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Wastewater-based epidemiology is an important public health tool with great applicability when facing the COVID-19 pandemic, since infected individuals are able to excrete SARS-CoV-2 particles. In this context, this study aimed to correlate the number of cases of COVID-19 with physical and chemical variables and the presence of the virus in raw sewage samples from a sewage treatment plant (SIP) in the municipality of Lavras, Minas Gerais, Brazil, collected between the 19th and 25th epidemiological weeks. The samples were concentrated by electronegative membrane adsorption method and SARS-CoV-2 RNA was extracted, detected, and quantified by RT-qPCR using oligonucleotides and probes for the N gene. Moreover, the variables pH, total suspended solids, and chemical oxygen demand were evaluated. COVID-19 cases were obtained from epidemiological bulletins made available by the municipal government From the 24th epidemiological week on, a reduction in viral concentration (copies L-1) was observed concomitantly with the pandemic response countermeasures initiated by the municipality. A strong and significant positive correlation (p<0.05) between viral load and number of confirmed cases was obtained through Spearman's test. However, there was no correlation between the presence of the virus and the physical and chemical characteristics of the sewage. Therefore, it is suggested that further research be carried out in order to track SARS-CoV-2 concentrations in wastewater, thus corroborating with the fight against the pandemic and the achievement of epidemiological surveillance systems based on sewage monitoring.
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In 2020, we live in obscure times of a health crisis due to the Sars-CoV-2 syndemic that opened up perverse social inequality and the inability to provide all basic public services with the legitimation of necropolitics and nefarious arguments. There was also a vertiginous growth of information, which was transmitted mainly by social media, with a global reach and which was not always accurate. In the midst of this scenario, an extension course was promoted in order to facilitate the dialogue and exchange of knowledge between the community and the university, thus overcoming the discourse of academic hegemony and replacing it with the idea of an alliance with movements, sectors and social organizations. In this work, the speeches of the course participants in relation to the texts produced during the course were analyzed, taking as a pillar the content analysis of Bardin (2002). Participants pondered, among other aspects, about underreporting, social inequality and the search for reliable information. We conclude with the understanding of the importance of facing the verb to hope as an imperative;not as a way to conform, but to resist and try to seek solutions together. © 2022, Brazilian Institute for Information in Science and Technology. All rights reserved.
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The use of hand antiseptics became widespread as a routine in the fight against COVID-19. In the market, the availability and purchase of substandard antiseptics create a permanent concern with safety, even after a pandemic. Therefore, the development of easy-to-deploy analytical methods for the quality control of alcohol-based hand antiseptics is needed. In this work, to determine the ethanol content in alcohol gel the use of refractometry and alcohol oxidation method by dichromate accompanied by UV-Vis spectroscopy were applied. The results indicated that 19 brands (out of the 70 evaluated) (27.1%) had levels of ethyl alcohol below the recommended level (68.25%), therefore, they are ineffective for hand asepsis. For the quality control of hand antiseptics, refractometry and the oxidation-reduction reaction are complementary analytical methodologies. As a quick, inexpensive screening method, refractometry provides a more suitable technique. However, the interference of emollients may affect the accuracy of the ethanol content determination. Therefore, applying the ethanol oxidation method coupled with electronic spectroscopy offers a simple and broadly accessible method to confirm the ethanol content in alcohol-based hand antiseptics. In addition to developing quality control protocols, is also described the 3.5-ton production of alcohol gel at the Federal University of Bahia.
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Background: Despite using biosafety protocols, dentists fear contracting COVID-19 and face economic uncertainties about their professional future caused by the pandemic. Objective: This study aimed at determining the prevalence of anxiety and identifying factors associated with it among dentists during the COVID-19 pandemic in Brazil. Methods: A cross-sectional study involving 408 Brazilian dental surgeons selected by snowball technique who filled an electronic questionnaire about sex, race, dental specialty, health habits, health-related quality of life, anxiety, and COVID-19-related aspects. Symptoms of anxiety were measured by the Beck anxiety inventory, and health-related quality of life was assessed by the World Health Organization Quality of Life questionnaire. Poisson regression was used to obtain estimates of adjusted prevalence ratios. Results: The prevalence rate of anxiety was found to be 27.5% and it was significantly higher among dentists who were afraid of catching COVID-19 (Prevalence Ratio=PR=2.52), and among those who reported sweating, wheezing, and increased heart rate during work (PR=3.67). Afro-American dentists were 48% more anxious than dentists belonging to the white/yellow race. The mean value of the quality of life of anxious dentists compared to non-anxious dentists was 13% lower in the physical domain, 12% lower in the psychological domain, and 7% higher in the social relationship domain. Conclusion: The prevalence of anxiety among Brazilian dentists, in the context of economic uncertainty and social distance imposed by the COVID-19 pandemic, is high and associated with the fear of contracting the disease, physical symptomatology of stress, being Afro-American, and altered quality of life in the physical, psychological, and social relationships domains.
