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1.
11th International Conference on the Internet of Things, IoT 2021 ; : 211-214, 2021.
Article in English | Scopus | ID: covidwho-1784893

ABSTRACT

The COVID-19 pandemic crisis raised public health attention closer to our global society's demands. The disease proliferation occurs typically by droplet transmission, by being close to an infected person. Social distancing, a natural solution, is not always applicable to everyday needs, such as in the public transportation system, which is a space highly susceptible to viral proliferation. A set of ways to reduce proliferation in these infrastructures is by reinforcing facial masks usage, restraining symptomatic users, and reducing physical contact with public devices. Safe Gate, an Internet of Things (IoT) solution to enforce containment measures for disease proliferation, is proposed in this paper. This IoT solution is based on a network of edge computing devices used to control access to the entrance gate of the stations. The edge devices service samples an user's temperature and facial image to verify that body temperature is within normal bounds and the user is correctly wearing a face mask. The system is contact-free and does not require an active operator, with no personal data stored, preserving privacy. Additionally, it minimizes personnel involvement with passengers, ensuring staff protection. The research question is whether the solution with two levels of facial recognition using cognitive edge computing will meet the requirements of a real system. In addition to this question, a queuing model to verify the feasibility of the solution is presented and evaluates the operational impact on a real transportation system. © 2021 ACM.

2.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-330706

ABSTRACT

With the emergence of SARS-CoV-2 variants that may increase transmissibility and/or cause escape from immune responses 1-3 , there is an urgent need for the targeted surveillance of circulating lineages. It was found that the B.1.1.7 (also 501Y.V1) variant first detected in the UK 4,5 could be serendipitously detected by the ThermoFisher TaqPath COVID-19 PCR assay because a key deletion in these viruses, spike DELTA69-70, would cause a "spike gene target failure" (SGTF) result. However, a SGTF result is not definitive for B.1.1.7, and this assay cannot detect other variants of concern that lack spike DELTA69-70, such as B.1.351 (also 501Y.V2) detected in South Africa 6 and P.1 (also 501Y.V3) recently detected in Brazil 7 . We identified a deletion in the ORF1a gene (ORF1a DELTA3675-3677) in all three variants, which has not yet been widely detected in other SARS-CoV-2 lineages. Using ORF1a DELTA3675-3677 as the primary target and spike DELTA69-70 to differentiate, we designed and validated an open source PCR assay to detect SARS-CoV-2 variants of concern 8 . Our assay can be rapidly deployed in laboratories around the world to enhance surveillance for the local emergence spread of B.1.1.7, B.1.351, and P.1.

3.
Science ; 372(6544):815-821, 2021.
Article in English | EMBASE | ID: covidwho-1735994

ABSTRACT

Cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Manaus, Brazil, resurged in late 2020 despite previously high levels of infection. Genome sequencing of viruses sampled in Manaus between November 2020 and January 2021 revealed the emergence and circulation of a novel SARS-CoV-2 variant of concern. Lineage P.1 acquired 17 mutations, including a trio in the spike protein (K417T, E484K, and N501Y) associated with increased binding to the human ACE2 (angiotensin-converting enzyme 2) receptor. Molecular clock analysis shows that P.1 emergence occurred around mid-November 2020 and was preceded by a period of faster molecular evolution. Using a two-category dynamical model that integrates genomic and mortality data, we estimate that P.1 may be 1.7- to 2.4-fold more transmissible and that previous (non-P.1) infection provides 54 to 79% of the protection against infection with P.1 that it provides against non-P.1 lineages. Enhanced global genomic surveillance of variants of concern, which may exhibit increased transmissibility and/or immune evasion, is critical to accelerate pandemic responsiveness.

