Long-term home oxygen therapy as a strategy to reduce hospitalization time in patients affected by COVID-19 with persistent hypoxemia

Introduction: Some patients affected by COVID-19 remain hospitalized due exclusively to persistent hypoxemia. The indication of long-term home oxygen therapy (LTOT) has become a strategy adopted to reduce the length of hospital stay. The influence of the degree of severity of disease involvement on the effectiveness of the strategy is unknown. Objective(s): To evaluate the clinical characteristics of patients with LTOT indication according to the type of hospitalization in COVID-19 patients. Method(s): An exploratory cross-sectional study of associated factors in stable discharged COVID-19 patients using LTOT were consecutively included. Result(s): Between April and December 2021, a total of 62 patients with LTOT indication were evaluated 15 days after hospital discharge. Of these, 32 of them required intensive care unit (ICU) at some point during their hospitalization. When we compared the ICU and ward care groups, we observed differences in age (55.84 +/-13.5 vs 68.42 +/- 14.8, p=0.001) and time of hospitalization (31.63 +/- 21.8 v 17.65 +/-9, p=0.002). However, we did not identify statistical differences between groups on gender and degree of pulmonary involvement on tomography during hospitalization. After 15 days of discharge, there was no statistically significant difference between the two groups in terms of the number of patients who needed to maintain LTOT for more period (8 vs 11). Conclusion(s): Regardless of the severity of hospitalization, most patients did not need to maintain LTOT for more than 15 days. LTOT proved to be a temporary and effective strategy to shorten the length of stay in both groups in stable COVID-19 patients.

TRANSFORMATION OF A SURGICAL CLINIC FOR COVID-19 PATIENTS: EXPERIENCE REPORT

Objective: to report the transformation process of a surgical inpatient unit into a coronavirus patient care unit and the impact on the health of nursing professionals and users of this service, in the opinion of nurses who experienced the process. Method: this is an experience report of nurses of a surgical inpatient unit of a Federal Teaching Hospital in the Midwest region of Brazil. The experience was presented in three thematic axes: 1) Internal restructuring of the surgical hospitalization unit;2) Training, personnel management and distribution of resources;3) Impacts on worker health. Results: the surgical clinic started to have an exclusive team and flow of single care. Pre-surgical patients were discharged from the hospital with no prospect of returning to the planned treatment. Surgical wards were adapted to isolation wards, and equipment facilities for ventilatory care were optimized. The lack of adequate Personal Protective Equipment and work overload were identified as situations that increase the risk of infection in health professionals. Conclusion: the study demonstrated unhealthy conditions that favor the physical exhaustion and mental suffering of nursing professionals. New research in occupational health planning which supports the work of health service managers in future pandemic scenarios in Brazil is suggested. © 2022, Universidade Federal de Santa Catarina. All rights reserved.

Postpartum period and infection by the new coronavirus: a scoping review

Objective: to map the evidence available in the literature about management and outcomes of postpartum infection by the new coronavirus. Method: scoping review conducted in four electronic sources, following Joanna Briggs Institute guidelines. Data were extracted, analyzed and summarized by four researchers independently. Results: nine of the 188 publications located were reviewed. The evidence, all obtained and published in 2020, was produced in six countries. These publications considered 21 cases of postpartum COVID-19, 15 (71.4%) of which related to severe developments / exacerbation of the disease and six (28.6%) diagnosed after hospital discharge. Conclusion: the mapping points to the occurrence of infection or worsening of the disease in the postpartum period, indicating the need for monitoring of signs and symptoms, diagnostic exploration and accurate treatment and the need for close monitoring of postpartum women diagnosed with COVID-19, whether symptomatic or not. © 2021, Centro de Estudos da Faculdade de Enfermagem da UERJ. All rights reserved.

