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Objetivo: analisar o nível de estresse percebido e sofrimento psíquico em gestores de saúde na pandemia da Covid-19. Método: estudo descritivo, transversal com abordagem quantitativa. A coleta ocorreu de abril a setembro de 2021, com 40 gestores de serviço de saúde. Utilizou-se para a coleta de dados um instrumento para caracterização sociodemográfica e ocupacional e as escalas "Perceived Stress Scale-14" e "Self Reporting Questionnaire" para avaliação do estresse percebido e sofrimento psíquico. Os dados coletados foram analisados no Statistical Package for the Social Sciences versão 22.0. O presente estudo faz parte de um projeto intitulado "Trabalhadores dos Serviços de Saúde Frente à Pandemia de Covid-19", aprovado pelo Comitê de Ética em Pesquisa sob CAAE número 35260620.9.0000.5231. Resultados: a maioria dos profissionais eram do sexo feminino (90%, N=36), casados (70%, N=28), com filhos (80%, N=32), com média de idade de 45 anos e com pós--graduação (47,5%, N=19). A média dos escores relacionados ao estresse percebido foi 31,13 pontos (DP=3,77) sendo o mínimo 24 e máximo de 42 pontos. Com relação ao sofrimento psíquico, (40%, N=16) os gestores apresentaram prováveis casos de transtornos. A prática de atividades físicas e de lazer (p<0,05) tem papel importante na diminuição do estresse percebido e do sofrimento psíquico. Conclusão: os gestores em saúde apresentaram, durante a pandemia, estresse e sofrimento psíquico, resultados esses que devem ser considerados para promoção de autocuidado aos gestores de saúde, enfatizando a necessidade da realização de atividades físicas e de lazer.

Objective: to analyze the level of perceived stress and psychological suffering in health managers during the Covid-19 pandemic. Method: descriptive, cross-sectional study with a quantitative approach. The collection took place from April to September 2021, with 40 health service managers. An instrument for socio-demographic and occupational characterization and the "Perceived Stress Scale-14" and "Self Reporting Questionnaire" scales were used for the assessment of perceived stress and psychic suffering. The collected data were analyzed using the Statistical Package for the Social Sciences version 22.0. The present study is part of a project entitled "Health Service Workers in the Face of the Covid-19 Pandemic", approved by the Research Ethics Committee under CAAE number 35260620.9.0000.5231. Results: most professionals were female (90%, N=36), married (70%, N=28), with children (80%, N=32), with a mean age of 45 years and with a postgraduate degree. -graduation (47.5%, N=19). The average score related to perceived stress was 31.13 points (SD=3.77), with a minimum of 24 and a maximum of 42 points. With regard to psychic suffering, (40%, N=16) the managers presented probable cases of disorders. The practice of physical and leisure activities (p<0.05) plays an important role in reducing perceived stress and psychological distress. Conclusion: health managers presented, during the pandemic, stress and psychic suffering, results that should be considered for promoting self-care to health managers, emphasizing the need to carry out physical and leisure activities.Keywords: Health manager; Occupational stress; Covid-19; Coronavirus infections.

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Introduction: Health workers are exposed to a wide variety of risks in their workplaces, including psychosocial risks, which are increasingly taking on special importance, with primary health care being little studied in this area, despite having taken great responsibilities in the COVID-19 pandemic. Objectives: To analyze the relationship between psychosocial risks and quality of life in health team workers in Family Health Centers Antofagasta, Chile, in 2021, in the context of the COVID-19 pandemic. Methods: This was a quantitative study, analytical, descriptive, cross-sectional type with 78 workers from the Primary Care health team of three Family Health Centers in the city of Antofagasta. The Superintendência de Seguridad Social/Instituto Sindical de Trabajo, Ambiente y Salud 21 brief version and the World Health Organization Quality of Life instrument-Abbreviated version instrument were applied. Results: The presence of a globally high psychosocial risk stands out, being this classified as high risk/level 1. The professional groups with the highest risks were nursing technicians and nurses; regarding quality of life, the dimension with the lowest score was psychological health, with a mean of 73.6. Conclusions: A negative relationship between psychosocial risks in the workplace and workers' quality of life was evidenced In this hostile scenario, it is imperative that nurses, at a tactical and strategic level, promote workers' health, cultivate healthy work environments, promote labor relations, and exercise more empathetic leadership as care managers.

Introducción: Los trabajadores de la salud están expuestos a una gran variedad de riesgos en sus lugares de trabajos, incluyendo los riesgos psicosociales, que cada vez toman una especial importancia, siendo la atención primaria de la salud pobremente abordada en esta área, pese a que haya asumido grandes responsabilidades en la pandemia por COVID-19. Objetivos: Analizar la relación de los riesgos psicosociales y la calidad de vida en trabajadores del equipo de salud en Centros de Salud Familiar de Antofagasta, Chile, en 2021, en el contexto de la pandemia por COVID-19. Métodos: Se trata de un estudio de tipo cuantitativo, analítico, descriptivo, de corte transversal, con 78 trabajadores del equipo de salud de Atención Primaria de tres Centros de Salud Familiar de la ciudad de Antofagasta. Se aplicaron los instrumentos Superintendencia de Seguridad Social/Instituto Sindical de Trabajo, Ambiente y Salud 21 version breve y World Health Organization Quality of Life instrument-Abbreviated version. Resultados: Se destaca la presencia de un riesgo psicosocial elevado de manera global, siendo este clasificado como riesgo alto/nivel 1. Los estamentos con mayores riesgos fueron los técnicos de enfermería y enfermería; en lo referente a la calidad de vida, la dimension con menor puntaje fue la salud psicológica, con media de 73,6. Conclusiones: Se evidenció una relación negativa entre riesgos psicosociales en el lugar de trabajo y calidad de vida de los trabajadores. Ante este escenario hostil, se hace perentorio que los enfermeros, a nivel táctico y estratégico, promuevan la salud de los trabajadores, cultiven ambientes laborales saludables, favorezcan las relaciones laborales y ejerzan un liderazgo más empático como gestores del cuidado.

