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Introduction: In early 2020, restrictions were established to control the transmission of COVID-19, such as the suspension of elective public health care. Dental teleservice has become an alternative to patient follow-up. In Brazil, the Federal Council of Dentistry published Resolution 226/2020, allowing the performance of dentistry at a distance. Objective(s): To assess dentists' satisfaction with the use of the oral telediagnosis service during the COVID-19 pandemic. Material(s) and Method(s): Cross-sectional and quantitative study. An online questionnaire was released to 636 dentists in the North of Minas Gerais, Brazil, between May and September 2022, with 298 respondents. The database was built using the Statistical Package for the Social Sciences, 24.0 software. This study was approved by the CEP (#5.267.570). Result(s): There was a predominance of dentists working in the public health network (86.2%;n=257). Most profession-als reported a drop in face-to-face calls during the pandemic (94.2%;n=281), and 86.2% (n=257) had losses from their activities. Teleservice resources were used during social isolation by 75.8% (n=226) of dentists, mainly for patient follow-up (63.7%;n=190). Consultation by phone was the main virtual method (63.7%;n=190). Regarding teleservice, 58.6% (n=119) of dentists realized the system was easy to use, and 50.2% (n=101) would like to continue using it after the pandemic. Conclusion(s): This is the first Brazilian study to assess dentists' satisfaction with teleservice. It is concluded that teleservice can contribute to early diagnosis and assistance by professional users.
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Background: Recent studies reported low rates of seroconversion response to COVID-19 vaccination in patients (pts) with hematologic malignancies (HMs). Vaccine choice among the 3 FDA-authorized products (BNT162b2/Pfizer-BioNTech, mRNA-1273/Moderna, or Ad26.COV2.S/J&J), prior therapy, and disease-specific factors may affect seroconversion. Addressing these factors may improve seroconversion rates and identify pts at risk of severe COVID-19 infection despite vaccination. Methods: We conducted a retrospective study of adults with HMs vaccinated in our center between 2/2021 and 7/2021, excluding pts with prior COVID-19 infection. Seroconversion was assessed by the qualitative SARS-CoV-2 Total Antibody Test (IgG/IgM against Receptor Binding Domain [RBD], Wondfo USA, Willowbrook, IL). A subset of samples was tested by the semi-quantitative Abbott AdviseDx SARS-CoV-2 IgG II assay (IgG against RBD). For univariate associations (UVA) we used Fisher's exact test for categorical variables, and fractional polynomial fits for continuous variables to examine non-linearity. Multivariable analysis (MVA) used a robust Poisson model reporting risk ratio (RR) with 95% confidence intervals (CI). Results: Among 239 eligible pts, median age was 70 (range, 28-94), and 112 (47%) were female. HMs included aggressive B-cell lymphomas (n=74, 31%), indolent B-cell lymphomas (n=52, 22%), chronic lymphocytic leukemia (CLL, n=30, 13%), other lymphomas (n-19, 8%), plasma cell neoplasms (n=43, 18%), and myeloid cancers (n=21, 9%);140 pts (59%) received BNT162b2/Pfizer, 74 (31%) mRNA-1273/Moderna, and 23 (10%) Ad26.COV2.S/J&J vaccines (2 pts had undetermined vaccine type). HM was active in 100 pts (42%), whereas 108 (45%) pts were in remission after treatment, and 31 (13%) on watchful waiting (WW, never treated);141 (59%) had a prior exposure to an anti-B-cell monoclonal antibody, and 22 (9%) prior stem cell transplantation. Overall, 99 pts (41%;binomial 95% CI, 35-48%) showed post-vaccination seroconversion upon testing at median 10 weeks from first vaccine. Seroconversion was significantly less frequent among pts with lymphomas compared with plasma cell or myeloid neoplasms (overall P=.020;Fig A). It was also less frequent after prior anti-B-cell antibody exposure (29% vs 59%, P<.0001;Fig. B), and in those with active disease (28%, vs 49% for remission [P=.0027], vs 58% for WW [P=.0045];Fig. C). Furthermore, seroconversion was significantly more frequent after mRNA-1273/Moderna vaccine (57%) compared with BNT162b2/Pfizer (36%, P=.006) or Ad26.COV2.S/J&J (22%, P=.004;Fig. D). It was not associated with age (Fig. E), WBC (Fig. G), or time from vaccination (Fig. I), but was significantly higher with increased lymphocyte count (P<.0001;Fig F) and time elapsed from last chemotherapy (P=.0039;Fig. H). In a MVA (Fig. J), vaccination with mRNA-1273 remained significantly associated with higher rate of seroconversion compared with BNT162b2 (RR=0.59;95%CI, 0.44-0.79) or Ad26.COV2.S (RR=0.35;95%CI, 0.16-0.77). Higher seroconversion rate was also associated with remission (RR=1.98;95%CI, 1.42-2.76) or WW status (RR=1.72;95%CI 1.02-2.89) compared with active disease, and higher lymphocyte count. Exposure to anti-B-cell antibodies remained associated with lack of seroconversion (RR=0.66;95%CI, 0.44-0.99). Seroconversion was borderline less frequent in CLL than lymphomas, and higher with plasma cell or myeloid disorders. Results were similar in the subset of pts (n=191) with prior treatment, adjusting for time from last chemotherapy(data not shown). The anti-COVID-19 IgG titers on semiquantitative test (n=47, all after mRNA-based vaccines) were also lower in pts with active disease compared with those in remission (P=.065) or under WW (P=.028), and in those with prior anti-B-cell antibody (P=.0095). Conclusions: Pts with HMs demonstrate overall low rates of seroconversion after vaccination against COVID-19, particularly when they have active disease or are on/after B-cell depleting monoclonal antibody therapy. The mRNA vaccines (particularly mRNA- 273) appear to have elicited superior responses compared with the adenovirus-based product. Pts with active HMs or those within 2 years of last therapy should be particularly aware of the risk of infection despite vaccines and should be considered for strategies to enhance anti-COVID-19 immunity regardless of age. [Formula presented] Disclosures: Olszewski: TG Therapeutics: Research Funding;PrecisionBio: Research Funding;Celldex Therapeutics: Research Funding;Acrotech Pharma: Research Funding;Genentech, Inc.: Research Funding;Genmab: Research Funding.
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Objective: To describe the profile of deaths and the lethality of Severe Acute Respiratory Syndrome (SARS) due to COVID-19 in hospitalized children and adolescents in Brazil. Methods: This was a cross-sectional study conducted with data from the SARS notification forms of children and adolescents (0 to 19 years old) with laboratory-confirmed COVID-19. Notifications with complete progression of SARS due to COVID-19 were included, up to the 38th Epidemiological Week of 2020. Results: 6,989 hospitalizations were investigated, 661 died, resulting in 9.5% hospital lethality. Higher lethality rates were observed among children under 1 year of age (14.2%), female children and adolescents (9.7%), the indigenous (23.0%), and those living in rural areas (18.1 %), as well as in the Northeast (15.4%) and North (9.7%) regions of Brazil. Conclusion: Differences in hospital mortality were found according to sociodemographic characteristics and marked regional inequalities.
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OBJECTIVES: Although research in relation to new vaccines for the coronavirus, SARS-CoV-2 (COVID-19), is ongoing, it has been reported that medical teams are also considering the use of antiviral drugs in patients in order to verify their effectiveness when infection signs and symptoms present, mainly in stages one and two of the disease. METHODS: For the selection of studies, the combination based on the Medical Subject Heading Terms (MeSH) was used, and the databases Medline (Pubmed), LILACS, SciELO, SCOPUS, Web of Science, and BIREME were searched. The search period for articles consisted of manuscripts published between January 2010 and July 2020 without language and localization restrictions. RESULTS: Initially, 20 articles were selected and then reduced to 19 after exclusion based on repetititve articles. Titles and abstracts were analyzed, and 14 articles were excluded because they did not meet the inclusion criteria and did not answer the guiding question. Studies show that patients receiving certain medications in the initial stages (one and two) indicate a reversal of complications during hospitalization or often do not require hospitalization in addition to being discharged in a shorter period of time. CONCLUSION: Studies have reported that effective drugs for treating COVID-19 exist. In addition, this study emphasizes the importance of performing therapeutic interventions in the initial stages of infection aimed at reversing the disease and minimizing public health costs.