A TOGAF-based framework for the development of sustainable product-service systems

Companies around the world have sought to produce sustainable products and services with less impact. The impact produced by the COVID-19 pandemic showed that the supply Systems Product-Service (PSS) with an emphasis on sustainability has grown to become one of the main strategic approaches used. The existence of an automated framework that can assist designers in creating a PSS that encompasses the preparation of products and services simultaneously, from its initial stages, has become extremely important. Thus, the objective of this article is to develop a Framework capable of organizing the necessary information for the development of product and service in an integrated way, using the development of information architectures rationale, such as TOGAF, so that in all stages there is fluidity and there are no duplicity terms in its development. The use of information architecture development methods to develop the PSS structure presents a great opportunity to carry out its mapping, thus ensuring that the model is suitable to represent real-world situations. © 2021 The Authors. Published by Elsevier Ltd.

Detection of SARS-CoV-2 in Saliva by RT-LAMP During a Screening of Workers in Brazil, Including Pre-Symptomatic Carriers

The coronavirus pandemic has been causing damage to many nations, as public and private health systems deteriorate by the increasing demand. Some infected patients have culturable severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) even though not presenting any symptoms, and therefore, are probably able to transmit it. Correctly diagnosing and isolating infected patients is an important step towards preventing new infections. Current diagnostic methods rely mainly on reverse transcription quantitative polymerase chain reaction (RT-qPCR). Methods such as reverse transcription loop-mediated isothermal amplification (RT-LAMP) have risen as viable alternatives, as they are cheaper and require less infrastructure, they have the potential to be applied in low-resource scenarios and even at point-of-care. Here we report a colorimetric RT-LAMP assay capable of detecting SARS-CoV-2 in ribonucleic acid (RNA) from saliva. In some cases, the test was able to detect viral RNA before symptom onset and even in a self-reported asymptomatic carrier. It had a limit of detection of 300 copies per reaction and showed a sensitivity of 80%, a specificity of 100%, a general accuracy of 99.59%, and a Cohen's kappa of 0.887. The possibility of detecting positive cases even before the clinical manifestation shows great potential and can contribute to controlling the pandemic.

Fashion consumption: trend of need amid a pandemic

The present study analises the forms of fashion consumption during the covid-19 pandemic. The research started from a historical conception and perception of semiotics in which consumption and expressiveness of fashion are associated with everyday habits. Two steps were used to structure this article: a bibliographic review that can be postulated as the main forms of consumption, such as building significant systems, structuring fashion, as well as possible justifications for such choices. Names such as Lipovetsky (2009), Greimas (1977, 1979), Barbosa (2004), Campbell (2001), Caldas (2006), Svendsen (2010) were used. Followed by the application of a questionnaire to confront ideas and the reality experienced by the interviewed, supporting an analysis by the methodology of Bardin (2010). Therefore, it was verified that the acquisition of fashion products amid the difficulties in accessing clothing stores, their relationship of needs, the systems of meanings and perception of the reality of fashion consumption.

COVID-19 cohort on children with cancer: delay in treatment and increased frequency of deaths. (Special Issue: Transparency in research and publications on COVID-19.)

Objectives: To describe epidemiological characteristics and deaths in children with cancer and COVID-19 at a reference hospital in Recife, Brazil.

COVID-19 cohort on children with cancer: Delay in treatment and increased frequency of deaths

Objectives: to describe epidemiological characteristics and deaths in children with cancer and COVID-19 at a reference hospital in Recife, Brazil. Methods: cohort involving children under the age of 19 underwent cancer treatment during April to July 2020. During the pandemic, real-time reverse transcriptase polymerase chain reaction assay (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS -CoV-2) in nasal / oropharyngeal swab were collected in symptomatic patients or before hospitalization. Those with detectable results were included in this cohort study. The outcomes were delayed on cancer treatment and death. Descriptive analysis was performed and presented in preliminary results. Results: 48 children participated in the cohort, mostly with hematological neoplasms (66.6%.),69% were male, median age was 5.5 years. The most frequent symptoms were fever (58.3%) and coughing (27.7%);72.9% required hospitalization, 20% had support in ICU and 10.5% on invasive ventilatory assistance.66.6% of the patients had their oncological treatment postponed, 16.6% died within 60 days after confirmation of SARS-CoV-2 infection. Conclusions: COVID-19 led a delay in the oncological treatment for children with cancer and a higher mortality frequency when compared to the historical series of the service. It would be important to analyze the risk factors to determine the survival impact. © 2021, Instituto Materno Infantil Professor Fernando Figueira. All rights reserved.

