RESUMO

Introduction: Vitamin C supplementation has been seen as a supportive treatment to control and prevent complications of COVID-19 by enhancing the immune response against infection. However, the effects of high doses of this vitamin are not yet fully understood. Objective: To analyze the effects of high-dose vitamin C in patients with COVID-19. Methods: This was a systematic review, using original studies published from April 2020 to November 2022 in PubMed, ScienceDirect, Scopus and Web of Science databases. The combination of descriptors registered in Medical Subject Headings (MeSH) used to search for articles were: (("vitamin C" OR "ascorbic acid") AND ("COVID-19" OR "SARS-CoV-2" OR "coronavirus")). Original articles of clinical trials conducted with patients diagnosed with COVID-19 and submitted to high-dose vitamin C supplementation were included. Results: Eligible studies included patients in intensive care units, wards, or outpatient clinics, who were given doses of vitamin C, ranging from 6,000 to 8,000 mg/day, with an average duration of 6.25 days of supplementation and mostly intravenous administration. A reduction in fever and myalgia was observed, as well as an improvement in oxygen saturation and lung impairment rate. Conclusion: The role of high-dose vitamin C in patients affected by COVID-19 requires further study, however, to date, the results have been promising for symptom reduction and improvement in lung function and oxygenation.

Introducción: La administración de suplementos de vitamina C se ha considerado un tratamiento de apoyo para controlar y prevenir las complicaciones del COVID-19 al mejorar la respuesta inmunitaria contra la infección. Sin embargo, los efectos de dosis elevadas de esta vitamina aún no se conocen en su totalidad. Objetivo: Analizar los efectos de altas dosis de vitamina C en pacientes con COVID-19. Métodos: Se trata de un estudio de revisión sistemática, utilizando artículos originales publicados desde abril de 2020 hasta noviembre de 2022 en las bases de datos PubMed, ScienceDirect, Scopus y Web of Science. Para la búsqueda de los artículos se utilizó la combinación de descriptores registrados en Medical Subject Headings (MeSH): (("vitamin C" OR "ascorbic acid") AND ("COVID-19" OR "SARS-CoV-2" OR "coronavirus")). Se incluyeron artículos originales de tipo ensayo clínico realizados con pacientes diagnosticados con COVID-19 y sometidos a suplementación con altas dosis de vitamina C. Resultados: Los estudios elegibles se realizaron con pacientes ingresados en unidades de cuidados intensivos, salas o ambulatorios, a los que se administraron dosis de vitamina C que oscilaban entre 6.000 y 8.000 mg/día, con una duración media de 6,25 días de suplementación y vía de administración mayoritariamente intravenosa. Se observó una reducción de la fiebre y las mialgias, además de una mejoría de la saturación de oxígeno y de la tasa de compromiso pulmonar. Conclusión: El papel de las dosis altas de vitamina C en pacientes afectados por COVID-19 requiere más estudios; sin embargo, hasta la fecha, los resultados han sido prometedores en cuanto a la reducción de los sintomas, y la mejora de la función pulmonar y la oxigenación.

RESUMO

While the multifaceted social, economic, and public health impacts associated with the COVID-19 pandemic are known, little is known about its effects on non-target aquatic ecosystems and organisms. Thus, we aimed to evaluate the potential ecotoxicity of SARS-CoV-2 lysate protein (SARS.CoV2/SP02.2020.HIAE.Br) in adult zebrafish (Danio rerio) at predicted environmentally relevant concentrations (0.742 and 2.226 pg/L), by 30 days. Although our data did not show locomotor alterations or anxiety-like or/and anxiolytic-like behavior, we noticed that exposure to SARS-CoV-2 negatively affected habituation memory and social aggregation of animals in response to a potential aquatic predator (Geophagus brasiliensis). An increased frequency of erythrocyte nuclear abnormalities was also observed in animals exposed to SARS-CoV-2. Furthermore, our data suggest that such changes were associated with a redox imbalance [↑ROS (reactive oxygen species), ↑H2O2 (hydrogen peroxide), ↓SOD (superoxide dismutase), and ↓CAT (catalase)], cholinesterasic effect [↑AChE (acetylcholinesterase) activity], as well as the induction of an inflammatory immune response [↑NO (nitric oxide), ↑IFN-γ (interferon-gamma), and ↓IL-10 (interleukin-10)]. For some biomarkers, we noticed that the response of the animals to the treatments was not concentration-dependent. However, principal component analysis (PCA) and the "Integrated Biomarker Response" index (IBRv2) indicated a more prominent ecotoxicity of SARS-CoV-2 at 2.226 pg/L. Therefore, our study advances knowledge about the ecotoxicological potential of SARS-CoV-2 and reinforces the presumption that the COVID-19 pandemic has negative implications beyond its economic, social, and public health impacts.

Assuntos

RESUMO

BACKGROUND: To evaluate the impact of coronavirus disease 2019 (COVID-19) on the clinical practice, health, and quality of life of Brazilian hand surgeons when only essential services and emergency procedures were being provided. METHOD: A questionnaire of 50 questions was sent to members of the Brazilian Society of Hand Surgery addressing work and life routines before the pandemic and during the initial quarantine period from April to August 2020. RESULTS: Two hundred ten hand surgeons answered the questionnaire; 55.2% lived in the southeast region and worked in the capital and metropolitan regions, in both the private and public systems. Thirty-eight percent of the sample had other sources of income besides medicine, and due to a drop of 50% or more in the volume of consultations and surgeries, one-third had to apply for financial loans or access personal savings, and 69% made financial cuts in their domestic and life routines. More than 40% gained weight and stopped doing physical activities, while 20% lost weight and started physical activities. Approximately 30% were diagnosed with COVID-19, 92% of whom had mild symptoms and quarantined at home, and 89% had psychological symptoms such as anxiety, fear, insecurity, and insomnia. CONCLUSIONS: Coronavirus disease 2019 had a significant impact on the lives of Brazilian hand surgeons by drastically reducing the number of consultations and surgical procedures, generating not only financial difficulties but also changes in the exercise routine, changes in body weight, associated psychological symptoms, and changes in the family/life routine.

