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2.
American Journal of Respiratory and Critical Care Medicine ; 205:2, 2022.
Article in English | English Web of Science | ID: covidwho-1880226
3.
Hematology, Transfusion and Cell Therapy ; 43:S512-S513, 2021.
Article in English | EMBASE | ID: covidwho-1859709

ABSTRACT

Objetivos: A COVID-19, oriunda do novo coronavírus (SARS-CoV-2) se espalhou como uma pandemia, causando mais de 4 milhão de mortes globalmente, tornando-se uma emergência de saúde pública. O número de casos de pacientes recuperados é crescente, o que pode ser crucial sobre o curso da doença. Na forma grave da doença é possível observar linfopenia e leucopenia. Estes achados podem ser auxiliares como indicadores clínicos para avaliação e progressão da doença. Desta forma, este trabalho teve como objetivo descrever o perfil leucocitário dos indivíduos positivos na sorologia para o SARS-CoV-2. Material e métodos: Trata-se de um estudo prospectivo em que indivíduos adultos de ambos os sexos, participantes do projeto EpiSergipe e que apresentaram resultado positivo ao teste rápido para IgG/IgM confirmado por sorologia. Foram coletadas amostras de sangue periférico para realização do hemograma e análise sorológica utilizando o kit comercial de imunoensaio fluorescente (IchromaTM COVID-19 Ab) em que os procedimentos foram realizados de acordo com as recomendações do fabricante. Resultados: Foram analisadas amostras de 847 pacientes com sorologia positiva para o SARS-CoV-2, assintomáticos ou com sintomas leves, sendo 275 do sexo masculino (32,47%) e 572 do sexo feminino (67,53%). Do total de hemogramas analisados, 9,33% apresentaram leucocitose e 2,01% leucopenia (média leucócitos totais = 7.370/mm3 /±2,10). A linfocitose foi observada em 23,61% dos indivíduos e a linfopenia foi observada em apenas 1,18% (média linfócitos = 2.550/mm3/±772). A neutrofilia foi observada em 5,90% dos participantes e a neutropenia em 5,31% (média neutrófilos = 4.280/mm3/±1,67). A maioria dos hemogramas analisados (67,41%) apresentaram todos os parâmetros normais. Discussão: A linfocitose, de acordo com estudos, pode auxiliar na previsão e acompanhamento da progressão da COVID-19, neste estudo foi observada em 23,61% dos hemogramas analisados, enfatizando que os participantes do presente estudo eram assintomáticos e sintomáticos leves, o que pode justificar o porquê grande parte dos pacientes apresentaram parâmetros dentro da normalidade. Além disso um estudo publicado em 2021, comparou os achados hematológicos de óbitos por COVID-19 com os de sobreviventes, nos indivíduos que morreram havia maior contagem de neutrófilos e leucócitos, e uma diminuição nos linfócitos, quando comparados aos sobreviventes. Neste estudo, não houveram óbitos, as taxas encontradas de leucocitose e neutrofilia foram de 9,33% e 5,90% respectivamente, e a linfopenia 1,18%. Conclusão: A partir dos resultados prévios encontrados, observa-se alterações no perfil leucocitário em indivíduos com COVID-19, condizentes com os descritos recentemente na literatura.

4.
Periferia ; 13(3):211-229, 2021.
Article in Portuguese | Web of Science | ID: covidwho-1856352

ABSTRACT

This work is a qualitative biographical research, which aims to reflect the right to education and play of children who are the target audience of Early Childhood Education (El), for this, we resorted to the main educational public policies aimed at implementation of these rights, from which, we highlight the Common National Curriculum Base - BNCC (2017), the National Curriculum Reference for Early Childhood Education - RCNEI (1998), the Child and Adolescent Statute - ECA (1990), the Laws of Guidelines of Bases of National Education - LDB (1961;1971;1996), among other documents, we also rely on the studies of theorists such as Aries (1978), Saviane (2008;2018), Kunz (2015), among other authors. In this work, it is possible to perceive the gradual historical evolution of the conception of the child, currently recognized as a subject of rights, including the right to education and play in El institutions. We also emphasize our considerations about the defense of the child's right to education and to play, even in times of the Covid-19 pandemic and the absence of public policies in this adverse context.