Vertical transmission and COVID-19: a scoping review

OBJECTIVE: Analyze available evidence related to SARS-CoV-2 infection and vertical transmission. METHODS: Scoping review, according to the Joanna Briggs Institute and PRISMA-ScR. Searches were conducted in five electronic databases to find publications about coronavirus infection and vertical transmission. Data were extracted, analyzed and synthesized by three independent researchers using a descriptive approach. RESULTS: The search resulted in 76 publications. After selective steps, 15 articles - retrospective descriptive or case studies - were analyzed, all in English. In order to track the infection, specimens were collected from neonates through nasal swabs and C-reactive protein from breast milk, cord blood, amniotic fluid, placenta and vaginal secretion was analyzed. A small percentage of neonates tested positive for COVID-19, but these cases were not attributed to vertical transmission. CONCLUSION: Vertical transmission could not be demonstrated. Research protocol registered with the Open Science Framework (https://osf.io/fawmv).

Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study

INTRODUCTION: Cardiac involvement seems to impact prognosis of COVID-19, being more frequent in critically ill patients. We aimed to assess the prognostic value of right ventricular (RV) and left ventricular (LV) dysfunction, evaluated by bedside echocardiography (echo), in patients hospitalized with COVID-19. METHODS: Patients admitted in 2 reference hospitals in Brazil from Jul to Sept/2020 with confirmed COVID-19 and moderate/severe presentations underwent clinical and laboratory evaluation, and focused bedside echo (GE Vivid-IQ), at the earliest convenience, with remote interpretation. The association between demographics, clinical comorbidities and echo variables with all-cause hospital mortality was assessed, and factors significant at p<0.10 were put into multivariable models. RESULTS: Total 163 patients were enrolled, 59% were men, mean age 64+/-16 years, and 107 (66%) were admitted to intensive care. Comorbidities were present in 144 (88%) patients: hypertension 115 (71%), diabetes 61 (37%) and heart failure 22 (14%). In-hospital mortality was 34% (N=56). In univariate analysis, echo variables significantly associated with death were: LV ejection fraction (LVEF, OR=0.94), RV fractional area change (OR=0.96), tricuspid annular plane systolic excursion (TAPSE, OR=0.83) and RV dysfunction (OR=5.3). In multivariate analysis, after adjustment for clinical and demographic variables, independent predictors of mortality were age>=63 years (OR=5.53, 95%CI 1.52-20.17), LVEF<64% (OR=7.37, 95%CI 2.10-25.94) and TAPSE<18.5 mm (OR=9.43, 95% CI 2.57-35.03), and the final model had good discrimination, with C-statistic=0.83 (95%CI 0.75-0.91). CONCLUSION: Markers of RV and LV dysfunction assessed by bedside echo are independent predictors of mortality in hospitalized COVID-19 patients, after adjustment for clinical variables.

Potential loss in years of life arising from COVID-19 in Brazilian regions: evaluation of the six first months of pandemic

This research note estimates the impact of deaths by Covid-19 on life expectancy in Brazil and the Regions for the first six months of 2020. Based on data from Datasus and the decreasing life tables, it was estimated that deaths by Covid-19 that occurred until August 18, 2020 had a statistically negative impact on life expectancy at birth, both male (-1.05 years) and female (-0.85 years). In regional terms, the greatest loss in years of life is estimated in the North (-1.65 years for men and-1.48 years for women), while in the South it was-0.5 year for men and-0.36 for women. The results of the logistic model for the country show that Covid-19 mortality tends to be higher among males, blacks, people with low education level and people over 65 years old. Comorbidities increase the chance of death, especially liver disease and chronic kidney disease. Such analyzes were further disaggregated by large Brazilian regions. © 2022, Associacao Brasileira de Estudos Populacionais. All rights reserved.