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Background The coronavirus disease 2019 (COVID-19) pandemic provoked disruptions in healthcare delivery. Following the recommendations of major surgical societies and surgical departments globally, most surgeries were widely canceled or postponed, causing significant disruptions to healthcare delivery worldwide, including in Brazil. Brazil's public healthcare system - Sistema Único de Saúde (SUS) was particularly affected, with a substantial decline in elective procedures, especially during the pandemic's early stages. The impact of the pandemic on surgical services in Brazil has not been adequately studied since most studies only cover the early phases of the pandemic. Thus, this study aims to analyze the case fatality rates and costs, associated with the different surgical procedure subgroups performed during the pre-pandemic, pandemic, recovery, and post-pandemic periods in all five regions of Brazil. Methods A retrospective cross-sectional design was used to examine surgical cases from 2019 to 2022. Data was divided into four time periods, named as the pre-pandemic (March-December 2019), pandemic (March-December 2020), recovery (March-December 2021), and post-pandemic (March-December 2022), and was analyzed for the cost of surgical procedures in the aforementioned four periods. In addition, the case fatality rates and rate ratios in the four periods stratified according to region were calculated. Results The cost of surgical procedures decreased during the pandemic and recovery period compared with pre-pandemic for all procedures except thoracic surgery where it was higher in the recovery period than pre-pandemic. No statistically significant change in cost was observed in surgeries of the central and peripheral nervous system, circulatory system, obstetric, and oncology. Case fatality rates increased among all five regions of Brazil in pandemic and recovery periods compared to pre-pandemic and post-pandemic periods. Case fatality rates increased during the pandemic and/or recovery as compared to pre-pandemic in all procedures except visual apparatus and obstetric surgeries were not affected by the pandemic in terms of case fatality rates. Conclusion The COVID-19 pandemic had a significant impact on surgical care costs and case fatality rates for surgery in Brazil. There was a decreasing trend in the costs of procedures during the pandemic, followed by a gradual recovery to baseline values, except for thoracic surgery. Case fatality rates rose initially and then declined, ultimately reaching baseline levels. The pandemic posed significant challenges to the healthcare system, affecting medical services, including surgical care.

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Resumo Este artigo analisa o impacto dos fatores psicossociais provocado pela pandemia da covid-19 em lésbicas, gays, bissexuais e transgêneros (LGBT) na Colômbia. Trata-se de um estudo exploratório misto, que utilizou dados qualitativos para explicar os dados quantitativos, com ênfase na interpretação das relações entre ambos. Para tanto, foram utilizados como instrumentos um questionário e grupos de estudo. Participaram do estudo 219 pessoas LGBT, sendo 18 lésbicas, 128 gays, 36 bissexuais e 37 pessoas transgênero. Os impactos psicossociais mais significativos associados à covid-19 foram relacionados a fatores econômicos (como desemprego e diminuição da renda familiar), conflitos familiares (como perda da privacidade da população LGBT que tiveram que retornar a seu lar de origem) e tensões nas relações sociais, gerando insegurança, medo e ansiedade nessa população durante o lockdown. Tais aspectos evidenciam um aumento da desigualdade social vivenciada por pessoas de orientações sexuais e identidades de gênero não hegemônicas durante a pandemia.

Abstract The article presents an analysis of the impact generated by the covid-19 pandemic on the psychosocial aspects of lesbian, gay, bisexual and transgender (LGBT) people in Colombia. The methodology used was mixed, with a sequential explanatory approach, in which the qualitative results were used to explain the quantitative results and its emphasis was to interpret the relationships between the two, for this purpose the survey and discussion groups were used as research techniques. In total, 219 LGBT people participated in the study, of which 18 were lesbian, 128 gay, 36 bisexual and 37 transgender people. The most significant psychosocial impacts associated with covid-19 are related to economic aspects linked to unemployment and the decrease in family income, as well as conflicts in the family environment determined by the loss of privacy of LGBT people who must return to their homes. homes of origin; in addition to the tensions in social relationships that generate feelings of insecurity, fear and anxiety in this population due to mandatory confinement, which shows greater social inequality linked to non-hegemonic sexual orientations and gender identities that increased during the pandemic.