5.
Blood ; 138(SUPPL 1):3525, 2021.
Article in English | EMBASE | ID: covidwho-1770434

ABSTRACT

Background - The WINDOW-1 regimen introduced first-line ibrutinib with rituximab (IR) followed by 4 cycles of R-HCVAD for younger mantle cell lymphoma (MCL) patients (pts) demonstrating 90% CR on IR alone and we aimed to improve the CR rate with the addition of venetoclax. We therefore investigated the efficacy and safety of IR and venetoclax (IRV) followed by risk-stratified observation or short course R-HCVAD/MTX-ARA-C as consolidation in previously untreated young patients with mantle cell lymphoma (MCL). Our aim was to use a triplet chemotherapy-free induction to reduce the toxicity, complications and minimize chemotherapy exposure in MCL pts. Methods - We enrolled 50 previously untreated pts in this single institution, single arm, phase II clinical trial - NCT03710772. Pts received IR induction (Part-1) for initial 4 cycles. Pts were restaged at cycle 4 and received IRV for up to eight cycles (Cycle 5 to Cycle 12) starting with ramp up venetoclax dosing in Cycle 5. All pts who achieved CR prior to cycle 12 continued to receive IRV for 4 cycles (maximum 12 cycles) and then moved to part 2. Pts were stratified into three disease risk groups: high, moderate and low risk categories from the baseline data for assignment to R-HCVAD/MTX-ARA-C as consolidation in part 2 (4 cycles, 2 cycles, or no chemotherapy for high, medium and low risk pts respectively). Briefly, low risk pts were those with Ki-67 ≤30%, largest tumor mass <3 cm, low MIPI score and no features of high risk disease (Ki-67 ≥50%, mutations in the TP53, NSD2 or in NOTCH genes, complex karyotype or del17p, MYC positive, or largest tumor diameter >5 cm or blastoid/pleomorphic histology or if they remain in PR after 12 cycles of part 1. Medium risk are pts which did not belong to low or high-risk category. Those who experienced progression on part 1 went to part 2 and get 4 cycles of part 2. Patient were taken off protocol but not off study, if they remained in PR after 4 cycles of chemotherapy, these patients were followed up for time to next treatment and progression free survival on subsequent therapies. After part 2 consolidation, all pts received 2 years of IRV maintenance. The primary objective was to assess CR rates after IRV induction. Adverse events were coded as per CTCAE version 4. Molecular studies are being performed. Results - Among the 50 pts, the median age was 57 years (range - 35-65). There were 20 pts in high-risk group, 20 pts in intermediate-risk group and 10 pts in low-risk group. High Ki-67 (≥30%) in 18/50 (36%) pts. Eighteen (36%) had high and intermediate risk simplified MIPI scores. Six (12%) pts had aggressive MCL (blastoid/pleomorphic). Among the 24 TP53 evaluable pts, eight pts (33%) had TP53 aberrations (mutated and/or TP53 deletion by FISH). Forty-eight pts received IRV. Best response to IRV was 96% and CR of 92%. After part 2, the best ORR remained unaltered, 96% (92% CR and 4% PR). The median number of cycles of triplet IRV to reach best response was 8 cycles (range 2-12). Fifteen pts (30%) did not receive part 2 chemotherapy, two pts (4%) received 1 cycle, 16 pts (32%) 2 cycles and 13 pts (26%) got 4 cycles of chemotherapy. With a median follow up of 24 months, the median PFS and OS were not reached (2 year 92% and 90% respectively). The median PFS and OS was not reached and not significantly different in pts with high and low Ki-67% or with/without TP53 aberrations or among pts with low, medium or high-risk categories. The median PFS and OS was inferior in blastoid/pleomorphic MCL pts compared to classic MCL pts (p=0.01 and 0.03 respectively). Thirteen pts (26%) came off study - 5 for adverse events, 3 for on study deaths, and 2 for patient choice, 2 patients lost to follow up and one for disease progression. Overall, 5 pts died (3 on trial and 2 pts died off study, one due to progressive disease and another due to COVID pneumonia). Grade 3-4 toxicities on part 1 were 10% myelosuppression and 10% each with fatigue, myalgia and rashes and 3% mucositis. One pt developed grade 3 atrial flutter on part 1. None had grade 3-4 bleeding/bruising. Conclusions - Chemotherapy-free induction with IRV induced durable and deep responses in young MCL pts in the frontline setting. WINDOW-2 approach suggests that pts with low risk MCL do not need chemotherapy but further follow up is warranted. This combined modality treatment approach significantly improves outcomes of young MCL pts across all risk groups. Detailed molecular analyses will be reported. (Figure Presented).

