O impacto da pandemia de COVID-19 nas alterações do sono de profissionais de enfermagem1 1 Este artigo refere-se à chamada temática "Inovação na prática, no ensino ou na pesquisa em saúde e Enfermagem”

Objetivo: analisar os fatores relacionados às alterações no sono relatadas pelos profissionais de enfermagem durante a pandemia de COVID-19. Método: trata-se de um estudo transversal e analítico, realizado com profissionais de enfermagem de todas as regiões do Brasil. Foram coletados dados de caracterização sociodemográfica, condições de trabalho e questões sobre alterações de sono. Para estimar o Risco Relativo foi utilizado o modelo de regressão de Poisson com medidas repetidas. Resultados: foram analisadas 572 respostas, as quais revelaram que a duração não ideal do sono, a má qualidade do sono e os sonhos com o ambiente de trabalho foram predominantes durante a pandemia, com 75,2%, 67,1% e 66,8% respectivamente, assim como as queixas de dificuldade ao dormir, sonolência diurna e sono não restaurador durante a pandemia foram relatadas por 523 (91,4%), 440 (76,9%) e 419 (73,2%) dos profissionais de enfermagem, respectivamente. O risco relativo de apresentar tais alterações de sono, durante a pandemia foi significativo para todas as variáveis e as categorias estudadas. Conclusão: duração não ideal do sono, má qualidade do sono, sonhos com o ambiente de trabalho, queixas de dificuldade ao dormir, sonolência diurna e sono não restaurador foram as alterações do sono predominantes entre os profissionais de enfermagem durante a pandemia. Estes achados apontam para possíveis consequências na saúde, bem como na qualidade do trabalho realizado.

Impacto de la pandemia de COVID-19 en los trastornos del sueño de profesionales de enfermería1 1 Este artículo hace referencia a la convocatoria "Innovación en la práctica, enseñanza o investigación en salud y Enfermería”

Objetivo: analizar los factores relacionados con los trastornos del sueño que informaron los profesionales de enfermería durante la pandemia de COVID-19. Método: se trata de un estudio transversal y analítico realizado con profesionales de enfermería de todas las regiones de Brasil. Se recolectaron datos sobre caracterización sociodemográfica, condiciones de trabajo y preguntas sobre trastornos del sueño. Para estimar el Riesgo Relativo se utilizó el modelo de regresión de Poisson con medidas repetidas. Resultados: se analizaron 572 respuestas, que revelaron que durante la pandemia predominaron la duración del sueño no ideal, la mala calidad del sueño y los sueños sobre el ambiente laboral, con 75,2%, 67,1% y 66,8% respectivamente, además 523 (91,4%), 440 (76,9%) y 419 (73,2%) profesionales de enfermería manifestaron quejas de dificultad para conciliar el sueño, somnolencia diurna y sueño no reparador durante la pandemia, respectivamente. El riesgo relativo de padecer trastornos del sueño durante la pandemia fue significativo para todas las variables y categorías estudiadas. Conclusión: la duración del sueño no ideal, la mala calidad del sueño, los sueños sobre el ambiente laboral, las quejas de dificultad para conciliar el sueño, la somnolencia diurna y el sueño no reparador fueron los trastornos del sueño predominantes en los profesionales de enfermería durante la pandemia. Estos hallazgos indican posibles consecuencias para la salud, así como para la calidad del trabajo realizado.

The impact of the COVID-19 pandemic on sleep disorders among Nursing professionals1 O impacto da pandemia de COVID-19 nas alterações do sono de profissionais de enfermagem Impacto de la pandemia de COVID-19 en los trastornos del sueño de profesionales de enfermería