Resumen Este artículo presenta un análisis del impacto generado por la pandemia del covid-19 en los aspectos psicosociales de las personas lesbianas, gais, bisexuales y transgénero (LGBT) en Colombia. La metodología empleada fue mixta, con un enfoque secuencial explicativo, en el cual los resultados cualitativos se utilizaron para explicar los resultados cuantitativos y su énfasis fue interpretar las relaciones entre ambos; para tal fin se utilizaron la encuesta y los grupos de discusión como técnicas de investigación. En total, participaron en el estudio 219 personas LGBT, de las cuales 18 eran lesbianas, 128 gais, 36 bisexuales y 37 personas transgénero. Los impactos psicosociales más significativos asociados al covid-19 están relacionados con los aspectos económicos vinculados al desempleo y la disminución de los ingresos familiares, así como los conflictos en el ámbito familiar determinados por la pérdida de la privacidad de las personas LGBT que debieron regresar a sus hogares de origen; además de las tensiones en las relaciones sociales que generan sentimientos de inseguridad, temor y ansiedad en esta población debido al confinamiento obligatorio, lo cual evidencia una mayor desigualdad social vinculada a las orientaciones sexuales e identidades de género no hegemónicas que se acrecentaron en tiempos de pandemia.

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INTRODUCTION: At the beginning of the pandemic, studies showed a higher risk of severe surgical complications and mortality among patients with perioperative SARS-CoV-2 infection, which led to the suspension of elective surgery. Confinement and lockdown measures were shown to be associated with weight gain and less access to medical and surgical care in patients with obesity, with negative health consequences. To evaluate the safety of bariatric surgery during the pandemic, we compared 30-day complications between patients who underwent bariatric surgery immediately before with those who underwent bariatric surgery during the opening phase of the pandemic. METHODS: Observational analytical study of a non-concurrent cohort of patients who underwent bariatric surgery in 2 periods: pre-pandemic March 1 to December 31, 2019, and pandemic March 1 to December 31, 2020. Surgical complications were defined using the Clavien-Dindo classification. RESULTS: Pre-pandemic and pandemic groups included 256 and 202 patients who underwent primary bariatric surgery, respectively. The mean age was 37.6 + 10.3 years. The overall complication rate during the first 30 days of discharge was 7.42%. No differences between groups were observed in severe complications (pre-pandemic 1.56% vs. pandemic 1.98%, p: 0.58). No mortality was reported. Overall 30-day readmission was 3.28% with no differences between groups. CONCLUSION: The findings of this study did not find a difference in the rate of severe complications, nor also we report severe COVID-19 complications in this high-risk population. During the pandemic, with appropriately implemented protocol, the resumption of bariatric surgery is possible with no increased risk for patients.

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The ideal food packaging materials are recyclable, biodegradable, and compostable. Starch from plant sources, such as tubers, legumes, cereals, and agro-industrial plant residues, is considered one of the most suitable biopolymers for producing biodegradable films due to its natural abundance and low cost. The chemical modification of starch makes it possible to produce films with better technological properties by changing the functional groups into starch. Using biopolymers extracted from agro-industrial waste can add value to a raw material that would otherwise be discarded. The recent COVID-19 pandemic has driven a rise in demand for single-use plastics, intensifying pressure on this already out-of-control issue. This review provides an overview of biopolymers, with a particular focus on starch, to develop sustainable materials for food packaging. This study summarizes the methods and provides a potential approach to starch modification for improving the mechanical and barrier properties of starch-based films. This review also updates some trends pointed out by the food packaging sector in the last years, considering the impacts of the COVID-19 pandemic. Perspectives to achieve more sustainable food packaging toward a more circular economy are drawn.

