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Introduction: Diabetes mellitus is associated with poorer outcomes in patients with coronavirus disease (COVID-19). The mechanisms for this association are not fully elucidated. We aimed to evaluate the clinical characteristics and outcomes of hospitalized patients with type 2 diabetes (T2DM) and COVID-19, as well as the impact of blood glucose control on mortality. Material and Methods: In this retrospective study, we included 97 patients (38 with T2DM, 59 without diabetes). We compared demographic characteristics, comorbidities, admission findings and outcomes between patients with and without diabetes. To assess glycaemic control, individual derived time in range (70-180 mg/dL) was derived as the proportion of values within range. Derived time above range was calculated as the proportion of values above range. Results: The fatality rate of patients with diabetes was 36.8%. Among these patients, nonsurvivors presented with higher Pneumonia Severity Index score (159 +/- 36 vs 109 +/- 30, p=0.001), a higher N-terminal brain natriuretic peptide (5521 [4256-15280] vs 1541 [288-2349] pg/mL, p=0.047), a lower PaO2/FiO2 ratio (214 [181-259] vs 300 [248-347], p=0.033) and were more likely to have bilateral lung involvement at admission (78.6% vs 29.2%, p=0.013). Rates of acute kidney injury (85.7% vs 33.3%, p=0.003), acute heart failure (57.1% vs 25.0%, p=0.048) and secondary bacterial infection (64.3 vs 26.1%, p=0.022) were higher in deceased patients. Nonsurvivors had a lower derived time in range (38% vs 73%, p=0.020) and a higher derived time above range (62% vs 27%, p=0.020). Conclusion: A poorer glucose control assessed by lower derived time in range during hospitalization was associated with in-hospital death.
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In December 2019, the world experienced a pandemic that called into question what we always took for granted, such as our freedom of movement. Tough restrictions imposed across the world were necessary to stem the transmission of the COVID-19 virus and have largely affected the mobility and transport sector. In a first phase, due to the mandatory confinement that forced people not to leave their houses;in a second phase, when the measures eased and people started to have the need to move again, it was necessary to look for alternative means of transport that avoided the gathering of people. In view of the advances that were being made in recent years towards a Mobility-as-a-Service paradigm that advocates multimodal and shared transport, the pandemic has raised many challenges. In this paper, a statistical analysis of the mobility data made available by Apple from January 2020 to March 2021 is presented, where the reduction in the use of public transport becomes evident, leading us to question what the future of Mobility-as-a-Service will be as its foundation advocates, among other aspects, the use of a shared transport model. Despite the challenges that the pandemic has brought to Mobility-as-a-Service, a set of opportunities are presented that can be used in the short and medium term to strengthen the paradigm and enhance its massive adoption. © 2021 IEEE.
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This article aims to show that the expectation of a robust and effective response to the sanitary and economic damages caused by the COVID-19 pandemic, through the strengthening of the institutional culture of cooperative federalism, was frustrated. The result has been related to the violation of subnational autonomy by the Federal Government, which has obstructed a historical movement of decentralization and cooperative federalism, fostering litigation and preventing the construction of coordinated institutional strategies with shared responsibilities.
