Previous BCG vaccination is associated with less severe clinical progression of COVID-19.

BACKGROUND: BCG vaccination, originally used to prevent tuberculosis, is known to "train" the immune system to improve defence against viral respiratory infections. We investigated whether a previous BCG vaccination is associated with less severe clinical progression of COVID-19 METHODS: A case-control study comparing the proportion with a BCG vaccine scar (indicating previous vaccination) in cases and controls presenting with COVID-19 to health units in Brazil. Cases were subjects with severe COVID-19 (O2 saturation < 90%, severe respiratory effort, severe pneumonia, severe acute respiratory syndrome, sepsis, and septic shock). Controls had COVID-19 not meeting the definition of "severe" above. Unconditional regression was used to estimate vaccine protection against clinical progression to severe disease, with strict control for age, comorbidity, sex, educational level, race/colour, and municipality. Internal matching and conditional regression were used for sensitivity analysis. RESULTS: BCG was associated with high protection against COVID-19 clinical progression, over 87% (95% CI 74-93%) in subjects aged 60 or less and 35% (95% CI - 44-71%) in older subjects. CONCLUSIONS: This protection may be relevant for public health in settings where COVID-19 vaccine coverage is still low and may have implications for research to identify vaccine candidates for COVID-19 that are broadly protective against mortality from future variants. Further research into the immunomodulatory effects of BCG may inform COVID-19 therapeutic research.

High SARS-CoV-2 tropism and activation of immune cells in the testes of non-vaccinated deceased COVID-19 patients.

BACKGROUND: Cellular entry of SARS-CoV-2 has been shown to rely on angiotensin-converting enzyme 2 (ACE2) receptors, whose expression in the testis is among the highest in the body. Additionally, the risk of mortality seems higher among male COVID-19 patients, and though much has been published since the first cases of COVID-19, there remain unanswered questions regarding SARS-CoV-2 impact on testes and potential consequences for reproductive health. We investigated testicular alterations in non-vaccinated deceased COVID-19-patients, the precise location of the virus, its replicative activity, and the immune, vascular, and molecular fluctuations involved in the pathogenesis. RESULTS: We found that SARS-CoV-2 testicular tropism is higher than previously thought and that reliable viral detection in the testis requires sensitive nanosensors or RT-qPCR using a specific methodology. Through an in vitro experiment exposing VERO cells to testicular macerates, we observed viral content in all samples, and the subgenomic RNA's presence reinforced the replicative activity of SARS-CoV-2 in testes of the severe COVID-19 patients. The cellular structures and viral particles, observed by transmission electron microscopy, indicated that macrophages and spermatogonial cells are the main SARS-CoV-2 lodging sites, where new virions form inside the endoplasmic reticulum Golgi intermediate complex. Moreover, we showed infiltrative infected monocytes migrating into the testicular parenchyma. SARS-CoV-2 maintains its replicative and infective abilities long after the patient's infection. Further, we demonstrated high levels of angiotensin II and activated immune cells in the testes of deceased patients. The infected testes show thickening of the tunica propria, germ cell apoptosis, Sertoli cell barrier loss, evident hemorrhage, angiogenesis, Leydig cell inhibition, inflammation, and fibrosis. CONCLUSIONS: Our findings indicate that high angiotensin II levels and activation of mast cells and macrophages may be critical for testicular pathogenesis. Importantly, our findings suggest that patients who become critically ill may exhibit severe alterations and harbor the active virus in the testes.

Profile of Brazilian inpatients with COVID-19 vaccine breakthrough infection and risk factors for unfavorable outcome.

Objective: To characterize the epidemiological and clinical profile of individuals more likely to become infected with SARS-CoV-2 after the fully vaccination schedule in order to profile priority groups to receive a booster dose in situations of vaccine doses shortage as well as for maintenance of personal protective care. Methods: This cross-sectional study used data from hospitalized COVID-19 patients aged ≥18 years, who had been fully vaccinated and had a SARS-CoV-2 infection positive diagnosis collected from the SIVEP-Gripe database (Influenza Epidemiological Surveillance Information System) from January 18, 2021 to September 15, 2021. Demographic data, clinical symptoms and preexisting medical conditions (comorbidities) were analyzed. The primary outcome was in-hospital death. Results: The majority of hospitalized patients with vaccine breakthrough infection were ≥60 years old, male, with critical or severe COVID-19. The fatality rate was extremely high (50.27%) and more pronounced in elderly groups. The most prevalent symptoms were cough, dyspnea, respiratory distress, and low blood oxygen saturation. The most frequent comorbidities were heart disease and diabetes. High fatality rates were observed among patients admitted to the intensive care units (72.88%) and those who required invasive mechanical ventilation (87.82%). The main risk factors for an unfavorable outcome were older age, respiratory compromise, inactivated virus vaccine immunization, and preexisting medical conditions. Conclusions: We characterized the profile of hospitalized Brazilian patients with COVID-19 vaccine breakthrough infection and the risk factors for an unfavorable outcome. These data allow to identify priority groups to receive a booster dose and to continue using personal protection.