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This was a cross-sectional, anonymous, online survey aimed at assessing the perceptions and basic knowledge of COVID-19, a highly transmissible disease caused by SARS-CoV-2, in a sample population in the Triângulo Mineiro region, Minas Gerais, Brazil. A questionnaire devised by the researchers and distributed through social media was applied between June 16, 2020 and August 21, 2020. The survey consisted of questions about the basic aspects of COVID-19, which included symptoms, risk groups, suspicion of infection, prevention, transmission, and perception regarding social isolation. The average distribution, frequencies, similarities and differences between the responses for the different variables were evaluated. Five hundred twenty valid responses were obtained from participants aged ≥18 years. Most of the respondents showed satisfactory basic knowledge of COVID-19. Moreover, the data showed that the participants scored an average of 87.6%. Sex, age, and socioeconomic vulnerability presented a statistically significant link with knowledge of the disease;women, young participants, and the least socioeconomically vulnerable had the highest scores. This study indicated that the population in the Triângulo Mineiro region able to access social networking platforms were basically well informed regarding COVID-19, although differences were observed depending on the group analyzed. © 2021 Brazilian Society of Parasitology. All rights reserved.
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Introduction: Fast and efficient assessment of prognosis of coronavirus disease 19 (COVID-19) is needed to optimize the allocation of health care and human resources, to empower early identification and intervention of patients at higher risk of poor outcome. A proper assessment tool may guide decision making, to develop an appropriate plan of care for each patient. Although different scores have been proposed, the majority of them are limited due to high risk of bias, and there is a lack of reliable prognostic prediction models. Purpose: To develop and validate an easy applicable rapid scoring system that employs routinely available clinical and laboratory data at hospital presentation, to predict in-hospital mortality in patients with COVID-19, able to discriminate high vs non-high risk patients. Additionally, we aimed to compare this score with other existing ones. Method: Cohort study, conducted in 36 Brazilian hospitals in 17 cities. Consecutive symptomatic patients (≥18 years old) with laboratory confirmed COVID-19 admitted to participating hospitals. Primary outcome was in-hospital mortality. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients that were admitted between March-July, 2020. The model was then validated in the 1054 patients admitted during August-September, as well as in an external cohort of 474 Spanish patients. Results: Median (25th-75th percentile) age of the model-derivation cohort was 60 (48-72) years, 53.8% were men, in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. From 20 potential predictors, seven significant variables were included in the in-hospital mortality risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO2/FiO2 ratio, platelet count and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829 to 0.859), which was confirmed in the Brazilian (0.859) and Spanish (0.899) validation cohorts. Our ABC2-SPH score showed good calibration in both Brazilian cohorts, but, in the Spanish cohort, mortality was somewhat underestimated in patients with very high (>25%) risk. The ABC2- SPH score is implemented in a freely available online risk calculator. Conclusions: We designed and validated an easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation, for early stratification for in-hospital mortality risk of patients with COVID-19.
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Background: A lot of attention has been drawn to the identification of predictors of VTE in COVID-19 patients, and an accurate clinical prediction model is still lacking in this context. Aims: To develop a clinical prediction model using artificial intelligence techniques, to predict VTE in COVID-19 patients, using variables easily available upon hospital admission. Methods: This multicenter cohort included consecutive adult patients (≥ 18 years-old) with laboratory-confirmed COVID-19 from 37 Brazilian hospitals from 17 cities, between March and September 2020. Study data were collected from medical records using Research Electronic Data Capture (REDCap) tools. We trained multiple machine learning models on various combinations of structured and non-structured features, calibrated to reflect a probability distribution while predicting the desired clinical outcome. Subsequently, we analyzed the relationship between this model ' s predicted confidence score and the fraction of false negatives in the test sample to devise a splitting point where no false negatives would occur, thus calibrating for sensitivity over specificity. The study was approved by the National Research Ethics Commission waiving off the application of informed consent. Results: The dataset included 6421 patients (median age 61 [P25-75 48-73] years-old, 54.8% men), 4.5% of them developed venous thromboembolic disease. Patient ' s age, sex and comorbidities, as well as their list of household prescription drugs, history of recent surgery and laboratory tests were significant predictors. Given a proper confidence level, our model predicted 100% of the true positive cases while eliminating a significant portion of the true negatives (Figure 1). (Figure Presented) Conclusions: This study suggests that an ensemble of decision rules can effectively predict COVID patients with high risk of VTE. It might be possible to decrease the use of anticoagulants while still treating patients with an appreciable likelihood of thromboembolism.