Objective: to analyze the factors related to sleep disorders reported by Nursing professionals during the COVID-19 pandemic. Method: this is a cross-sectional and analytical study conducted with Nursing professionals from all Brazilian regions. Sociodemographic data, working conditions and questions about sleep disorders were collected. The Poisson regression model with repeated measures was used to estimate the Relative Risk. Results: 572 answers were analyzed, which revealed that non-ideal sleep duration, poor sleep quality and dreams about the work environment were predominant during the pandemic, with 75.2%, 67.1% and 66.8% respectively;as well as complaints of difficulty sleeping, daytime sleepiness and non-restorative sleep during the pandemic were reported by 523 (91.4%), 440 (76.9%) and 419 (73.2%) of the Nursing professionals, respectively. The relative risk of having such sleep disorders during the pandemic was significant for all variables and categories studied. Conclusion: non-ideal sleep duration, poor sleep quality, dreams about the work environment, complaints regarding difficulty sleeping, daytime sleepiness and non-restorative sleep were the predominant sleep disorders among Nursing professionals during the pandemic. Such findings point to possible consequences on health, as well as on the quality of the work performed.

The impact of the COVID-19 pandemic on sleep disorders among Nursing professionals.

OBJECTIVE: to analyze the factors related to sleep disorders reported by Nursing professionals during the COVID-19 pandemic. METHOD: this is a cross-sectional and analytical study conducted with Nursing professionals from all Brazilian regions. Sociodemographic data, working conditions and questions about sleep disorders were collected. The Poisson regression model with repeated measures was used to estimate the Relative Risk. RESULTS: 572 answers were analyzed, which revealed that non-ideal sleep duration, poor sleep quality and dreams about the work environment were predominant during the pandemic, with 75.2%, 67.1% and 66.8% respectively; as well as complaints of difficulty sleeping, daytime sleepiness and non-restorative sleep during the pandemic were reported by 523 (91.4%), 440 (76.9%) and 419 (73.2%) of the Nursing professionals, respectively. The relative risk of having such sleep disorders during the pandemic was significant for all variables and categories studied. CONCLUSION: non-ideal sleep duration, poor sleep quality, dreams about the work environment, complaints regarding difficulty sleeping, daytime sleepiness and non-restorative sleep were the predominant sleep disorders among Nursing professionals during the pandemic. Such findings point to possible consequences on health, as well as on the quality of the work performed.

Oil Spill in Brazil - Analysis of Vulnerabilities and Socio-Environmental Conflicts

The 2019 oil spill was considered the largest environmental disaster in the Brazilian Northeastern coast. It was associated with mostly ineffective government actions, thus intensifying historical vulnerabilities faced by local populations. We aimed to analyze the environmental conflicts and injustices and the socio-environmental, economic, and health vulnerabilities arising from the oil spill, considering the COVID-19 pandemic, impacting artisanal fishing communities of the Northeastern coast. A document-based, qualitative, cross-sectional research was carried out between September 2019 and October 2022, in open access secondary databases, and using field diaries from research of the Environmental Health and Work Laboratory (LASAT) of the Aggeu Magalhães Institute of the Oswaldo Cruz Foundation. The disaster caused situations of injustice and environmental conflicts that had negative repercussions in the territories with socioeconomic impacts, on the environment, and on the health of the population. The entire marine environment was affected, resulting in physical and chemical alterations. The health vulnerabilities faced by local people were intensified, influencing the social determination of the health-disease process. The local economy was extremely affected, generating job insecurity and several socio-cultural problems. It is essential to build environmental and health diagnoses for remedial measures in disasters such as the oil spill.

The National Response to Patients with Acute Coronary Syndrome during the First Wave of the COVID-19 Pandemic in Portugal.