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The COVID-19 pandemic raises concerns about risks for pregnant women and fetuses, considering factors such as vertical transmission and neonatal alterations caused by maternal infection. Despite this, neuropsychomotor and functional complications in infants delivered by mothers with COVID-19 are still little studied. Thus, we aimed to describe the health history and development based on ICF (International Classification of Functioning, Disability and Health) components of a high-risk preterm infant born to a mother hospitalized due to COVID-19 complications. This case report was based on medical records, developmental assessments, and maternal reports. The infant was born at 30 weeks and 3 days, weighing 1,300 g, measuring 40 cm, and with Apgar scores of 2, 5, 6, and 7. COVID-19 test was negative 1 and 72 h after birth. Moreover, the infant had cardiorespiratory complications and hyperechogenicity of the periventricular white matter. The infant presented speech and language delays during follow-up, but neuromotor development occurred according to age. The health care and follow-up provided helped the development of resilience mechanisms by the infant and family to overcome adversities in the prenatal, perinatal, and neonatal periods. The assessments based on ICF components can contribute to future studies on this topic.

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BACKGROUND: The onset of the SARS-Cov-2 pandemic brought with it important changes in the hospital care for all diseases. According to the international literature, since the beginning of the pandemic there has been an impact in the incidence, etiology, and severity of head trauma, all these changes as a direct consequence of lockdown. OBJECTIVE: In this article we analyzed the characteristics of craniofacial trauma in patients admitted to a private hospital in Mexico City during the SARS-CoV-2 pandemic. METHOD: Medical records from patients admitted in Medica Sur between March 2020 and June 2021. In this study, incidence, etiology, severity of the injuries and the SARS-CoV-2 PCR result performed upon admission were analyzed. RESULTS: Although there is no study in Mexico like ours, the results were similar to those reported by other hospital centers worldwide, presenting a greater number of cases classified as mild craniofacial trauma, in addition to finding that the main age group affected were older adults. CONCLUSIONS: The reported information in our study provides a general view of craniofacial trauma characteristics during SARS-CoV-2 pandemic.

INTRODUCCIÓN: El inicio de la pandemia provocada por SARS-CoV-2 trajo consigo importantes cambios en los cuidados hospitalarios para todas las enfermedades. De acuerdo con la literatura internacional, desde el comienzo, y a consecuencia del aislamiento, ha existido un impacto en la incidencia, la etiología y la gravedad del trauma craneomaxilofacial. OBJETIVO: Estudiar las características del trauma craneofacial en los pacientes ingresados a un hospital privado en la Ciudad de México durante la pandemia por SARS-CoV-2. MÉTODO: Se revisaron los expedientes clínicos de los pacientes ingresados a Médica Sur, entre marzo de 2020 y junio de 2021. Se analizaron la incidencia, la etiología, la gravedad de las lesiones y el resultado de la prueba de reacción en cadena de la polimerasa para SARS-CoV-2 que se realizó durante la atención hospitalaria. RESULTADOS: En México no existe un estudio semejante al nuestro, pero los resultados fueron similares a los reportados por otros centros hospitalarios en el mundo, presentando un mayor número de casos clasificados como traumatismo craneofacial leve, además de encontrar que el principal grupo de edad afectado fueron los adultos mayores. CONCLUSIONES: La información reportada en nuestro estudio brinda un panorama general sobre las características del trauma craneofacial durante la pandemia por SARS-CoV-2.