Assuntos

RESUMO

According to the World Health Organization (WHO), in the second half of 2022, there are about 606 million confirmed cases of COVID-19 and almost 6,500,000 deaths around the world. A pandemic was declared by the WHO in March 2020 when the new coronavirus spread around the world. The short time between the first cases in Wuhan and the declaration of a pandemic initiated the search for ways to stop the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or to attempt to cure the disease COVID-19. More than ever, research groups are developing vaccines, drugs, and immunobiological compounds, and they are even trying to repurpose drugs in an increasing number of clinical trials. There are great expectations regarding the vaccine's effectiveness for the prevention of COVID-19. However, producing sufficient doses of vaccines for the entire population and SARS-CoV-2 variants are challenges for pharmaceutical industries. On the contrary, efforts have been made to create different vaccines with different approaches so that they can be used by the entire population. Here, we summarize about 8162 clinical trials, showing a greater number of drug clinical trials in Europe and the United States and less clinical trials in low-income countries. Promising results about the use of new drugs and drug repositioning, monoclonal antibodies, convalescent plasma, and mesenchymal stem cells to control viral infection/replication or the hyper-inflammatory response to the new coronavirus bring hope to treat the disease.

RESUMO

Abstract Introduction After several months of COVID-19 lockdown, addressing the implications related to the emotional distress and well-being of the population during confinement has become increasingly evident. Objective To explore, through a lexicometric and content-based approach, the responses related to discomfort and emotional well-being during the first confinement due to the COVID-19 lockdown. Method Subjects included 2,555 adults in Mexico, mainly women (78.3%), with an average age of 46. Data were drawn from an online survey published on social networks from June 3 to July 5, 2020. The open answers of the subjects about discomfort and emotional well-being during lockdown, together with suggestions to improve the handling of the pandemic, were analyzed using word frequency analysis (clouds) and thematic content analysis. Result Findings highlighted the implications of lockdown, including loss of social interaction, teleworking and overexposure to the news, associated with discomfort. In turn, activities related to self-care, doing household repairs, and sharing activities with the family were linked to well-being. Discussion and conclusion Findings show that time was a key factor to transition from well-being to boredom, where space and material resources played a preponderant role during confinement.

Resumen Introducción Tras largos meses, incluso años de enfrentar el confinamiento por la pandemia generada por la COVID-19, se ha hecho cada vez más evidente la importancia de abordar las implicaciones relacionadas con el bienestar y el malestar de la población durante el confinamiento. Objetivo Explorar, por medio de un abordaje lexicométrico y de contenido, las respuestas vinculadas al malestar y al bienestar emocional durante el primer confinamiento por la pandemia de COVID-19. Método Los participantes fueron 2,555 personas mexicanas adultas, principalmente mujeres (78.3%), cuya edad promedio fue de 46 años. Los datos provienen de una encuesta en línea difundida a través de las redes sociales en el periodo comprendido del 3 de junio al 5 de julio de 2020. Se analizaron las respuestas abiertas acerca de las atribuciones de los participantes acerca del malestar y bienestar emocional durante el confinamiento, así como algunas sugerencias para un manejo más adecuado de la pandemia empleando un análisis de frecuencia de las palabras (nubes) y un análisis temático de los contenidos. Resultados Los hallazgos remiten a las implicaciones del confinamiento. Entre ellas destaca la pérdida de la interacción social, el teletrabajo y la sobreexposición a las noticias, las cuales se asociaron con el malestar, mientras que las actividades relacionadas con el autocuidado y con realizar reparaciones en la casa, así como compartir actividades con la familia se vincularon con el bienestar. Discusión y conclusión Los hallazgos muestran que el tiempo fue un factor clave para transitar del bienestar al hastío, así como la disposición de espacios en el hogar y otros los recursos materiales cumplieron un papel preponderante durante el confinamiento.

RESUMO

The short time between the first cases of COVID-19 and the declaration of a pandemic initiated the search for ways to stop the spread of SARS-CoV-2. There are great expectations regarding the development of effective vaccines that protect against all variants, and in the search for it, we hypothesized the obtention of a predicted rational immunogenic peptide from structural components of SARS-CoV-2 might help the vaccine research direction. In the search for a candidate of an immunogenic peptide of the SARS-CoV-2 envelope (E), membrane (M), nucleocapsid (N), or spike (S) proteins, we access the predicted sequences of each protein after the genome sequenced worldwide. We obtained the consensus amino acid sequences of about 14,441 sequences of each protein of each continent and the worldwide consensus sequence. For epitope identification and characterization from each consensus structural protein related to MHC-I or MHC-II interaction and B-cell receptor recognition, we used the IEDB reaching 68 epitopes to E, 174 to M, 245 to N, and 833 to S proteins. To select an epitope with the highest probability of binding to the MHC or BCR, all epitopes of each consensus sequence were aligned. The curation indicated 1, 4, 8, and 21 selected epitopes for E, M, N, and S proteins, respectively. Those epitopes were tested in silico for antigenicity obtaining 16 antigenic epitopes. Physicochemical properties and allergenicity evaluation of the obtained epitopes were done. Ranking the results, we obtained one epitope of each protein except for the S protein that presented two epitopes after the selection. To check the 3D position of each selected epitope in the protein structure, we used molecular homology modeling. Afterward, each selected epitope was evaluated by molecular docking to reference MHC-I or MHC-II allelic protein sequences. Taken together, the results obtained in this study showed a rational search for a putative immunogenic peptide of SARS-CoV-2 structural proteins that can improve vaccine development using in silico approaches. The epitopes selected represent the most conserved sequence of new coronavirus and may be used in a variety of vaccine development strategies since they are also presented in the described variants of SARS-CoV-2.