Tracking the turnover of SARS-CoV-2 VOCs Gamma to Delta in a Brazilian state (Minas Gerais) with a high-vaccination status.

The emergence and global dissemination of Severe Acute Respiratory Syndrome virus 2 (SARS-CoV-2) variants of concern (VOCs) have been described as the main factor driving the Coronavirus Disease 2019 pandemic. In Brazil, the Gamma variant dominated the epidemiological scenario during the first period of 2021. Many Brazilian regions detected the Delta variant after its first description and documented its spread. To monitor the introduction and spread of VOC Delta, we performed Polymerase Chain Reaction (PCR) genotyping and genome sequencing in ten regional sentinel units from June to October 2021 in the State of Minas Gerais (MG). We documented the introduction and spread of Delta, comprising 70 per cent of the cases 8 weeks later. Comparing the viral loads of the Gamma and Delta dominance periods, we provide additional evidence that the latter is more transmissible. The spread and dominance of Delta did not culminate in the increase in cases and deaths, suggesting that the vaccination may have restrained the epidemic growth. Analysis of 224 novel Delta genomes revealed that Rio de Janeiro state was the primary source for disseminating this variant in the state of MG. We present the establishment of Delta, providing evidence of its enhanced transmissibility and showing that this variant shift did not aggravate the epidemiological scenario in a high immunity setting.

Timeline Kinetics of Systemic and Airway Immune Mediator Storm for Comprehensive Analysis of Disease Outcome in Critically Ill COVID-19 Patients.

In the present study, the levels of serum and airway soluble chemokines, pro-inflammatory/regulatory cytokines, and growth factors were quantified in critically ill COVID-19 patients (total n=286) at distinct time points (D0, D2-6, D7, D8-13 and D>14-36) upon Intensive Care Unit (ICU) admission. Augmented levels of soluble mediators were observed in serum from COVID-19 patients who progress to death. An opposite profile was observed in tracheal aspirate samples, indicating that systemic and airway microenvironment diverge in their inflammatory milieu. While a bimodal distribution was observed in the serum samples, a unimodal peak around D7 was found for most soluble mediators in tracheal aspirate samples. Systems biology tools further demonstrated that COVID-19 display distinct eccentric soluble mediator networks as compared to controls, with opposite profiles in serum and tracheal aspirates. Regardless the systemic-compartmentalized microenvironment, networks from patients progressing to death were linked to a pro-inflammatory/growth factor-rich, highly integrated center. Conversely, patients evolving to discharge exhibited networks of weak central architecture, with lower number of neighborhood connections and clusters of pro-inflammatory and regulatory cytokines. All in all, this investigation with robust sample size landed a comprehensive snapshot of the systemic and local divergencies composed of distinct immune responses driven by SARS-CoV-2 early on severe COVID-19.

An overview of Brazilian working age adults vulnerability to COVID-19.

Brazil is a country of continental dimensions, where many smaller countries would fit. In addition to demographic, socioeconomic, and cultural differences, hospital infrastructure and healthcare varies across all 27 federative units. Therefore, the evolution of COVID-19 pandemic did not manifest itself in a homogeneous and predictable trend across the nation. In late 2020 and early 2021, new waves of the COVID-19 outbreak have caused an unprecedented sanitary collapse in Brazil. Unlike the first COVID-19 wave, in subsequent waves, preliminary evidence has pointed to an increase in the daily reported cases among younger people being hospitalized, overloading the healthcare system. In this comprehensive retrospective cohort study, confirmed cases of hospitalization, ICU admission, IMV requirement and in-hospital death from Brazilian COVID-19 patients throughout 2020 until the beginning of 2021 were analyzed through a spatio-temporal study for patients aged 20-59 years. All Brazilian federative units had their data disaggregated in six periods of ten epidemiological weeks each. We found that there is a wide variation in the waves dynamic due to SARS-CoV-2 infection, both in the first and in subsequent outbreaks in different federative units over the analyzed periods. As a result, atypical waves can be seen in the Brazil data as a whole. The analysis showed that Brazil is experiencing a numerical explosion of hospitalizations and deaths for patients aged 20-59 years, especially in the state of São Paulo, with a similar proportion of hospitalizations for this age group but higher proportion of deaths compared to the first wave.