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to changes in healthcare institutions and medical assistance. Non-SARS-CoV-2 related diseases were indirectly affected by the pandemic. Nonetheless, their treatment remains crucial. Cardiovascular conditions such as acute coronary syndrome (ACS) are common, and it was necessary to adjust medical assistance to these diseases during the pandemic. This study aimed to assess the national impact and healthcare system response during the first wave of the pandemic in patients admitted for ACS. MATERIAL AND METHODS: Multicenter retrospective study based on the Acute Coronary Syndrome Portuguese National Registry between the 1st January 2016 and the 28th February 2021. Two groups were defined: the previous year to the SARS-CoV-2 pandemic (March, April, May and June 2019) (952 patients) and the first wave of the pandemic (March, April, May and June 2020) (642 patients). Clinical course, time until reperfusion, in-hospital outcomes and follow-up at one year were compared between both periods. RESULTS: There was a lower incidence of ACS between March and June 2020 compared with the same period in 2019, with a reduction of 32.6%. There were no statistically significant differences between the two periods regarding patient demographic characteristics (except for a higher prevalence of familiar cardi vascular history and chronic obstructive pulmonary disease in 2020 and higher prevalence of diabetes in 2019), clinical features, clinical management, in-hospital major adverse cardiac events, mortality and readmission at one-year follow-up. There was a trend towards longer delays until reperfusion, yet without statistical significance. The patients that developed ACS during the first wave of the SARS-CoV-2 pandemic were less often referred to percutaneous coronary intervention centers (p = 0.034) and were more frequently transferred to another hospital (p < 0.001). CONCLUSION: During the first wave of the SARS-CoV-2 pandemic there was a nationwide reduction in demand of healthcare services due to ACS events. Even though the Portuguese healthcare system was under strain and forced to divert resources and medical assistance towards the pandemic management, it was capable of responding adequately to ACS.

Family supportive supervisor behavior and work-family boundary control in teleworkers during a lockdown: Portugal and Pakistan comparison

The imposition of telework due to the COVID-19 pandemic brought with it the need for individuals to readjust their work-non-work boundaries. In this crisis situation, individuals’ needs to manage these boundaries may have been influenced by contextual factors, such as family-supportive supervisor behaviors (FSSB) and macro-structural aspects, such as the country to which the teleworkers belong. This study tests the mediating effect of boundary control on the relationship between FSSB and satisfaction with life and examines the moderating effect of the country (Pakistan vs. Portugal) in the relationship between FSSB and boundary control. With a sample of 108 Portuguese and 118 Pakistani individuals, the results were analyzed using Process tool. FSSB was found to be important for teleworkers to control their boundaries and for their satisfaction with life and this control was also seen to contribute to higher levels of life satisfaction. Differences between the two countries were observed: boundary control mediates the relationship between FSSB and satisfaction with life for Pakistani teleworkers and these workers are more dependent on FSSB to exercise boundary control than Portuguese teleworkers. This study highlights the importance of considering contextual factors when implementing telework. Practical implications are discussed.

Sleep and Professional Burnout in Nurses, Nursing Technicians, and Nursing Assistants During the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic may trigger sleep disorders and burnout in nursing professionals. PURPOSE: This study was designed to describe the occurrence of sleep disorders and burnout in a nursing team during the COVID-19 pandemic and to identify the associated factors. METHODS: A cross-sectional approach was used. The questionnaire was administered via the Internet. All of the participants were nursing professionals who had provided care during the COVID-19 pandemic, and data were collected between June and August 2020. Sociodemographic and work characterization instruments, the Jenkins Sleep Scale, and the Maslach Burnout Inventory were used. RESULTS: Five hundred seventy-two nursing professionals (nurses, nursing technicians, and nursing assistants) responded. Slightly over one quarter (26.4%) presented a sleep disorder, and 17.3% presented burnout. Professional category was a factor found to be associated with having a sleep disorder. Moreover, a lower prevalence both of disorders and of starting to use sleep medication was found among nurses than nursing assistants. Moreover, an association was found between having a high level of emotional exhaustion burnout and being a nursing technician, having a higher number of patients needing care, and starting to use sleep medication. The level of burnout related to depersonalization was significantly higher for nursing assistants, those with a weekly workload of 50 hours or more, and those starting to use sleep medication. Furthermore, burnout related to personal accomplishment was significantly higher in those starting to use sleep medication. Among the participants with sleep disorders, according to Jenkins Sleep Scale results, all of the participants presented a high or moderate level of emotional exhaustion and a high level of burnout related to personal accomplishment. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings indicate that the incidence of sleep disorders and burnout were high among nursing professionals during the COVID-19 pandemic and mainly related with starting to use sleep medication. The results demonstrate the importance of detecting and assessing the frequency of sleep disorders and professional exhaustion. Interventions that aim to improve sleep quality and working conditions for these professionals should be developed.