6.
9th International Conference on Technological Ecosystems for Enhancing Multiculturality, TEEM 2021 ; : 647-651, 2021.
Article in English | Scopus | ID: covidwho-1613100

ABSTRACT

The pandemic caused by COVID-19 had and still has implications in the social relationship between human beings and at the school level and families with school-age children and young people. The school had to quickly conceive an effective intervention plan regarding learning. Teachers, some with more, others with less training in Educational Technology, had to, in record time, modify their entire methodological plan of intervention with their students. This research team decided to study the implications of this pandemic in the educational context in the teaching community. This research focuses on the repercussions of the pandemic on teachers' emotional management and psychological well-being through an online questionnaire (Google Forms) administered between the beginning of the school term in September 2020 and March 2021. © 2021 ACM.

7.
MAI Journal ; 10(2):207-215, 2021.
Article in English | Scopus | ID: covidwho-1596419

ABSTRACT

Recent years have been extraordinary for race issues in Aotearoa. The Christchurch mosque shootings in March 2019 shattered long-held illusions of New Zealand exceptionalism;Islamophobia increased following the attacks;an increase in racialised abuse of Asian people followed the outbreak of COVID-19;the Black Lives Matter movement in the United States provided a platform for discussing anti-Black racism and white supremacy in Aotearoa;and in last year’s general election, many political parties campaigned on border security or restricting immigration. This status report explores race-based offending in Aotearoa in light of these critical social contexts and ongoing settler colonial structural racism against Māori, and offers recommendations to address racial discrimination. We suggest that despite the clear need to protect communities of colour from discrimination, current legislative approaches for addressing hate crime and hate speech are inadequate. Discrimination must be understood by the justice sector as a driver of crime, and community organisations must be resourced to provide education, advocacy, monitoring and support for racialised communities. © 2021, Nga Pae o te Maramatanga. All rights reserved.

10.
Journal of Control, Automation and Electrical Systems ; 2021.
Article in English | Scopus | ID: covidwho-1469794

ABSTRACT

This paper proposes a new mathematical model called SIRDQ considering control laws for the government actions in order to reduce the quarantine periods. The proposed control laws guarantee the regulation of the effective number of reproduction to a desired value, which is directly related to the propagation of the epidemic model. We consider two control strategies based on first-order sliding mode and super-twisting algorithm due to its robustness with respect to parametric uncertainties and disturbances, as found in epidemiological models. The stability analysis of the closed-loop system is rigorously presented. Simulations show that the employed control strategies assure better levels of isolation to be adopted. © 2021, Brazilian Society for Automatics--SBA.