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Objective: To compare the effectiveness and safety of non-mRNA versus mRNA COVID-19 vaccines on pregnant women and their newborns in a systematic review with meta-analysis. Data sources: We searched PubMed, Embase, and Cochrane Central in May 2023. Study selection: The search strategy yielded 4451 results, 16 studies were fully reviewed. We selected case-control studies analysing non-mRNA versus mRNA vaccines. Data collection and analysis: we assessed the risk of bias using the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Standardised mean differences were pooled using random-effect models. Data synthesis: We identified 8 prospective and retrospective studies with a total of 32,153 patients. Non-mRNA vaccines were associated with a higher incidence of fever (OR 2.67; 95% CI 2.08-3.43; p<0.001), and a lower incidence of fetal or neonatal death (OR 0.16; 95% CI 0.08-0.33; p<0.001). In subgroup analyses, the Jansen vaccine (Ad26.COV2.S) was found to have a higher rate of premature labor/delivery (OR 4.48; 95% CI 1.45-13.83; p=0.009) and missed/spontaneous abortion (OR 1.90; 95% CI 1.09-3.30; p=0.02), as compared with the Pfizer (BNT162b2) vaccine. Conclusion: non-mRNA vaccines are associated with a lower incidence of fetal or neonatal death among pregnant women who receive a Covid19 vaccine, although at an increased rate of pyrexia compared with mRNA vaccines. Other studies are required for better assessment. PROSPERO: CRD42023421814.

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Abstract Introduction: Factors associated with mortality among mechanically ventilated COVID-19 patients have been scarcely studied in Latin America. Objective: To identify factors associated with mortality in mechanically ventilated COVID-19 patients. Methods: This prospective study was undertaken in a single center between April and October 2020, recruiting COVID-19 patients managed with mechanical ventilation. We excluded patients who died within the first 24 hours after endotracheal intubation. Clinical characteristics, laboratory results, ventilation interventions, and outcomes were collected and compared between the deceased and surviving groups. The association between these factors and hospital death was examined, and relevant covariates were included in a multivariate logistic regression model. Results: A total of 273 patients were included (72.5% male), the mortality rate was 37% (95% CI 31% - 43%), and the median age was 63 years (IQR 52-72). The most frequent comorbidity was hypertension (45%). Factors associated with mortality were: older age (OR 1.08; 95% CI 1.051.11), male gender (OR 2.79; 95% CI 1.30-6.01), immunosuppression (OR 3.98; 95% CI 1.57-10.06), thrombocytopenia (OR 3.84; CI 95% 1.47-10.01), driving pressure (OR 1.20; 95% CI 1.07-1.34) and the use of dialysis (OR 4.94; 95% CI 2.56-9.51). Chronic hypertension (OR 0.35; 95% CI 0.17-0.71) and fever on admission (OR 0.51; 95% CI 0.27-0.98) were found to have a protective effect. Conclusions: Older age, male sex, immunosuppression, thrombocytopenia, increased driving pressure, use of dialysis, absence of fever, or arterial hypertension were associated with an increased risk of mortality among mechanically ventilated COVID-19 patients.

Resumen Introducción: Es poco lo que se han estudiado en América Latina los factores asociados con mortalidad en pacientes con COVID-19 ventilados mecánicamente. Objetivo: Identificar los factores asociados con mortalidad en pacientes con COVID-19 manejados con ventilación mecánica. Métodos: Este estudio prospectivo se adelantó en un solo centro entre los meses de abril y octubre de 2020 e incluyó pacientes con COVID-19 manejados con ventilación mecánica. Se excluyeron pacientes que fallecieron en las primeras 24 horas después de la intubación orotraqueal. Se recopilaron datos de las características clínicas, resultados de laboratorio, intervenciones ventilatorias y desenlaces, y se hizo una comparación entre el grupo de pacientes fallecidos y el grupo de sobrevivientes. Se examinó la asociación entre estos factores y la muerte intrahospitalaria, y las covariables relevantes se incluyeron en un modelo multivariable de regresión logística. Resultados: Se incluyó un total de 273 pacientes (72.5% hombres), la tasa de mortalidad fue del 37% (IC 95% 31% - 43%), la mediana de edad fue de 36 años (RIC 52-72) y la comorbilidad más frecuente fue la hipertensión (45%). Los factores asociados con mortalidad fueron: edad avanzada (OR 1.08; IC 95% 1.05-1.11), género masculino (OR 2.79; IC 95% 1.30-6.01), inmunosupresión (OR 3.98; IC 95% 1.57-10.06), trombocitopenia (OR 3.84; CI 95% 1.47-10.01), presión de distensión (OR 1.20; IC 95% 1.07-1.34) y el uso de diálisis (OR 4.94; IC 95% 2.56-9.51). La presencia de hipertensión (OR 0.35; IC 95% 0.17-0.71) y de fiebre (OR 0.51; IC 95% 0.27-0.98) al momento de la hospitalización demostraron tener un efecto protector. Conclusiones: Se encontró asociación entre la edad avanzada, el sexo masculino, la inmunosupresión, la trombocitopenia, una presión de distensión elevada, el uso de diálisis, la ausencia de fiebre o de hipertensión y un mayor riesgo de mortalidad en pacientes con COVID-19 ventilados mecánicamente.

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RESUMEN Introducción: la pandemia por COVID-19 presentó desafíos a nivel mundial. La aceptación de las vacunas en la población es indispensable como medida preventiva. Es innegable que existen factores que elevan el rechazo o cuestionamiento al respecto, que pueden estar relacionados con la cultura, política, confianza, conveniencia, experiencia en servicios sanitarios, también la opinión del entorno. Objetivo: determinar el porcentaje de estudiantes y docentes vacunados, y el número de dosis aplicadas contra el COVID-19 de la Facultad de Odontología de la Universidad Nacional de Asunción, en el año 2022. Metodología: estudio observacional descriptivo de corte transversal, aplicando una encuesta en digital con 23 preguntas acerca del conocimiento, aplicación y autopercepción de la vacuna; además de datos demográficos. Resultados: fueron incluidos 168 encuestados, 128 estudiantes y 40 docentes. 80,0 % fueron mujeres. 97,6 % se ha vacunado contra COVID-19, la mayoría (85,4 %) se aplicó tres dosis de la vacuna. 34,1 % se aplicó la vacuna Covaxin, 32,9 % Sputnik V, 15,9 % AstraZeneca y 17,1 % otras (Pfizer, Sinopharm y Moderna). El 35,1 % tuvo dudas acerca de la eficacia pero que en su mayoría se aplicaron igualmente. El 94,1 % consideró necesaria y el 88,7 % segura la vacuna. El 78,5 % respondió que la cobertura es elevada para prevenir los síntomas de la enfermedad. El 35,1 % mencionó sentirse protegido en su totalidad con la vacuna. El 78,6 % sabe que puede presentarse luego de la aplicación alguna reacción adversa. Conclusión: casi la totalidad de los encuestados se encontraban vacunados y se aplicaron las tres dosis de la vacuna COVID-19 al momento de la encuesta.