RESUMO

RESUMEN Introducción: La infección por SARS-CoV-2 produce alteraciones laboratoriales, que, si bien son inespecíficas, sus valores pueden resultar de utilidad como marcadores pronósticos. Materiales y métodos: Estudio observacional, analítico de casos y controles, con un muestreo no probabilístico de casos consecutivos de enero a julio de 2021 en pacientes con infección a SARS-CoV-2 del Hospital Nacional. Resultados: Se incluyeron un total de 237 pacientes (79 casos y 158 controles), la franja etaria estuvo comprendida de 21 a 90 años (53,67±15,11). El 66,7% era del sexo masculino. Se hallaron diferencias estadísticamente significativas, con tendencia de los pacientes fallecidos a presentar valores más elevados de leucocitos (12600 vs 9672; p=0,001), PCR (15,40 vs 10,97; p=0,002), Dímero D (15725 vs 3714; p=0,004), Ferritina (1312 vs 1049; p=0,020), Troponina I (1,71 vs 1,87; p=0,003). Conclusión: Los valores de leucocitos, PCR, Dímero D, Ferritina, Troponina I, se asocian significativamente a la mortalidad en esta serie de casos.

ABSTRACT Introduction : SARS-CoV-2 infection produces laboratory abnormalities, which, although they are nonspecific, their values can be useful as prognostic markers. Materials and methods : Observational, analytical study of cases and controls, with a non-probabilistic sampling of consecutive cases from January to July 2021 in patients with SARS-CoV-2 infection at Hospital National. Results : A total of 237 patients (79 cases and 158 controls) were included, the age range was between 21 and 90 years (53.67±15.11). 66.7% were male. Statistically significant differences were found, with a tendency for deceased patients to present higher values of leukocytes (12,600 vs 9,672; p=0.001), CRP (15.40 vs 10.97; p=0.002), D-dimer (15,725 vs 3,714 ; p=0.004), Ferritin (1312 vs 1049; p=0.020), Troponin I (1.71 vs 1.87; p=0.003). Conclusion : The values of leukocytes, PCR, Dimer D, Ferritin, Troponin I, are significantly associated with mortality in this series of cases.

RESUMO

Homem de 53 anos, hipertenso e portador de bronquite, admitido em um serviço de urgência no dia 15 de dezembro de 2020 devido sintomas gripais, febre e cefaleia iniciados há oito dias. Após constatação de acometimento pulmonar importante mediante tomografia computadorizada (TC) de tórax, sugestivo de infecção pelo vírus SARS-CoV2, o paciente foi internado em unidade de terapia intensiva. Foi intubado no décimo dia de internação, e, dois dias após, evoluiu com labilidade pressórica importante, recorrendo ao uso de noradrenalina e nitroprussiato, além de outros anti-hipertensivos, conforme a necessidade. O quadro predominante foi a hipertensão arterial sistêmica, manifestada principalmente com a mudança de decúbito, sendo o maior valor pressórico registrado de 240x90 mmHg. A disautonomia também se manifestou por ausência de dejeções, sudorese excessiva e espasmos musculares. A frequência cardíaca se manteve estável e dentro dos parâmetros de normalidade.A partir do trigésimo dia de internação, observou-se melhora progressiva do quadro e reestabelecimento da homeostase. Obteve alta após 59 dias de internação, sem sequelas significativas. A explicação mais razoável para o caso é o aumento da resistência vascular periférica, por ação da angiotensina II, associada à supressão do sistema parassimpático, o que explica, também, a incompetência do barorreflexo para compensação da frequência cardíaca. Adicionalmente, o paciente estava em uso de carvedilol. Este caso enfatiza o desafio diagnóstico precoce da disautonomia em pacientes críticos, devido a carência de ferramentas adequadas para uso na prática cotidiana. A estimulação vagal pode constituir opção terapêutica eficaz, mas carece de mais estudos

A 53-year-old male, hypertensive and with bronchitis, was admitted to the emergency department on December 15, 2020 due to flu-like symptoms, fever and headache that started eight days ago. After finding significant lung involvement by chest computed tomography (CT) suggestive of SARS-CoV2 virus infection, the patient was admitted to the intensive care unit. He was intubated on the tenth day of hospitalization, and, 2 days later, he evolved with significant pressure lability, using norepinephrine and nitroprusside, in addition to other antihypertensive drugs, as needed. The predominant state was hypertension, expressed mainly when there is interference from the patient's position in bed. The highest pressure value recorded was 240x90 mmHg. Dysautonomy was also manifested by the absence of stools, excessive sweating and muscle spasms. Heart rate remains stable and within normal limits. From the thirtieth day of hospitalization onwards, there was an evolution with progressive improvement and restoration of homeostasis. He was discharged after 59 days of hospitalization, without sequelae. The most reasonable explanation for the case is the increase in peripheral vascular resistance, due to the action of angiotensin II, associated with the suppression of the parasympathetic system, which also explains the incompetence of the baroreflex to compensate the heart rate. Additionally, the patient was using carvedilol. This case emphasizes the importance of tools that early identify dysautonomy, prepare the team. Vagal stimulation can be an effective therapeutic option, but further studies are needed