11.
Hematology, Transfusion and Cell Therapy ; 42:129-129, 2020.
Article in Portuguese | PMC | ID: covidwho-1385626

ABSTRACT

Objetivo: Em 2019, um surto de pneumonia surgiu na cidade de Wuhan, China. Apos investigacoes, descobriu-se que o agente causador da doenca era um virus atualmente nomeado SARS-CoV-2, causador da COVID-19. Diversos trabalhos dedicam-se a investigar a sua atuacao no organismo humano e o seu comportamento em pacientes contaminados que ja sofrem com outras doencas. Assim, esta revisao objetiva investigar a relacao da Leucemia Mieloide Cronica (LMC), um cancer raro em celulas do sangue, com a COVID-19, associando os aspectos da resposta imune dentro destas doencas. Metodologia: Este estudo trata de uma revisao sistematica da literatura, a partir de buscas nas bases de dados PubMed, ScienceDirect e Web of Science, utilizando os descritores especificos: "Chronic Myeloid Leukemia", "COVID-19" e "SARS-CoV-2" combinados mediante descritores booleanos. A pesquisa ocorreu entre os dias 06 e 15 de agosto de 2020. Para a construcao da revisao sistematica foi utilizado o protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Como criterios de inclusao: artigos em suas versoes completas, sem restricao de idiomas, publicados nos ultimos 5 anos. Aqueles que nao apresentavam informacoes relevantes em relacao ao tema, duplicatas e os que nao obedeciam aos criterios de inclusao foram excluidos. Resultados: 32 estudos foram encontrados, 8 no PubMed, 17 na base de dados ScienceDirect e 7 no Web of Science. A priori, foram excluidos 10 artigos por repeticao. Dos 22 restantes, 14 trabalhos por nao possuir relacao com a tematica ou por nao atender aos demais criterios de inclusao tambem foram excluidos. Logo, restaram 8 trabalhos para compor esta revisao. Discussao: Na literatura ainda nao ha dados suficientes que comprovem que pacientes com LMC sob tratamento com Inibidores de Tirosina Quinase (ITQ) estao no grupo de risco. Entretanto, ha casos em que esses pacientes contrairam o SARS-CoV-2 e apresentaram quadros nao graves da doenca - exceto caso haja crise blastica - alem de uma suposta protecao contra o virus mediada pela terapia. Os casos graves da COVID-19 apresentam hiperatividade das celulas T pro-inflamatorias e diminuicao dos linfocitos T reguladores e consequente exacerbacao da inflamacao, caracteristico da tempestade de citocinas, incluindo TNF-alpha, IL-1 e IL-6 - sendo esta uma importante mediadora da tempestade associada a COVID-19. O uso de Tocilizumabe - anticorpo monoclonal humanizado inibidor de receptores de IL-6 - foi relatado em paciente com LMC com rapida recuperacao da inflamacao e regulacao da resposta imune. Ademais, ja foi relatado que ITQ possuem eficacia contra outros coronavirus, como o Imatinibe, evitando a replicacao viral na celula hospedeira. Apesar destes dados, a recomendacao a esses pacientes e o distanciamento social e, se possivel, continuacao do tratamento. Caso sejam infectados, propoe-se a quarentena e atencao redobrada para possiveis interacoes medicamentosas entre o tratamento da LMC e o da COVID-19, ja que ambos podem prolongar o intervalo QT e provocar complicacoes cardiacas. Conclusao: Os estudos apontaram que pacientes em tratamento da LMC podem demonstrar uma melhor resposta ao virus. Observou-se que esses individuos, ao contrair o virus, podem apresentar uma resposta diferente, seja freando a inflamacao ou impedindo a replicacao viral. Entretanto, faz-se necessario maiores pesquisas objetivando investigar as interacoes imunes e medicamentosas entre pacientes com LMC e COVID-19.Copyright © 2020

12.
International Journal on Working Conditions ; - (21):17-35, 2021.
Article in Portuguese | Web of Science | ID: covidwho-1365935

ABSTRACT

Objective: to analyze the aspects of violence at work (structural, illnesses and deaths and stigma/discrimination) of Brazilian health professionals in the Covid-19 pandemic, through analyzes of Brazilian journalistic media. Methodology: Qualitative analysis of reports reported in two Brazilian news websites (G1 and Uol), within the period from April 20th to 30th in 2020, by using the words "Covid-19 and professional *";10 reports were selected, whose witch focus predominantly violence and health aspects of healthcare professionals during the pandemic. We used thematic content analysis to explore the journalistic material found. Results: violence is related to the intensification of work, in views of the increased demands for health care;shortage of personal protective equipment (PPE) and human resources to face the pandemic, illnesses and deaths by Covid-19, as well as difficulties in producing data on this matter;experiences of stigmas and discrimination because they are "possible spreaders of the virus";health professionals feel guilty and afraid of contaminating their families. Conclusion: there are impacts of structural violence at work, experiences of illnesses and deaths of professionals, stigma and discrimination, which corroborate the health care needs.