A temporal study of Brazilian pregnant and postpartum women vulnerability for COVID-19: Characteristics, risk factors and outcomes.

BACKGROUND: During the COVID-19 second wave in Brazil, there has been a significant increase in the number of daily cases and deaths, including pregnant and postpartum women. We assess risk factors and outcomes for this priority group compared to the COVID-19 non-pregnant cohort in two epidemic waves. METHODS: In this retrospective cohort study we evaluated data of hospitalized pregnant, postpartum, and nonpregnant women aged 15-44 years, between epidemiological weeks 2020-8 and 2021-15, who tested positive for SARS-CoV-2, retrieved from the Influenza Epidemiological Surveillance Information System maintained by Ministry of Health of Brazil. We analysed in-hospital case fatality rate, crude and adjusted risk ratios on different outcomes aiming to compare data in two waves. FINDINGS: The study included pregnant women (n = 7,132), postpartum women (n = 2,405) and nonpregnant women (n = 76,278) hospitalized with COVID-19. Case fatality rates of pregnant women were lower in both waves compared to nonpregnant women, but higher among postpartum women. The risk for admission to the intensive care unit and invasive mechanical ventilation requirement in both waves was significantly higher among postpartum women compared to nonpregnant women. Cardiac disease, diabetes, obesity, and asthma were the most frequent underlying medical conditions in all patient groups. These comorbidities were significantly less frequent among pregnant women. INTERPRETATION: Pregnant women with COVID-19 are at lower risk of poor outcome compared to nonpregnant women. On the other hand, postpartum women are at higher risk of adverse outcomes compared to pregnant and nonpregnant women, especially during the second wave. There was a significant increase in the in-hospital case fatality rate for all patient groups during the second wave of COVID-19. FUNDING: This study was financed in part by CAPES, CNPq, FAPEMIG and UFSJ.

Home confinement during COVID-19 pandemic reduced physical activity but not health-related quality of life in previously active older women

We investigate the effect of COVID-19 home confinement on levels of physical activity, sedentary behavior, and health-related quality of life (HRQL) in older women previously participating in exercise and educational programs. Our hypothesis was that home confinement would result in a reduction in levels of physical activity, an increase in sedentary behavior, and a reduction in HRQL. Sixty-four older women (age = 72 ± 5 yrs) under home confinement who participated in a physical exercise/educational program had their levels of physical activity, sedentary behavior, and HRQL assessed before and during (11 to 13 weeks after the introduction of government recommendations to reduce virus transmission) COVID-19 pandemic. There were significant reductions in total physical activity (−259 METs/week, P = .02), as a result of a ~17.0% reduction in walking (−30.8 min/week, P = .004) and ~41.8% reduction in vigorous-intensity activity (−29.6 min/week, P < .001). Sedentary behavior also increased (2.24 h/week, P < .001;1.07 h/week days, P < .001;and 1.54 h/weekend days, P < .001). However, no significant change occurred in moderate-intensity physical activity, and HRQL domains and facets, except for an improvement in the environment domain. Home confinement due to COVID-19 pandemic decreased levels of physical activity and increased levels of sedentary behavior in previously active older women. However, there were no significant changes in HRQL. These results suggest that educational programs promoting healthy behaviors may attenuate the impact of home confinement in older women. [ FROM AUTHOR] Copyright of Educational Gerontology is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

COVID-19 Misinformation in Portuguese-Speaking Countries: Agreement with Content and Associated Factors