Assuntos

RESUMO

Introducción: El coronavirus es una enfermedad infecciosa causada por el virus SARS-CoV-2 y catalogada como una emergencia en salud pública de importancia internacional que ha generado consecuencias en diferentes as-pectos de la vida social y, principalmente, en la salud mental. En este aspecto, los trabajadores del sector de la salud fueron una de las poblaciones más afectadas, al estar en la primera línea de cuidado de los pacientes contagiados.Objetivo: Describir el efecto de lapandemia por COVID-19 sobre la salud mental del personal sanitario.Metodología: Búsqueda de literatura con investigaciones originales publicadas entre 2020 y 2021 en las bases de datos Pubmed, SciELO, Proquest y Science Direct, escritas en español, inglés y portugués. La estrategia de bús-queda incluyó las palabras clave: personal de salud, COVID-19, pandemias por el nuevo coronavirus, salud mental e impacto psicosocial. Se excluyeron artículos de revisión, revisiones sistemáticas y literatura gris. Se encontraron 152 publicaciones, de las cuales se seleccionaron 50 artículos originales.Resultados: Los trabajadores del sector de la salud fueron una de las poblaciones más afectadas por la pandemia, debido a las altas cargas laborales, escasez de personal, condiciones de trabajo, inestabilidad económica y defi-ciente material de protección, que los volvió vulnerables y propensos a desencadenar síntomas de estrés, ansiedad, depresión e insomnio. Conclusión: La evidencia científica recomienda implementar estrategias adecuadas de intervención psicosocial, por medio de diferentes componentes interdisciplinarios que regulen y resuelvan el riesgo inmediato y futuro en esta población.

Introduction: Coronavirus is an infectious disease caused by the SARS-CoV-2 virus and classified as a public health emergency of international importance, which has generated consequences in different aspects of social life and mainly mental health, with health sector workers being a of the most affec-ted populations by being in the first line of care for infected patients. Objective: To describe the effect of the COVID-19 pandemic on the mental health of health personnel. Methodology: A literature search was carried out with original research published between 2020 and 2021, in the Pubmed, Scielo, Proquest and Science Direct databases written in Spanish, English and Portuguese. The search strategy included keywords: health personnel, COVID-19, pandemics due to the new coronavirus, mental health, and psychosocial impact. Review articles, systematic reviews and gray literature were excluded. 152 publications were found, of which 50 original articles were selected. Results: Health sector workers are one of the populations most affected by the current pandemic due to high workloads, staff shortages, working conditions, economic instability, and poor protection ma-terial, which makes them vulnerable and prone to triggering symptoms of stress., anxiety, depression and insomnia, among others. Conclusion: Scientific evidence recommends implementing appropriate psychosocial intervention strategies through different interdisciplinary components that regulate and resolve immediate and future risk in this population.

Introdução: O coronavírus é uma doença infecciosa causada pelo vírus SARS-CoV-2 é classificada como uma emergência de saúde pública de importância internacional que tem gerado consequências em diferentes aspetos da vida social e, principalmente, na saúde mental. Neste sentido, os profissio-nais de saúde eram uma das populações mais afetadas, pois estavam na linha de frente do atendi-mento a pacientes infectados. Objetivo: Descrever o efeito da pandemia COVID-19 na saúde mental dos profissionais da saúde. Métodos: Pesquisa bibliográfica de pesquisas originais publicadas entre 2020 e 2021 nas bases de dados Pubmed, SciELO, Proquest e Science Direct, escritas em espanhol, inglês e português. A estraté-gia de busca incluiu as palavras-chave: pessoal de saúde, COVID-19, nova pandemia de coronavírus, saúde mental e impacto psicossocial. Foram excluídos artigos de revisão, revisões sistemáticas e litera-tura cinzenta. 152 publicações foram encontradas, das quais foram selecionados 50 artigos originais. Resultados: Os profissionais da saúde foram uma das populações mais afetadas pela pandemia, devido à alta carga de trabalho, escassez de pessoal, condições de trabalho, instabilidade econômica e equipamentos de proteção deficientes, o que os tornou vulneráveis e propensos a desenvolver sin-tomas de estresse, ansiedade, depressão e insônia. Conclusão: A evidencia científica recomenda a implementação de estratégias adequadas de inter-venção psicossocial, através de diferentes componentes interdisciplinares que regulem e resolvam o risco imediato e futuro desta população

Assuntos

RESUMO

Objetivo: Analisar as complicações do novo coronavírus SARS-CoV-2 em mulheres que desenvolveram a infecção durante a gestação acolhidas no Hospital Regional de Taguatinga (HRT). Método: Este estudo utilizou como referencial os pressupostos de Minayo, por meio de abordagem qualitativa e método de pesquisa exploratória. As entrevistas tiveram início somente após autorização do CEP e foram realizadas por meio da plataforma Google Forms. Para a coleta dos dados as participantes primeiramente fizeram o aceite para participação da pesquisa por meio do TCLE. Resultados: Foram entrevistadas 10 mulheres com idade acima de 18 anos, onde responderam um questionário referente ao diagnóstico, sintomas e complicações pelo novo coronavírus na gestação. Para a discussão, os dados foram organizados em gráficos e categorias. Considerações finais: Este estudo atendeu aos objetivos propostos, descrevendo sobre as complicações que o novo coronavírus pode causar na gestação, sendo assim, evidenciando que as gestantes são mais propensas a infecção pelo novo coronavírus SARS-CoV-2. Portanto, este estudo deixa esta contribuição para os profissionais de saúde, apresentando os comprometimentos que esta infecção pode causar na gestação.

Objective: To analyze the complications of the new SARS-CoV-2 coronavirus in women who developed the infection during pregnancy at the Hospital Regional de Taguatinga (HRT). Method: This study used Minayo's assumptions as a reference, through a qualitative approach and exploratory research method. The interviews started only after authorization from the CEP and were carried out through the Google Forms platform. For data collection, the participants first accepted to participate in the research through the IC. Results: 10 women over 18 years of age were interviewed, where they answered a questionnaire regarding the diagnosis, symptoms and complications of the new coronavirus in pregnancy. For discussion, data were organized into graphs and categories. Final considerations: This study met the proposed objectives, describing the complications that the new coronavirus can cause during pregnancy, thus showing that pregnant women are more prone to infection with the new SARS-CoV-2 coronavirus. Therefore, this study leaves this contribution to health professionals, presenting the impairments that this infection can cause in pregnancy.