13.
Arquivos Brasileiros de Psicologia ; 72(Special Issue):139-155, 2020.
Article in English, Portuguese, Spanish | Scopus | ID: covidwho-1348921

ABSTRACT

Taking Covid-19 Pandemic as a context and analyzer, this article discusses the historical links between racism and the medicalized management of the right to life and death in Brazil. It is based on the understanding that listening and clinical management of situations of psychological distress in the context of the medicalization of life (in Pandemic, and even outside it) necessarily imply making social criticism as well. To this end, we propose a debate that encapsulates clinical theory, the histories of social medicine and psychoanalysis in Brazil, and the concepts of bio and necropoli-tics. Our hypothesis is that if, on the one hand, on its arrival in Brazil, psychoanalysis was “co-opted” by a hygienist medical tradition (which for years polarized the way it was seen in our country), on the other, by its conceptual structure, by the initial counterpoint with Brazilian modernism, and by its current debate on segregation, this praxis can make explicit its anti-racist power and vocation. © 2020. All Rights Reserved.

14.
Geo Uerj ; - (39):19, 2021.
Article in Portuguese | Web of Science | ID: covidwho-1346750

ABSTRACT

The aim of this article is to evaluate how the State of Pernambuco, Brazil, through its public policies, has responded to the COVID-19 pandemic concerning the tourism sector. Therefore, the study presents an overview of the impacts caused by the pandemic, considering the first semester of 2020, on public accounts, air traffic, accommodation and employability, based on transparency websites and other open information provided by federal and state governments. The creation of the Northeast Scientific Committee and its recommendations on pandemic response are analysed in order to establish the adoption (or not) of such guidelines for the achievement of state decrees aimed at combating the pandemic. It is intended to highlight how the state of Pernambuco seeks to manage the crisis by weighing both sides of the scale: The Consortium's recommendations and sector's pressure to reopen through the interviews with the Secretariat of Tourism, on the one hand, and with people linked to the tourist trade on the other, reveal such impasse. Lastly, the article concludes by pointing out that, as far as possible, Pernambuco has faced the crisis positively, including welcoming the tourism sector, making efforts to provide alternatives within the presented scenario.

15.
Farmaceutski Glasnik ; 77(3-4):169-171, 2021.
Article in Croatian | Scopus | ID: covidwho-1282928
16.
Obesity Facts ; 14(SUPPL 1):48, 2021.
Article in English | EMBASE | ID: covidwho-1255695

ABSTRACT

Introduction: Adolescence is a period where important lifestyle changes take place, accompanied by steep rises in obesity prevalence1. This is particularly relevant for Portugal as one third of 10-17-year-olds are overweight 2. Although adolescents are acknowledged as the next generation of adults, parents, workers, and decision makers3, and thus as an important target group for obesity prevention strategies, there are few examples where adolescents themselves are active actors in the development of such strategies. The CO-CREATE (CC) Project aims to involve young people in the policy-making process to effectively prevent obesity. We present one of the Project's stages (WP5), where youth alliances (YA) were established to develop policy ideas and how Covid-19 pandemic affected the project, in Portugal. Methods: For WP5, a common methodological protocol for the 5 European CC countries was based on youth-led participatory action research where youths (15-18 years old) used their new knowledge to co-create with researchers novel policy ideas to tackle obesity. This stage included face to face meetings from December 2019 and, by March 2020, these were forced to stop due to the Covid-19 pandemic. As a solution to continue with the progress of the YA, an online approach was immediately established with regular contact with the youth to keep them engaged. Additionally, to accommodate some of the needs raised by the YA, E-books on the related topics were shared as well as Q&A sessions (about 90 min each) were arranged. Results: Out of the almost 40 adolescents enrolled in the Portuguese YA, all remaining online sessions in WP5, were participated by more than 80% of the adolescents, in each. A total of 5 Q&A sessions were conducted online on a weekly basis, from mid-March until April 2020, where young professionals experienced in several fields (namely nutritionists, a physical activity expert, a psychologist and a member of youth organizations) helped discussing and strengthening the YA policy ideas proposals. The 5 online Q&A sessions had an average participation of 16 teens per session. Conclusion: The Covid-19 pandemic and the challenges imposed by it proved to be an opportunity to include new dynamics into CC. The online approach was successful in maintaining the youth engaged and ensuring the progress of the policy development process, which will culminate in the discussion of the policy ideas between the youth and relevant stakeholders in the upcoming stage of the project. Thus, the YA members showed a swift adaptation and remarkable dedication to the project without compromising its objectives even during these challenging times.