ABSTRACT Introduction: the COVID-19 pandemic presented challenges worldwide. The acceptance of vaccines in the population is essential as a preventive measure. It is undeniable that there are factors that increase rejection or questioning in this regard, which may be related to culture, politics, trust, convenience, experience in health services, and also the opinion of the environment. Objective: to determine the percentage of students and teachers vaccinated, and the number of doses applied against COVID-19 in Facultad de Odontología at the Universidad Nacional de Asunción, in the year 2022. Methodology: cross-sectional descriptive observational study, applying a digital survey with 23 questions about knowledge, application and self-perception of the vaccine; in addition to demographic data. Results: 168 respondents were included, 128 students and 40 teachers. 80.0 % were women. 97.6 % have been vaccinated against COVID-19, the majority (85.4 %) received three doses of the vaccine. 34.1 % received the Covaxin vaccine, 32.9 % Sputnik V, 15.9 % AstraZeneca and 17.1 % others (Pfizer, Sinopharm and Moderna). 35.1 % had doubts about the effectiveness but most of them were applied anyway. 94.1 % considered the vaccine necessary and 88.7 % safe. 78.5 % responded that coverage is high to prevent the symptoms of the disease. 35.1% mentioned feeling fully protected with the vaccine. 78.6% know that some adverse reaction may occur after application. Conclusion: almost all of the respondents were vaccinated and had received all three doses of the COVID-19 vaccine at the time of the survey.

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The lifestyle of the population has undergone significant changes due to the COVID-19 pandemic, which could have influenced alterations in dietary habits and overall well-being among workers. This study aimed to evaluate healthy eating practices and their relationship with the workers' quality of life and physical activity during the COVID-19 pandemic. This was a cross-sectional investigation involving workers in the city of Curitiba, southern Brazil. The study was conducted through the application of an online questionnaire. The data were evaluated using non-parametric tests and fitting a logistic regression model. A total of 123 workers participated in the study, most of them male (53.2%), aged between 31 and 40 years (42.2%), with a predominance of workers with postgraduate degrees (62.6%, n = 77), and the majority of workers (68.2%, n = 84) were performing their professional activities remotely for at least one day during the week, and 73.2% (n = 90). It was observed that 52.8% had excellent healthy eating practices, and the older their age and the greater the practice of physical activity (time and frequency), the better the workers' healthy eating practices. When assessing quality of life, the lowest average score for healthy eating practices was in the domain of social relationships. A direct relationship of older age, social relationships, and the practice of physical activity with the best individuals' healthy eating practices was detected. Considering that remote work continues to be adopted post-pandemic, evaluating the dietary practices, physical activity, and quality of life of workers is necessary to understand this new labour phenomenon.

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Objective: To analyze the death of Brazilian pregnant and postpartum women due to COVID-19 or unspecific cause. Methods: This is retrospective, descriptive-exploratory, population-based study carried out with the Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) database, with pregnant and postpartum women of reproductive age who died from confirmed COVID-19 between 2020 and 2021. The chosen variables were: age, gestational period, type and number of comorbidities, skin color, using the statistical software R Foundation for Statistical Computing Platform, version 4.0.3 and Statistical Package for Social Science, version 29.0 for analysis. Results: A total of 19,333 cases of pregnant and postpartum women aged between 10 and 55 years diagnosed with SARS were identified, whether due to confirmed COVID-19 or unspecific causes. Of these, 1,279 died, these cases were classified into two groups according to the cause of death: deaths from COVID-19 (n= 1,026) and deaths from SARS of unspecific cause (n= 253). Conclusion: The risk of death increased among black and brown women, in the postpartum period and with the presence of comorbidities, mainly diabetes, cardiovascular diseases and obesity. The data presented here draw attention to the number of deaths from SARS, especially among sociodemographic profiles, precarious access to health, such as the black population. In addition, limitations in adequate access to health care are reinforced by even lower rates of ICU admissions among women who died from SARS of an unspecified cause.

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Background and objectives: During the SARS-CoV-2 pandemic, reduction in detection of other Respiratory Viruses (RV) was observed. Epidemiological studies are needed to understand the impact of the pandemic on the circulation of RV. The aim of this study is to analyze the epidemiological profile of cases of severe acute respiratory infection (SARI) associated with the main RV in hospitalized patients from Rio Grande do Sul, Brazil (RS), between 2010 and 2019 (period A) and between 2020 and 2021 (period B). Methods: Data related to SARI cases in RS were retrieved from SIVEP-Gripe. Results: In period A there were more infections with Influenza, Parainfluenza, Adenovirus and Respiratory Syncytial Virus, while in period B most cases were of SARS-CoV-2 infection. The most affected age groups were individuals <5 years old (67.1%) in period A, and >60 years old (50%) in period B. The main symptoms were fever and cough in period A, and dyspnea and O2 saturation <95% in period B. The most reported comorbidities were lung diseases and chronic cardiovascular diseases in period A, and chronic cardiovascular diseases and diabetes mellitus in period B. Importantly, a higher fatality rate was observed in period B. Most cases occurred between May and July in period A, and in November and December 2021 in period B. Conclusion: This study reveals that the COVID-19 pandemic changed the epidemiological profile of SARI in RS, and most cases were in the elderly with chronic cardiovascular disease and diabetes mellitus.(AU)