Objetivo: Analizar las complicaciones del nuevo coronavirus SARS-CoV-2 en mujeres que desarrollaron la infección durante el embarazo en el Hospital Regional de Taguatinga (HRT). Método: Este estudio tomó como referencia los supuestos de Minayo, a través de un enfoque cualitativo y un método de investigación exploratorio. Las entrevistas comenzaron solo después de la autorización del CEP y se llevaron a cabo a través de la plataforma Google Forms. Para la recolección de datos, los participantes primero aceptaron participar en la investigación a través del CI. Resultados: Se entrevistó a 10 mujeres mayores de 18 años, donde respondieron un cuestionario sobre el diagnóstico, síntomas y complicaciones del nuevo coronavirus en el embarazo. Para la discusión, los datos se organizaron en gráficos y categorías. Consideraciones finales: Este estudio cumplió con los objetivos propuestos, describiendo las complicaciones que puede ocasionar el nuevo coronavirus durante el embarazo, mostrando así que las mujeres embarazadas son más propensas a contagiarse con el nuevo coronavirus SARS-CoV-2. Por tanto, este estudio deja este aporte a los profesionales de la salud, presentando las deficiencias que esta infección puede ocasionar en el embarazo.

Assuntos

RESUMO

A pandemia da Covid-19 acentuou a necessidade de melhorar o planejamento e a gestão da força de trabalho no Sistema Único de Saúde (SUS), dentre elas, a atenção à saúde dos trabalhadores, com a instituição de medidas de monitoramento dos sintomáticos e contactantes de caso positivo, tais como detecção precoce, isolamento e acompanhamento da evolução dos casos, além de estratégias de humanização do trabalho. Nesse sentido, foi realizado um estudo descritivo com elementos quantitativos, no qual se busca descrever a implantação de 76 centros de testagem para diagnóstico da Covid-19 entre os trabalhadores da saúde na Secretaria da Saúde do Estado da Bahia (Sesab), sendo um deles matricial, localizado na capital, e os demais em cada uma das unidades da rede própria, sob gestão direta e indireta. Nesses centros, foram realizados, até fevereiro de 2021, um total de 69.134 testes de diagnóstico da Covid-19 relativos a 43.575 trabalhadores da saúde que atuam na rede estadual, com incidência global de 21,9 casos da doença. Também atendeu-se a uma lacuna de suporte diagnóstico a 12.859 trabalhadores de outras áreas do serviço público estadual consideradas essenciais. Além das testagens regulares que eram feitas dos casos suspeitos ou contactantes diretos de caso positivo, foram realizados dois ciclos de testes, sendo um pelo método imunocromatográfico e outro pelo método RT-PCR. A criação desses serviços demonstra o esforço do governo do estado da Bahia em atuar no bloqueio da infecção da Covid-19, bem como na preocupação com a saúde e segurança de seus trabalhadores e usuários.

The COVID-19 pandemic emphasized the need for better planning and management of the workforce in the SUS, including strategies for humanizing work and health care for workers, with the establishment of measures to monitor symptomatic people and positive case contacts, such as early detection, isolation and monitoring of the evolution of cases. This is a descriptive study with quantitative elements that seeks to describe the implementation of 76 testing centers for the diagnosis of COVID-19 among health workers at the Health Department of the State of Bahia, Brazil, whose matrix is based in the capital, and the others in each of the units of the own network under direct and indirect management. In these centers, until February 2021, a total of 69,134 diagnostic tests of COVID-19 were performed relative to 43,575 health workers that work in the state network, with a global incidence of 21.9 cases of the disease. Moreover, a gap of diagnostic support was provided to 12,859 workers from other areas of the state public service considered essential. Besides the regular tests on suspicious cases or direct positive case contacts, two test cycles were performed, one using the immunochromatographic method and the other using the RT-PCR method. The creation of these services shows the efforts of the government of the state of Bahia to act in blocking the infection of COVID-19 and in the concern with the health and safety of its workers and users.

La pandemia del covid-19 enfatizó la necesidad de una mejor planificación y gestión de la fuerza laboral en el Sistema Único de Salud (SUS), entre ellas la atención de la salud de los trabajadores, con el establecimiento de medidas de seguimiento de personas sintomáticas y contactos de casos positivos, como la detección temprana, el aislamiento y seguimiento de la evolución de los casos, además de las estrategias para humanizar el trabajo. Para ello, se realizó un estudio descriptivo con elementos cuantitativos en el que se busca describir la implementación de 76 centros de pruebas para el diagnóstico del covid-19 entre los trabajadores de salud de la Secretaría de Salud del Estado de Bahía (Sesab), siendo uno de ellos la matriz, ubicada en la capital, y los demás en cada una de las unidades de la propia red bajo gestión directa e indirecta. En estos centros, hasta febrero de 2021, se realizaron un total de 69.134 pruebas diagnósticas del covid-19 relativas a 43.575 trabajadores de la salud que laboran en la red estadual, con una incidencia global de 21,9 casos de la enfermedad. Además, se brindó una brecha de apoyo diagnóstico a 12.859 trabajadores de otras áreas del servicio público estadual consideradas imprescindibles. Además de las pruebas periódicas que se realizaron en casos sospechosos o contactos de casos positivos directos, se realizaron dos ciclos de prueba, uno por el método inmunocromatográfico y el otro por el método de RT-PCR. La creación de estos servicios demuestra los esfuerzos del gobierno del estado de Bahía para actuar en el bloqueo de la infección por covid-19, así como en la preocupación por la salud y seguridad de sus trabajadores y usuarios.

