ABSTRACT
Introduction With the COVID-19 pandemic, hospitals in low-income countries were faced with a triple challenge. First, a large number of patients required hospitalization because of the infection’s more severe symptoms. Second, there was a lack of systematic and broad testing policies for early identification of cases. Third, there were weaknesses in the integration of information systems, which led to the need to search for available information from the hospital information systems. Accordingly, it is also important to state that relevant aspects of COVID-19’s natural history had not yet been fully clarified. The aim of this research protocol is to present the strategies of a Brazilian network of hospitals to perform systematized data collection on COVID-19 through the World Health Organization (WHO) Platform. Methods and Analysis This is a multicenter project among Brazilian hospitals to provide data on COVID-19 through the WHO global platform, which integrates patient care information from different countries. From October 2020 to March 2021, a committee worked on defining a flowchart for this platform, specifying the variables of interest, data extraction standardization and analysis. Ethics and Dissemination This protocol was approved by the Research Ethics Committee (CEP) of the Research Coordinating Center of Brazil (CEP of the Hospital Nossa Senhora da Conceição), on January 29, 2021, under approval No. 4.515.519 and by the National Research Ethics Commission (CONEP), on February 5, 2021, under approval No. 4.526.456. The project results will be explained in WHO reports and published in international peer-reviewed journals, and summaries will be provided to the funders of the study. Strengths and limitations of this study As the study involves a convenience and non-probabilistic sample of patients hospitalized in health units, it may not represent the population of patients with COVID-19 hospitalized in the country. However, the information generated by this research can serve as a basis for the development of maps of the evolution of SARS-CoV-2 infection and public policies to face pandemics. It is a study that uses secondary data, and therefore, information bias may occur, but on the other hand, it has a low cost and facilitates a population-based study with national coverage. Article Summary This is a multicenter project among Brazilian hospitals to provide data on COVID-19 through the WHO global platform. It is expected to deepen knowledge about the pandemic scenario and help hospital institutions to develop preventive measures, health service protocols and strengthen the training of teams in the existing complications.
Subject(s)
COVID-19ABSTRACT
Background: Ecologic studies support non-pharmacologic measures to protect against SARS-CoV-2, but few studies have evaluated their effects at the individual level in the community. We aimed to assess the magnitude of the associations of social distancing and mask use with laboratory-confirmed infection by SARS-CoV-2 in adults living in Porto Alegre, Brazil, a city with 1,483,771 inhabitants.Methods: We conducted a population-based case-control study from late April to June 2020. Cases came from a list of all cases mandatorily notified to municipal authorities; controls were antibody-negative participants of three representative household surveys conducted at the same time-period.Findings: In logistic regression analyses of 271 cases and 1396 controls adjusted for age, sex, race, educational attainment, income, household size and pandemic moment, those reporting moderate to greatest adherence to social distancing had between 59% (OR=0·41; 95%CI 0·24-0·70) and 75% (OR=0·25; 0·15-0·42) lower odds of becoming infected, compared to those reporting very little adherence. Lesser out-of-household exposure reduced odds between 52% (OR=0·48; 0·29-0·77) and 75% (OR=0·25; 0·18-0·36), compared to going out every day all day. In a subsample of controls with data on mask use and cases of equivalent pandemic moment (198 cases and 420 controls), mask use reduced odds of infection by 87% (OR=0·13; 0·04-0·36).Interpretation: Greater social distancing and always using masks while away from home provided major protection against SARS-CoV-2. These simple measures can be of great benefit during the upcoming phases of the pandemic.Funding: IATS/FAPERGS, UNIMED Porto Alegre, Instituto Cultural Floresta, Instituto Serrapilheira, Ministry of Health.Declaration of Interests: The authors have no conflicts of interest to declare.Ethics Approval Statement: The ethics committee of the Hospital de Clínicas de Porto Alegre approved our study (No. 31499420·5·0000·5327) and the Brazilian National Ethics Committee (No. 30415520·2·0000·5313) approved the accompanying seroprevalence surveys. All participants gave prior informed consent, in written form by the controls and verbally for cases.