Justificativa e Objetivos: Durante a pandemia de SARS-CoV-2 foi observada redução na detecção de outros vírus respiratórios (VR). Estudos epidemiológicos são importantes para uma melhor compreensão dos impactos da pandemia sobre a circulação de VR. O objetivo deste estudo foi analisar o perfil epidemiológico dos casos de síndrome respiratória aguda grave (SRAG) associados aos principais VR em pacientes internados no Rio Grande do Sul, Brasil (RS), entre 2010 e 2019 (período A) e entre 2020 e 2021 (período B). Métodos: Dados relacionados a casos de SRAG no RS foram obtidos do SIVEP-Gripe. Resultados: No período A houve mais infecções por Influenza, Parainfluenza, Adenovírus e Vírus Sincicial Respiratório, enquanto no período B a maioria foi por SARS-CoV-2. Os grupos etários mais afetados foram de indivíduos <5 anos de idade (67,1%) no período A, e >60 anos (50%) no período B. Os principais sintomas foram febre e tosse no período A, e dispneia e saturação de O2 <95% no período B. As principais comorbidades no período A foram pneumopatias e cardiopatias, enquanto no período B foram cardiopatias e diabetes mellitus. A mortalidade foi maior no período B. A maioria dos casos no período A foram entre maio e julho, e no período B entre novembro e dezembro de 2021. Conclusão: Este estudo revela que a pandemia de COVID-19 alterou o perfil epidemiológico de SRAG no RS, sendo a maioria dos casos em indivíduos idosos com doença cardiovascular e diabetes. (AU)

Justificación y Objetivos: Durante la pandemia por SARS-CoV-2 se observó reducción en la detección de otros virus respiratorios (VR). Los estudios epidemiológicos son importantes para comprender los impactos de la pandemia en la circulación de VR. Este estudio analizó variables epidemiológicas asociadas al Síndrome Respiratorio Agudo Grave (SRAG) en Rio Grande do Sul (RS), Brasil, antes de la aparición del SARS-CoV-2 (período A, 2010-2019) y durante la pandemia (período B, 2020-2021). Métodos: Los datos relacionados con los casos de SRAG en RS se obtuvieron de SIVEP-Gripe. Resultados: En el período A hubo más infecciones por Influenza, Parainfluenza, Adenovirus y Virus Respiratorio Sincitial, mientras que en el período B la mayoría de los casos fueron causados por SARS-CoV-2. Los grupos de edad más afectados fueron <5 años (67,1%) en el período A, y >60 años (50%) en el período B. Los principales síntomas fueron fiebre y tos en el período A, y disnea y saturación de O2 <95% en el período B. Las principales comorbilidades en el período A fueron enfermedades pulmonares y cardíacas, y en el período B fueron enfermedades cardíacas y diabetes mellitus. La mortalidad fue mayor en el período B. La mayoría de los casos en el período A fueron entre mayo y julio, y en el período B entre noviembre y diciembre. Conclusiones: Este estudio revela que la pandemia de COVID-19 cambió el perfil epidemiológico del SRAG en RS. La mayoría de los casos se dan en personas de edad avanzada con enfermedades cardiovasculares y diabetes. (AU)

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Non-communicable chronic diseases (NCDs) are considered one of the leading causes of death worldwide. During the COVID-19 pandemic, these diseases have been neglected due to the Brazilian Unified National Health System (BHUS) overload. In this context, this study aimed to analyze the bond between patients with NCDs and primary care during the COVID-19 pandemic while also seeking to identify the population's level of knowledge about health parameters and their relationship with the healthcare system. A cross-sectional and observational study was conducted, in which an online questionnaire was administered to collect socioeconomic information from patients and their bond with BHUS in the metropolitan region of Maringa, Parana, Brazil, encompassing individuals over 18 years of age. The survey was promoted on social media, and interested participants responded to the questionnaire, which addressed topics such as identification, medication use, disease information, knowledge about NCDs, and general data related to COVID-19. The obtained and analyzed responses revealed a low bond level between this population and primary care and a lack of knowledge about NCDs and their health during the pandemic. There was a notable decrease in seeking healthcare services during this period, which may be explained by the fear of contracting the novel coronavirus. This study is essential to understand patients' responses to public health challenges during the pandemic. It can become a valuable ally in dealing with future pandemics and endemic crises, enabling improvements in care and raising awareness among the population about NCDs and the healthcare system.

Las enfermedades crónicas no transmisibles (ENT) son consideradas una de las principales causas de muerte a nivel mundial. Durante la pandemia de COVID-19, estas enfermedades han sido desatendidas debido a la sobrecarga de las Unidades Básicas de Salud (UBS). En ese contexto, el objetivo de este estudio es analizar el vínculo entre los pacientes con enfermedades crónicas no transmisibles (ECNT) y la atención primaria durante la pandemia de COVID-19, buscando identificar el nivel de conocimiento de la población sobre los parámetros de salud y la relación con el sistema de salud. Se realizó un estudio transversal y observacional, en el que se aplicó un cuestionario en línea para recolectar información socioeconómica de los pacientes y su vínculo con las BHU en la región metropolitana de Maringá/PR, abarcando personas mayores de 18 años. La divulgación se realizó en las redes sociales y los interesados respondieron el cuestionario que abordó temas como identificación, uso de medicamentos, información sobre enfermedades, conocimientos sobre ECNT y datos generales relacionados con el COVID-19. Las respuestas obtenidas y analizadas revelaron un bajo nivel de vinculación de esta población con la atención primaria, así como un desconocimiento sobre las ECNT y su propia salud durante la pandemia. Hubo una notable reducción en la demanda de servicios de salud durante este período, lo que puede explicarse por el temor a la contaminación por el nuevo coronavirus. Este estudio se presenta como una herramienta importante para comprender la respuesta de los pacientes a los desafíos de salud pública durante la pandemia. Puede convertirse en un valioso aliado para enfrentar futuras pandemias y crisis endémicas, posibilitando mejoras en la atención y concientización de la población sobre las ECNT y el sistema de salud.