Mapping of New Pharmacological Alternatives in the Face of the Emergence of Antibiotic Resistance in COVID-19 Patents Treated for Opportunistic Respiratory Bacterial Pathogens.

BACKGROUND: The increase in bacterial resistance against antibiotics is thought to be another type of pandemic after COVID-19. Emergency treatment based on antibiotics is a major influence in increasing this resistance. Bacteria, such as Klebsiella pneumoniae, are the most affected by the indiscriminate use of antibiotics, since they are resistant to most antibiotics currently available on the market. OBJECTIVE: This review aimed to evaluate patents of new drugs and formulations, for the treatment of infections caused by Klebsiella pneumoniae. METHODS: The present patent review was carried out through a specialized search database Espacenet. The selection was based on the criteria of patents published from 2010 to May 2021, in any language, and containing the keywords in title or abstract. Also, a research was performed on the PubMed database, using the inclusion criteria. RESULTS: Twenty-two patents were selected for the analysis according to the aim of the study. The advance of new patents has been mostly observed in the World Intellectual Property Organization, China, and United States. The results showed that the main approach was the drug association, followed by drug carriers, new isolated products, and vaccines. CONCLUSION: It has been observed that few studies use new drug alternatives for the treatment, probably due to the higher cost of the development and lack of investments. The effectiveness and safety of these therapies depend on the acceptance, the correct prescription, and rational use of medicines. Therefore, this review can further develop new treatments as alternatives against Klebsiella pneumoniae and pneumonia caused by it.

Does COVID-19 infection increase the risk of pressure injury in critically ill patients?: A narrative review.

ABSTRACT: Patients with severe COVID-19 may have endothelial dysfunction and a hypercoagulable state that can cause skin damage. In the presence of external pressure on the tissues, the local inflammatory process regulated by inflammatory cytokines can increase and prolong itself, contributing to the formation of pressure injury (PI). PI is defined as localized damage to the skin or underlying tissues. It usually occurs as a result of intense and/or prolonged pressure in combination with shear. The aim of the study is to perform a narrative review on the physiological evidence of increased risk in the development of PI in critically ill patients with COVID-19.In patients with severe COVID-19 a pattern of tissue damage consistent with complement-mediated microvascular injury was found in the lungs and skin of critically ill COVID-19 patients, suggesting sustained systemic activation of complement pathways. Theoretically, the same thrombogenic vascular changes related to COVID-19 that occur in the skin also occur in the underlying tissues, making patients less tolerant to the harmful effects of pressure and shear. Unlike the syndromes typical of acute respiratory illnesses and other pathologies that commonly lead to intensive care unit admission, COVID-19 and systemic viral spread show that local and systemic factors overlap. This fact may be justified by current epidemiological data showing that the prevalence of PI among intensive care unit patients with COVID-19 was 3 times higher than in those without COVID-19. This narrative review presents physiological evidence to suggesting an increased risk of developing PI in critically ill patients with COVID-19.

One Year of COVID-19 in Pregnancy: A National Wide Collaborative Study.

INTRODUCTION: Even though the risk of COVID-19 in pregnancy may be increased, large-scale studies are needed to better understand the impact of the infection in this population. The aim of this study is to describe obstetric complications and the rate of vertical transmission in pregnant women with SARS-CoV-2 infection. MATERIAL AND METHODS: Detected cases of SARS-CoV-2 infection in pregnancy were registered in Portuguese hospitals by obstetricians. Epidemiological, pregnancy and childbirth data were collected. RESULTS: There were 630 positive cases in 23 Portuguese maternity hospitals, most at term (87.9%) and asymptomatic (62.9%). The most frequent maternal comorbidity was obesity. The rates of preterm birth and small-to-gestational-age were 12.1% and 9.9%, respectively. In the third trimester, 2.9% of pregnant women required respiratory support. There were eight cases (1.5%) of fetal death, including two cases of vertical transmission. There were five cases of postpartum respiratory degradation, but no maternal deaths were recorded. The caesarean section rate was higher in the first than in the second wave (68.5% vs 31.5%). RT-PCR SARS-CoV-2 positivity among newborns was 1.3%. CONCLUSION: SARS-Cov-2 infection in pregnancy may carry increased risks for both pregnant women and the fetuses. Individualized surveillance and the prophylaxis of this population with vaccination. is recommended in these cases.