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Introdução: Descrever o perfil epidemiológico de crianças com infecção confirmada por SRAG internadas no Hospital Infantil João Paulo II (HIJPII), referência em doenças infectocontagiosas, entre março de 2020 e agosto de 2021. Método: Trata-se de um estudo realizado pelo Núcleo de Vigilância Epidemiológica Hospitalar (NUVEH) do HIJPII, utilizando os dados das fichas de notificação de SRAG, Este estudo foi aprovado pelo Comité de Ética em Pesquisa da FHEMIG sob parecer: 4.312.966. Resultados: Entre março de 2020 e agosto de 2021, 2702 crianças internaram no HIJPII e foram notificados com SRAG. Foram realizados 2269 testes RT-PCR para SARS-CoV-2, 1026 pacientes realizaram teste rápido de antígeno e/ou fizeram o painel viral na Fundação Ezequiel Dias. A etiologia viral foi identificada em 692 crianças: 278 (40,2%) positivos para vírus sincicial respiratório (VSR), 174 (25,1%) positivos para rinovírus, 164 (23,7%) positivos para SARS-CoV2, 34 (4,9%) positivos para influenza A e/ou B, e 5,9% foram positivos para outros vírus (25 bocavirus, 3 parainfluenza, 13 adenovírus e 1 coronavírus sazonal). O diagnóstico de VSR foi realizado por RT-PCR em 72% e teste rápido de antígeno em 28%. SARS-CoV-2 foi detectado por RT-PCR em 81% e por teste rápido de antígeno em 19%. A idade variou entre 15 dias de vida e 18 anos, mas 72,9% eram menores de 6 anos, 55,5% do sexo masculino, 82% moravam em Belo Horizonte ou na região metropolitana. Entre as manifestações clínicas mais frequentes foram febre, tosse, diarreia, esforço respiratório, cianose e saturação menor que 95%. Nos casos mais graves as crianças tinham comorbidades, as mais frequentes: displasia broncopulmonar, doença neurológica crônica não progressiva, obesidade, anemia falciforme e cardiopatia. A letalidade por SRAG no HIJPII no período foi de 20,5% (4 crianças com SARS-CoV-2 e uma criança com VRS);entretanto apenas 29,4% dos óbitos por SRAG tiveram a etiologia viral identificada por não terem coletado painel viral. Conclusão: Os resultados encontrados reforçam a necessidade da realização do painel viral, para melhorar os dados da Vigilância Epidemiológica. Sua solicitação foi reduzida na pandemia, devido ao alto número de internações e necessidade de leitos, optou-se por realizar testes rápidos. Entretanto, como no HIJPII estão disponíveis testes rápidos apenas para VRS, SARS-CoV-2 e influenza, muitas crianças com SRAG ficaram sem identificação viral.
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Since its inception, COVID-19 has changed several dynamics in society, both on a personal and professional level. Mobility was one of the most affected aspects, as a result of the necessary social distancing and preventive measures that had to be enacted by the various countries and which restricted, at various times, freedom of movement. The impact that COVID-19 had, and still has, on mobility is important to be understood so that the necessary measures can be taken in order to return to normality and, for example, not regress in the steps that were being taken in encouraging the use of public transport as a measure to combat the carbon footprint as well as traffic congestion in cities. This paper intends to analyze the reality of Spain and Portugal, in the period between May 10th and July 2nd, 2021, in which both countries had already finished restricting mobility measures. The study used data from Google Community Mobility Reports and was done by regions, taking into account the average age of inhabitants and the number of inhabitants in each region. The analysis focused on different categories of places such as retail and recreation, groceries and pharmacies, parks, transit stations, workplaces, and residential. Author
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This work aims to evaluate the possible relations between the confirmed daily cases of COVID-19 and the environmental parameters for the Cuiaba-Varzea Grande conurbation in the state of Mato Grosso, Brazil. The data sets used to cover the rainy-dry periods, from January to December 2020, were achieved from a database of government institutions, and processed through the Spearman correlation test. Our results showed that atmospheric pressure and fire radiative power has a significant positive correlation, suggesting that these parameters favor the transmission of COVID-19. On the other hand, the relative humidity of the air and the total column of water vapor showed a significant negative correlation with the number of confirmed daily cases of COVID-19, which indicates that the water vapor present in the atmosphere acts in the regulation of virus transmission. Thus, taking into account the results obtained, there is a need for collaborative policies and measures among the three spheres of executive power in Brazil, to act in the surveillance of fire cases, which can favor the transmission of COVID-19. In addition, prevention and protection measures aimed at reducing the spread of coronavirus continue to be indispensable.