In the wake of the COVID-19 pandemic, a complex phenomenon called the “infodemic”has emerged, compromising coping with the pandemic. This study aims to estimate the prevalence of agreement with misinformation about COVID-19 and to identify associated factors. A web survey was carried out in Portuguese-speaking countries in two stages: 1. the identification of misinformation circulating in the included countries;2. a multicentric online survey with residents of the included countries. The outcome of the study was agreement or disagreement with misinformation about COVID-19. Multivariate analyzes were conducted using the Poisson regression model with robust variance, a logarithmic link function, and 95% confidence intervals. The prevalence of agreement with misinformation about COVID-19 was 63.9%. The following factors increased the prevalence of this outcome: having a religious affiliation (aPR: 1.454, 95% CI: 1.393–1.517), having restrictions on leisure (aPR: 1.230, 95% CI: 1.127–1.342), practicing social isolation (aPR: 1.073, 95% CI: 1.030–1.118), not avoiding agglomeration (aPR: 1.060, 95% CI: 1.005–1.117), not seeking/receiving news from scientific sources (aPR: 1.153, 95% CI: 1.068–1.245), seeking/receiving news from three or more non-scientific sources (aPR: 1.114, 95% CI: 1.049–1.182), and giving credibility to news carried by people from social networks (aPR: 1.175, 95% CI: 1.104–1.251). There was a high prevalence of agreement with misinformation about COVID-19. The quality, similarity, uniformity, and acceptance of the contents indicate a concentration of themes that reflect “homemade”, simple, and easy methods to avoid infection by SARS-CoV-2, compromising decision-making and ability to cope with the disease.

On the analysis of mortality risk factors for hospitalized COVID-19 patients: A data-driven study using the major Brazilian database.

BACKGROUND: Brazil became the epicenter of the COVID-19 epidemic in a brief period of a few months after the first officially registered case. The knowledge of the epidemiological/clinical profile and the risk factors of Brazilian COVID-19 patients can assist in the decision making of physicians in the implementation of early and most appropriate measures for poor prognosis patients. However, these reports are missing. Here we present a comprehensive study that addresses this demand. METHODS: This data-driven study was based on the Brazilian Ministry of Health Database (SIVEP-Gripe) regarding notified cases of hospitalized COVID-19 patients during the period from February 26th to August 10th, 2020. Demographic data, clinical symptoms, comorbidities and other additional information of patients were analyzed. RESULTS: The hospitalization rate was higher for male gender (56.56%) and for older age patients of both sexes. Overall, the lethality rate was quite high (41.28%) among hospitalized patients, especially those over 60 years of age. Most prevalent symptoms were cough, dyspnoea, fever, low oxygen saturation and respiratory distress. Cardiac disease, diabetes, obesity, kidney disease, neurological disease, and pneumopathy were the most prevalent comorbidities. A high prevalence of hospitalized COVID-19 patients with cardiac disease (65.7%) and diabetes (53.55%) and with a high lethality rate of around 50% was observed. The intensive care unit (ICU) admission rate was 39.37% and of these 62.4% died. 24.4% of patients required invasive mechanical ventilation (IMV), with high mortality among them (82.98%). The main mortality risk predictors were older age and IMV requirement. In addition, socioeconomic conditions have been shown to significantly influence the disease outcome, regardless of age and comorbidities. CONCLUSION: Our study provides a comprehensive overview of the hospitalized Brazilian COVID-19 patients profile and the mortality risk factors. The analysis also evidenced that the disease outcome is influenced by multiple factors, as unequally affects different segments of population.

Determinants of COVID-19 Vaccine Hesitancy in Portuguese-Speaking Countries: A Structural Equations Modeling Approach.

COVID-19 vaccine hesitancy (VH) has caused concerns due to the possible fluctuations that may occur directly impacting the control of the pandemic. In this study, we aimed to estimate the prevalence and factors associated with COVID-19 VH in Portuguese-speaking countries. We developed a web survey (N:6,843) using an online, structured, and validated questionnaire. We used Measurement Models, Exploratory Factor Analysis, Exploratory Structural Equation Models, and Confirmatory Factor Analysis for the data analysis. The overall prevalence of COVID-19 VH in Portuguese-speaking countries was 21.1%. showed a statistically significant direct effect for VH: vaccine-related conspiracy beliefs (VB) (ß = 0.886), perceived stress (PS) (ß = 0.313), COVID-19 Misinformation (MIS) (ß = 0.259) and individual responses to COVID-19 (CIR) (ß = -0.122). The effect of MIS and CIR for VH was greater among men and of PS and VB among women; the effect of PS was greater among the youngest and of VB and CIR among the oldest. No discrepant differences were identified in the analyzed education strata. In conclusion, we found that conspiracy beliefs related to the vaccine strongly influence the decision to hesitate (not to take or to delay the vaccine). Specific characteristics related to gender, age group, social and cognitive vulnerabilities, added to the knowledge acquired, poorly substantiated and/or misrepresented about the COVID-19 vaccine, need to be considered in the planning of vaccination campaigns. It is necessary to respond in a timely, fast, and accurate manner to the challenges posed by vaccine hesitancy.