17.
Obesity Facts ; 14(SUPPL 1):87, 2021.
Article in English | EMBASE | ID: covidwho-1255681

ABSTRACT

Introduction: The worldwide COVID-19 pandemic has been presenting a high risk for the development or exacerbation of obesity and overweight in children, particularly during the lockdown period which brought a complete modification in their lifestyle with homeschooling, stress to cope with, lack of structured activities and social interaction as well as changes in eating habits1-4. In Portugal, studies haven't identified yet these changes in children.The present study analysed the parental perception on changes of their children eating habits, who participated in the community and school-based program MUN-SI Cascais 19/20, during the 2020 Portuguese first lockdown due to COVID-19. Methods: A longitudinal study in 11 primary schools with 113 children( 3rd and 4th grades)was carried out through a survey online using a family questionnaire to address the children's eating habits, which included a list of food items adapted from validated national questionnaires. The survey included 2 moments: pre-lockdown(Sep19-Mar20) and lockdown(Apr20-Jun20). Parental perception on changes of children' eating habits, from moment 1 to 2 was assessed using the following options: “More than before COVID-19“, “Same as Before COVID-19” and “Less than Before COVID-19“. Results: Parents reported that children's consumption on breakfast cereals, sliced white bread and french fries were the food items identified as consumed by the children “more than before COVID-19“(25.5%, 19.4% and 18.8%, respectively), unlike pastry products, sweets and 100% fruit juices where parents reported a “less than Before COVID-19” children's consumption(25.8%, 21.2% and 20.6%, respectively). There was a reported perception of the increase in children's intake of bakery bread by 21.9%, as well as of eggs, reported in 16.6% of cases and a parental perception on the decrease of children's fish intake by 15.8%, in fruit consumption in 8.6% of cases, and in vegetables in 10.0% reported by the families. Conclusion: This study adds some insights into the future impact of the confinement period on children's health, which adding to poorer eating habits, children who are confined at home, without any outdoor activities and social interaction, might result in worse children health outcomes.

18.
Topics in Antiviral Medicine ; 29(1):66-67, 2021.
Article in English | EMBASE | ID: covidwho-1250810

ABSTRACT

Background: Uncontrolled inflammatory responses, ranging from cytokine storm to immune-paralysis were described in COVID-19 worse prognosis. Patients with an aggressive course are the bottleneck of COVID-19 pandemic management, and there is urgent need of understanding the underlying mechanisms to guide clinical decisions. Myeloid cell activation is likely a key player in SARS-CoV-2 infection. Methods: Here, we longitudinally evaluated COVID-19 patients with respiratory insufficiency admitted to Hospital Santa Maria (Lisbon, Portugal), comparing those that did not require intensive care admission (NO-ICU) with those requiring high flux oxygen and/or mechanical ventilation (ICU). At each time point, an ex-vivo immune-phenotype by flow cytometry was analysed with both supervised and unsupervised approaches and clustering analysis of circulating cell subsets of monocytes (Mo) and dendritic cells (DCs), in parallel with specific antibody responses and a wide array of inflammatory mediators. Results: Contrarily to other systemic viral infections, we found that COVID-19 patients with respiratory insufficiency featured systemic immune-suppressive/ regulatory myeloid cell responses. Specifically, we observed a global reduction of CD14lowCD16+ Mo, and reduced expression of CD80, CD86, and SLAN. Contemporaneously, both Mo and DC showed increased expression of CD163, CD204, CD206 and PD-L1 immune-regulatory markers. Moreover, cDC2s, pDCs and basophils were significantly reduced. Inflammatory cytokines and chemokines associated with myeloid cell chemotaxis correlated with the phenotype changes. In NO-ICU patients (n=9) we observed a peak of these alterations at admission and a progressive regression to healthy phenotype at hospital discharge (as compared to age-matched controls, n=11). On the other hand, in ICU patients (n=11), the expression of immuno-suppressive markers progressively increased until discharge. Notably, they featured significant reduction of HLA-DRhighPD-L1- and expansion of CD80-CD86- classical Mo and an increase of HLA-DRhighPD-L1+ cells in Mo and in all DC subsets at recovery. Conclusion: Altogether, these data favour an alternative view of a beneficial role of suppressive/regulatory myeloid responses in coping with COVID-19 pathogenesis. To further support our hypothesis, we are currently collecting data on lung injury and SARS-CoV-2 viremia to correlate with the kinetics of myeloid responses.