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The outbreak of the coronavirus disease (COVID-19) is global health and humanitarian emergency. To respond effectively to this pandemic, it is mandatory to reaffirm science in its different fields of study, including the food safety area. Presently, we review food safety in times of COVID-19, exploring whether the virus can be transmitted by food or water; recommendations from regulatory agencies; perceptions of food hygiene practices during the pandemic; and post-pandemic perspectives. The review was based on papers published in Web of Science, Scopus, Pubmed, and covered recommendations of public health protection and regulatory agencies around the world. The transmission of the severe acute respiratory syndrome (SARS-CoV-2) by food was not confirmed until the present time. In any case, the protocols already established for food safety were reinforced, emphasizing the proper hygiene of hands after shopping, handling food packages, or before manipulating or eating food, adequate social distance, the use of individual protection equipment, the health of employees, and the proper preparation of food. It is hoped, in the post-pandemic scenario, to reach a better understanding of the particularities that led to greater care with food hygiene. Moreover, it is expected that the food system will creatively adapt the way meals are served.

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Background: In an elderly population with hypertension, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a higher incidence of mortality and a protracted course of clinical symptoms. Objective: To assess the perceived risk of infection and complications due to COVID-19 in people with hypertension living in a semi-urban city of Ecuador. Methods: A cross-sectional telephone survey of adult outpatients with a previous diagnosis of hypertension in the semi-urban community of Conocoto in Quito, Ecuador was conducted from August to December 2020. Results: A total of 260 adult outpatients, aged 34-97 years, completed telephone surveys. Of total, 71.5% (n = 186) of respondents were women and 28.5% (n = 74) of respondents were men. Overall, 18.1% believe that their risk of infection is "very high," 55.4% believe that their risk of infection is "high," 21.5% believe that their risk of infection is "low," and 5% believe that their risk of infection is "very low." The perceived risk of complications, if infected by COVID-19, revealed that 21.9% believe that their risk of complication is "very high," 65.0% believe that their risk of complication is "high," 10.4% believe that their risk of complication is "low," and 2.7% believe that their risk of complication is "very low." Conclusion: Patients with hypertension are aware of the risks posed by COVID-19 infection and its impact on their health. However, the health system must educate the population on health practices and behaviors to avoid COVID-19 infection until the majority of the population of Ecuador can be vaccinated.

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Resumen El análisis de la salud mental de las personas en contexto de pandemia por SARS-Cov-2 constituye un reto de gran relevancia para la psicología actual. La presente investigación se propuso dos objetivos. En primer lugar, analizar las asociaciones entre el continuo de salud mental y los síntomas de ansiedad, depresión e intolerancia a la incertidumbre en adultos argentinos en pandemia por COVID-19 y, en segundo lugar, comparar los niveles de bienestar emocional, psicológico y social según asistencia psicológica en contexto de pandemia por COVID-19. El tipo de estudio fue descriptivo, correlacional y de diferencia de grupos bajo un diseño no experimental de corte transversal. Se utilizó una muestra de 1120 adultos de entre 18 y 84 años (MEdad 37.32, DE = 14.81), 60.1% mujeres y 39.9% varones. Los resultados informaron que las asociaciones entre los niveles de bienestar emocional, psicológico, social y total y los síntomas de depresión e intolerancia a la incertidumbre fueron negativas y significativas. Sin embargo, las correlaciones con los síntomas de ansiedad fueron positivas y significativas. Se hallaron diferencias significativas en los niveles de bienestar emocional, psicológico, social y total según asistencia a tratamiento psicoterapéutico. En todos los casos, las personas que asistieron a tratamiento psicoterapéutico demostraron mayores niveles de bienestar en comparación a quienes no lo realizaron. Se concluye que las personas que se encontraban en la categoría de salud mental floreciente y realizaban tratamiento psicoterapéutico presentaron menores indicadores de depresión e intolerancia a la incertidumbre.