Predicting the Disease Outcome in COVID-19 Positive Patients Through Machine Learning: A Retrospective Cohort Study With Brazilian Data.

The first officially registered case of COVID-19 in Brazil was on February 26, 2020. Since then, the situation has worsened with more than 672, 000 confirmed cases and at least 36, 000 reported deaths by June 2020. Accurate diagnosis of patients with COVID-19 is extremely important to offer adequate treatment, and avoid overloading the healthcare system. Characteristics of patients such as age, comorbidities and varied clinical symptoms can help in classifying the level of infection severity, predict the disease outcome and the need for hospitalization. Here, we present a study to predict a poor prognosis in positive COVID-19 patients and possible outcomes using machine learning. The study dataset comprises information of 8, 443 patients concerning closed cases due to cure or death. Our experimental results show the disease outcome can be predicted with a Receiver Operating Characteristic AUC of 0.92, Sensitivity of 0.88 and Specificity of 0.82 for the best prediction model. This is a preliminary retrospective study which can be improved with the inclusion of further data. Conclusion: Machine learning techniques fed with demographic and clinical data along with comorbidities of the patients can assist in the prognostic prediction and physician decision-making, allowing a faster response and contributing to the non-overload of healthcare systems.

Experiências e desafios da formação médica durante a pandemia da COVID-19

Objective: to report the experience and challenges of medical students in the first semester of medical training during the COVID-19 pandemic. Method: Report of experience and challenges of medical graduation during the pandemic of the new coronavirus in a private higher education institution, from March to July 2020. Results: The University Center (UNIVAG) established measures to face COVID-19, adopting Emergency Home Education. This experience demonstrated great adaptive capacity of those involved in the learning processes of theoretical content, as well as more creative attitudes of students and the inclusion of other active methodologies in the teaching plan of the Community Interaction Program in order to bring the student closer to reality. Conclusion: Given this scenario, adapting to the use of available technologies was a challenge, but essential to add knowledge to medical students and continue the school year. Objetivo: reportar la experiencia y desafíos de los estudiantes de medicina en el primer semestre de formación médica durante la pandemia de COVID-19. Método: Informe de experiencia y desafíos de la graduación médica durante la pandemia del nuevo coronavirus en una institución privada de educación superior, de marzo a julio de 2020. Resultados: El Centro Universitario (UNIVAG) estableció medidas para enfrentar el COVID-19, adoptando la educación de emergencia en el hogar. Esta experiencia demostró una gran capacidad adaptativa de los involucrados en los procesos de aprendizaje de contenidos teóricos, así como actitudes más creativas de los estudiantes y la inclusión de otras metodologías activas en el plan docente del Programa de Interacción Comunitaria con el fin de acercar al estudiante a la realidad. Conclusión: Ante este escenario, adaptarse al uso de las tecnologías disponibles fue un desafío, pero fundamental para sumar conocimientos a los estudiantes de medicina y continuar el curso escolar. Objetivo: relatar a experiência e os desafios dos estudantes de medicina do primeiro semestre da formação médica durante a pandemia da COVID-19. Método: Relato de experiência e desafios da graduação médica durante a pandemia do novo coronavírus em uma instituição de ensino superior privada, no período de março a julho de 2020. Resultados: O Centro Universitário (UNIVAG) estabeleceu medidas para o enfrentamento da COVID-19, adotando a Educação Domiciliar Emergencial. Essa experiência demonstrou grande capacidade adaptativa dos envolvidos nos processos de aprendizagem dos conteúdos teóricos, bem como atitudes mais criativas dos alunos e a inclusão de outras metodologias ativas no plano de ensino do Programa de Interação Comunitária a fim de aproximar o aluno da realidade. Conclusão: Diante deste cenário, a adaptação para a utilização de tecnologias disponíveis foi um desafio, porém essencial para agregar conhecimento aos graduandos de medicina e continuar o ano letivo.

