ABSTRACT
Introduction: SARS-CoV-2 pandemic has highlighted the importance of using Telehealth technologies to offer medical care to patients. Teleneurology can provide access to specialists with quality and safety, in addition to presenting great potential in reducing care gaps, especially in the Brazilian public system. Objective: Demonstrate the profile and impact of the population assisted by Teleneurology during the SARS-CoV-2 pandemic in 2020 and 2021, in addition to the outcomes at the end of this strategy in a city located in the northeast Brazil's territory. Methodology: Retrospective and cross-sectional analysis of medical records of patients treated by the team of neurologists at Hospital Alemão Oswaldo Cruz, through the Regula Mais Brasil Collaborative project in 2020 and 2021, using telehealth strategies. Results: 657 teleconsultations (video or phone) were carried out, all from users of the public health system, and referred for neurological assessment from primary care. The median age was 45,03 ± 15,9 years and 79,3% were women. According to the international code of diseases (ICD-10), the main diagnoses referred to were Headache (51.6%), followed by Epilepsy (16.6%) and Stroke (ischemic and hemorrhagic) at 2.8%. After the first teleconsultation, 56.2% were followed by teleconsultation and 27.4% returned to primary care. Conclusion: Using teleneurology as strategy helped to reduce the gaps in healthcare due to the closing of Primary Care Centers during the coronavirus pandemic, avoided unnecessary displacements, especially of patients with several comorbidities, in addition to ensuring the safety of users, since they were cared for in their respective homes.
ABSTRACT
This study assesses the relationship between COVID-19 anxiety and subjective well-being in terms of the mediating role of COVID-19 preventive behaviors. Additionally, the contribution of sociodemographic factors (sex and age) and risk perception on COVID-19 anxiety and its potential measurement invariance was tested in 5655 participants from 12 countries in Latin America and the Caribbean. A mixture of both latent and observable variables were analyzed using a system of structural equations. The Coronavirus Anxiety Scale (CAS), Preventive COVID-19 Infection Behaviors Scale (PCIBS) and single-item measures were used to assess the perceived probability of death, perceived severity and concern about transmitting COVID-19. The results indicated that there is a significant and relevant direct effect of COVID-19 anxiety on participants' well-being. Furthermore, COVID-19 anxiety significantly predicted both preventive behavior (beta = .29, p < .01) and well-being (beta = -.32, p < .01). The effects of COVID anxiety and preventive behavior explained 9.8% of the variance in well-being (R-square = .098);whereas, 8.4% of the variance in preventive behavior was associated with COVID anxiety (R-square = .084). Likewise, perceived likelihood of death from COVID, perceived severity of COVID, and concerns about COVID transmission were positively related to anxiety. Age was negatively related to anxiety, with men being less anxious than women. The results are invariant by country, i.e., the broad relationships found in the combined sample are also present in each individual country. The findings indicate that, although the exact relationships between variables may vary between countries, there are enough similarities to provide useful information about the impact of the COVID-19 pandemic in each of the countries included in the study.
ABSTRACT
Background and aims: COVID-19 disease has quickly evolved into a full-scale pandemic. Little is known about the predictors of the impact of COVID-19 pandemic in multiple sclerosis (MS) patients' lives. Methods: A cross-sectional study using an online survey was conducted from 21st December 2020 through 3rd January 2021. Patients with MS followed-up at Egas Moniz Hospital (Lisbon) were invited to participate. We assed participants self-reported impact of COVID-19 pandemic in their lives. The effect of the demographic, clinical and psychosocial factors was analyzed through univariable and, when applicable, multivariable analysis. Results: We obtained 256 valid responses (response rate 81%). The median age of the participants was 45 years [18- 77] and most of them were females (187, 73.0%). Overall, 205 (80.1%) patients reported that COVID-19 has had a substantial impact in their lives - extreme (40, 15.6%) or high (165, 64.5%). In the univariate analysis, greater impact from COVID-19 was associated with female gender(p=0.011), age (p=0.026), being professionally active(p<0.010), having more concerns about the pandemic (p<0.001), reporting a higher perceived risk to get a future COVID-19 infection (p=0.002) and a possible severe infection (p=0.008). The multivariate regression analysis revealed that factors predicting greater impact from COVID-19 were age <45 years (OR 2,409;CI95% 1.112- 5.220;p=0.026), being professionally active (OR 2.374 CI95% 1.139-4.947;p=0.021) and having more concerns about the pandemic (OR 17.928 CI95% 7.020-45.790;p<0.001). Conclusion: Younger and professionally active MS patients are suffering from COVID-19 pandemic. Although they could be at lower risk of severe infection, doctors should be aware of their concerns.
ABSTRACT
The understanding of health care demands and possible access barriers may support policymaking and best practices targeting the lesbian, gay, bisexual, transgender, and related identities (LGBT+) population. The aims of the Brazilian LGBT+ Health Survey were to characterize the LGBT+ population during the COVID-19 pandemic and to specify the characteristics of the COVID-19 pandemic in this population. This is a cross-sectional online study, with a convenience sample of 976 individuals identified as LGBT+, aged 18 years or older from Brazil. It allows investigations of sexuality, discrimination, internal homophobia, health-related behaviors, and health care access. The study adopts a conceptual framework (i.e., validated tools and measures) common to other epidemiological studies, allowing comparisons. We describe the study methodology, some descriptive results, and health-selected indicators compared with the Brazilian National Health Survey. Most of the respondents were from Southeast Region (80.2%), mean aged 31.3 (± 11.5 years). Regarding COVID-19, 4.8% tested positive. Both weekly episodes of discrimination (36%) and depression prevalence (24.8%) were high among the LGBT+ population in Brazil, highlighting mental health and homophobia as major concerns in the LGBT+ context during the pandemic. Although a decade has passed since the institution of the Brazilian National Policy for Comprehensive LGBT Health, appropriate training of health professionals to offer adequate services is still needed. Knowledge of the specific health demands of this group might guide person-centered best practices, promote sexual minority high-acceptance settings, and contribute to higher equity during the pandemic.