Abstract: The people's mental health analysis in SARS-Cov-2 pandemic context constitutes a highly relevant challenge for current psychology. The present research had two goals, firstly to analyze the associations between the mental health continuum and symptoms of anxiety, depression and intolerance to uncertainty in Argentine adults in the COVID-19 pandemic, and secondly to compare the levels of emotional, psychological and social well-being according to psychological assistance in the context of the COVID-19 pandemic. The study included a sample of 1120 adults between 18 and 84 years of age (Mage 37.32, SD = 14.81), 60.1% women and 39.9% men. The results reported that the associations between levels of emotional, psychological, social and total well-being and symptoms of depression and intolerance of uncertainty were negative and significant. However, the correlations with anxiety symptoms were positive and significant. Significant differences were found in the levels of emotional, psychological, social and total well-being according to attendance to psychotherapeutic treatment. In all cases, people who attended psychotherapeutic treatment showed higher levels of well-being compared to those who did not. It is concluded that people who were in the flourishing mental health category and underwent psychotherapeutic treatment showed lower indicators of depression and intolerance to uncertainty.

Resumo: A análise da saúde mental das pessoas no contexto de uma pandemia de SARS-Cov-2 é um desafio altamente relevante para a psicologia actual. A presente investigação tinha dois objectivos, primeiro para analisar as associações entre a continuidade da saúde mental e os sintomas de ansiedade, depressão e intolerância à incerteza em adultos argentinos numa pandemia COVID-19, e segundo para comparar os níveis de bem-estar emocional, psicológico e social de acordo com a assistência psicológica no contexto de uma pandemia COVID-19. O tipo de estudo foi descritivo, correlacional e de diferença de grupo, sob um desenho transversal não experimental. Foi utilizada uma amostra de 1120 adultos de 18-84 anos (Midade 37.32, DP = 14.81), 60.1% feminino e 39.9% masculino. Os resultados relataram que as associações entre os níveis de bem-estar emocional, psicológico, social e total e os sintomas de depressão e de intolerância à incerteza eram negativas e significativas. No entanto, as correlações com sintomas de ansiedade foram positivas e significativas. Foram encontradas diferenças significativas nos níveis de bem-estar emocional, psicológico, social e total de acordo com a assistência ao tratamento psicoterapêutico. Em todos os casos, as pessoas que assistiram ao tratamento psicoterapêutico mostraram níveis mais elevados de bem-estar em comparação com as que não o fizeram. Concluise que as pessoas que se encontravam na próspera categoria de saúde mental e foram submetidas a tratamento psicoterapêutico mostraram indicadores mais baixos de depressão e intolerância à incerteza.

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ABSTRACT Introduction: As coronavirus disease-2019 (COVID-19) spread worldwide and social restrictions were intensified, difficulties in blood supply were expected to result in a shortage of blood donors, logistic issues and a change in blood consumption. Consequences could be detrimental to the meeting of the blood supply demand, especially in a decentralized blood bank in the State of São Paulo responsible for providing blood to more than 100 hospitals, mostly of the public health system. Aiming to minimize negative effects and focusing on maintenance of the blood supply, a different approach was discussed and adopted. Materials and methods: Briefly, strategies were related to monitoring and promoting measures to achieve a positive RBC unit balance. Thus, the number of donors, transfusions, RBC unit inventory, RBC unit loss and RBC units within up to 5 days from the expiration date were evaluated. Results: Several strategies were adopted to ensure sufficient availability of RBC units: blood donation was improved with social media and extra blood collections, a restrictive transfusion protocol was implemented, a new logistic process to use RBC units closer to the expiration date was established and non-isogroup transfusions were avoided. Conclusion: Altogether, described strategies were crucial to optimize blood storage during the pandemic. Investing in monitoring and logistics contributed to a positive RBC unit balance and conserving these strategies could be useful.

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This article discusses the theory of constraint interval solutions to interval nonlinear initial value problems and applies the notion of constraint interval solutions to analyze the asymptotic behavior of a susceptible-infected-recovered (SIR) epidemiological nonlinear differential equation model, specifically the covid pandemic, in the presence of interval uncertainty to illustrate the efficacy of this approach. Furthermore, constraint interval solutions are used to estimate the intervals for the parameters by fitting solutions to the Brazilian's Sars-Cov-2 pandemic official data. Simulations and graphical solutions incorporating constraint interval uncertainties are presented to help in the visualization of the pandemic's behavior.