5.
MEDLINE;
Preprint in English | MEDLINE | ID: ppcovidwho-326624

ABSTRACT

Cases of SARS-CoV-2 infection in Manaus, Brazil, resurged in late 2020, despite high levels of previous infection there. Through genome sequencing of viruses sampled in Manaus between November 2020 and January 2021, we identified the emergence and circulation of a novel SARS-CoV-2 variant of concern, lineage P.1, that acquired 17 mutations, including a trio in the spike protein (K417T, E484K and N501Y) associated with increased binding to the human ACE2 receptor. Molecular clock analysis shows that P.1 emergence occurred around early November 2020 and was preceded by a period of faster molecular evolution. Using a two-category dynamical model that integrates genomic and mortality data, we estimate that P.1 may be 1.4-2.2 times more transmissible and 25-61% more likely to evade protective immunity elicited by previous infection with non-P.1 lineages. Enhanced global genomic surveillance of variants of concern, which may exhibit increased transmissibility and/or immune evasion, is critical to accelerate pandemic responsiveness. One-Sentence Summary: We report the evolution and emergence of a SARS-CoV-2 lineage of concern associated with rapid transmission in Manaus.

6.
Acs Applied Nano Materials ; 4(12):8, 2021.
Article in English | Web of Science | ID: covidwho-1586049

ABSTRACT

The successful development of multifunctional cotton fabrics with antimicrobial and antiviral activities is essential to prevent the proliferation of microorganisms and transmission of coronavirus virions today, especially with the emergence of new variants of SARS-CoV-2. In this work, we developed antimicrobial cotton fabrics with Ag/TiO2 nanoparticles synthesized via sonochemistry. Here, we show that more than 50% of infectious SARS-CoV-2 remain active after prolonged direct contact self-disinfecting materials capable of inhibiting the proliferation of Escherichia coli and Staphylococcus aureus. The findings bring several epidemiologic worries about using silver and TiO2 as self-disinfecting nanostructured agents to prevent coronavirus transmission.

10.
HemaSphere ; 5(SUPPL 2):379, 2021.
Article in English | EMBASE | ID: covidwho-1393457

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) pandemic has imposed several constrains in the medical practice, especially in hematologic patients (pts) where a higher mortality rate is expected. In our center strict measures were implemented earlier, with the use of personal protective equipment, hand wash at all times, internal separated circuits, frequent prophylactic tests, teleconsultation and rapid isolation of positive cases. However, data is still limited and risk factors for increased susceptibility remain unclear. Aims: Characterize our pts with COVID-19 regarding the type of hematologic disease, the respective treatment, infection severity and identification of any possible risk factors that may have impact in the outcome. Methods: Pts with a positive quantitative RT-PCR from nasopharyngeal swab between 18/03/2020 and 02/02/2021 were identified. Epidemiologic, laboratory, and clinical characteristics were retrospectively collected. Chi-square and Mann-Whitney-U tests were performed to identify statistical differences between groups and logistic binary regression to assess predictive risk factors. Severity of illness was defined by level of care [ambulatory, general inpatient wards and intensive care unit (ICU)], need for respiratory support, incidence of thrombotic events, acute kidney injury and/or death. Active hematologic treatment was defined as therapy within 6 months of COVID-19 diagnosis. Results: A total of 81 pts were identified, with a median age of 61 years (19-88), 52% were male, 63% had an ECOG PS 0 and 69% had at least one comorbidity (hypertension 36%, dyslipidemia 21%, cardiovascular disease 21%, diabetes mellitus 14% and pulmonary disease 11%). Regarding the hematologic disease, 83% had a neoplastic malignancy (non-Hodgkin lymphoma 30%, myeloproliferative neoplasms 16%, acute myeloid leukemia 11% and multiple myeloma 11%), 64% were in active treatment and 43% had active disease. Concerning the COVID-19 infection, 46% required hospital admission among which 65% needed respiratory support and 9% admitted to an ICU. Median overall survival (OS) was not reached (84% at 1 month) and the mortality rate was 17%, mainly in pts with active disease and neoplastic malignancy. Non-survival pts had a lower hemoglobin level (8,3g/dL vs 12g/dL;p-value 0,016), a higher CRP (218mg/L vs 22mg/L;p-value 0,041), acute renal failure (36% vs 6%;p-value 0,014), more need of respiratory support (71% vs 27%;p-value 0,004) and mechanical ventilation (21% vs 5%;p-value 0,022). There were no statistical differences regarding age, absolute lymphocyte count, platelet count and LDH. Regression analysis revealed hemoglobin level (p-value 0,026), CRP (p-value 0,05) and respiratory support (p-value 0,003) as predictive factors for death. In our pts there were no thrombotic events. Summary/Conclusion: Nearly half of the pts were admitted to the hospital and discharged. In our analysis low hemoglobin level, high CRP and respiratory support were associated with poorer survival, however, given our small sample, these findings need to be confirmed. Contrary to most of the published results, the number of confirmed COVID-19 positive cases was surprisingly low, with only 81 cases in 11 months, with a mortality rate similar to the general population and lower than expected. We believe that implementing early and rigorous protective measures as well as create self-awareness may be the key to improve mortality rate in this highly susceptible population.