Introdução: Apesar do risco da COVID-19 na gravidez poder ser acrescido, são necessários estudos em larga escala para o melhor conhecimento do impacto desta infeção nesta população. O objetivo deste estudo é descrever as complicações obstétricas e a taxa de transmissão vertical em grávidas com infeção a SARS-CoV-2. Material e Métodos: Os casos conhecidos de infeção por SARS-CoV-2 na gravidez foram registados nos hospitais portugueses por obstetras. Foram recolhidos dados epidemiológicos, da gravidez e do parto. Resultados: Registaram-se 630 casos positivos em 23 maternidades portuguesas, a maioria no termo (87,9%) e assintomática (62,9%). A comorbilidade materna mais frequente foi a obesidade. A taxa de parto pré-termo e de leves para a idade gestacional foi de 12,1% e 9,9%, respectivamente. No terceiro trimestre, 2,9% das grávidas necessitaram de suporte respiratório. Verificou-se uma taxa de 1,5% de morte fetal, incluindo dois casos de transmissão vertical. Houve cinco casos de degradação respiratória no pós-parto, mas sem mortes maternas registadas. A taxa de cesarianas foi mais elevada na primeira do que na segunda vaga (68,5% vs 31,5%). A positividade do RT-PCR SARS-CoV-2 entre os recém-nascidos foi de 1,3%. Conclusão: A infeção pelo SARS-Cov-2 na gravidez pode acarretar riscos aumentados para as grávidas e fetos. Recomenda-se uma vigilância individualizada nestes casos e a profilaxia desta população com a vacinação.

Seroprevalence of SARS-CoV-2 and assessment of epidemiologic determinants in Portuguese municipal workers.

OBJECTIVES: To assess the seroprevalence of SARS-CoV-2 antibodies in municipal employees of Northern Portugal during the first pandemic wave (May-June 2020) and its association with potentially related risk factors for infection. MATERIAL AND METHODS: The authors assessed municipal employees of 2 cities in Northern Portugal, in whom serological tests to SARS-CoV-2 and an epidemiological survey were applied. The authors assessed the proportion of individuals presenting IgM and/or IgG antibodies to SARS-CoV-2, and evaluated the association between having positive serological test results, epidemiologic variables and clinical presentations. Reported symptoms were evaluated on their sensitivity, specificity, and predictive values. RESULTS: The authors assessed 1696 employees, of whom 22.0% were firefighters, 10.4% were police officers, 10.3% were maintenance workers, and 8.1% were administrative assistants. The seroprevalence of SARS-CoV-2 infection was 2.9% (95% CI: 2.1-3.7%). Administrative assistants comprised the professional group with highest seroprevalence of SARS-CoV-2 (OR = 1.9 in the comparison with other occupational groups, 95% CI: 0.8-4.3, p = 0.126). The seroprevalence of SARS-CoV-2 infection among those who were in direct contact with COVID-19 patients in their professional activity was 3.9%, compared to 2.7% among those who were not in direct contact with such patients (OR = 1.5, 95% CI: 0.8-2.8, p = 0.222). The highest risk of infection was associated with the presence of a confirmed SARS-CoV-2 infection in the household (OR = 17.4, 95% CI: 8.3-36.8, p < 0.001). Living with a healthcare professional was not associated with a higher risk of infection (OR = 1.0, 95% CI: 0.4-2.5, p = 0.934). Anosmia/ dysgeusia was the symptom with the highest positive predictive value (52.2%, 95% CI: 31.8-72.6, p < 0.001) and specificity (99.3%, 95% CI: 98.9-99.7, p < 0.001), while cough was the most prevalent symptom among SARS-CoV-2 seropositive participants (36%). CONCLUSIONS: The authors observed a SARS-CoV-2 seroprevalence of 2.9% among assessed municipal employees. Anosmia/dysgeusia was the COVID-19 symptom which displayed the highest positive predictive value and specificity. Int J Occup Med Environ Health. 2022;35(3):297-307.

