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1.
Infect Control Hosp Epidemiol ; : 1-3, 2022 May 26.
Article in English | MEDLINE | ID: covidwho-1864706

ABSTRACT

A survey evaluated 2,300 healthcare workers following the first dose of a coronavirus disease 2019 (COVID-19) vaccine in a tertiary-quaternary hospital in São Paulo, Brazil. Adherence to protective measures following vaccination was compared to previous non-work-related behaviors. Younger age, previous COVID-19, and burnout symptoms were associated with reduced adherence to mitigation measures.

2.
Front Med (Lausanne) ; 9: 779516, 2022.
Article in English | MEDLINE | ID: covidwho-1798934

ABSTRACT

SARS-CoV-2 infection has a wide spectrum of presentations, from asymptomatic to pneumonia and sepsis. Risk scores have been used as triggers for protocols that combine several interventions for early management of sepsis. This study tested the accuracy of the score SIRS, qSOFA, and NEWS in predicting outcomes, including mortality and bacterial infection, in patients admitted to the emergency department (ED) during the COVID-19 pandemic. We described 2,473 cases of COVID-19 admitted to the ED of the largest referral hospital for severe COVID-19 in Brazil during the pandemic. SIRS, qSOFA and NEWS scores showed a poor performance as prognostic scores. However, NEWS score had a high sensitivity to predict in-hospital death (0.851), early bacterial infection (0.851), and ICU admission (0.868), suggesting that it may be a good screening tool for severe cases of COVID-19, despite its low specificity.

3.
Frontiers in medicine ; 9, 2022.
Article in English | EuropePMC | ID: covidwho-1743980

ABSTRACT

SARS-CoV-2 infection has a wide spectrum of presentations, from asymptomatic to pneumonia and sepsis. Risk scores have been used as triggers for protocols that combine several interventions for early management of sepsis. This study tested the accuracy of the score SIRS, qSOFA, and NEWS in predicting outcomes, including mortality and bacterial infection, in patients admitted to the emergency department (ED) during the COVID-19 pandemic. We described 2,473 cases of COVID-19 admitted to the ED of the largest referral hospital for severe COVID-19 in Brazil during the pandemic. SIRS, qSOFA and NEWS scores showed a poor performance as prognostic scores. However, NEWS score had a high sensitivity to predict in-hospital death (0.851), early bacterial infection (0.851), and ICU admission (0.868), suggesting that it may be a good screening tool for severe cases of COVID-19, despite its low specificity.

4.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-320731

ABSTRACT

The disease caused by the SARS-CoV-2 virus, which originated in Wuhan, Hubei Province, China, in December 2019 spread rapidly, causing a high number of deaths worldwide. The difficult ability to contain the transmission of the disease raised doubts about the possible forms of contamination. Studies have shown an increase in new cases of the disease on days when the level of pollution was high, raising questions that pollutants may be carriers of the virus. In this study, we investigated the involvement of fine particulate matter (PM2.5) in virus loading in common circulation (indoor and outdoor) environments and in the intensive care unit (ICU) of a hospital. PM2.5 was collected from May to November 2020, and the collection time per day was 48 to 72 h. After collection, the material was stored at a temperature of -80°C until the moment of analysis. Our results demonstrated that SARS-CoV-2 can be found in fine particulate material (PM2.5), but there is an essential interference of temperature, humidity and UV rays in the preservation of viral RNA.

5.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-319266

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused a global health crisis and it might have affected healthcare-associated infections (HAI) prevention strategies. This study aims to evaluate the impact of the COVID-19 pandemic on HAI incidence in Brazilian ICUs.Methods: This ecological study compared adult patients admitted to the ICU from April through June 2020 (pandemic period) with the same period in 2019 (pre-pandemic period). We collected data from 21 hospitals from the three most populated Brazilian regions. The difference in microbiologically confirmed central line-associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) incidence density, and the proportion of organisms that caused HAI between the pandemic and the pre-pandemic periods were compared in a pairwise analysis using the Wilcoxon signed rank sum test. Findings: We observed a significant increase in CLABSI incidence during the pandemic (2.81 [1.35 - 6.89] vs. 1.60 [0.44 - 4.20], p = 0.002). Overall, there was no difference in VAP incidence between the two periods, but there was an increase in VAP incidence in private hospitals during the pandemic (3.65 [1.42 - 6.57] vs. 2.54 [0 - 3.98], p = 0.033). In addition, there was a significant increase in the proportion of CLABSI caused by Enterococcus faecalis and candida species during the pandemic.Interpretation: There was an increase in CLABSI incidence in Brazilian hospitals during the COVID-19 pandemic. Additionally, we observed an increase in the proportion of CLABSI caused by E. faecalis and candida species in this period. Funding: None.Declaration of Interests: None. Ethics Approval Statement: The study protocol 77243517.8 was approved by the ethics committee of each participating hospital.