Allocation of resources for health care in COVID-19 pandemic times: integrative review

ABSTRACT Objective: To analyze information on resource allocation in the context of the COVID-19 pandemic, published in indexed scientific journals, from December 2019 to March 2020. Methods: This is an integrative literature review, which took place in March 2020. All databases were investigated and studies were found only in MEDLINE. After applying the established criteria, six articles were selected. Results: It was evident that the allocation of resources is carried out as the demands emerge. The fragility in presenting scientific-methodological evidence that can guide decision makers for assertive allocation of available resources is highlighted. The results showed that studies on this subject are incipient and need to be expanded. Final considerations: The need for health organizations and area authorities to be better prepared for the proper use of available resources, with allocation based on scientific evidence and maximization of resources is indicated. RESUMEN Objetivo: Analizar las informaciones sobre la asignación de recursos en el contexto de la pandemia de COVID-19, publicadas en periódicos científicos indexados, en el período de diciembre de 2019 a marzo de 2020. Métodos: Se trata de revisión integrativa de la literatura, realizada en marzo de 2020. Han sido investigadas todas las bases de datos y encontrados estudios solamente en la MEDLINE. Después de la aplicación de los criterios establecidos, han sido seleccionados seis artículos. Resultados: Se evidenció que la asignación de recursos es realizada conforme emergen las demandas. Se destaca la fragilidad en la presentación de evidencia científico-metodológica que pueda orientar los tomadores de decisión para asignación asertiva de los recursos disponibles. Los resultados demostraron que estudios sobre esa temática son incipientes y necesitan ser ampliados. Consideraciones finales: Se indica la necesidad de las organizaciones de salud y las autoridades del área estar más bien preparadas para el uso adecuado de los recursos disponibles, con la asignación basada en evidencias científicas y maximización de los recursos. RESUMO Objetivo: Analisar as informações sobre a alocação de recursos no contexto da pandemia de COVID-19, publicadas em periódicos científicos indexados, no período de dezembro de 2019 a março de 2020. Métodos: Trata-se de revisão integrativa da literatura, realizada em março de 2020. Foram investigadas todas as bases de dados e encontrados estudos somente na MEDLINE. Após a aplicação dos critérios estabelecidos, foram selecionados seis artigos. Resultados: Evidenciou-se que a alocação de recursos é realizada conforme emergem as demandas. Destaca-se a fragilidade na apresentação de evidência científico-metodológica que possa nortear os tomadores de decisão para alocação assertiva dos recursos disponíveis. Os resultados demonstraram que estudos sobre essa temática são incipientes e necessitam ser ampliados. Considerações finais: Indica-se a necessidade de as organizações de saúde e as autoridades da área estarem mais bem preparadas para o uso adequado dos recursos disponíveis, com a alocação baseada em evidências científicas e maximização dos recursos.

Allocation of resources for health care in COVID-19 pandemic times: integrative review

ABSTRACT Objective: To analyze information on resource allocation in the context of the COVID-19 pandemic, published in indexed scientific journals, from December 2019 to March 2020. Methods: This is an integrative literature review, which took place in March 2020. All databases were investigated and studies were found only in MEDLINE. After applying the established criteria, six articles were selected. Results: It was evident that the allocation of resources is carried out as the demands emerge. The fragility in presenting scientific-methodological evidence that can guide decision makers for assertive allocation of available resources is highlighted. The results showed that studies on this subject are incipient and need to be expanded. Final considerations: The need for health organizations and area authorities to be better prepared for the proper use of available resources, with allocation based on scientific evidence and maximization of resources is indicated. RESUMEN Objetivo: Analizar las informaciones sobre la asignación de recursos en el contexto de la pandemia de COVID-19, publicadas en periódicos científicos indexados, en el período de diciembre de 2019 a marzo de 2020. Métodos: Se trata de revisión integrativa de la literatura, realizada en marzo de 2020. Han sido investigadas todas las bases de datos y encontrados estudios solamente en la MEDLINE. Después de la aplicación de los criterios establecidos, han sido seleccionados seis artículos. Resultados: Se evidenció que la asignación de recursos es realizada conforme emergen las demandas. Se destaca la fragilidad en la presentación de evidencia científico-metodológica que pueda orientar los tomadores de decisión para asignación asertiva de los recursos disponibles. Los resultados demostraron que estudios sobre esa temática son incipientes y necesitan ser ampliados. Consideraciones finales: Se indica la necesidad de las organizaciones de salud y las autoridades del área estar más bien preparadas para el uso adecuado de los recursos disponibles, con la asignación basada en evidencias científicas y maximización de los recursos. RESUMO Objetivo: Analisar as informações sobre a alocação de recursos no contexto da pandemia de COVID-19, publicadas em periódicos científicos indexados, no período de dezembro de 2019 a março de 2020. Métodos: Trata-se de revisão integrativa da literatura, realizada em março de 2020. Foram investigadas todas as bases de dados e encontrados estudos somente na MEDLINE. Após a aplicação dos critérios estabelecidos, foram selecionados seis artigos. Resultados: Evidenciou-se que a alocação de recursos é realizada conforme emergem as demandas. Destaca-se a fragilidade na apresentação de evidência científico-metodológica que possa nortear os tomadores de decisão para alocação assertiva dos recursos disponíveis. Os resultados demonstraram que estudos sobre essa temática são incipientes e necessitam ser ampliados. Considerações finais: Indica-se a necessidade de as organizações de saúde e as autoridades da área estarem mais bem preparadas para o uso adequado dos recursos disponíveis, com a alocação baseada em evidências científicas e maximização dos recursos.