As doenças crônicas não transmissíveis (DCNTs) são consideradas uma das principais causas de morte em todo o mundo. Durante a pandemia da COVID-19, essas doenças têm sido negligenciadas devido à sobrecarga das Unidades Básicas de Saúde (BHU). Neste contexto, o objetivo deste estudo é analisar o vínculo dos pacientes com DCNTs com a atenção primária durante a pandemia da COVID-19, ao mesmo tempo em que busca identificar o nível de conhecimento da população sobre os parâmetros de saúde e o relacionamento com o sistema de saúde. Realizou-se um estudo transversal e observacional, no qual foi aplicado um questionário online para coletar informações socioeconômicas dos pacientes e seu vínculo com as BHUs na região metropolitana de Maringá/PR, abrangendo indivíduos maiores de 18 anos. A divulgação foi realizada em mídias sociais e os interessados responderam ao questionário que abordou tópicos como identificação, uso de medicações, informações sobre doenças, conhecimento acerca das DCNTs e dados gerais relacionados à COVID-19. As respostas obtidas e analisadas revelaram um baixo nível de vínculo dessa população com a atenção primária, assim como uma falta de conhecimento sobre as DCNTs e a própria saúde durante a pandemia. Observou-se uma notável redução na procura por serviços de saúde durante esse período, o que pode ser explicado pelo receio da contaminação pelo novo coronavírus. Este estudo se apresenta como uma ferramenta importante para compreender a resposta dos pacientes frente aos desafios da saúde pública durante a pandemia. Ele pode se tornar um aliado valioso para lidar com futuras pandemias e crises endêmicas, possibilitando melhorias nos cuidados e na conscientização da população sobre as DCNTs e o sistema de saúde.

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Objetivo: Descrever os parâmetros validados por enfermeiros relacionando com a sua prática assistencial na monitorização de pacientes críticos sob ventilação mecânica. Métodos: Estudo descritivo-exploratório, de abordagem quantitativa, cujos dados foram discutidos à luz da Resolução Conselho Federal de Enfermagem n. 639/2020 e de parâmetros clínicos obtidos validados por enfermeiros intensivistas. Resultados: Os parâmetros validados foram discutidos em termos de sua aplicabilidade clínica para o alcance da competência monitorização respiratória, um dos itens presentes na referida resolução como privativa do enfermeiro. Criou-se um quadro com os parâmetros gerais para a monitorização respiratória/ventilatória por enfermeiros, com alvo clínico e local de obtenção do parâmetro no ventilador mecânica, para colaborar com a sua usabilidade. Conclusão: Apresentou-se a aplicabilidade de parâmetros validados por enfermeiros na assistência aos pacientes sob ventilação mecânica. Pondera-se sua contribuição para maior qualidade na assistência, melhores desfechos clínicos, assim como, evitar complicações associadas à ventilação mecânica. (AU)

Objective: To describe the respiratory/ventilatory parameters validated by nurses relating to their care practice in critical patients on mechanical ventilation. Methods: Descriptive-exploratory study with quantitative approach, whose data were discussed based on COFEN Resolution 639/2020 and clinical parameters obtained validated by critical care nurses. Results: The validated parameters were discussed in terms of clinical applicability for achieving the competence "respiratory monitoring", one of the items present in the aforementioned resolution as private nurse care. A framework was created with the general parameters for respiratory/ventilatory monitoring by nurses, with clinical target and location of obtaining the parameter on the mechanical ventilator, to collaborate with its usability. Conclusion: The applicability of parameters validated by nurses in care of mechanically ventilated patients was presented. Its contribution to better quality care and clinical outcomes, as well as avoiding complications associated with mechanical ventilation. (AU)

Objetivo: describir los parámetros respiratorios/ventilatorios validados por enfermeros relacionando con su práctica asistencial en pacientes críticos con ventilación mecánica. Métodos: investigación descriptiva-exploratoria con abordaje cuantitativo, cuyos datos fueron discutidos en la Resolución COFEN 639/2020 y de parámetros clínicos obtenidos y validados por enfermeros intensivistas. Resultados: los parámetros validados fueron discutidos en términos de su aplicabilidad clínica para el alcance de la competencia "monitoreo respiratorio", uno de los ítems presentes en la referida resolución como exclusiva del enfermero. Se creó un cuadro con los parámetros generales para el monitoreo respiratorio/ventilatorio por enfermeros, con objetivo clínico y lugar de obtención del parámetro en el ventilador mecánico, para colaborar con su usabilidad. Conclusión: se presentó la aplicabilidad de parámetros validados por enfermeros en la asistencia a pacientes con ventilación mecánica. Se pondera su contribución para una mayor calidad en la asistencia, mejores desenlaces clínicos y, también, para evitar complicaciones asociadas con la ventilación mecánica. (AU)

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Objective: The aims of the study are to describe the association of coronavirus disease (COVID-19) with the abnormal histopathological findings in human placenta and to highlight the potential predictors of these histopathological findings. Methods: A retrospective cohort study, held in two obstetric units from January 2021- 2022, 34 patients who were confirmed cases of COVID- 19 were followed up till the time of delivery as their placenta were sent for histopathology. Patients diagnosed with other viral infections, chorioamnionitis, or were known case of as pre-term or term pre labour rupture of membrans (PROM) were excluded as well as pre exisiting diabetes mellitus or pre-eclampsia. Data analysis were performed using STATA software version 16. Result: Specific histopatological findings (fetal vascular malperfusion, maternal vascular malperfusion, inflammatory pathology and thrombotic finding) were significantly high among 13 (38.2%) of the study group who got infected earlier in pregnancy (P<0.001). The period between the diagnosis of COVID-19 and the delivery significantly increases the odds of the presence of pathological findings by 2.75 times for each week the patients getting infected earlier. Conclusion: Association of abnormal placental histopathological findings with COVID-19 infection in pregnancy and the potential predictor for the occurrence of placental findings is the longer duration between the diagnosis of the infection and the delivery.

