SAFETY AND IMMUNOGENICITY OF TWO HETEROLOGOUS VACCINE SCHEDULES AGAINST SARS-CoV-2 IN PATIENTS WITH RHEUMATOID ARTHRITIS: BRAZILIAN MULTICENTER STUDY

BackgroundPatients with immune-mediated rheumatic diseases (IMRDs) have been prioritized for COVID-19 vaccination to mitigate the infection severity risks. Patients with rheumatoid arthritis (RA) are at a high risk of severe COVID-19 outcomes, especially those under immunosuppression or with comorbidities associated. However, few studies in the literature assessed the safety and immunogenicity of the COVID-19 heterologous vaccine schedules in patients with RA.ObjectivesEvaluate the safety and immunogenicity of two heterologous vaccine schedules against SARS-CoV-2 in patients with RA.MethodsThese data are from the study "SAFER - Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases,” a Brazilian multicentric prospective phase IV study to evaluate COVID-19 vaccine in IMRDs in Brazil. Immunogenicity and adverse events (AEs) in patients with RA of all centers were assessed after two doses of ChAdOx1 plus additional dose of BNT162b2 or after two doses of inactivated SARS-CoV-2 vaccine CoronaVac plus additional dose of BNT162b2. The titers of neutralizing antibodies against the receptor-biding domain of protein spike (S) of SARS-CoV-2 (anti-RBD) were measured by chemiluminescence test after each dose of immunizers. Proportions between groups were compared using the chi-square and Fisher's exact tests for categorical variables. Clinical Disease Activity Index (CDAI) before and after vaccination was assessed using the McNemar test.ResultsA total of 107 patients with RA were include in the study, most of them female, with a mean age of 46 years. Biological disease modifying anti-rheumatic drugs (DMARDs) were used by 50 % of the patients and conventional synthetics DMARDs in 48 %. Two doses of CoronaVac plus additional dose of BNT162b2 was used in 66 patients and two doses of ChAdOx1 plus additional dose of BNT162b2 in 41. Only mild AEs were observed, mainly after the first dose. The most common AEs after all doses, regardless of the immunizer type, were pain at the injection, headache, arthralgia and myalgia. ChAdOx1 had a higher frequency of pain at the injection (66% vs 32 %, p < 0,001) and arthralgia (68% vs 15%, p < 0,001) compared to CoronaVac. No patients had flare after the vaccination. The titers of anti-RBD after two doses of ChAdOx1 were higher compared to two doses of CoronaVac (6,03 BAU/mL vs 4,67 BAU/mL, p < 0,001). However, after the additional dose of BNT162b2, the anti-RBD titers were similar in both groups (7.28 BAU/mL vs 7.06 BAU/mL, p = 0.56). Only two cases of COVID 19, with mild symptoms, were reported, one in each group.Figure 1.ConclusionChAdOx1, CoronaVac, and BNT162b2 vaccines are safe in RA patients. The frequency of local adverse effects, particularly pain at the injection site, is high. AEs are more frequent with ChAdOx1, especially after the first dose. The use of the immunizers does not change the degree of inflammatory activity of the disease. The immunogenicity of the two heterologous regimens analyzed was similar.References[1]Marques C, Kakehasi AM, Gomides APM, Paiva EDS, Dos Reis Neto ET, Pileggi GCS, et al. A Brazilian Cohort of Patients With Immuno-Mediated Chronic Inflammatory Diseases Infected by SARS-CoV-2 (ReumaCoV-Brasil Registry): Protocol for a Prospective, Observational Study. JMIR Res Protoc.[2]Medeiros-Ribeiro AC, Aikawa NE, Saad CGS, Yuki EFN, Pedrosa T, Fusco SRG, et al. Immunogenicity and safety of the CoronaVac inactivated vaccine in patients with autoimmune rheumatic diseases: a phase 4 trial. Nat Med. 2021;27(10):1744-1751.[3]Machado PM, Lawson-Tovey S, Strangfeld A, Mateus EF, Hyrich KL, Gossec L, et al. Safety of vaccination against SARS-CoV-2 in people with rheumatic and musculoskeletal diseases: results from the EULAR Coronavirus Vaccine (COVAX) physician-reported registry. Ann Rheum Dis. 2022;81(5):695-709.[4]Tavares ACFMG, Melo AKG, Cruz VA, Souza VA, Carvalho JS, Machado KLLL, et al. Guidelines on COVID-19 vaccination in patients with immunemediated rheumatic diseases: a Brazilian Society of Rheumatology task force. Adv Rheumatol. 2022;62:3.Acknowledg ments:NIL.Disclosure of InterestsNone Declared.