6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315929

ABSTRACT

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).

7.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-307774

ABSTRACT

The novel coronavirus disease (COVID-19) emerged in late 2019 has shown that research done with open data could bethe cornerstone for overcoming the need for collaborative, optimized and urgent analysis. Although several articles have beenpublished, identification of variables that can have correlation with positive PCR results is still a challenge. In this paper weshow a concrete example of open data analysis from 910 patients attended in the hospital undergoing SARS-CoV-2 RT-PCR inthree private institutions in S ̃ao Paulo, Brazil. We performed an exploratory analysis using principal component analysis, featureselection and predictive algorithms to test for associations between a number of laboratory test abnormalities and the SARS-CoV-2 RT-PCR result. More concretely, we found a set of 18 variables that showed some association with a positive PCR result.Among these variables elevated lactic dehydrogenase (LDH) and d-dimer were the most correlated with a positive RT-PCR. Wedeveloped a classifier that achieved 76% mean accuracy, 77% mean precision and 92% mean sensitivity to identify individualswith COVID-19

8.
Am J Infect Control ; 50(6): 707-711, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1588519

ABSTRACT

This study assessed, using a self-reported questionnaire, the adherence to PPE (mask, gowns, and gloves) at the workplace, as well as to non-pharmacological preventive measures (NPPM) (physical distance defined as hardly ever and/or never approaches other people within 1.5 meters, social isolation as leaving home less than once a week, hand hygiene was defined as performing hand hygiene ≥ 6 times per period, and adherence to the use of a mask outside of the workplace was defined as on all outings and hardly ever and/or never removes the mask) outside of the workplace among 1,296 health care workers (HCWs), including if NPPM adherence was associated with COVID-19 in HCWs. High adherence to PPE was independently associated with younger age, professional category, work in an area of direct patient assistance; use of public transportation, or adherence to NPPM outside of the workplace.


Subject(s)
COVID-19 , COVID-19/prevention & control , Health Personnel , Hospitals , Humans , Pandemics/prevention & control , SARS-CoV-2
9.
Clinics (Sao Paulo) ; 76: e3547, 2021.
Article in English | MEDLINE | ID: covidwho-1574414

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is associated with high mortality among hospitalized patients and incurs high costs. Severe acute respiratory syndrome coronavirus 2 infection can trigger both inflammatory and thrombotic processes, and these complications can lead to a poorer prognosis. This study aimed to evaluate the association and temporal trends of D-dimer and C-reactive protein (CRP) levels with the incidence of venous thromboembolism (VTE), hospital mortality, and costs among inpatients with COVID-19. METHODS: Data were extracted from electronic patient records and laboratory databases. Crude and adjusted associations for age, sex, number of comorbidities, Sequential Organ Failure Assessment score at admission, and D-dimer or CRP logistic regression models were used to evaluate associations. RESULTS: Between March and June 2020, COVID-19 was documented in 3,254 inpatients. The D-dimer level ≥4,000 ng/mL fibrinogen equivalent unit (FEU) mortality odds ratio (OR) was 4.48 (adjusted OR: 1.97). The CRP level ≥220 mg/dL OR for death was 7.73 (adjusted OR: 3.93). The D-dimer level ≥4,000 ng/mL FEU VTE OR was 3.96 (adjusted OR: 3.26). The CRP level ≥220 mg/dL OR for VTE was 2.71 (adjusted OR: 1.92). All these analyses were statistically significant (p<0.001). Stratified hospital costs demonstrated a dose-response pattern. Adjusted D-dimer and CRP levels were associated with higher mortality and doubled hospital costs. In the first week, elevated D-dimer levels predicted VTE occurrence and systemic inflammatory harm, while CRP was a hospital mortality predictor. CONCLUSION: D-dimer and CRP levels were associated with higher hospital mortality and a higher incidence of VTE. D-dimer was more strongly associated with VTE, although its discriminative ability was poor, while CRP was a stronger predictor of hospital mortality. Their use outside the usual indications should not be modified and should be discouraged.


