Children's Physical Activity During the COVID-19 Lockdown: A Cross Cultural Comparison Between Portugal, Brazil and Italy.

The COVID-19 pandemic forced governments to implement measures that disrupted the daily routines of many families worldwide. We studied how the COVID-19 lockdown affected children's routines in Portugal (PT), Brazil (BR), and Italy (IT) to determine if children's age and country impacted their physical activity (PA) and sedentary time. We launched an anonymous online survey to assess how 3-12 years old children adjusted their daily routines to this situation. Parents reported the times each child was engaged in different activities throughout the day, and we used these data to calculate separately overall sedentary and physical activity time. We conducted separate analyses of variance for age and country on the percentage of time spent in the different activities. Results, based on the data from 3045 children in these three countries (PT n = 2044; BR n = 836; IT n = 165), showed that, during lockdown, most children spent most of their awake daily hours in sedentary activities. There was a clear age effect on the way their routines were organized. Percentages of time spent in intellectual activity, playful screen activity, and overall sedentary time were greater in the older age groups, whereas percentages of time spent in play (with and without PA) and in overall PA were greater in the younger groups. We found a main effect of country for all variables except play without PA. The country effect was mainly due to the difference between the routines in BR when compared to PT and IT. Values of playful screen time and overall sedentary activity were higher in BR than in the two European countries. Conversely, values for play with PA, PA, and overall PA (except in the older group) were lower in BR. Patterns of time spent in these activities were similar in IT and PT, but PA and overall PA times were higher in the two younger age groups in IT. In summary, percentage of PA time of confined children was low and decreased with age across all three countries and was particularly low for children in BR relative to those in PT and IT.

SARS-CoV-2 air and surface contamination in residential settings.

SARS-CoV-2 transmission occurs mainly indoors, through virus-laden airborne particles. Although the presence and infectivity of SARS-CoV-2 in aerosol are now acknowledged, the underlying circumstances for its occurrence are still under investigation. The contamination of domiciliary environments during the isolation of SARS-CoV-2-infected patients in their respective rooms in individual houses and in a nursing home was investigated by collecting surface and air samples in these environments. Surface contamination was detected in different contexts, both on high and low-touch surfaces. To determine the presence of virus particles in the air, two sampling methodologies were used: air and deposition sampling. Positive deposition samples were found in sampling locations above the patient's height, and SARS-CoV-2 RNA was detected in impactation air samples within a size fraction below 2.5 µm. Surface samples rendered the highest positivity rate and persistence for a longer period. The presence of aerosolized SARS-CoV-2 RNA occurred mainly in deposition samples and closer to symptom onset. To evaluate the infectivity of selected positive samples, SARS-CoV-2 viability assays were performed, but our study was not able to validate the virus viability. The presented results confirm the presence of aerosolized SARS-CoV-2 RNA in indoor compartments occupied by COVID-19 patients with mild symptoms, in the absence of aerosol-generating clinical procedures.

Operative public values as a tool for healthcare decisions: the social value and clinical criteria of triage.

With the current pandemic, many scholars have contended that clinical criteria offer the best way to implement triage. Further, they dismiss the criteria of social value as a good one for triage. In this paper, I respond to refute this perspective. In particular, I present two sets of arguments. Firstly, I argue that the objections to the social value criteria they present apply to the clinical criteria they favor. Secondly, they exaggerate the negative aspects of the social value criteria, while I suggest it is reasonable to use this. I end the article by recommending how operative public values can be a good way to make triaging decisions.

The Developmental Trajectory of Motor Competence of Children That Lived the COVID-19 Confinement Period: A Four-Year Follow-Up Study in Portuguese Children.

Children's motor competence (MC) was negatively affected by the COVID-19 pandemic; however, possible chronic effects have not been studied. Therefore, the aim of this study was to examine the possible impact of the forced lack of physical activity (PA) during the COVID-19 lockdown on children's MC two years later. The motor competence of sixty-seven healthy children (7.4-12.2 years old) was assessed using the Motor Competence Assessment (MCA). All participants completed the MCA tests at two different moments (before and after the COVID-19 lockdown), four years apart. The mean values after the COVID-19 lockdown for all participants on the subscales and on the Total MCA are lower, but no significant changes were found when controlling for gender and age (p > 0.05 in all analyses). However, a significant decrease was found in the Locomotor subscale in boys (p = 0.003). After dividing the participants into three age groups, the youngest also suffered a decrease in the Locomotor subscale (p < 0.001) and their Total MCA (p = 0.04). In addition, those participants who had a higher MC at baseline decreased their scores for the Locomotor (p < 0.001) and Manipulative (p < 0.001) subscales, and for the Total MCA (p < 0.001). In conclusion, the younger children and the more motor proficient did not fully recover from the negative effects of the pandemic lockdown after two years.