19.
Ensaio ; 29(111):525-542, 2021.
Article in English | Scopus | ID: covidwho-1215200

ABSTRACT

The COVID-19 pandemic draws into focus the need to rebuild resilient health systems with increased access to quality health services. Reaction ability to changing demand is crucial. Resilience is relevant because all countries have vulnerable communities. One could push the argument further, using as an example the resilience particularly present on the agenda of meetings of the World Health Organization. More critical than ever, it is to take stock of the lessons learned. The stakeholders need to work together to accelerate progress towards universal access to essential health information through resilience. Regarding major societal challenges, which have a local dimension, universities have a key role to play in the knowledge creation of innovative products and services. The need for timely, accurate, and reliable data about the Vale do Jequitinhonha in the health system is unarguably overdue for a real-time, technology-driven, surveillance and reporting infrastructure to respond effectively to public health emergencies. Health system resilience is one of the focuses in low-income region framework and it is an indispensable university strategy for managing the health risks of older adults, and chronic disease patients. COVID-19 can cause disruption in health systems. Disruptions to health service infrastructure can result in loss of life, negative economic impact, and harm to communities. Focused actions include investing in Primary Health Care (PHC) and this encompasses basic preventive, promotive, and curative health cares for enhancing the health status of the people by reducing morbidity and mortality rates. Given the key role of such information for health, the university located in a low-income health region has a fundamental role. The reflections and shreds of evidence showed during this essay can serve as a framework for health policies in post-pandemic reality and university acting in the population. © 2021. All Rights Reserved.

20.
J Hosp Infect ; 113: 145-154, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1182572

ABSTRACT

BACKGROUND: SARS-CoV-2 predisposes patients to secondary infections; however, a better understanding of the impact of coinfections on the outcome of hospitalized COVID-19 patients is still necessary. AIM: To analyse death risk due to coinfections in COVID-19 patients. METHODS: The odds of death of 212 severely ill COVID-19 patients were evaluated, with detailed focus on the risks for each pathogen, site of infection, comorbidities and length of hospitalization. FINDINGS: The mortality rate was 50.47%. Fungal and/or bacterial isolation occurred in 89 patients, of whom 83.14% died. Coinfected patients stayed hospitalized longer and had an increased odds of dying (odds ratio (OR): 13.45; R2 = 0.31). The risk of death was increased by bacterial (OR: 11.28) and fungal (OR: 5.97) coinfections, with increased levels of creatinine, leucocytes, urea and C-reactive protein. Coinfections increased the risk of death if patients suffered from cardiovascular disease (OR: 11.53), diabetes (OR: 6.00) or obesity (OR: 5.60) in comparison with patients with these comorbidities but without pathogen isolation. The increased risk of death was detected for coagulase-negative Staphylococcus (OR: 25.39), Candida non-albicans (OR: 11.12), S. aureus (OR: 10.72), Acinetobacter spp. (OR: 6.88), Pseudomonas spp. (OR: 4.77), and C. albicans (OR: 3.97). The high-risk sites of infection were blood, tracheal aspirate, and urine. Patients with coinfection undergoing invasive mechanical ventilation were 3.8 times more likely to die than those without positive cultures. CONCLUSION: Severe COVID-19 patients with secondary coinfections required longer hospitalization and had higher risk of death. The early diagnosis of coinfections is essential to identify high-risk patients and to determine the right interventions to reduce mortality.


Subject(s)
Bacterial Infections/mortality , COVID-19/mortality , Coinfection/mortality , Mycoses/mortality , Adult , Aged , Bacterial Infections/complications , COVID-19/complications , Female , Humans , Length of Stay , Male , Middle Aged , Mycoses/complications , Respiration, Artificial
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