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Objetivo: Discutir um caso clínico de paciente em cuidado paliativo exclusivo com covid-19, que foi acompanhado por dois processos: assistência domiciliar e internação hospitalar. Métodos: Estudo qualitativo, do tipo caso clínico, realizado com idosa com os diagnósticos de câncer avançado e covid-19, internada em um hospital especializado em cuidados paliativos exclusivos (CPE) oncológicos, no Rio de Janeiro. Os dados foram coletados no prontuário em dezembro/2020. Resultados: As ações de enfermagem foram fundamentadas na teoria de Wanda de Aguiar Horta. Os principais diagnósticos da taxonomia da North American Nursing Diagnosis Association - NANDA-1 identificados, foram correlacionados às Necessidades Humanas Básicas afetadas, em especial as psicossociais e psicobiológicas. Conclusão: Gerenciar o cuidado na atenção paliativa oncológica frente à pandemia de covid-19 abarca compreender os fatores diretamente relacionados ao cuidado, bem como questões amplas que envolvem políticas, condições de trabalho, recursos humanos, dentre outros fatores capazes de influenciar as ações de cuidado. (AU)

Objective: To discuss a clinical case of a patient in exclusive palliative care with covid-19, who was followed by two processes: home care and hospital admission. Methods: Qualitative study, of the clinical case type, carried out with an elderly woman diagnosed with advanced cancer and covid-19, admitted to a hospital specializing in exclusive palliative care (CPE) oncology, in Rio de Janeiro. Data were collected from the medical record in December/2020. Results: The nursing actions were based on Wanda de Aguiar Horta's theory, the main diagnoses of the North American Nursing Diagnosis Association - NANDA-1 taxonomy making a correlation with the Basic Human Needs affected, in particular the psychosocial and psychobiological needs. Conclusion: Managing care in palliative cancer care in the face of the covid-19 pandemic encompasses understanding the factors directly related to care, as well as broad issues involving policies, working conditions, human resources, among other factors capable of influencing the actions of care. (AU)

Objetivo: Discutir un caso clínico de un paciente en cuidados paliativos exclusivos con covid-19, al que le siguieron dos procesos: atención domiciliaria e ingreso hospitalario. Métodos: Estudio cualitativo, tipo caso clínico, realizado con una anciana diagnosticada de cáncer avanzado y covid-19, ingresada en un hospital especializado en oncología de cuidados paliativos exclusivos (CPE), en Río de Janeiro. Los datos fueron recolectados de la historia clínica en diciembre / 2020. Resultados: Las acciones de enfermería se fundamentaron en la teoría de Wanda de Aguiar Horta. Los principales diagnósticos identificados por la taxonomía de la Asociación Norteamericana de Diagnóstico de Enfermería - NANDA-1 se correlacionaron con las Necesidades Humanas Básicas afectadas, especialmente psicosociales y psicobiológicas. Conclusion: Gestionar los cuidados en cuidados paliativos oncológicos frente a la pandemia covid-19 comprende comprender los factores directamente relacionados con el cuidado, así como temas amplios que involucran políticas, condiciones laborales, recursos humanos, entre otros factores capaces de incidir en las acciones de cuidado. (AU)

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Resumen Objetivo: "Determinar el estado emocional de acuerdo al DASS-21 en enfermos post COVID-19 en el primer nivel de atención en salud". Material y métodos: Estudio observacional, transversal, descriptivo realizando encuesta sobre el estado emocional (DASS-21; Lovibond y Lovibond, 1995) en enfermos post COVID-19 a una muestra de 70 pacientes de la Unidad de Medicina Familiar No. 34 anexo Unidad Médica de Atención Ambulatoria de La Paz, Baja California Sur. Se realizó un análisis estadístico con frecuencias, porcentajes para variables cualitativas nominales, con medidas de tendencia central y dispersión en variables cuantitativas, con determinación de Chi2. Previa autorización de los comités local de investigación y de ética. Resultados: Se encontró 45 pacientes femeninos (64.3%), edad 39.41 ± 13.930, con una asociación estadísticamente significativa entre ansiedad y presencia de síntomas graves con una p= 0.014 (IC95% 0.000-0.042), depresión y grupo etario p= 0.029 (IC95% 0.000-0.068); y no se encontró asociación estadísticamente significativa con el estrés. Conclusión: La ansiedad afecta de manera leve y extremadamente severa a enfermos post COVID-19 relacionada a la presencia de síntomas graves, la depresión detectada fue moderada y está relacionada al grupo etario en cambio el estrés detectado fue leve y no presentó asociación de variables.

Abstract Objective: "Determine the emotional state following the DASS-21 in postCOVID-19 patients at the first level of health care". Material and methods: Observational, cross-sectional, descriptive study conducting a survey on the emotional state (DASS-21; Lovibond and Lovibond, 1995) in post-COVID-19 patients in a sample of 70 patients from the Family Medicine Unit No. 34 annex Ambulatory Care Medical Unit of La Peace, Baja California Sur. A statistical analysis was carried out with frequencies, percentages for nominal qualitative variables, with measures of central tendency and dispersion in quantitative variables, with determination of chi2. With prior authorization from the local research committee and ethics committee. Results: 45 female patients were found (64.3%), age 39.41 ± 13.930, with a statistical significance between anxiety and presence of severe symptoms with p= 0.014 (95%CI 0.000-0.042), depression and age group p= 0.029 (95%CI % 0.000-0.068); and no significance was found with stress. Conclusion: Anxiety mildly and extremely severely affects post-COVID-19 patients related to the presence of severe symptoms, the depression detected was moderate and is related to the age group, while the stress detected was mild and did not present an association of variables.

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RESUMEN Introducción: En 2020, Colombia adoptó diferentes medidas para mitigar el impacto de la pandemia por Covid-19, principalmente medidas de aislamiento social y fortalecimiento en la prestación de servicios hospitalarios. Sin embargo, el país no contempló acciones para abordar los otros problemas en salud, como tampoco consideró la relevancia de la Atención Primaria en Salud (APS) para responder a la pandemia. Por lo cual se realizó una investigación para indagar por la oferta y posicionamiento de la APS entre los tomadores de decisiones para atender la emergencia de Covid-19 durante la primera ola de la pandemia y los aprendizajes para las siguientes. Metodología: De abril a junio de 2020 se realizó un estudio descriptivo exploratorio mixto en 2 fases: (1) Encuesta a tomadores de decisiones, prestadores y académicos, y (2) Grupo focal a informantes clave. Resultados: La encuesta fue respondida por 227 participantes, 41 % académicos, 34.8 % prestadores y 17.6 % funcionarios de direcciones locales de salud; el 28.2 % consideró que la APS estuvo adaptada en los territorios para diferentes programas de salud por ciclo vital y entre el 80 al 98 % que la APS debía instaurarse en el territorio para vigilancia de casos, atención ambulatoria, manejo de pacientes crónicos, atención de otros programas y educación sanitaria. En el grupo focal participaron 12 informantes claves, quienes concluyeron que desde la autoridad sanitaria se debía promover la integración de la APS de forma urgente en los territorios, y garantizar una gobernanza eficaz para lograrlo; igualmente, recomendaron intensificar la alfabetización en salud y el empoderamiento de la población para la adopción de medidas individuales y colectivas. Conclusiones: Se concluye que la APS era una oportunidad para responder a la primera ola de la pandemia, como también para subsanar los problemas actuales y anticiparse a problemas futuros. Por lo cual, la APS debe convertirse en una política de Estado.