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OBJECTIVE: The study aimed to investigate the misreporting number of positively tested individuals for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) succumbed or not to coronavirus disease 2019 (COVID-19) pandemic in Brazil at the city, state, and national scales using statistical forensic analysis. STUDY DESIGN: This is a register-based study over public health data collected, organized, and maintained by the Ministry of Health covering the Brazilian population. METHODS: We evaluated the Brazilian notifications of positively tested cases for SARS-CoV-2 who have succumbed or not to COVID-19 between February 26th to September 7th of 2020 at the city, state, and national scales for conformity to expected distribution provided by Benford's law (BL). RESULTS: Statistical analyzes demonstrated a significant rejection of SARS-CoV-2 notification cases at the city and the number of deaths by COVID-19 in all regional levels according to the hypothesis of conformity to BL. CONCLUSION: We demonstrated by BL, which has been widely applied to query the quality and reliability of different numerical data sources, the misreporting number of cases and deaths throughout the SARS-CoV-2 pandemic in Brazil. Therefore, we brought to light pieces of evidence that raise questions about the reliability of SARS-CoV-2 data in Brazil. This situation may have led to inconsistencies in public health policy actions, recommendations, and drastic humanitarian, social, and economic consequences such as the intensive unit care overload in some Brazilian regions.

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As of October 8th, 2020, the number of confirmed cases and deaths in Brazil due to COVID-19 hit 5,002,357 and 148,304, respectively, making the country one of the most affected by the pandemic. The State of São Paulo (SSP) hosts the largest number of confirmed cases in Brazil, with over 1,016,755 cases to date. This study was carried out to investigate how the social distancing measures could have influenced the Ibitinga reservoir's water transparency in São Paulo State, Brazil. We hypothesize that although the city's drainage is the major reservoir's input, as opposed to what has been reported elsewhere, the effect of extensive lockdown in the city of São Paulo due to COVID-19 is marginal on the water transparency. A time series of OLI/Landsat-8 images since 2014 were used to estimate the Secchi Disk Depth (ZSD). The COVID-19 cases and deaths (per 100,000 inhabitants), and social isolation index were used to find links between the ZSD and COVID-19. The results showed that the highest ZDS (higher than 1.6 m) occurred during the dry season (Austral autumn and beginning of Austral winter) and the lowest (0.4-0.8 m) during March 2020 (end of Austral summer). Paired sample t-Tests between images of 2020 and all the others showed that April 20th values were not different from that of June 14th, April 17th and March 18th. ZSD values from May 20th were not statistically different from May 14th and April 15th; June 20th values were not different from June 14th; and March 20th values were statistically different from all. We therefore conclude that, based on satellite data, the lockdown in SSP unlikely have influenced the water transparency in the Ibitinga reservoir.

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INTRODUCTION: As coronavirus disease-2019 (COVID-19) spread worldwide and social restrictions were intensified, difficulties in blood supply were expected to result in a shortage of blood donors, logistic issues and a change in blood consumption. Consequences could be detrimental to the meeting of the blood supply demand, especially in a decentralized blood bank in the State of São Paulo responsible for providing blood to more than 100 hospitals, mostly of the public health system. Aiming to minimize negative effects and focusing on maintenance of the blood supply, a different approach was discussed and adopted. MATERIALS AND METHODS: Briefly, strategies were related to monitoring and promoting measures to achieve a positive RBC unit balance. Thus, the number of donors, transfusions, RBC unit inventory, RBC unit loss and RBC units within up to 5 days from the expiration date were evaluated. RESULTS: Several strategies were adopted to ensure sufficient availability of RBC units: blood donation was improved with social media and extra blood collections, a restrictive transfusion protocol was implemented, a new logistic process to use RBC units closer to the expiration date was established and non-isogroup transfusions were avoided. CONCLUSION: Altogether, described strategies were crucial to optimize blood storage during the pandemic. Investing in monitoring and logistics contributed to a positive RBC unit balance and conserving these strategies could be useful.