11.
Journal of Clinical Rheumatology ; 27(SUPPL 1):S19, 2021.
Article in English | EMBASE | ID: covidwho-1368233

ABSTRACT

Objectives: To determine the main risk factors associated with COVID-19 in SLE patients. Methods: The Reuma CoV Brazil is a multicenter, observational, prospective cohort designed to monitor immune-mediated rheumatic diseases patients during SARS-CoV-2 pandemic in Brazil. SLE adult patients according to SLE SLICC criteria classification (2012), with and without (control group-CG) COVID-19 diagnosis were matched. Demographic data, managing of COVID-19, comorbidities, clinical characteristics (disease activity: Patient Report Outcomes-PROs, Physician Global Assessment and SLEDAI-2 K)were collected. Results: From May 2020 to January 2021, 604 SLE patients were included, 317 (52.4%) with COVID-19 and 287 (47.6%) in the CG. Both groups were homogeneous and comparable regarding sex and comorbidities. SLE patients with COVID-19 declared a lower level of social isolation (49.5% vs. 61.9%;p = 0.002), worked more commonly in health professions (10.4% vs. 3.5%;p = 0.002), presented more frequently joint (32.5% vs. 22.0%;p = 0.004) and hematological manifestations (18.0% vs. 11.5%;p = 0.025). SLEDAI-2 K did not differ among groups prior and after COVID-19 infection. However, considering the mean duration of COVID-19 symptoms (12.1 ± 8.8 days), infected patients had more severe disease activity's PROs after resolution of COVID-19 symptoms (2.9 ± 2.9 vs. 2.3 ± 2.6;p = 0.031). The hospitalization rate was 20.5% (n = 65), of whom 23 (7.2%) needed intensive care unit and 14 (4.4%) patients died. Hypertension [5,26 (1,9714,07);p = 0.001] and recently cyclophosphamide pulses [39,21 (4,17-368,53);p = 0.001] were associated with hospitalization and patients who received telemedicine medical care presented 72% less chance of hospitalization [0.28 (0.09-0.83);p = 0.023). Conclusion: COVID-19 was associated with a lower level of declared social isolation and more severe disease activity perception after SARS-CoV-2 infection according to PROs. Hypertension and cyclophosphamide were associated with hospitalization and telemedicine can be a useful tool for SLE patients with COVID-19. These data should be considered to perform public health policy and national guidelines to manage SLE patients during the pandemic, as well as to prioritize some special groups for the immunization program.

12.
Journal of Clinical Rheumatology ; 27(SUPPL 1):S114, 2021.
Article in English | EMBASE | ID: covidwho-1368218

ABSTRACT

Objectives: The engagement of undergraduate medical students (MS) in clinical research may lead to improvement in scientific method critical analysis, better performance as young physicians, awareness of innovation, and the development of leadership skills and teamwork perspectives (1). This study evaluated changings in daily routine and the awareness of patients' realities reported by MS participating on a research project involving rheumatic patients in Brazil during the COVID-19 pandemic. Methods: A secondary analysis of a web-based cross-sectional survey (2) including MS participating of Mário Pinotti II study (MPII) (3) was performed. Demographic characterization and the description of the MS impressions of the impact of participating of MPII are reported. Results: A total of 228 (58%) MS involved in MPII responded to the survey: 151 (66%) were women with (Mean(SD)) 22.8 (2.8) years of age, most were studying in public (N = 135 (59%)) medical schools, from 10 Brazilian states. Figures 1 and 2 summarizeMS' reports on the impact of participating of MPII on their daily routine and increased awareness of patient's realities. Conclusion: MS participating on the MPII study reported a better understanding of rheumatic patients' fears and uncertainties during the COVID-19 pandemic, including hydroxychloroquine shortage, lack of medical appointments and an unmet need related to more adequate information addressed to the rheumatic diseases. Furthermore, the close interaction among rheumatic patients, faculty, rheumatologists, and otherMShave provided a significant improvement in their feelings of usefulness during the pandemic and could contribute to their future professional activities.