Tele-care intervention performed by parents involving specific task- environment- participation (STEP protocol) for infants at risk for developmental delay: protocol of randomized controlled clinical trial

Background With the implementation of social distancing due to the Covid-19 pandemic, many at-risk infants are without therapy. An alternative mode of therapy in this situation is tele-care, a therapy in which assessments and interventions are carried out online, in the home environment. We describe a tele-care protocol involving parent delivered task and context specific movement training, participation and environmental adaptation for infants at risk for developmental delay. Methods Randomized controlled trial. Infants at risk, with 3 to 9 months corrected age, will be included, and randomized into two groups: control group (conventional guidelines) and experimental group (task, environment and participation in context-specific home program). Infants will be assessed for motor capacity (Infant Motor Profile and Alberta Infant Motor Scale);participation (Young Children’s Participation and Environment Measure) and environment factors (Parent-Child Early Relational Assessment;Affordances in the Home Environment for Motor Development). The intervention period will be 10 weeks, and evaluations will be carried out before and after that period. All the assessment and intervention procedures will be carried out online, with instructions to parents for home therapy. The statistical analysis will be guided according to the distribution of the data, and a significance level of 5% will be adopted. All ethical approvals were obtained by the Ethics Committee of the University of São Carlos (Case number 31256620.5.0000.5504). The protocol will follow the SPIRIT statement. Findings will be disseminated in peer-reviewed publications and presented at national and international conferences. Discussion The results of this study will describe the effectiveness of a home intervention, focusing on specific activities, participation and environmental changes. These results will support the implementation of a remote protocol, with lower financial costs and focused on the particularities of the family. This type of care model can possibly help public policies to ensure equal access to evidence-based quality healthcare. Trial registration Brazilian Clinical Trials Registry: RBR8xrzjs, registered September 1, 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03126-3.

SARS-CoV-2 can recruit a heme metabolite to evade antibody immunity.

The coronaviral spike is the dominant viral antigen and the target of neutralizing antibodies. We show that SARS-CoV-2 spike binds biliverdin and bilirubin, the tetrapyrrole products of heme metabolism, with nanomolar affinity. Using cryo-electron microscopy and x-ray crystallography, we mapped the tetrapyrrole interaction pocket to a deep cleft on the spike N-terminal domain (NTD). At physiological concentrations, biliverdin significantly dampened the reactivity of SARS-CoV-2 spike with immune sera and inhibited a subset of neutralizing antibodies. Access to the tetrapyrrole-sensitive epitope is gated by a flexible loop on the distal face of the NTD. Accompanied by profound conformational changes in the NTD, antibody binding requires relocation of the gating loop, which folds into the cleft vacated by the metabolite. Our results indicate that SARS-CoV-2 spike NTD harbors a dominant epitope, access to which can be controlled by an allosteric mechanism that is regulated through recruitment of a metabolite.

Opinions, beliefs and knowledge of people with multiple sclerosis on COVID-19 pandemic and vaccine.

BACKGROUND: Considering the potential COVID-19 impact on pwMS health and the importance of vaccination for this population, we decided to assess: (a) pwMS' beliefs and knowledge on COVID-19 pandemic; (b) their acceptance towards COVID-19 vaccination and (c) pwMS' opinions on general vaccination. METHODS: Observational study, based on a cross-sectional (10-20th September 2020) online survey, conducted in a cohort of pwMS' followed at two Portuguese hospitals. The survey included measures to characterize the sample and a questionnaire designed to assess the topics defined for this study. RESULTS: 270 respondents completed the full survey (response rate 58.2%). pwMS greatest concern during the pandemic was an aggravation of MS, especially by patients older than 50 years old. Almost 40% of the patients older than 50 felt that the pandemic negatively affected their MS related medical assistance. Most patients believed they would recover from COVID-19 infection. More than half of the responders feared a MS aggravation if they got COVID-19; this was more pronounced in patients with progressive MS. About 12% of the participants did not want to be vaccinated and almost 40% was unsure. Regarding vaccines in general, almost a third of the participants feared their side effects or MS related complications. CONCLUSION: Having knowledge of pwMS' opinions on COVID-19 pandemic impact and vaccination is useful to better address these issues. Fears and expectations towards vaccination must be discussed with pwMS.