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In this stage 1 registered report, we propose an analysis of the spatio-temporal patterns of the COVID-19 epidemic in Mexico using the georeferenced confirmed cases aggregated at the municipality level. We will compute weekly Moran index to assess spatial autocorrelation over time and identify clusters of the disease using the "flexibly shaped spatial scan" approach. Finally, different distance models will be compared to select the best suited to predict inter-municipality contagion. This study will help us understand the spread of the epidemic over the Mexican territory and give insights to model and predict the epidemic behavior.

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In recent history, Coronavirus Disease 2019 (COVID-19) is one of the worst infectious disease outbreaks affecting humanity. The World Health Organization has defined the outbreak of COVID-19 as a pandemic, and the massive growth of the number of infected cases in a short time has caused enormous pressure on medical systems. Mexico surpassed 3.7 million confirmed infections and 285,000 deaths on October 23, 2021. We analysed the spatio-temporal patterns of the COVID-19 epidemic in Mexico using the georeferenced confirmed cases aggregated at the municipality level. We computed weekly Moran's I index to assess spatial autocorrelation over time and identify clusters of the disease using the "flexibly shaped spatial scan" approach. Finally, we compared Euclidean, cost, resistance distances and gravitational model to select the best-suited approach to predict inter-municipality contagion. We found that COVID-19 pandemic in Mexico is characterised by clusters evolving in space and time as parallel epidemics. The gravitational distance was the best model to predict newly infected municipalities though the predictive power was relatively low and varied over time. This study helps us understand the spread of the epidemic over the Mexican territory and gives insights to model and predict the epidemic behaviour.

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ABSTRACT The novel coronavirus has swept across the world in 2020 and ushered a new era. In the current scenario, it is not clear how patients with myeloproliferative neoplasms (including chronic myelogenous leukemia) should be managed, considering the risk of therapy, the need for social distancing and the risk of untimely therapy discontinuation of delay. This guideline aims to give providers a sense of direction in order to better take care of patients and prioritize care.

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The novel coronavirus has swept across the world in 2020 and ushered a new era. In the current scenario, it is not clear how patients with myeloproliferative neoplasms (including chronic myelogenous leukemia) should be managed, considering the risk of therapy, the need for social distancing and the risk of untimely therapy discontinuation of delay. This guideline aims to give providers a sense of direction in order to better take care of patients and prioritize care.

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BACKGROUND: We investigated a likely scenario of COVID-19 spreading in Brazil through the complex airport network of the country, for the 90 days after the first national occurrence of the disease. After the confirmation of the first imported cases, the lack of a proper airport entrance control resulted in the infection spreading in a manner directly proportional to the amount of flights reaching each city, following the first occurrence of the virus coming from abroad. METHODOLOGY: We developed a Susceptible-Infected-Recovered model divided in a metapopulation structure, where cities with airports were demes connected by the number of flights. Subsequently, we further explored the role of the Manaus airport for a rapid entrance of the pandemic into indigenous territories situated in remote places of the Amazon region. RESULTS: The expansion of the SARS-CoV-2 virus between cities was fast, directly proportional to the city closeness centrality within the Brazilian air transportation network. There was a clear pattern in the expansion of the pandemic, with a stiff exponential expansion of cases for all the cities. The more a city showed closeness centrality, the greater was its vulnerability to SARS-CoV-2. CONCLUSIONS: We discussed the weak pandemic control performance of Brazil in comparison with other tropical, developing countries, namely India and Nigeria. Finally, we proposed measures for containing virus spreading taking into consideration the scenario of high poverty.