13.
Annals of the Rheumatic Diseases ; 80(SUPPL 1):909-910, 2021.
Article in English | EMBASE | ID: covidwho-1358867

ABSTRACT

Background: The role of chronic use of hydroxychloroquine (HCQ) in rheumatic disease (RD) patients during the SARS-CoV-2 pandemic is still subject of discussion. Objectives: To compare the occurrence of COVID-19 and its outcomes between RD patients on HCQ use with individuals from the same household not taking the drug during community viral transmission in an observational prospective multicenter study in Brazil. Methods: Participants were enrolled and monitored through 24-week (From March 29th to Sep 30th, 2020) regularly scheduled phone calls performed by trained medical professionals. Epidemiological and demographic data, as well as RD disease activity status and current treatment data, specific information about COVID-19, hospitalization, need for intensive care, and death was recorded in both groups and stored in the Research Electronic Data Capture (REDCap) database. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. The statistical analysis was performed using IBM-SPSS v.20.0 software. Group comparisons were made using the Man-Whitney, Chi-Square and Fisher Exact Test, as well as multivariate regression models adjusted to confounders. Survival curves were performed using Kaplan-Meier analysis. Results: A total of 10,427 participants mean age (SD) of 44.04 (14.98) years were enrolled, including 6004 (57.6%) rheumatic disease patients, of whom 70.8% had systemic lupus erythematosus (SLE), 6.7% rheumatoid arthritis (RA), 4% primary Sjögren's syndrome (pSS), 1.8% mixed connective tissue disease (DMTC), 1% systemic sclerosis (SSc) and others (15.9), including overlap syndromes. In total, 1,132 (10.8%) participants fulfilled criteria for COVID-19, being 6.7% RD patients and 4.1% controls (p=0.002). A recent influenza vaccination had a protective role (p<0.001). Moderate and severe COVID-19 included the need for hospitalization, intensive care, mechanical ventilation or death. Infection severity was not different between groups (p=0.391) (Table 1). After adjustments for multiple confounders, the main risk factors significantly associated with COVID-19 were higher education level (OR=1.29 95%CI 1.05-1.59), being healthcare professionals (OR=1.91;95%CI 1.45-2.53), presence of two comorbidities (OR=1.31;95%CI 1.01-1.66) and three or more comorbidities associated (OR=1.69;95%CI 1.23-2.32). Interestingly, age ≥=65 years (OR=0.20;95%CI 0.11-0.34) was negatively associated. Regarding RD, the risk factors associated with COVID-19 diagnosys were SLE (OR= 2.37;95%CI 1.92-293), SSc (OR=2.25;95%CI 1.05-4.83) and rituximab use (OR=1.92;95%CI 1.13-3.26). In addition, age ≥=65 years (OR=5.47;95%CI 1.7-19.4) and heart disease (OR=2.60;95%CI 1.06-6.38) were associated with hospitalization. Seven female RD patients died, six with SLE and one with pSS, and the presence of two or more comorbidities were associated with higher mortality rate. Conclusion: Chronic HCQ use did not prevent COVID-19 in RD compared to their household cohabitants. Health care profession, presence of comorbidities LES, SSc and rituximab were identified as main risk factors for COVID-19 and aging and heart disease as higher risk for hospitalization. Our data suggest these outcomes could be considered to manage them in clinical practice.

