95%: 1,09­1,48) e na região nordeste (IC95%: 1,72­1,91). Febre, tosse, internação em UTI, uso de suporte ventilatório e caso nosocomial também foram significativamente associados a uma maior probabilidade de SRAG por COVID-19 nesses indivíduos. CONCLUSÃO: Há alta prevalência de SRAG por COVID-19 em adultos e idosos com DCV no Brasil. Associaram-se fatores relacionados a características sociodemográficas, clínicas, sinais e sintomas.

Smell and taste alterations in COVID-19 patients: a systematic review

SUMMARY OBJECTIVE: To present scientific evidence based on a systematic review of the literature (PRISMA) to systematize information on smell and taste alterations in patients diagnosed with COVID-19. METHODS: The studies were selected through combinations based on the Medical Subject Headings (MeSH). The MEDLINE (PubMed), LILACS, SciELO, and BIREME databases were used. The search encompassed articles published from January 2010 to May 2020, with no restriction of language or localization. RESULTS: A total of 665 retrieved articles had the potential for inclusion. Of these, two answered the research question, which was to verify the smell and taste alterations in patients diagnosed with COVID-19. CONCLUSION: The results found in this review demonstrated that there likely is an association between self-reported smell and taste dysfunctions and COVID-19 infection in such patients.

Kawasaki and COVID-19 disease in children: a systematic review.

OBJECTIVE: To present scientific evidence based on a systematic literature review (PRISMA) evaluating the association of Kawasaki Disease (DK) and COVID-19 in children. METHODS: For the selection of studies, a combination based on the Medical Subject Heading Terms (MeSH) was used. The Medline (Pubmed), LILACS, SciELO, COCHRANE, and BIREME databases were used. The search period for the articles comprised the last 10 years (2010 to 2020). RESULTS: 840 articles with potential for inclusion were retrieved, one of which met the inclusion criteria and the guiding question that consisted of evaluating the association of Kawasaki disease and COVID-19 in children. CONCLUSION: A significant increase in the incidence of Kawasaki-type diseases after the onset of the epidemic has been reported, suggesting an association between the COVID-19 epidemic and the high incidence of a severe form of KD. However, further studies are needed to conduct an investigation of the association between these two diseases.

Smell and taste alterations in COVID-19 patients: a systematic review

SUMMARY OBJECTIVE: To present scientific evidence based on a systematic review of the literature (PRISMA) to systematize information on smell and taste alterations in patients diagnosed with COVID-19. METHODS: The studies were selected through combinations based on the Medical Subject Headings (MeSH). The MEDLINE (PubMed), LILACS, SciELO, and BIREME databases were used. The search encompassed articles published from January 2010 to May 2020, with no restriction of language or localization. RESULTS: A total of 665 retrieved articles had the potential for inclusion. Of these, two answered the research question, which was to verify the smell and taste alterations in patients diagnosed with COVID-19. CONCLUSION: The results found in this review demonstrated that there likely is an association between self-reported smell and taste dysfunctions and COVID-19 infection in such patients.

Kawasaki and COVID-19 disease in children: a systematic review

SUMMARY OBJECTIVE To present scientific evidence based on a systematic literature review (PRISMA) evaluating the association of Kawasaki Disease (DK) and COVID-19 in children. METHODS For the selection of studies, a combination based on the Medical Subject Heading Terms (MeSH) was used. The Medline (Pubmed), LILACS, SciELO, COCHRANE, and BIREME databases were used. The search period for the articles comprised the last 10 years (2010 to 2020). RESULTS 840 articles with potential for inclusion were retrieved, one of which met the inclusion criteria and the guiding question that consisted of evaluating the association of Kawasaki disease and COVID-19 in children. CONCLUSION A significant increase in the incidence of Kawasaki-type diseases after the onset of the epidemic has been reported, suggesting an association between the COVID-19 epidemic and the high incidence of a severe form of KD. However, further studies are needed to conduct an investigation of the association between these two diseases. RESUMO OBJETIVO Apresentar evidências científicas com base em revisão sistemática da literatura (Prisma) avaliando a associação da Doença de Kawasaki (DK) e COVID-19 em crianças. MÉTODOS Para a seleção dos estudos foi utilizada a combinação baseada no Medical Subject Heading Terms (MeSH). Foram utilizadas as bases de dados Medline (PubMed), Lilacs, SciELO, Cochrane e Bireme.O período de busca dos artigos compreendeu os últimos dez anos (2010 a 2020). RESULTADOS Foram recuperados 840 artigos com potencial de inclusão, sendo que um respondeu aos critérios de inclusão e à pergunta norteadora que consistiu em avaliar a associação da Doença de Kawasaki e COVID-19 em crianças. CONCLUSÃO Um aumento significativo na incidência de doenças do tipo Kawasaki após o início da epidemia já foi relatado, sugerindo a associação entre a epidemia de COVID-19 e a elevada incidência de uma forma grave da DK. Contudo, mais estudos são necessários para conduzir a investigação da associação entre essas duas doenças.

Impact of super-spreaders on COVID-19: systematic review.

BACKGROUND: Spreader and super-spreader are terms that refer to people who have greater potential for disease transmission, to infect other people. OBJECTIVE: To present scientific evidence regarding the impact of COVID-19 spreaders. DESIGN AND SETTING: Systematic review of the literature (using the PRISMA framework), performed at the Federal University of Santa Catarina (UFSC), Florianópolis (SC), Brazil. METHODS: A search for articles was carried out in the SciELO, LILACS, PubMed, Scopus, Bireme and Web of Science databases. A search for gray literature was also conducted via Google Scholar. There was no restriction regarding place or language, and the search covered the period from January 2010 to August 2020. Studies were selected based on a combination of descriptors from the Medical Subject Headings (MeSH). RESULTS: Isolated cases of people diagnosed with COVID-19 who were classified as super-spreaders were found. They had been classified thus because they may have had greater potential for infecting other individuals. However, greater numbers of interventions are needed in order to identify and manage COVID-19 cases. There is little evidence regarding this detection, which further hinders recognition and understanding of super-spreading events. CONCLUSION: The scientific community needs greater depth of evaluation and understanding of how these patients physiologically develop the ability to propagate COVID-19 more intensely. A simpler way of tracking them is also necessary, given that many infected people are asymptomatic. Many patients also have mild symptoms, suggesting that these individuals could also be classified as possible COVID-19 spreaders.PROSPERO Number: ID 217874 (submitted for publication and is being assessed by the editorial team).