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This study aimed to raise coping strategies to deal with social isolation during the COVID-19 pandemic. The spread of the Covid-19 virus has turned into a pandemic as it spread throughout the world, leading to mobility restrictions for billions of people who have faced varying degrees of confinement. This situation has led to extreme emotions of fear, sadness, and feelings of anxiety, with impacts on people's psychological health. Research has shown that the ability to adequately regulate one's own emotions is important for mental physical, and social health and it is relevant to study how people deal with their emotions in stressful situations, such as the current context of isolation in the pandemic. A questionnaire was applied electronically to 463 participants from all over Brazil over the age of 18 years. Data analysis was qualitative, based on responses to an open item that asked about coping strategies to deal with social isolation. The results showed the use of varied strategies to minimize stress and increase well-being. Cognitive reassessment, the search for social support, and distraction were highlighted.
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Spain is one of the countries most affected by COVID-19. Until May 5, 2021 there have been 3.54 million people infected and 78,399 deaths according to the Johns Hopkins Institute. This has meant that Spain is one of the countries in the world where the most restrictive measures have been adopted and which have had a strong impact on the economic, social, and mental health of citizens. One of the consequences of this pandemic is a severe increase in the strain on the healthcare system. Many of those infected had to be admitted to hospitals and even to Intensive Care Units (ICU). In this scenario, it is essential to reduce traffic accidents in order to avoid overcrowded hospitals. However, the Spanish General Directorate of Traffic highlights in several traffic reports that despite the decrease in the volume and distance of trips, the number of traffic accidents has not altered significantly and even during some periods has been higher than before the pandemic. The aim of this work is to establish if there has been a change in the driving style of drivers during the pandemic and to identify the group of people adopting a more inefficient and unsafe driving style. To this end, a study was carried out with 30 volunteers and their current driving style was compared with their driving style before the pandemic. The results show that drivers have adopted a more aggressive driving style than before the pandemic, especially women and those who have suffered anxiety due to COVID-19.
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From the moment that COVID-19 was considered a pandemic disease, it began a constant search for a vaccine and/or medicine that would bring relief or quick recovery to individuals affected by the virus. Although there are several scientific evidences that justify the general benefits of immunization, vaccine hesitation remains in constant growth among the Brazilian population, due to beliefs and imprecise and misleading content that rapidly proliferates online, favoring the resurgence of pathologies that can be avoided through vaccination. The acceptance of the Covid-19 vaccine by the Brazilian population will also be a guide for future vaccination studies in Brazil. The aim of this study is to describe the profile of the Brazilian population regarding vaccine hesitation and its supposed future risks. From the data that were collected, future research and intervention actions can be traced. The sample consisted of 158 participants from various regions of the country, aged 18 years or over. Data were obtained through forms in electronic format, made possible by the free tool offered by Google: Google Forms. Through the data obtained, it was possible to show that although several attitudinal, political, and religious beliefs associated with vaccination generate vaccine hesitation in the population, most participants in this study did not show significant hesitation about the vaccine. The results indicated a favorable sample for vaccination, it is believed that these results are related to the characteristics of the sample, which is formed by individuals with a high level of education.
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The contact tracing mobile Apps are one of the many initiatives to fight the COVID-19 virus. These Apps use the Exposure Notification (EN) system available on Google and Apple’s operating systems. However, contact tracing applications depend on the availability of Bluetooth interfaces to exchange proximity identifiers that, if compromised, directly impact the effectiveness of the apps. This paper discloses and details the Advertising Overflow attack, a novel internal Denial of Service (DoS) attack targeting the EN system on Android Operating System (OS) devices. The attack is performed by a malicious App that occupies all the Bluetooth advertising slots in an Android device, effectively blocking any advertising attempt of EN. The impact of the disclosed attack and other already disclosed DoSbased attacks, namely Battery Exhaustion and Storage Drain, was tested using two target smartphones and other six smartphones as attackers. The results show that the Battery Exhaustion attack imposes a battery discharge rate 1.95 times superior to the baseline. Regarding the Storage Drain, the storage usage increased more than 30 times the baseline results. The results of the novel attack reveals that a malicious App is able to block the usage of Bluetooth advertising by any other App by any chosen time period, canceling the operation of the EN system and compromising the efficiency of any COVID’s contact tracing App based on EN. CCBY