Safety and Immunogenicity of Coronavac and Chadox1 Vaccines against Sars-Cov-2 in Patients with Rheumatoid Arthritis: Brazilian Multicentric Study

Objectives: To evaluate the safety and immunogenicity of CoronaVac and ChAdOx1 vaccines against SARS-CoV-2 in patients with Rheumatoid Arthritis (RA). Method(s): These data are from the 'SAFER (Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases)' study, a Brazilian multicentric longitudinal phase IV study to evaluate COVID-19 vaccine in immunomediated rheumatic diseases (IMRDs). Adverse events (AEs) in patients with RA were assessed after two doses of ChAdOx1 or CoronaVac. Stratification of postvaccination AEs was performed using a diary, filled out daily. The titers of neutralizing antibodies against the receptor-biding domain of SARS-CoV-2 (anti-RBD) were measured by chemilumine scence test after each dose of immunizers. Proportions between groups were compared using the Chi-square and Fisher's exact tests for categorical variables. Clinical Disease Activity Index (CDAI) before and after vaccination was assessed using the McNemar test. Result(s): A total of 188 patients with RA were included in the study, most of them were female. CoronaVac was used in 109 patients and ChAdOx1 in 79. Only mild AEs were observed. The more common AEs after the first dose were pain at injection site (46,7%), headache (39,4%), arthralgia (39,4%) and myalgia (30,5%), and ChAdOx1 had a higher frequency of pain at the injection site (66% vs 32 %, p alpha 0.001) arthralgia (62% vs 22%, p alpha 0.001) and myalgia (45% vs 20%, p alpha 0.001) compared to CoronaVac. The more common AEs after the second dose were pain at the injection site (37%), arthralgia (31%), myalgia (23%) and headache (21%). Arthralgia (41,42 % vs 25 %, p = 0.02) and pain at injection site (51,43% vs 27%, p = 0.001) were more common with ChAdOx1. No patients had a flare after vaccination. The titers of anti-RBDafter two doses of ChAdOx1 were higher compared to two doses of CoronaVac (6,03 BAU/mL vs 4,67 BAU/mL, p alpha 0,001). Conclusion(s): The frequency of local adverse effects, particularly pain at injection site, was high. AEs were more frequent with ChAdOx1, especially after the first dose. The use of the immunizers dis not change the degree of inflammatory activity of the disease. In patients with RA, ChAdOx1 was more immunogenic than CoronaVac. .

Distance teaching during the Covid-19 pandemic and school-related well-being of primary school students

Bromeliad phytotelmata: the first scientometric study Bromeliads are plants predominantly found in the Neotropical Region, with high diversity of species and wide distribution. Some representatives of this family have the ability to form phytotelma environments through the accumulation of water and organic matter, serving as substrate and food for a variety of organisms. Here, a scientometric analysis was carried out to show trends in scientific work on bromeliad phytotelmata and the importance of these microcosms for the maintenance of biodiversity. The papers were analyzed using the Thomson Reuters, Scopus and Scielo databases between the years 1970 and 2021. Information was sought on the years of publications, geographic regions, countries, article design (descriptive, predictive, experimental, review), focus (ecological, biological, molecular), and ecological level of study (organism, population, community and ecosystem). South America presented the highest number of works developed with the subject and also with researchers involved. Most studies presented predictive designs focusing on community ecology. Insecta, followed by Crustacea and Anura, were the most studied groups of organisms. The results contribute to a better understanding of biodiversity in bromeliad phytotelmata, pointing out gaps and trends in research directed at these natural microcosms.

Class struggle, health crisis and human dignity: a discursive analysis of structural social inequality materialized in discourses about Covid-19

In this text, we analyze from a Materialist Discourse Analysis perspective of Discourse Analysis of Pecheuxtian based, discursive practices representing knowledge and interests of economically privileged social classes in social formations organized from the capitalist mode of production, whose basis is the exploitation of labor. The proposal is to think about the class struggle in the context of the health crisis in Brazil, based on the understanding that the pandemic was/is experienced differently by each social class. Thus, we seek to understand how this part of society attributes meaningto the health crisis and what effects emerge from these discourses that oppose the interests of other classes, with regard to protection against the health risks of Covid-19 for the Brazilian population. This analytical gesture, brings a cut of four discursive sequences that we consider representative of a discursive formation in which an ideological formation underlies. Therefore, thiswork presents a discussion on the intertwining between class issues, human dignity and right to health, with the interest of reflecting on the nexus between ideology and discourse, paying attention to the relations of inequality/subordination and invisibility of vulnerable social classes, sharpened in this scenario.

Pedagogic Workshops In The Supervised Internship In Geography In Non-School Spaces: Challenges And Possibilities Of The Remote Modality

This article discusses experiences of the Supervised Internship in Geography II of the undergraduate course in Geography at the Universidade do Estado da Bahia, Campus IV, aimed at educational actions in non-school spaces, highlighting the possibilities and challenges of teaching and learning in remote modality, in the context of the Covid-19 pandemic. The methodology used was action -research with intervention through pedagogical workshops. The work aimed to answer how the concepts of place and landscape can be apprehended through theater. The locus of the research was the Artefato Theater Group, a member of the Associac5o Cultural e Arte-Educativa de Serrolandia-BA, with the participation of 11 people. To obtain data, synchronous and asynchronous activities were carried out, through the use of communication tools such as Google Meet and WhatsApp, theatrical games, dynamics, text production, construction of mind maps and digital logbook. The research results reveal that the internship in the remote format enhanced the knowledge of both the intern and the workshop participants, and provided efficiency in pedagogical practices, even with the isolation among workshop participants, because, amidst the challenges and adaptation of activities, the workshops took on the role of presenting an alternative and dynamic learning proposal, enabling the reflection process of the experiences, through playful activities, with theater as a common thread for the discussion of the geographic science concepts of place and landscape.