Assuntos

RESUMO

Introducción: La tasa de letalidad por COVID-19 ha generado mucha preocupación entre los ciudadanos y los medios de comunicación con respecto a los números oficiales proporcionados por distintos gobiernos. La salud pública en la actualidad debe hacer frente a la pandemia más significativa del siglo xxi. Objetivo: Analizar la tasa de letalidad por COVID-19 y su relación con recursos hospitalarios críticos, en el contexto de la pandemia de la COVID-19. Métodos: Se analizó la tasa de letalidad sobre la base de datos oficiales. Se subestimó el número de casos para obtener una estimación más real del alcance de la infección, de los indicadores de recursos hospitalarios importantes (críticos) en transición pandémica que podrían elevar la tasa de letalidad posterior al estudio. Se emplearon curvas de tendencia exponencial doblemente suavizadas, distribución S y técnicas de regresión. Resultados: La curva que mejor explicó el comportamiento de fallecidos por COVID-19 en Chile fue una ecuación de regresión cúbica. La variable hospitalización básica se distribuyó como una curva S. Las variables hospitalización media, pacientes críticos, unidad tratamiento intensivo, unidad cuidado intensivo, ventiladores mecánicos totales y ventiladores mecánicos ocupados; se pudieron explicar mediante regresiones cúbicas. En todos los casos, los valores de R2 fueron superiores al 95 por ciento. Conclusiones: El número de fallecidos seguirá en aumento. Se sugiere fortificar las unidades de hospitalización básica para imposibilitar el colapso de la red sanitaria. Es necesario seguir creciendo en términos de hospitalización de media complejidad, unidad tratamiento intensivo, unidad cuidado intensivo y número total de ventiladores mecánicos para asegurar el soporte sanitario(AU)

Introduction: The fatality rate by COVID-19 has generated a lot of concern among citizens and the media regarding the official numbers provided by different governments. Public health today must cope with the most significant pandemic of the twenty-first century. Objective: Analyze the fatality rate due to COVID-19 and its relation with critical hospital resources, in the context of the COVID-19 pandemic. Methods: The fatality rate was analyzed on the basis of official data. The number of cases was underestimated to obtain a more real estimate of the extent of the infection, of the indicators of important (critical) hospital resources in pandemic transition that could raise the post-study fatality rate. Double-smoothed exponential trend curves, S-distribution and regression techniques were used. Results: The curve that best explained the behavior of COVID-19 deaths in Chile was a cubic regression equation. The basic hospitalization variable was distributed as an S-curve. The variables called mean hospitalization, critical patients, intensive treatment unit, intensive care unit, total mechanical ventilators and busy mechanical ventilators could be explained by cubic regressions. In all cases, R2 values were greater than 95percent. Conclusions: The number of deaths will continue to rise. It is suggested to fortify the basic hospitalization units to prevent the collapse of the health network. It is necessary to continue growing in terms of medium complexity hospitalization, intensive treatment unit, intensive care unit and total number of mechanical ventilators to ensure health support(AU)

Assuntos

RESUMO

Coronavirus disease 2019 (COVID-19) was initially described as a viral infection of the respiratory tract. It is now known, however, that several other organs are affected, including the brain. Neurological manifestations such as stroke, encephalitis, and psychiatric conditions have been reported in COVID-19 patients, but the neurotropic potential of the virus is still debated. Herein, we sought to investigate SARS-CoV-2 infection in human neural cells. We demonstrated that SARS-CoV-2 infection of neural tissue is non-permissive, however, it can elicit inflammatory response and cell damage. These findings add to the hypothesis that most of the neural damage caused by SARS-CoV-2 infection is due to a systemic inflammation leading to indirect harmful effects on the central nervous system despite the absence of local viral replication.

Assuntos

RESUMO

As the COVID-19 pandemic has made visible, childhood is the virus's proverbial south: a world where care is not a value chosen from a place of desire, and where children's voices are silenced at the hands of an ancestral epistemic injustice. Thus, the transformation that human societies are undergoing due to COVID-19 has significantly impacted the rights of children, both at the micro and the macro levels. In Spain - a country that has been particularly hard-hit by the pandemic - we find that both infancy (especially through obstetric violence) and childhood at all its stages fall victim to an adultcentric paradigm based on control and epistemic injustice. This essay analyzes and discusses some of the negative consequences observed in this country related to the care for and the confinement of minors and their families - which has occurred as a result of the pandemic - and considers that the crisis triggered by COVID-19 may be an opportunity to shed light on situations of ancestral injustice towards children.

La infancia es el sur del virus, como ha visibilizado la pandemia de COVID-19: un mundo donde el cuidado no es un valor escogido desde el deseo, y donde la voz infantil es silenciada en virtud de una injusticia epistémica ancestral. Así, la transformación que las sociedades humanas están experimentando debido a la COVID-19 ha impactado significativamente en los derechos de la infancia, a niveles micro y macro. En España, como país especialmente golpeado por la pandemia, encontramos que tanto la primera infancia (a través especialmente de la violencia obstétrica) como ella misma en todas sus fases, están siendo víctimas de un paradigma adultocéntrico de control e injusticia epistémica basales. En este ensayo se analiza y discute algunas de las consecuencias negativas observadas en este país con relación al cuidado y el confinamiento de menores y sus familias, acaecidas a raíz de la pandemia, considerando que la crisis desencadenada por la COVID-19 puede ser una oportunidad para visibilizar situaciones de injusticia ancestral para con la niñez.