14.
Annals of the Rheumatic Diseases ; 80(SUPPL 1):1448, 2021.
Article in English | EMBASE | ID: covidwho-1358707

ABSTRACT

Background: Mental health was widely affected during the new coronavirus pandemic. In addition, some measures adopted by most countries in order to contain the virus spread, such as isolation and social distancing, leading to the interruption of routine activities, including partial or complete interruption of face-to-face classes may be associated with increased stress, depression and anxiety among undergraduate medical students (1). From March to September, 2020, the Brazilian Society of Rheumatology carried out the Mario Pinotti II Project (MPII), a prospective, multicenter, observational cohort study designed to monitor the COVID-19 in patients with rheumatic disease on hydroxychloroquine, using periodic telephone calls performed by undergraduate medical students (2). Objectives: To compare the mental health status of medical students who were participating from the MPII with theirs colleagues not involved in this project. Methods: A web-based survey via google forms platform was developed by a panel composed of undergraduate medical students, rheumatologists, medical school professors, and a psychology professor. It included details on demographic and life habits data and domains regarding depression, anxiety and stress, using the DASS-21 (Depression, Anxiety & Stress Scale), Brazilian version. Data collection occurred from July 20th to August 31st, 2020. Statistical analysis was performed using the SPSS version 20.0. Univariate and multivariate linear regression analysis were performed to verify associations with the DASS-21, defined as dependent variable. A p-value < 0.05 was deemed as significant. This study was approved by the Institutional Research Ethics Committee. Results: A total of 684 undergraduate medical students were included in this study, of whom 228 as MPII volunteers (VG) and 456 as control group (CG). Median age was 23 years (IQ 21-24) and the CG was older than the VG (p<0.03). Most of them were white (68.8%) and women (63%). There were no significant differences regarding comorbidities, ethnicity, smoking status, alcohol intake and physical activity. Older age, male gender, participation of MPII study, absence of a worsening in sleep pattern during the pandemic and a lower number of prior comorbidities were associated with lower DASS21 scores, suggesting a better mental health (Table 1). Conclusion: Several aspects may be involved with mental health, including increased emotional maturity, gender and sleep pattern. Although with marginal independent association, medical students with participation in the MPII study had better mental health than their student colleagues not engaged with this research. Our data pointed out that voluntary participation in a research project which foresees interaction by telephone contact with rheumatic patients, professors, rheumatologists, and colleagues is associated with better mental health.

15.
Clinical & Experimental Rheumatology ; 07:07, 2021.
Article in English | MEDLINE | ID: covidwho-1305088

ABSTRACT

OBJECTIVES: To evaluate the incidence of COVID-19 and its main outcomes in rheumatic disease (RD) patients on hydroxychloroquine (HCQ) compared to household cohabitants (HC). METHODS: This is a 24-week nationwide prospective multi-centre cohort with a control group without RD and not using HCQ. All participants were monitored through scheduled phone interviews performed by health professionals. Details regarding COVID-19 symptoms, and epidemiological, clinical, and demographic data were recorded on a specific web-based platform. COVID-19 was defined according to the Brazilian Ministry of Health criteria and classified as mild, moderate or severe. RESULTS: A total of 9,585 participants, 5,164 (53.9%) RD patients on HCQ and 4,421 (46.1%) HC were enrolled from March 29th, 2020 to September 30th, 2020, according to the eligibility criteria. COVID-19 confirmed cases were higher in RD patients than in cohabitants [728 (14.1%) vs. 427 (9.7%), p<0.001] in a 24-week follow-up. However, there was no significant difference regarding outcomes related to moderate/ severe COVID-19 (7.1% and 7.3%, respectively, p=0.896). After multiple adjustments, risk factors associated with hospitalisation were age over 65 (HR=4.5;95%CI 1.35-15.04, p=0.014) and cardiopathy (HR=2.57;95%CI 1.12-5.91, p=0.026). The final survival analysis demonstrated the probability of dying in 180 days after a COVID-19 diagnosis was significantly higher in patients over 65 years (HR=20.8;95%CI 4.5-96.1) and with 2 or more comorbidities (HR=10.8;95%CI 1.1-107.9 and HR=24.8;95%CI 2.5-249.3, p=0.006, respectively). CONCLUSIONS: Although RD patients have had a higher COVID-19 incidence than individuals from the same epidemiological background, the COVID-19 severity was related to traditional risk factors, particularly multiple comorbidities and age, and not to underlying RD and HCQ.

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