Interdisciplinary practices in coping with covid-19 in the family health strategy

Objetivo: Descrever as experiências de residentes multiprofissionais na Estratégia Saúde da Família acerca da aplicação de ações interdisciplinares no enfrentamento do novo Coronavírus. Método: Estudo descritivo, do tipo relato de experiência realizado por residentes multiprofissionais do núcleo Saúde da Família em uma Estratégia Saúde da Família. O estudo foi desenvolvido em três fases: levantamento das problemáticas enfrentadas pela equipe;formulação do plano de contingência local com base a teoria da interdisciplinaridade e implementação das ações. Resultados: Evidenciou-se uma maior adesão da população as recomendações da equipe de saúde, observados na demarcação do fluxo de indivíduos que mostrou bons resultados, reduzindo o risco da transmissão viral entre pacientes e os profissionais da saúde, bem como possibilitou uma diminuição significativa da permanência dos usuários na unidade de modo que a população continuasse a ser assistida, garantindo a segurança de todos os atores envolvidos. Considerações finais: As práticas interdisciplinares têm se destacado nos mais diversos serviços de saúde como método de ascensão essencial para gestores, profissionais de saúde e estudantes na produção de relações mais atuantes de forma integrada no campo da saúde como um todo, principalmente no enfrentamento da pandemia. (AU) Objective: To describe the experiences of multiprofessional residents in the Family Health Strategy regarding the application of interdisciplinary actions for coping with the new Coronavirus. Method: This is an experience report by multiprofessional Family Health residents. The descriptive study was developed in three phases: the first, the survey of the problems faced by the team;the second stage was the formulation of a local contingency plan based on the theory of interdisciplinarity and the third was the implementation of these actions. Results: The population adherence to the recommendations from the health team was observed in the demarcation of the flow of individuals. Which showed good results, reducing the risk of viral transmission among patients and health professionals, as consequence of a significant decreased in permanence of users in the unit. Additionally, the population continues to be assisted, ensuring the safety of all actors involved. Conclusion: Interdisciplinary practices have stood out in the most diverse health services as an essential ascension method for managers, health professionals and students in the production of more active relationship in an integrated manner in the field of health as a whole, especially of coping with the pandemic. (AU) Objetivo: Describir las experiencias del equipo de profesionales multidisciplinario en la Estrategia de Salud Familiar con respecto a la aplicación de acciones interdisciplinarias para enfrentar el nuevo Coronavirus. Método: Un estudio descriptivo, un informe de experiencia realizado por profesionales de la Unidad de Salud de la Familia. El estudio fue desarrollado en tres fases: la primera, la encuesta de los problemas que enfrenta el equipo;la segunda etapa fue la formulación del plan de contingencia local basado en la teoría de la interdisciplinariedad y la tercera fue la implementación de acciones. Resultados: Se observó una mayor adherencia de la población a las recomendaciones del equipo de salud, observada en la demarcación del flujo de individuos que mostró buenos resultados, reduciendo el riesgo de transmisión viral entre pacientes y profesionales de la salud, así como permitiendo una disminución significativa en permanencia de los usuarios en la unidad para que la población continúe siendo asistida, garantizando la seguridad de todos los actores involucrados. Conclusión: Las prácticas interdisciplinarias se han destacado en los servicios de salud más diversos como un método esencial para los gerentes, profesionales de la salud y estudiantes en la producción de relaciones más activas de manera integrada en el campo de la salud en general, y especialmente en este contexto para enfrentar la pandemia. (AU)