ABSTRACT Introduction: In 2020, Colombia adopted different measures to mitigate the impact of the Covid-19 pandemic, social isolation measures and strengthening the provision of hospital services. However, the country did not contemplate actions to address other health problems, nor did it consider the relevance of Primary Health Care (PHC) to respond to the pandemic. Therefore, an investigation was done to investigate the offer and positioning of PHC among decision-makers to address the Covid-19 emergency during the first wave of the pandemic and the learning for the following ones. Methodology: From April to June 2020, a mixed exploratory descriptive study was conducted in two phases: (1) a survey of decision-makers, providers, and academics, and (2) a focus group of key informants. Results: The survey was answered by 227 participants, 41 % academics, 34.8 % providers, and 17.6 % officials from local health directorates; 28.2 % considered that PHC was adapted in the territories for different life cycle health programs, and between 80 and 98 % that PHC should be established in the territory for case surveillance, outpatient care, management of chronic patients, care of other programs and health education. Twelve key informants participated in the focus group, who concluded that the health authority should urgently promote the integration of PHC in the territories, and guarantee effective governance to achieve it; Likewise, they recommended intensifying health literacy and the empowerment of the population for the adoption of individual and collective measures. Conclusions: It is concluded that PHC was an opportunity to respond to the first wave of the pandemic, as well as to correct current problems and anticipate future problems. Therefore, PHC must become a state policy.

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The emergence of SARS-CoV-2, leading to the widespread outbreak of COVID-19, has unveiled a spectrum of symptoms and severe health complications, challenging healthcare systems and impacting millions of lives worldwide. To analyze events allegedly attributable to vaccination or immunization (ESAVI) against SARS-CoV-2 (COVID-19) in the municipality of Santarém, in the interior of the state of Pará, an epidemiological, descriptive study was conducted using data from e-SUS Notifica in Santarém/PA from January 2021 to January 2022. The analyzed data for ESAVI cases included the administered immunobiologicals (Coronavac, Covishield, and Comirnaty), the type of event, case progression, time in days between immunobiological administration, and symptom onset, causality, and classification of ESAVI according to the vaccine package inserts. The incidence rate of ESAVI due to the COVID-19 vaccine was 17 per 100,000 doses administered in the municipality. According to the ESAVI classification, 14.0% were classified as Serious ESAVI (ESAVIG) (IR: 8.12 per 100,000 doses administered), with 100% of these events resulting in full recovery without sequelae, and 82.4% of reported cases were classified as Non-Serious ESAVI (ESAVING) (IR: 47.78), of which 3.60% were immunization errors (IR: 2.08 IE per 100,000 doses). This study fosters discussion on the importance of accurate recording of ESAVI related to COVID-19 vaccines, demonstrating their safety for the population.

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Resumen: Introducción: La COVID-19 se acompaña de síntomas que suelen ser más evidentes cuando la enfermedad es severa. Objetivo: Evaluar los síntomas de pacientes hospitalizados por COVID-19 a través del cuestionario Evaluación de Síntomas de Edmonton ESAS-r(es) y comparar su intensidad de acuerdo con la gravedad. Material y métodos: Se realizó un estudio transversal, prospectivo y observacional, que consistió en la evaluación de la intensidad de síntomas en pacientes con COVID-19 hospitalizados y se comparó de acuerdo con la gravedad. Resultados: Se incluyeron 110 evaluaciones, la mayoría de síntomas se presentaron con mayor intensidad en el grupo gravedad severa: agotamiento (p ≤ 0.001), pérdida de apetito (p = 0.006), dificultad para respirar (p = 0.001), desánimo (p = 0.009) y nerviosismo/ansiedad (p = 0.041). Conclusión: Los síntomas se presentaron con mayor frecuencia e intensidad en enfermedad severa.

Abstract: Introduction: COVID-19 is accompanied by symptoms that are usually more evident when the disease is severe. Objective: To evaluate the symptoms of patients hospitalized for COVID-19 through the ESAS-r(es) questionnaire and compare their intensity according to severity. Material and methods: A cross-sectional, prospective and observational study was carried out, which consisted of the evaluation of the intensity of symptoms in hospitalized patients with COVID-19 and was compared according to severity. Results: 110 evaluations were included, most of the symptoms presented with greater intensity in the severe severity group: exhaustion (p ≤ 0.001), loss of appetite (p = 0.006), shortness of breath (p = 0.001), discouragement (p = 0.009) and nervousness/anxiety (p = 0.041). Conclusion: The symptoms occurred with greater frequency and intensity in severe disease.

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Introducción: La enfermedad por el nuevo coronavirus SARS-CoV-2 (COVID-19) se extendió rápidamente por todo el mundo y generó un gran desafío. La aparición de coinfecciones se encuentra entre las complicaciones más graves que pueden desarrollar los enfermos. La aspergilosis pulmonar se ha identificado como una complicación de la neumonía por la COVID-19 en los pacientes ventilados en las unidades de cuidados intensivos. Objetivo: Presentar un caso clínico poco común de aspergilosis pulmonar. Caso clínico: Se presenta el caso de una paciente con historia reciente de la COVID-19, con un cuadro clínico enteral dado por diarreas, vómitos e insuficiencia respiratoria en el que concomitan la evolución de un cáncer de colon y neumonía asociada a la ventilación provocada por Aspergillus niger. Conclusiones: La aspergilosis pulmonar asociada a la COVID-19 es una complicación que debe considerarse y buscarse en pacientes con historia reciente de esta enfermedad(AU)