COVID-19 cutaneous manifestations in children and adolescents: a systematic review

Objective: The aim of this study was to evaluate the coronavirus disease 2019 (COVID-19) cutaneous manifestations described in pediatric patients and discuss their relevance for early diagnosis. Data source: The study consisted of a systematic review of original articles indexed in PubMed and Embase databases, as well as gray literature articles found through Google Scholar. A search strategy, based on PICO (Patient, Intervention, Comparison, Outcome) Tool, with the terms "child," "infant," "childhood," "adolescents," "teenagers," "COVID-19," "SARS-CoV-2," and "skin manifestations," was performed to optimize the findings. The study did not restrict any article regarding language. Data synthesis: Out of the 310 articles that initially met the inclusion criteria, 35 were selected for review, totalizing 369 patients. The most common COVID-19 cutaneous manifestations in children and adolescents were Chilblain-like lesions, presented in 67.5% of the cases, followed by erythema multiforme-like (31.7%) and varicella-like lesions (0.8%). The Chilblain-like lesions appeared 7.6 days (95%CI 7.4-7.8) after the viral infection and lasted for 17.5 days (95%CI 16.5-18.5), erythema multiformelike lesions appeared in 9.5 days (95%CI 9-10) and lasted for 10.3 days (95%CI 9.1-11.5), and varicella-like lesions appeared in 12.3 days (95%CI 4-20.6) and lasted for 7 days. Conclusions: Knowledge of the different skin manifestations in children and adolescents with COVID-19 is essential for an early diagnosis and, consequently, the possibility of promptly care adoption as well as to interrupt the new coronavirus transmission chains in the current pandemic context.

COVID-19 and the circulation information on social networks: analysis in a Brazilian Facebook group about the Coronavirus

This article aims to quantify and qualify the information circulating in social media groups about COVID-19, the subjects covered in posts, as well as the possible relations with other subjects, events or social events, in order to generate a representative panorama of perception and social reaction to the coronavirus pandemic. For this, statistical techniques, data mining and machine learning are used to the characterization, pattern detection, and grouping of textual data. The experiments are carried out on a dataset of textual data extracted from a Brazilian public group about COVID-19 (SARS-cov-2) of the social network Facebook. Statistical analyzes are crossed with data on the advance of the number of infected, and with specific political-social events, revealing variations and influences in terms of participation and engagement in the analyzed group. In addition, through the results obtained by the clustering method used, two main groups of posts are detected, the first presenting a content pattern geared to governmental issues, and the second to personal issues. The results achieved still allow a reflection on the possible social impacts of the creation or absence of public policies to deal with the COVID-19 pandemic.

Design of an Interactive Mobile Platform to Assist Communities in Voluntary Cooperation to Counter the COVID-19 Outbreak

The COVID-19 pandemic brought some challenges to humanity, such as the need to reduce the circulation of people while still meeting basic needs such as food, health care and education. People with commodities or who belong to risk groups needed to isolate themselves and the world saw several new technologies and business models being launched in a short time. This work, in line with the necessary innovations given the health crisis, but also striving for solidarity, proposes and demonstrates the functions of a free platform based on a mobile application that provides essential services for the population of risk groups. In addition, it also uses the moment to launch and encourage the consumption of services by the application that can speed up the orientation work and even increase the public safety of the university campus. This project was implemented at one University. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Nursing process directed to patients with COVID-19: record of the stages

Objective: to identify the record of the stages of the Nursing Process directed to patients with COVID-19. Method: descriptive and documentary research, with analysis of 37 medical records. Results: 83.8% of the medical records presented a record of Nursing Data Collection;56.8%, from the Nursing Assessment;and, 51.4%, of Implementation. However, no records were identified involving the stage of Nursing Diagnosis and Nursing Planning. Conclusion: the registration has occurred in an incipient and discontinuous way;however, it is an analysis carried out in a pandemic scenario, in which the professional's overload and feelings of helplessness and insecurity must be considered. Therefore, it is suggested that research be carried out to assess the impact of the pandemic in the context of nursing, thus enabling subsidies for the development of strategies that aim to support the registration of the Nursing Process by the professional.

Use of digital technologies in mental health during COVID-19

Most countries did not have a consolidated digital health structure before the pandemic. Both social distancing and mental health problems resulting from the situation justify the urgency of discussions on web-mediated interventions. The objective of this work is to present the panorama of technological mediation in mental health services and their specificities in the context of the pandemic. This paper is grounded on a critical look at the migration from face-to-face care to the Internet environment, highlighting: the international experiences using digital technologies in the pandemic context;the challenges in online consultations, emphasizing the importance of the ethical, technical/technological, and clinical domains, which are recurring issues in the international literature;the challenges and perspectives in the use of technologies. It is essential to develop strategies aligned with government incentives, aiming at the quality of the offered services and the guarantee of an adequate hybrid qualification. © 2022. Estudos de Psicologia.All Rights Reserved