Assuntos

RESUMO

ABSTRACT BACKGROUND: Spreader and super-spreader are terms that refer to people who have greater potential for disease transmission, to infect other people. OBJECTIVE: To present scientific evidence regarding the impact of COVID-19 spreaders. DESIGN AND SETTING: Systematic review of the literature (using the PRISMA framework), performed at the Federal University of Santa Catarina (UFSC), Florianópolis (SC), Brazil. METHODS: A search for articles was carried out in the SciELO, LILACS, PubMed, Scopus, Bireme and Web of Science databases. A search for gray literature was also conducted via Google Scholar. There was no restriction regarding place or language, and the search covered the period from January 2010 to August 2020. Studies were selected based on a combination of descriptors from the Medical Subject Headings (MeSH). RESULTS: Isolated cases of people diagnosed with COVID-19 who were classified as super-spreaders were found. They had been classified thus because they may have had greater potential for infecting other individuals. However, greater numbers of interventions are needed in order to identify and manage COVID-19 cases. There is little evidence regarding this detection, which further hinders recognition and understanding of super-spreading events. CONCLUSION: The scientific community needs greater depth of evaluation and understanding of how these patients physiologically develop the ability to propagate COVID-19 more intensely. A simpler way of tracking them is also necessary, given that many infected people are asymptomatic. Many patients also have mild symptoms, suggesting that these individuals could also be classified as possible COVID-19 spreaders. PROSPERO Number: ID 217874 (submitted for publication and is being assessed by the editorial team).

Assuntos

RESUMO

Abstract Objectives: to determine the frequency and factors associated with severe / extreme signs and symptoms of stress, anxiety and depression in diabetic patients during the COVID-19 pandemic. Methods: cross-sectional study conducted in April /May 2020, which included 162 individuals with diabetes mellitus and over 18 years old. An online questionnaire was applied on social networks, composed of biological, sociodemographic, clinical characteristics and the Stress, Anxiety and Depression Scale (DASS-21). For statistical analysis, a multivariate logistic regression model was applied with a 5% significance level. Results: frequency of 37.7%, 43.3% and 45.1% were found for some symptom of stress, anxiety and depression, respectively. The factors associated with sign and symptoms of severe / extreme psychic disorders were: not having religion (stress, anxiety and depression); be at graduation (stress and anxiety); history of anxiety and depression (anxiety and depression); not practicing or decreasing physical exercises and starting, increased or continue taking sleeping medications (stress); history of contact with a suspected case of COVID-19, absence or decreased leisure (anxiety); female gender, absence of a partner, decreased family income and work or study (depression). Conclusion: the frequency of psychological disorders was higher than described in the literature on diabetic patients, being associated with biological, sociodemographic, clinical factors and aspects related to COVID-19 during the pandemic

Resumo Objetivos: determinar a frequência e os fatores associados aos sinais e sintomas de estresse, ansiedade e depressão grave/extremos em pacientes diabéticos durante a pandemia pela COVID-19. Métodos: realizou-se estudo de corte transversal em abril/maio de 2020 que incluiu 162 indivíduos com diabetes mellitus e maiores de 18 anos. Aplicou-se um questionário online divulgado nas mídias sociais, sendo composto por características biológicas, sociodemográ-ficas, clínicas e a Escala de Estresse, Ansiedade e Depressão (DASS-21). Para análise estatística foi aplicado modelo de regressão logística multivariado com nível de significância de 5%. Resultados: encontrou-se frequência de 37,7%, 43,3% e 45,1% para qualquer sinal e sintoma de estresse, ansiedade e depressão, respectivamente. Os fatores associados a sinais e sintomas psíquicos graves/extremos foram: não ter religião (estresse, ansiedade e depressão); estar na graduação (estresse e ansiedade);antecedente de ansiedade e/ou depressão (ansiedade e depressão); não realizar ou ter diminuído exercícios físicos, iniciado, aumentado ou mantido medicações para dormir (estresse); história de contato com caso suspeito da COVID-19; ausência ou diminuição de lazer (ansiedade) e sexo feminino, ausência de companheiro, diminuição da renda familiar e do trabalho ou estudo (depressão). Conclusão: a frequência de transtornos psíquicos foi maior que a descrita na literatura em pacientes diabéticos, sendo associada a fatores biológicos, sociodemográficos, clínicos e aspectos relacionados à COVID-19 durante a pandemia.

Assuntos

RESUMO

Coronavirus disease 2019 (COVID-19) was initially described as a viral infection of the respiratory tract. It is now known, however, that several other organs are affected, including the brain. Neurological manifestations such as stroke, encephalitis, and psychiatric conditions have been reported in COVID-19 patients, but the neurotropic potential of the virus is still debated. Herein, we sought to investigate SARS-CoV-2 infection in human neural cells. We demonstrated that SARS-CoV-2 infection of neural tissue is non-permissive, however, it can elicit inflammatory response and cell damage. These findings add to the hypothesis that most of the neural damage caused by SARS-CoV-2 infection is due to a systemic inflammation leading to indirect harmful effects on the central nervous system despite the absence of local viral replication.

RESUMO

The text addresses the risks involving xenophobia against the Chinese on the internet, and social networks, from the COVID-19 pandemic, in addition to demonstrating how irrational this manifestation is, especially the idea of virus creation in a laboratory. For this purpose, historical examples of how xenophobic prejudice is meaningless and have damaged humanity's trajectory in all world regions are addressed. Finally, I warn about the need to use science to confront the new coronavirus and abandon conspiracy theories.