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COVID-19, that appeared in China on December 2019, led to a Global Public Health Emergency decreed by World Health Organization on 30 January 2020. With several lockdowns taking place worldwide, various tasks and activities started to rely on technology to deliver services and elementary goods. In an attempt to stop the spread and help save lives, we have assisted to the appearance of several software applications using AI, big data, robots and drones for several and distinct purposes and domains of the society, business and citizen´s daily lives, claiming the importance technology can have in a pandemic crisis. This paper addresses several domains such e-commerce, the health sector, education and public services, in order to summarize the impacts during this COVID-19 pandemic crisis and refers to how technology was used so far. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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The COVID-19 pandemic has emerged as one of the most crucial health emergencies in the last decade where almost all entities of a nation’s ecosystem like inhabitants, businesses, governments, economies, and environment are impacted. The large volumes of epidemiological, clinical, personal, and environmental data generated during any pandemic can provide useful insights about the underlying causes, symptoms, relations, and correlations, which if analyzed can assist in mitigating the impact to a great extent. The cheap and easy connectivity and communication provided by the social media platforms (SMP) have established them as one of the most preferred mediums of communications among the masses. The data generated by these platforms can be analyzed in context of the ongoing COVID-19 crisis to provide critical information and insights related to the ground level realities like spread and severity of infection, the state of implementation of control measures, the mental state of individuals, and their needs. The tweets and comments of the users can provide information about the current situation and intensity of the problems in the affected regions. With the help of techniques like sentiment analysis and web mining, we can identify the emergent requirements and needs (like food, shelter, medicine, medical emergencies, security, etc.) of the population in the COVID-19-affected areas. With this chapter we aim to identify several use cases where the big medical data from the patients, epidemiological data, social media data, and environment-related data can be used to identify patterns, causes, and other growing factors of the COVID-19 pandemic with a goal to mitigate the damages and contain further spread of the disease. The chapter also discusses the impact of a preferred mitigation measure of nationwide lockdown on the number of new novel coronavirus-positive patients as well as the impact on the environment by analyzing the available data. Since the tourism industry is now of the worst hit businesses, we also discussed the impact of COVID-19 on tourism industry. Furthermore, we identify the challenges associated with handling the massive amount of data generated during such pandemics. Finally, the future avenues of using big data for effectively devising predictive mechanisms and techniques to contain such pandemics in the initial stages are discussed. The chapter also discusses the importance of edge/fog technologies and IoT to identify possible use cases and where immediate point of contact actions is needed to mitigate the situations. Since edge computing facilitates calculations near the origin of data, it is imperative to understand the potential use cases in times of COVID-19-like pandemics. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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OBJECTIVES: This study aimed to estimate the incidence and mortality rates of coronavirus disease 2019 (COVID-19) in Brazilian children and to analyze its relationship with socio-economic inequalities in a state-level analysis. STUDY DESIGN: This is a nationwide register-based study. METHODS: To estimate the incidence and mortality rates of COVID-19 in Brazilian children aged 0-19 years, we extracted data of confirmed cases and deaths from the de-identified microdata catalog and official bulletins of the 27 Brazilian states' health department websites until September 3, 2020. Social and economic inequalities were evaluated using the Social Vulnerability Index and Gini coefficient, respectively. The relationship between COVID-19 rates in Brazilian children and socio-economic vulnerability at the state level was analyzed using Spearman's rank correlation. RESULTS: Of the 3,998,055 individuals with COVID-19 included in our database, 335,279 (8.4%) were children aged 0-19 years. Eight hundred deaths in children were registered, which accounts for about 0.7% of the deaths related to COVID-19 in the country. There were important differences in the incidence and mortality rates among Brazilian regions, and a correlation between mortality rates and social (ρ = 0.519; P-value = 0.007; effect magnitude: moderate) and economic (ρ = 0.615; P-value < 0.001; effect magnitude: strong) inequalities was found in a state-level analysis. CONCLUSIONS: This population-based study showed important regional differences in COVID-19 estimates for children in Brazil and a relationship between mortality rates and socio-economic inequalities. The knowledge of sociogeographic differences in the estimates of COVID-19 is crucial to planning societal strategies and local decision-making to mitigate the effects of disease in the pediatric population.