ABSTRACT
The COVID-19 pandemic caused by the SARS-CoV-2 virus led to changes in the lifestyle and human behaviour, which resulted in different consumption patterns of some classes of pharmaceuticals including curative, symptom-relieving, and psychotropic drugs. The trends in the consumption of these compounds are related to their concentrations in wastewater systems, since incompletely metabolised drugs (or their metabolites back transformed into the parental form) may be detected and quantified by analytical methods. Pharmaceuticals are highly recalcitrant compounds and conventional activated sludge processes implemented in wastewater treatment plants (WWTP) are ineffective at degrading these substances. As a results, these compounds end up in waterways or accumulate in the sludge, being a serious concern given their potential effects on ecosystems and public health. Therefore, it is crucial to evaluate the presence of pharmaceuticals in water and sludge to assist in the search for more effective processes. In this work, eight pharmaceuticals from five therapeutic classes were analysed in wastewater and sludge samples collected in two WWTP located in the Northern Portugal, during the third COVID-19 epidemic wave in Portugal. The two WWTP demonstrated a similar pattern with respect to the concentration levels in that period. However, the drugs loads reaching each WWTP were dissimilar when normalising the concentrations to the inlet flow rate. Acetaminophen (ACET) was the compound detected at highest concentrations in aqueous samples of both WWTP (98. 516 µg L - 1 in WWTP2 and 123. 506 µg L - 1in WWTP1), indicating that this drug is extensively used without the need of a prescription, known of general public knowledge as an antipyretic and analgesic agent to treat pain and fever. The concentrations determined in the sludge samples were below 1.65 µg g - 1 in both WWTP, the highest value being found for azithromycin (AZT). This result may be justified by the physico-chemical characteristics of the compound that favour its adsorption to the sludge surface through ionic interactions. It was not possible to establish a clear relationship between the incidence of COVID-19 cases in the sewer catchment and the concentration of drugs detected in the same period. However, looking at the data obtained, the high incidence of COVID-19 in January 2021 is in line with the high concentration of drugs detected in the aqueous and sludge samples but prediction of drug load from viral load data was unfeasible.
ABSTRACT
Objective: To assess the sleep quality of Brazilian adolescents during the COVID-19 pandemic. Methods: Observational, analytical, cross-sectional study with data from a questionnaire on individual characteristics and health, Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index (PSQI). 153 adolescents participated - 61.4% females, 38.6% males, aged 13 to 18 years, enrolled at school. Results: 58.2% worsened their sleep quality during the pandemic. In the PSQI, 22 (14.4%) had a good, 104 (68%), a poor sleep quality, 27 (17.6%), suggestive of sleep disorders. Excessive daytime sleepiness occurred in 44.4% of the students. Significant associations appeared between sleep and decreased school motivation (p = 0.005), and between sleep and sex (p = 0.015). The pandemic affected more the females - 25.5% reported worse sleep quality, 67% had PSQI scores suggestive of sleep disorders; 46 (30.1%) students reported stress, anxiety, sadness -76.1% were girls. Discussion: Adolescents had impaired sleep during the COVID-19 pandemic, reinforcing their sleep must be assessed in critical periods.
ABSTRACT
Information on the risk factors for COVID-19 mortality in low- and middle-income countries is still scarce. In this retrospective cohort study, we analyzed the factors associated with COVID-19 mortality in hospitalized patients in a poor area of Brazil. Logistic regression was used to identify factors independently associated with mortality, including gender, age, and the presence of underlying medical conditions. A total of 1,207 patients were included in the analysis, and a 1.5-fold increase in COVID-19 mortality was found among patients aged > 65 years with hypertension and diabetes (odds ratio [OR]: 1.50, 95% CI: 1.02-2.19). Moreover, infectious disease (OR: 4.31, 95% CI: 1.39-13.39), kidney disease (OR: 2.59, 95% CI: 1.27-5.27), and heart disease (OR: 2.00, 95% CI: 1.31-3.04) were also predictive for COVID-19 in-hospital death. This large cohort provides important data on potential factors associated with COVID-19 mortality in Brazil.