RESUMO

RESUMEN La infancia es el sur del virus, como ha visibilizado la pandemia de COVID-19: un mundo donde el cuidado no es un valor escogido desde el deseo, y donde la voz infantil es silenciada en virtud de una injusticia epistémica ancestral. Así, la transformación que las sociedades humanas están experimentando debido a la COVID-19 ha impactado significativamente en los derechos de la infancia, a niveles micro y macro. En España, como país especialmente golpeado por la pandemia, encontramos que tanto la primera infancia (a través especialmente de la violencia obstétrica) como ella misma en todas sus fases, están siendo víctimas de un paradigma adultocéntrico de control e injusticia epistémica basales. En este ensayo se analiza y discute algunas de las consecuencias negativas observadas en este país con relación al cuidado y el confinamiento de menores y sus familias, acaecidas a raíz de la pandemia, considerando que la crisis desencadenada por la COVID-19 puede ser una oportunidad para visibilizar situaciones de injusticia ancestral para con la niñez

ABSTRACT As the COVID-19 pandemic has made visible, childhood is the virus's proverbial south: a world where care is not a value chosen from a place of desire, and where children's voices are silenced at the hands of an ancestral epistemic injustice. Thus, the transformation that human societies are undergoing due to COVID-19 has significantly impacted the rights of children, both at the micro and the macro levels. In Spain - a country that has been particularly hard-hit by the pandemic - we find that both infancy (especially through obstetric violence) and childhood at all its stages fall victim to an adultcentric paradigm based on control and epistemic injustice. This essay analyzes and discusses some of the negative consequences observed in this country related to the care for and the confinement of minors and their families - which has occurred as a result of the pandemic - and considers that the crisis triggered by COVID-19 may be an opportunity to shed light on situations of ancestral injustice towards children.

Assuntos

RESUMO

INTRODUCCIÓN: El pasado 11 de marzo del 2020 la OMS (Organización Mundial para la Salud) realizó la declaratoria de pandemia por Sars-Cov 2, un nuevo coronavirus identificado en China a finales del 2019. Hasta la actualidad el virus se ha diseminado rápidamente en varios países poniendo a prueba los sistemas de salud de los mismos. Los modelos epidemiológicos matemáticos como SEIR (susceptible, expuesto, infectado, removido) han sido utilizados durante años para la gestión y estudio de enfermedades infecciosas. OBJETIVO: describir las características del modelo matemático SEIR y su aplicación en la gestión de la pandemia con su implicación en las decisiones de salud pública. METODOLOGÍA: se realizó una revisión bibliográfica de artículos originales escritos en español o inglés y publicados entre 2015-2020, sobre modelos matemáticos y de tipo SEIR, la relación con las enfermedades infecciosas, la pandemia por Covid-19 e influencia en las decisiones en salud pública. La búsqueda se realizó en las bases de datos google scholar, Medline, Science Direct. No se hicieron restricciones respecto al tipo de estudio. RESULTADOS: el modelamiento matemático para enfermedades infecciosas de tipo SEIR se utiliza como herramienta de predicción para la toma decisiones y deben valorarse objetivamente. Una opción para evaluar las ecuaciones y graficar sus resultados del modelo es el uso del software MATLAB. CONCLUSIÓN: se destaca su aporte en la comprensión del avance de la pandemia por Covid-19 y la influencia en la toma de decisiones para diseñar estrategias de prevención y respuesta en salud pública.

INTRODUCTION: on March 11, 2020, the WHO (World Health Organization) declared a pandemic for Sars-Cov 2, a new coronavirus identified in China at the end of 2019. Until now, the virus has spread rapidly in several countries testing their health systems. Mathematical epidemiological models such as SEIR (susceptible, exposed, infected, removed) have been used for years for the management and study of infectious diseases. OBJETIVE: to describe the characteristics of the SEIR mathematical model and its application in pandemic management with its implication in public health decisions. METHODOLOGY: a bibliographic review was carried out of original articles written in Spanish or English and published between 2015-2020 on mathematical and SEIR-type models, the relationship with infectious diseases, the Covid-19 pandemic and influence on health decisions public. The search was carried out in the google scholar, Medline, Science Direct databases. There were no restrictions regarding the type of study. RESULTS: mathematical modeling for infectious diseases of the SEIR type is used as a prediction tool for decision making and should be objectively assessed. One option for evaluating the equations and graphing your model results is to use MATLAB software. CONCLUSION: their contribution to understanding the progress of the Covid-19 pandemic and the influence on decision-making to design prevention and response strategies in public health is highlighted.

INTRODUÇÃO: em 11 de março de 2020, a OMS (Organização Mundial da Saúde) declarou uma pandemia de Sars-Cov 2, um novo coronavírus identificado na China no final de 2019. Até agora, o vírus se espalhou rapidamente em vários países testando sua saúde sistemas. Modelos epidemiológicos matemáticos comoo SEIR (suscetível, exposto, infectado, removido) são usados há anos para o gerenciamento e estudo de doenças infecciosas. OBJETIVO: descrever as características do modelo matemático SEIR e sua aplicação na gestão de pandemias com sua implicação nas decisões de saúde pública. METODOLOGIA: foi realizada uma revisão bibliográfica de artigos originais escritos em espanhol ou inglês e publicados entre 2015-2020, sobre modelos matemáticos e do tipo SEIR, a relação com doenças infecciosas, a pandemia de Covid-19e a influência nas decisões de saúde públicas. A pesquisa foi realizada nas bases de dados google scholar, Medline, Science Direct. Não houve restrições quanto ao tipo de estudo. RESULTADOS: A modelagem matemática para doenças infecciosas do tipo SEIR é utilizada como ferramenta de previsão para a tomada de decisão e deve ser avaliada objetivamente. Uma opção para avaliar as equações e representar graficamente os resultados do seu modelo é usar o software MATLAB. CONCLUSÃO: destaca-se a contribuição deles para a compreensão do progresso da pandemia Covid-19 e a influência na tomada de decisões para a formulação de estratégias de prevenção e resposta em saúde pública

Assuntos