Detection of SARS-CoV-2 RNA on public surfaces in a densely populated urban area of Brazil: A potential tool for monitoring the circulation of infected patients.

The world is experiencing the worst global health crisis in recent decades since December/2019 due to a new pandemic coronavirus. The COVID-19 disease, caused by SARS-CoV-2, has resulted in more than 30 million cases and 950 thousand deaths worldwide as of September 21, 2020. Determining the extent of the virus on public surfaces is critical for understanding the potential risk of infection in these areas. In this study, we investigated the presence of SARS-CoV-2 RNA on public surfaces in a densely populated urban area in Brazil. Forty-nine of 933 samples tested positive (5.25%) for SARS-CoV-2 RNA, including samples collected from distinct material surfaces, including metal and concrete, and distinct places, mainly around hospital care units and public squares. Our data indicated the contamination of public surfaces by SARS-CoV-2, suggesting the circulation of infected patients and the risk of infection for the population. Constant monitoring of the virus in urban areas is required as a strategy to fight the pandemic and prevent further infections.

Allocation of resources for health care in COVID-19 pandemic times: integrative review.

OBJECTIVE: To analyze information on resource allocation in the context of the COVID-19 pandemic, published in indexed scientific journals, from December 2019 to March 2020. METHODS: This is an integrative literature review, which took place in March 2020. All databases were investigated and studies were found only in MEDLINE. After applying the established criteria, six articles were selected. RESULTS: It was evident that the allocation of resources is carried out as the demands emerge. The fragility in presenting scientific-methodological evidence that can guide decision makers for assertive allocation of available resources is highlighted. The results showed that studies on this subject are incipient and need to be expanded. FINAL CONSIDERATIONS: The need for health organizations and area authorities to be better prepared for the proper use of available resources, with allocation based on scientific evidence and maximization of resources is indicated.

COVID-19: why the protection of health workers is a priority in the fight against the pandemic? COVID-19: ¿por qué la protección de los trabajadores de la salud es prioridad en la lucha contra la pandemia?

The pandemic caused by the new coronavirus (SARS-CoV-2) is a worldwide public health emergency. Some occupational categories, such as health workers, are at high risk of exposure to the infection. This article aims to summarize and systematize aspects related to the health and working conditions of health workers in this pandemic, especially in Brazil, successful experiences in the protection of healthcare work in other countries and recommendations for the Brazilian context. Immediate initiatives to protect and combat the pandemic in other countries included as strategic points: adequacy of working conditions;systematic testing and specific assistance actions for healthcare workers. In order to face COVID-19 in Brazil, the following recommendations stand out: review of service flows and definition of characteristics and conditions for each stage of service;establishment of COVID-19 as a work-related disease for exposed groups;effective registration of ‘occupation’ in information systems;establishment of special conditions for carrying out work in the event of an epidemic;attention to working hours and actions to reduce occupational stressors. The performance of these workers is a central element in facing the pandemic, therefore, the plan to combat COVID-19 must include protection and preservation of their physical and mental health.