Correction to: Effects of COVID-19 Confinement on the Household Routines of Children in Portugal.

[This corrects the article DOI: 10.1007/s10826-021-01961-z.].

Do children's previous physical activity habits influence their behaviors during the Covid-19 social distancing period?

OBJECTIVE: Verify whether the practice of physical activity, before the social distancing imposed by COVID-19, influences children's routines during this period, in children of different ages. METHODS: Descriptive cross-sectional study carried out with an online questionnaire from LimeSurvey and disseminated for four months during social distancing. The questionnaire contained questions about family composition, household characteristics, household and children's routines, including habits such as sleeping, physical activity, intellectual activity, playing with and without physical activity, and screen time. The final sample consisted of 916 participating families that answered about the physical activity habits of their respective children before the pandemic. Children were divided into three age groups (three to five years, six to nine years, and ten to twelve years). Independent Student's t-tests were performed to investigate whether the previous practice of scheduled physical activity group and the no physical activity group differed as to the time dedicated to children's activities and routines (intellectual activity, sleeping, screen time, playing with and without physical activity), by age groups, during social distancing. RESULTS: There was a decrease in the levels of physical activity undertaken by Brazilian children during social distancing. There was no difference when both groups. The children with previous practice of scheduled physical activity did not display different habits from the children who did not adopt this practice. CONCLUSIONS: The practice of physical activity before social distancing did not influence the level of physical activity and other habits during social distancing. Healthy habits should be encouraged and targeted for all children during the pandemic. These findings can contribute to the formulation of public policies for children during pandemic times.

The type of SARS-CoV-2 vaccine influences serological response in kidney transplant recipients.

Vaccination is a promising strategy to control the ongoing pandemic; however, solid organ recipients tend to develop a weaker immune response to vaccination. Anti-spike SARS-CoV-2 antibodies titers were measured 2-4 weeks post-vaccination completion in 131 KT patients without previous infection. Demographic, clinical, and laboratorial parameters were analyzed to identify which factors contributed to seroconversion. Factors that influenced seroconversion, that occurred in 76 patients (58%), were longer time post-transplant, immunosuppression without an antiproliferative drug and vaccination with mRNA vaccines. Patients who received mRNA vaccines had significantly higher rates of seroconversion compared with adenovirus vector vaccines (67% vs 33%, P < .001) and higher anti-spike IgG titers. These findings reinforce the need to discuss the vaccination strategy in this population, including a third dose with a mRNA vaccine.

A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine.

BACKGROUND: The development of vaccines to prevent COVID-19 breakouts came with highly positive results but some unexpected side effects. Rare side effects have been seen with the BNT162b2 SARS-CoV 2 vaccine. CASE PRESENTATION: We present the case of a 45-year-old female patient who developed an acute kidney injury needing urgent hemodialysis one week after the second administration of the BNT162b2 SARS-CoV 2 vaccine. She developed a macular rash on her lower limbs and palms as well. A kidney biopsy was performed 10 days after vaccine inoculation, diagnosing acute interstitial nephritis and acute tubular necrosis with cellular casts. The patient was treated with three corticosteroid pulses followed by daily prednisolone. We witnessed clinical improvement 4 days after the initial corticosteroid treatment with progressive recovery of kidney function and hemodialysis withdrawal. After 2 weeks, the patient had recovered her kidney function. Immunophenotyping was performed, diagnosing a hypersensitivity to the vaccine and the polyethylene glycol excipient. CONCLUSION: Patients may develop acute reactions to vaccines. In this case, symptoms seem to correlate significantly with its inoculation and, although this case had a favourable outcome, these side effects must be made aware for clinicians and patients.

Effects of COVID-19 Confinement on the Household Routines Of Children in Portugal.

The severe acute respiratory syndrome coronavirus 2 disease (COVID-19) was first identified in December 2019 in Wuhan, China, and was declared a pandemic by the World Health Organization on 11 March, 2020. Since then, physical distancing measures such as confinement have been adopted by different governments to control human to human transmission. This study aimed to determine how confinement affects children's routines, more specifically their physical activity (PA) and sedentary time. An online survey was launched to assess how Portuguese children under 13 years of age adjusted their daily routines to confinement. Parents reported the time each child was engaged in different activities throughout the day, which was used to calculate overall sedentary time and overall physical activity time. Based on the data of 2159 children, our study showed that during confinement: (i) there was a decrease in children's physical activity time and an increase in screen time and family activities; (ii) boys engaged in more playful screen Time than girls (p < 0.05), and girls played more without PA than boys (p < 0.05); (iii) along the age groups, there was a trend for an increase of the overall sedentary time and an associated decrease of the overall physical activity time. In summary, PA of confined children showed low levels and a clear decreasing trend along childhood. Conjoint family and societal strategies to target specific age groups should be organized in the future.