SARS-CoV-2 and Saliva as a Diagnostic Tool: A Real Possibility

Covid-19 is a respiratory disease caused by the SARS-CoV-2 virus. The high rate of contagion and the spread of the virus in the population make the early detection of the pathogen the means for the adequate targeting of infection control measures. WHO directs sample collection on upper respiratory specimens, including nasopharyngeal and oropharyngeal swab or wash in ambulatory patients, as well as lower respiratory specimens: sputum and/or endotracheal aspirate or bronchoalveolar lavage, in addition to citing blood and feces. Among the various sample collection methods, saliva has been investigated and reported as a potential source for diagnosis. Thus, we propose to evaluate the current scenario, based on recent publications on the perspective of detecting SARS-CoV-2 in saliva as a diagnostic method for Covid-19. The detection of SARS-CoV-2 through saliva seems to be very promising, although obstacles such as the technique and the location of the collection and the sample size of the research carried out so far may present a limitation for its use. The current scenario presents saliva as a reliable method for the detection of SARS-CoV-2, due to the ease of obtaining the samples, the possibility of self-collection, low cost because there is no need to use specific equipment, in addition to reducing the risk of transmission for health professionals.

Characteristics and outcomes of patients with COVID-19 admitted to the ICU in a university hospital in São Paulo, Brazil - study protocol

OBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital's electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials.gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.

Management and Nursing Education Experiences during the screening of COVID-19 in an Integrated Clinic

Objective: to discuss managerial experience and nursing education in the control of COVID-19. Method: report of experience of management and education in nursing, in an integrated school clinic during the return of the activities of the health courses. Result: management of COVID -19 control measures in the clinical screening sectors and contributions to management training in the nursing course emerged as results. The course participated in the implementation of COVID-19 control measures in the institution and the importance of articulating clinical and managerial knowledge was realized, preserving the teaching and learning process of nursing students and ensuring the safety of all in this confrontation of the pandemic. Conclusion: the management of the education of nursing students made it possible to develop their managerial and clinical skills in the face of the scenario, as well as allowing the concrete application of specific instruments that were previously applied only in theory. Objetivo: discutir la experiencia gerencial y la formación de enfermería en el control de COVID-19. Método: reporte de experiencia de gestión y educación en enfermería, en una clínica escolar integrada durante el retorno de las actividades de los cursos de salud. Resultado: surgieron como resultados la gestión de las medidas de control de COVID -19 en los sectores de cribado clínico y las contribuciones a la formación gerencial en el curso de enfermería. El curso participó en la implementación de las medidas de control de COVID-19 en la institución y se realizó la importancia de articular el conocimiento clínico y gerencial, preservando el proceso de enseñanza y aprendizaje de los estudiantes de enfermería y velando por la seguridad de todos en este enfrentamiento de la pandemia. Conclusión: la gestión de la formación de los estudiantes de enfermería permitió desarrollar sus habilidades gerenciales y clínicas frente al escenario, además de permitir la aplicación concreta de instrumentos específicos que antes solo se aplicaban en teoría. Objetivo: discorrer experiência gerencial e educação em enfermagem no controle da COVID-19. Método: relato de experiência da gestão e educação em enfermagem, em clínica escola integrada durante o retorno das atividades dos cursos da saúde. Resultado: gestão das medidas de controle da COVID -19 nos setores de triagem da clínica e as contribuições na formação para gestão no curso de enfermagem emergiram como resultados. O curso participou da implantação das medidas de controle de COVID-19 na instituição e percebeu-se a importância da articulação de conhecimentos clínicos e gerenciais preservando o processo de ensino e aprendizagem dos discentes de enfermagem e garantindo a segurança de todos neste enfrentamento da pandemia. Conclusão: a gestão da educação dos alunos do curso de enfermagem possibilitou o desenvolvimento de suas competências gerenciais e clínicas diante do cenário, bem como permitiu a aplicação concreta de instrumentos específicos que, antes eram aplicados apenas na teoria.