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Background : COVID-19 patients are at increased risk of venous thromboembolism (VTE), and this complication leads to a worse prognosis. However, to diagnose VTE on COVID-19 patients is a challenge to physicians, as the symptoms of pulmonary embolism can often be mistaken for the overlapped viral pneumonia. Herein, there is still little information on VTE incidence and associated risk factors specifically for this population. Aims : To assess the incidence and associated risk factors for VTE in hospitalized COVID-19 patients in Brazilian hospitals. Methods : Retrospective multicenter cohort in 15 Brazilian hospitals. Consecutive adult patients (≥ 18 years-old) with laboratoryconfirmed COVID-19 between March and September 2020 were included. Study data were collected from medical records using Research Electronic Data Capture (REDCap) tools. The study was approved by the National Research Ethics Commission waiving off the application of informed consent. Results : Of 4,021 patients included, 234 (5.8%) had VTE. When comparing VTE and non-VTE groups (Tables 1 and 2), there was no statistical difference in terms of sex and age between groups. The median age was 63 years-old (IQR 51-72 years-old) in VTE group. The most common comorbidities for both groups were hypertension and diabetes. Obesity, chronic pulmonary obstructive disease, previous VTE and recent surgery were more frequent in VTE group. D-dimer, C-reactive protein, lactate dehydrogenase levels and lymphocyte count were higher in the VTE group. Admission to intensive care units (37.6% vs 69.7%;P < 0,001) and in-hospital mortality (19.0% vs 28.3%;P < 0,01) were significantly higher in those who had VTE. Conclusions : Overall, 5.8% of COVID-19 hospitalized patients had VTE. Elevated laboratory values were associated with increased risk of this condition. VTE was associated with higher rates of intensive care admission and in-hospital mortality.
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Purpose: The purpose of this paper is to explore how the COVID-19 pandemic has been managed in Brazil, especially at the Federal Administrative level, with the focus being on the implications for human rights and public health in the country. Design/methodology/approach: The research is built on a qualitative design made up of a case-study and review of the literature and is based on inductive reasoning. Findings: Main conclusions were that: by not making sufficient efforts to safeguard the lives of Brazilians or to strengthen public health institutions amid the pandemic, Bolsonaro’s Administration may be violating the rights to life and health, among others, by omission;it was demonstrated that the President has worked unceasingly to bulldoze anti-COVID-19 efforts, which can be better explained through the concepts of necropolitics and neoliberal authoritarianism. Research limitations/implications: One of the limitations to this research is that this paper was not able to discuss more thoroughly which other human rights norms and principles (apart from the right to health, life and the duty to protect vulnerable populations) have possibly been violated amid the COVID-19 pandemic in the country. Overall, this research can help expand the literature on human rights in health management during and after emergency times. Originality/value: This paper focuses on recent events and on urgent matters that need to be addressed immediately in Brazil. This study provides an innovative health policy/human rights analysis to build an academic account of the ongoing pandemic in the largest country in South America. © 2020, Emerald Publishing Limited.
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Introduction: The new Coronavirus pandemic has had an impact on health systems worldwide. Smokers were directly affected by these changes. Objective: To measure the new Coronavirus pandemic impact on smoking cessation from the analysis of data from the Pernambuco State Tobacco Control Program. Method: Descriptive cross-sectional study, using data from the monitoring strategy of the State Tobacco Control Program of the State Health Secretariat of Pernambuco (SES-PE) as the unit of analysis, comparing services in the second quarter of 2019 and 2020. Results: Between May and August 2019, 3.282 smoking patients sought treatment for smoking cessation in SUS, in Pernambuco. In a similar period, between the months of May and August of the year 2020, treatment for smoking cessation was sought by 680 smoking users, representing a drop of 79,28%. In addition, the number of municipalities offering treatment for smoking cessation in SUS dropped from 97 to 36 (62,89%) and the number of primary health care units providing treatment for smoking cessation in SUS went from 277 to 80 (71,11%). Conclusions: The decrease in the offer of treatment by the State Program to Combat Smoking is worrying. Although its relation with COVID-19 has not been fully elucidated, the cessation of tobacco use has already established benefits. Thus, it is necessary to encourage the adoption of new strategies and technologies, using the window of opportunity that the fear of COVID-19/smoking association created.
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The National Policies of Humanization and Permanent Health Education (PHE) have shown advances and setbacks in their historical process. Some concepts from the theoretical framework of institutional analysis can contribute in these themes, such as the concept of analyzer. This article discusses the analyzers identified in an intervention research with professionals who work as supporters of humanization and/or articulators of PHE in municipalities of the state of São Paulo. The theoretical-methodological framework is the institutional analysis, socio-clinical line, focusing on the work of the analyzers. The intervention groups were composed of 30 participants. We highlight three analyzers: (1) the COVID-19 historical analyzer;(2) the time analyzer;(3) the silence analyzer. These analyzers evidence tensions such as: the peripheral place of primary care, discomfort in the face of “not knowing” and/or lethargy in the face of imposed non-doing, and the paradox of creating and interrupting both care actions and support for the teams. © 2022 Universidade de Sao Paulo 1. All rights reserved.