Effects of the COVID-19 Lockdown on Portuguese Children's Motor Competence.

During long periods without school, children are more susceptible to unhealthy behaviors, such as an increase in sedentary behaviors, which has a negative impact on children's motor competence (MC). The COVID-19 lockdown offered us a unique opportunity to test, in a quasi-experimental setting, the impact of lockdown movement restrictions on children's MC. We assessed the motor competence of 114 children aged 6-9 years using the motor competence assessment. All children were tested before and after the COVID-19 lockdown. Chi-square and 2 × 2 ANOVA (sex by moment) were used to further analyze the data. Regardless of sex, motor performances in all tests (except for jumping sideways in boys) were lower when compared with performances before lockdown. There was a marked decreasing trend in children's levels of MC, shifting from an upper to a lower quartile in different tests. The results after the lockdown were always significantly inferior to the results before lockdown in all motor tests (except jumping sideways), in the three components of MC, and in global MC. Children's global MC score decreased by an average of 13 points in boys and 16 points in girls. The imposed movement restrictions had a negative effect on children's motor competence development.

Injustice for the sake of public health: Freeing prisoners in Portugal during the COVID-19 pandemic.

This case study analysis looks at Portuguese policy during the COVID-19 pandemic whereby convicts were freed for the sake of public health. I defend this policy negatively by refuting the argument that suggested it involved various forms of injustice.

Influences of family and household characteristics on children's level of physical activity during social distancing due to covid-19 in brazil

ABSTRACT Objective: To evaluate if the variables child's sex, age, presence of siblings, parents working remotely, and external space affect the level of physical activity (PA) of Brazilian children during social distancing imposed by the COVID-19 pandemic. Methods: An online questionnaire was applied by the LimeSurvey software from March to April 2020. Children were divided into four age groups, and the questionnaire comprised questions on family and household characteristics, domestic and children's routines in the period of Brazilian social distancing. Based on the answers concerning children's activities, the following variable was created: percentage of physical activity (%PA) in one-day period. Analysis of variance and regression analysis were performed to investigate the effect of demographic and parental activities on %PA. Results: The %PA decreases with increasing age, but increases with the availability of external space at home. No significant or interaction effects were observed for other variables. Age and external space at home are predictors of %PA. Conclusions: Household and personal characteristics of Brazilian children influence the level of physical activity performed by them during social distancing. Preventive measures can be adopted in the face of another similar period. RESUMO Objetivo: Investigar se as variáveis sexo da criança, idade, presença de irmãos, pais trabalhando de maneira remota e espaço externo afetam o nível de atividade física das crianças brasileiras durante o distanciamento social por COVID-19. Métodos: Aplicou-se questionário online pelo LimeSurvey, em março e abril de 2020, sobre características familiares e habitacionais, rotinas domésticas e infantis no período de distanciamento social brasileiro, sendo as crianças divididas em quatro grupos etários. Com base nas atividades infantis realizadas, criou-se a porcentagem de atividade física (%AF) em relação ao período de um dia e foi desenvolvida análise de variância para investigar o efeito das variáveis na %AF, além de análise de regressão. Resultados: A %AF diminui conforme o aumento da idade, mas aumenta com a disponibilidade de espaço externo no domicílio. Não houve efeito significativo para as demais variáveis, tampouco efeito de interação. A idade e o espaço externo ao domicílio são preditores da %AF. Conclusões: Características habitacionais e pessoais das crianças brasileiras influenciam o nível de atividade física realizada por elas durante o distanciamento social. Medidas preventivas podem ser empregadas caso haja necessidade de outro período semelhante.

Influences of family and household characteristics on children's level of physical activity during social distancing due to covid-19 in brazil

ABSTRACT Objective: To evaluate if the variables child's sex, age, presence of siblings, parents working remotely, and external space affect the level of physical activity (PA) of Brazilian children during social distancing imposed by the COVID-19 pandemic. Methods: An online questionnaire was applied by the LimeSurvey software from March to April 2020. Children were divided into four age groups, and the questionnaire comprised questions on family and household characteristics, domestic and children's routines in the period of Brazilian social distancing. Based on the answers concerning children's activities, the following variable was created: percentage of physical activity (%PA) in one-day period. Analysis of variance and regression analysis were performed to investigate the effect of demographic and parental activities on %PA. Results: The %PA decreases with increasing age, but increases with the availability of external space at home. No significant or interaction effects were observed for other variables. Age and external space at home are predictors of %PA. Conclusions: Household and personal characteristics of Brazilian children influence the level of physical activity performed by them during social distancing. Preventive measures can be adopted in the face of another similar period. RESUMO Objetivo: Investigar se as variáveis sexo da criança, idade, presença de irmãos, pais trabalhando de maneira remota e espaço externo afetam o nível de atividade física das crianças brasileiras durante o distanciamento social por COVID-19. Métodos: Aplicou-se questionário online pelo LimeSurvey, em março e abril de 2020, sobre características familiares e habitacionais, rotinas domésticas e infantis no período de distanciamento social brasileiro, sendo as crianças divididas em quatro grupos etários. Com base nas atividades infantis realizadas, criou-se a porcentagem de atividade física (%AF) em relação ao período de um dia e foi desenvolvida análise de variância para investigar o efeito das variáveis na %AF, além de análise de regressão. Resultados: A %AF diminui conforme o aumento da idade, mas aumenta com a disponibilidade de espaço externo no domicílio. Não houve efeito significativo para as demais variáveis, tampouco efeito de interação. A idade e o espaço externo ao domicílio são preditores da %AF. Conclusões: Características habitacionais e pessoais das crianças brasileiras influenciam o nível de atividade física realizada por elas durante o distanciamento social. Medidas preventivas podem ser empregadas caso haja necessidade de outro período semelhante.

