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EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315929


Background: The Gamma variant has been considered the predominant SARS-CoV-2 lineage in Brazil during the first half of 2021. We aimed to characterise the clinical presentation of COVID-19 caused by the Gamma variant in comparison with strains that are not variants of concern (non-VoC).Method: We performed a prospective cohort study including symptomatic COVID-19 cases among healthcare workers from January 22 to May 15, 2021. Positive samples for SARS-CoV-2 RT-PCR underwent whole genome sequencing. COVID-19 symptoms, caused by the Gamma variant or non-VoC, and risk factors for Gamma variant infection were evaluated using multiple logistic regression analyses.Findings: We included 423 COVID-19 cases, of which 415 (98%) with mild disease. One hundred and seventy-five (41%) patients had been fully immunised, of which 173/175 (99%) had received CoronaVac. There were 313 (74%) Gamma variant cases and 110 (26%) non-VoC cases. Hyposmia/anosmia and dysgeusia were present in 129 (30%) and 108 (26%) of cases, respectively. Lower frequencies of hyposmia/anosmia (OR=0.304, p <0.001) and dysgeusia (OR=0.385, p =0.011) were the only symptoms significantly associated with Gamma variant infection. COVID-19 immunisation, previous COVID-19 and age were not associated with Gamma variant infection.Interpretation: The increase in Gamma variant cases should raise the awareness that COVID-19 may present more often with cold-like symptoms because of a decreased frequency of hyposmia/anosmia and dysgeusia.Funding: Supported by the Itau Unibanco “Todos pela saúde” program”.Declaration of Interest: None to declare. Ethical Approval: This study was approved by the Hospital’s Ethics Committee (CAAE: 42708721.0.0000.0068).

Clinics ; 76: e3299, 2021. tab
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1478393


OBJECTIVE: This study aimed to evaluate the occurrence of coronavirus disease 2019 (COVID-19) in hemodialysis facilities and the occurrence of and risk factors for clustering of COVID-19 cases. METHODS: We conducted a cross-sectional online survey between March and July 2020, in all dialysis facilities in São Paulo state, using Google Forms. The online questionnaire contained questions addressing specific components of infection prevention and control practices and the number of cases during the COVID-19 pandemic. RESULTS: A total of 1,093 (5%) COVID-19 cases were reported among 20,984 patients; approximately 56% of the facilities had ≥1 cluster. Most facilities implemented various measures (such as allocation of dedicated COVID-19 areas/shifts, symptom screening, environmental disinfection, and maintenance of adequate ventilation) to prevent the transmission of severe acute respiratory syndrome coronavirus 2. Clustering of COVID-19 cases was suspected in only 7% of dialysis facilities. The only variable associated with this event was the performance of aerosol-generating procedures (odds ratio: 4.74; 95% confidence interval: 1.75-12.86). CONCLUSION: Attention should be paid to avoiding the performance of aerosol-generating procedures in dialysis facilities and monitoring the clustering of cases.

Int J Infect Dis ; 104: 320-328, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1065182


OBJECTIVES: The coronavirus disease 2019 pandemic increased global demand for personal protective equipment (PPE) and resulted in shortages. The study evaluated the re-use of surgical masks and respirators by analysing their performance and safety before and after reprocessing using the following methods: oven, thermal drying, autoclave, and hydrogen peroxide plasma vapour. METHODS: In total, 45 surgical masks and 69 respirators were decontaminated. Visual integrity, air permeability, burst resistance, pressure differential and particulate filtration efficiency of new and decontaminated surgical masks and respirators were evaluated. In addition, 14 used respirators were analysed after work shifts before and after decontamination using reverse transcription polymerase chain reaction (RT-PCR) and viral culturing. Finally, reprocessed respirators were evaluated by users in terms of functionality and comfort. RESULTS: Oven decontamination (75 °C for 45 min) was found to be the simplest decontamination method. Physical and filtration assays indicated that all reprocessing methods were safe after one cycle. Oven decontamination maintained the characteristics of surgical masks and respirators for at least five reprocessing cycles. Viral RNA was detected by RT-PCR in two of the 14 used respirators. Four respirators submitted to viral culture were PCR-negative and culture-negative. Reprocessed respirators used in work shifts were evaluated positively by users, even after three decontamination cycles. CONCLUSION: Oven decontamination is a safe method for reprocessing surgical masks and respirators for at least five cycles, and is feasible in the hospital setting.

COVID-19/prevention & control , Decontamination/methods , Masks/virology , Pandemics , Personal Protective Equipment/virology , SARS-CoV-2/isolation & purification , Ventilators, Mechanical/virology , COVID-19/epidemiology , COVID-19/virology , Equipment Reuse , Hospitals , Hot Temperature , Humans , Hydrogen Peroxide/pharmacology , SARS-CoV-2/genetics