Subject(s)
Biomarkers , COVID-19 , Biomarkers/analysis , C-Reactive Protein , COVID-19/diagnosis , COVID-19/therapy , Fibrin Fibrinogen Degradation Products , Humans , Prospective Studies , Receptors, Immunologic/analysis , SARS-CoV-2
11.
BMJ Open ; 11(6): e051706, 2021 06 30.
Article in English | MEDLINE | ID: covidwho-1290077

ABSTRACT

INTRODUCTION: COVID-19 may lead to persistent and potentially incapacitating clinical manifestations (post-acute sequelae of SARS-CoV-2 infection (PASC)). Using easy-to-apply questionnaires and scales (often by telephone interviewing), several studies evaluated samples of COVID-19 inpatients from 4 weeks to several months after discharge. However, studies conducting systematic multidisciplinary assessments of PASC manifestations are scarce, with thorough in-person objective evaluations restricted to modestly sized subsamples presenting greatest disease severity. METHODS AND ANALYSES: We will conduct a prospective observational study of surviving individuals (above 18 years of age) from a cohort of over 3000 subjects with laboratory-confirmed COVID-19 who were treated as inpatients at the largest academic health centre in Sao Paulo, Brazil (Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo). All eligible subjects will be consecutively invited to undergo a 1-2-day series of multidisciplinary assessments at 2 time-points, respectively, at 6-9 months and 12-15 months after discharge. Assessment schedules will include detailed multidomain questionnaires applied by medical research staff, self-report scales, objective evaluations of cardiopulmonary functioning, physical functionality and olfactory status, standardised neurological, psychiatric and cognitive examinations, as well as diagnostic laboratory, muscle ultrasound and chest imaging exams. Remaining material from blood tests will be incorporated by a local biobank for use in future investigations on inflammatory markers, genomics, transcriptomics, peptidomics and metabolomics. ETHICS AND DISSEMINATION: All components of this programme have been approved by local research ethics committees. We aim to provide insights into the frequency and severity of chronic/post-COVID multiorgan symptoms, as well as their interrelationships and associations with acute disease features, sociodemographic variables and environmental exposures. Findings will be disseminated in peer-reviewed journals and at scientific meetings. Additionally, we aim to provide a data repository to allow future pathophysiological investigations relating clinical PASC features to biomarker data extracted from blood samples. TRIAL REGISTRATION NUMBER: RBR-8z7v5wc; Pre-results.


Subject(s)
COVID-19 , SARS-CoV-2 , Brazil , COVID-19/complications , Hospitalization , Humans , Observational Studies as Topic
12.
Am J Infect Control ; 49(4): 512-515, 2021 04.
Article in English | MEDLINE | ID: covidwho-866376

ABSTRACT

This study assessed the disinfection using 70% ethanol; H2O2-quaternary ammonium salt mixture; 0.1% sodium hypochlorite and autoclaving of four 3D-printed face shields with different designs, visor materials; and visor thickness (0.5-0.75 mm). We also investigated their clinical suitability by applying a questionnaire to health workers (HW) who used them. Each type of disinfection was done 40 times on each type of mask without physical damage. In contrast, autoclaving led to appreciable damage.


Subject(s)
COVID-19/prevention & control , Disinfectants/pharmacology , Disinfection/methods , Personal Protective Equipment/virology , Printing, Three-Dimensional , SARS-CoV-2 , COVID-19/epidemiology , Data Collection , Equipment Design , Ethanol/pharmacology , Health Personnel , Humans , Hydrogen Peroxide/pharmacology , Sodium Hypochlorite/pharmacology
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