Congenital SARS-CoV-2 Infection in a Neonate With Severe Acute Respiratory Syndrome.

Coronavirus disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is mainly transmitted through droplets, but other ways of transmission have been hypothesized. We report a case of vertical transmission of SARS-CoV-2 in a preterm born to an infected mother, confirmed by the presence of the virus in the neonatal blood, nasopharyngeal and oropharyngeal swabs collected in the first half an hour of life. The neonate presented with acute respiratory distress, similar to the findings in severely affected adults. This case highlights the importance of pregnancy, labor and neonatal period surveillance of affected mothers and their newborns.

Kinetics of torquetenovirus DNA load in a recent kidney transplant recipient with mild SARS-CoV-2 infection and a failed antibody response.

Kidney transplant (KT) recipients are at an increased risk for severe COVID-19 because of their immunosuppressed state. A 42-year-old KT patient was diagnosed with COVID-19 three months after KT. Despite lymphopenia and several risk factors, he had a mild disease course. Nasopharyngeal real-time reverse transcriptase polymerase chain reaction for SARS-CoV-2 became negative 48 days after detection. SARS-CoV-2 IgG antibodies became negative after day 40. TTV DNA load increased with the onset COVID-19 and reduced after its resolution. This is the first report where TTV DNA load was measured during the course of COVID-19.

Covid-19 social isolation in brazil: effects on the physical activity routine of families with children

ABSTRACT Objective: To identify how Brazilian families with children aged under 13 years face the period of social isolation resulting from the COVID-19 pandemic, especially regarding the time spent on physical activity (PA), intellectual activity, games, outdoor activities and screen. Methods: An anonymous online survey was launched on March 24, 2020 in Brazil to assess how families with children aged up to 12 years are adjusting their daily routines to this situation. In the survey, each family reported the daily time each child spent in sedentary activity (sum of intellectual activities, play time on screen, playing without PA) and PA (sum of playing with PA and PA). Results: The main findings based on data from 816 children indicate that most parents consider there was a reduction in the time that children spend practicing PA;increase in screen play time and family activities, differences between sex were found regarding screen play time (boys&gt;girls) and in playing without PA (girls&gt;boys), and there was an age effect for all categories analyzed, with a tendency to increase the total time of sedentary lifestyle and complementary reducing the time of PA over age. Conclusions: The household routines of families during the period of social isolation resulting from the COVID-19 pandemic confirm the general reduction tendency in PA time during childhood. RESUMO Objetivo: Identificar como as famílias brasileiras com crianças abaixo de 13 anos enfrentam o período de distanciamento social decorrente da pandemia de COVID-19, principalmente no que diz respeito ao tempo gasto em atividade física (AF), atividade intelectual, brincadeiras, atividades ao ar livre e em tela. Métodos: Uma pesquisa on-line anônima foi lançada em 24 de março de 2020 no Brasil para avaliar como as famílias com crianças de até 12 anos estão ajustando suas rotinas diárias a essa situação. Na pesquisa, cada família relatou o tempo diário em que cada criança esteve envolvida em atividade sedentária (somatório de atividades intelectuais, tempo lúdico de tela, brincar sem AF) e AF (somatório do brincar com AF e da AF). Resultados: Os principais achados com base em dados de 816 crianças indicam que a maioria dos pais considera que houve redução no tempo em que as crianças passam praticando AF e aumento do tempo lúdico de tela e das atividades em família. Diferenças entre o sexo foram encontradas no tempo lúdico de tela (meninos&gt;meninas) e no brincar sem AF (meninas&gt;meninos), bem como efeito da idade para todas as categorias analisadas, com tendência para aumento do tempo total de sedentarismo e diminuição complementar do tempo de AF ao longo da idade. Conclusões: As rotinas domiciliares das famílias durante o período de distanciamento social decorrente da pandemia de COVID-19 confirmam a tendência geral decrescente do tempo de AF na infância.