Introduction: The new SARS-CoV-2 coronavirus disease (COVID-19) spread rapidly throughout the world, which created a great challenge. The appearance of coinfections is among the most serious complications that these patients can develop. Pulmonary aspergillosis has been identified as a complication of COVID-19 pneumonia among ventilated patients in intensive care. Objective: To present an unusual clinical case of pulmonary aspergillosis. Clinical case: It is presented the case of a patient with a recent history of COVID-19, with an enteral clinical picture of diarrhea and vomiting plus respiratory failure, in which the evolution of colon cancer and ventilator-associated pneumonia caused by Aspergillus niger are concomitant. Conclusions: Pulmonary aspergillosis associated with COVID-19 is a complication that should be considered and sought in patients with a recent history of this disease(AU)

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Objective: To map the temporal evolution of overweight and obesity in Brazilian adults and estimate the prevalence of obesity for 2025 and 2030, evaluating the potential impact of the COVID-19 pandemic. Method: Data were collected on the nutritional status of adults from 2008 to 2021 from the Food and Nutrition Surveillance System (SISVAN), from which we calculated the prevalence and average annual rates of the variation of overweight and obesity. The projection of obesity, using linear regression, was analyzed in three scenarios: PP: with data from the pre-pandemic period (2008-2019); outlier: with adjustment of the data trend (2008-2021), including the pandemic period, considering a return of scenario PP for projections from 2022; P: adjustment of pandemic data (2019-2021) to estimate the projection. Result: In the period 2008­2021, we observed an average annual rate of overweight increase of 0.48 %/year. The prevalence of obesity more than doubled during this period, from 14.5% in 2008 to 32.9% in 2021 (i.e., an increase of 1.42). In the outlier scenario, the prevalence projections for obesity are 38.8% and 45.5% for 2015 and 2030, respectively. In the PP scenario (without the pandemic), the expected prevalence for the same period would be approximately 36.8% and 43.4%, respectively. Conclusion: Obesity and overweight follow an increasing trend. The COVID-19 pandemic accelerated the increase in the prevalence of obesity in Brazil and impacted its projections for the coming years

Objetivo: Mapear a evolução temporal de sobrepeso e obesidade de adultos brasileiros e estimar as prevalências de obesidade para 2025 e 2030, avaliando o potencial impacto da pandemia de COVID-19. Método: Foram coletados dados do estado nutricional de adultos de 2008 a 2021 do Sistema de Vigilância Alimentar e Nutricional (SISVAN), a partir dos quais foram calculadas as prevalências e taxas médias anuais da variação de sobrepeso e obesidade. A projeção da obesidade, utilizando regressão linear, foi analisada em três cenários: PP: com dados do período pré-pandemia (2008-2019); outlier: com ajuste da endência de dados (2008-2021), incluindo o período da pandemia, considerando um retorno do cenário PP para projeções a partir de 2022; P: ajuste dos dados da pandemia (2019-2021) para estimativa da projeção. Resultado: No período de 2008 e 2021, observamos uma taxa anual média de aumento de sobrepeso de 0,48 %/ano. A prevalência de obesidade mais que dobrou nesse período, passando de 14,5% em 2008 para 32,9% em 2021 (i.e., um aumento de 1,42). No cenário outlier, as projeções das prevalências de obesidade são de 38,8% e 45,5% para os anos de 2015 e 2030, respectivamente. No cenário PP (sem a pandemia), a prevalência esperada para o mesmo período estaria em torno de 36,8% e 43,4%, respectivamente. Conclusão: A obesidade e o sobrepeso seguem uma tendência de aumento crescente. A pandemia de COVID-19 acelerou o aumento da prevalência de obesidade no Brasil e impactou a sua projeção para os próximos anos.

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BACKGROUND: With the identification of COVID-19 disease in China, a pandemic began that affected health-care systems. The Neonatal Intensive Care Unit (NICU) of the Hospital de Ginecobstetricia del Centro Médico Nacional de Occidente experienced an increase in patient flow as part of the COVID-19 strategy of the Instituto Mexicano del Seguro Social (IMSS). This study aimed to analyze the impact of the COVID-19 pandemic on neonatal care and mortality indicators in our unit. METHODS: We conducted a retrospective study to compare the number of hospital births, pre-term newborns (PTNB), NICU admissions, and deaths. Changes in frequencies between 2019 and 2021 were analyzed using Poisson distribution. Changes in PTNB births, proportion of admissions, and deaths/NICU discharges were analyzed by z-test for two proportions. RESULTS: Between 2019 and 2021, the number of births increased by more than 2-fold. NICU admissions increased from 770 in 2019 to 1045 in 2021 (p < 0.01). The ratio of deaths/discharge from the service was 16.9% in 2019 and 13.1% in 2021 (p = 0.02). CONCLUSIONS: Mortality indicators in the NICU decreased from 2019 to 2021, even with the increase in the number of patients admitted during the COVID-19 pandemic.

INTRODUCCIÓN: Con la identificación de la enfermedad por COVID-19 en China, inició una pandemia que afectó a los sistemas de salud. La Unidad de Cuidados Intensivos Neonatales (UCIN) del Hospital de Ginecobstetricia del Centro Médico Nacional de Occidente del Instituto Mexicano del Seguro Social (IMSS) vio incrementado su flujo de pacientes como parte de la Estrategia COVID-19 del IMSS. El objetivo fue analizar el impacto de la pandemia COVID-19 en los indicadores de atención y mortalidad neonatal en nuestra unidad. MÉTODOS: Se realizó un estudio retrospectivo para comparar el número de nacimientos en el hospital, nacimientos de recién nacidos prematuros (RNPT), ingresos a UCIN y defunciones. Se analizaron los cambios en frecuencias entre los años 2019 a 2021 mediante la distribución de Poisson. Los cambios en nacimientos de RNPT, proporción de ingresos y defunciones/egreso en UCIN se analizaron mediante prueba Z para dos proporciones. RESULTADOS: Entre los años 2019 a 2021, el número de nacimientos incrementó más de 2 veces. Los ingresos a UCIN aumentaron de 770 en 2019, a 1045 en 2021 (p < 0.01). La proporción de defunciones/egreso del servicio fue de 16.9% en 2019, y 13.1% en 2021 (p = 0.02). CONCLUSIONES: Los indicadores de mortalidad en la UCIN disminuyeron de 2019 a 2021, aun con el incremento en el número de pacientes atendidos durante la pandemia COVID-19.

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