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AbstractCOVID-19 pandemic has burdened healthcare systems, necessitating the development of mortality prediction scores to guide clinical decisions and resource allocation. 4C ISARIC mortality score was developed and validated on a British cohort.ObjectivesExternal validation of the score in the setting of a large Saudi Arabian ICU.MethodRetrospective chart review of COVID-19 patients admitted to ICU of King Saud Medical City, Riyadh, Saudi Arabia. Collecting data to calculate the score, then fitting a ROC curve against known patients’ outcome.ResultsCohort included 1493 patients with 38% mortality, AUC of the score was 0.81 (95% CI: 0.79 – 0.83, p < 0.001), correctly classifying 72.67% of the cohort. Cut-off value of > 9 had sensitivity of 70.5% (95% CI: 66.6 – 74.3), specificity 73.97% (95% CI: 71 – 76.8), positive predictive value 62.4% (95% CI: 59.5 – 65.2), and negative predictive value 80.2% (95% CI: 78.2 – 82.4).Conclusion4C ISARIC mortality risk score performed well with a good discriminatory ability for critically ill patients admitted to ICU in our setting. Cut-off > 9 was the optimal criterion.

ABSTRACTThe COVID-19 pandemic began in the city of Wuhan, China, at the end of 2019 and quickly spread worldwide. The disease is caused by contact with the SARS-CoV-2 virus, which probably jumped from an animal host to humans. SARS-CoV-2 infects various tissues in the body, notably the lungs, and patients usually die from respiratory complications. Mathematical models of the disease have been instrumental to guide the implementation of mitigation strategies aimed at slowing the spread of the disease. One of the key parameters of mathematical models is the basic reproduction ratio R0, which measures the degree of infectivity of affected individuals. The goal of mitigation is to reduce R0 as close or below 1 as possible, as it means that new infections are in decline. In the present work, we use the recursive least-squares algorithm to establish the stochastic variability of a time-varying R0(t) from eight different countries: Argentina, Belgium, Brazil, Germany, Italy, New Zealand, Spain, and the United States of America. The proposed system can be implemented as an online tracking application providing information about the dynamics of the pandemic to health officials and the public at large.

COVID-19, as a global public health crisis, represents a major concern for international tourism. This study aims to explore the influence of COVID-19 on international tourists’ self-protection mot...

Introduction The coronavirus disease 2019 (COVID-19) pandemic has affected the care of patients with noncommunicable diseases, including those suffering from kidney-related ailments. Many parts of the world, including India, adopted lockdown to curb community transmission of disease. The lockdown affected transportation, access to health care facilities, and availability of medicines and consumables as well as outpatient and inpatient services. We aimed to analyze the effect of lockdown imposed due to the COVID-19 pandemic on the care of patients with kidney diseases in India. Methods We surveyed 19 major hospitals (8 in the public and 11 in the private sector) to determine the effect of lockdown on the care of patients with kidney disease, including those on dialysis after the first 3 weeks of lockdown. Results The total number of dialysis patients in these centers came down from 2517 to 2404. Approximately 710 (28.2%) patients missed 1 or more dialysis sessions, 69 (2.74%) required emergency dialysis sessions, 104 (4.13%) stopped reporting for dialysis, and 9 (0.36%) were confirmed to have died. Outpatient attendance in the surveyed hospital came down by 92.3%, and inpatient service reduced by 61%. Tele-consultation was started but was accessed by only a small number of patients. Conclusion Lack of preparedness before lockdown resulted in an interruption in health care services and posed an immediate adverse effect on the outcome of dialysis patients and patients with kidney disease in India. The long-term impact on the health of patients with less severe forms of kidney disease remains unknown.

The novel corona virus disease (Covid-19) outbreak has caused great uncertainty in all spheres of human life. The experience has been incredibly humbling given that no country or section of society, regardless of its wealth or status, has been spared. The pandemic is not only a health crisis, but is also having serious damaging effects on societies, economies and vulnerable groups. Timely response is necessary in order to alleviate human suffering and to prevent irreversible destruction of livelihoods. This paper provides preliminary data on the socio-economic impacts of Covid-19 in the coastal city of Mombasa, Kenya, at the time of government-imposed curfews and cessation of movement. We conducted online surveys for two weeks during the restrictions period. The data was collected using online questionnaires directed at the city residents. The data highlights the mobile gender gap resulting from gender inequalities, residents' reliance on the government for Covid-19 information but lack of trust for government interventions, inadequate provisions of essential services, and the residents' lack of preparedness to tackle similar challenges in the future.

Made available in DSpace on 2021-06-25T12:25:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-05-01 This article brings together two researchers who undertake investigations in different geographical contexts and with different actors, but who approach them by paying attention to their social vulnerability. The first is dedicated to the study of the daily work of sweepers of Presidente Prudente/SP, the second focuses on the study of the aging process, the senses and meanings, from the lenses of the geographies of aging. The Covid-19 health crisis in Brazil has demonstrated and accentuated socio-spatial inequalities and deepened social vulnerability. We are committed to presenting reflections based on the social experience of the (the) women(s) and the elderlys, in order to demonstrate the details that corroborate for the complex plot of social determination of the vulnerable. With this, we aim to contribute to the construction of a socially just and attentive reflection to invisible aspects. UNESP, Programa Pos Grad Geog, Campus Presidente Prudente, Presidente Prudente, SP, Brazil UNESP, Programa Pos Grad Geog, Campus Presidente Prudente, Presidente Prudente, SP, Brazil

Orientador: Prof. Dr. Roberto Pontarolo Dissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Ciências Farmacêuticas. Defesa : Curitiba, 25/08/2022 Inclui referências Resumo: A COVID-19 é uma doença pandêmica atual causada pelo vírus SARS-CoV-2 e que, devido ao seu perfil de infecção e transmissão, rapidamente se tornou problema mundial de saúde pública. Esse vírus, além de acometer as vias respiratórias, também afeta outros órgãos, sendo capaz de alterar e causar prejuízos no sistema nervoso central e periférico, por meio de diversos mecanismos fisiopatológicos relacionados à inflamação e danos estruturais em decorrência do neurotropismo do vírus e sua capacidade de ultrapassar a barreira hematoencefálica. Na rotina clínica da COVID-19, diversos biomarcadores são rastreados em fluidos de pacientes, e biomarcadores de dano neurológico têm sido encontrados em sangue e líquido cefalorraquidiano. Nesse cenário, o mapeamento e caracterização desses biomarcadores se fazem relevantes a fim de verificar a associação das alterações laboratoriais e dos sintomas neurológicos em decorrência da infecção pelo novo coronavírus. Com isso, a partir da abordagem da Saúde Baseada em Evidências (SBE), o presente trabalho é uma revisão sistemática de estudos observacionais, seguindo as recomendações da do PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement) e da Colaboração Cochrane (registro PROSPERO: CRD42021266995), com busca realizada nas bases Pubmed e Scopus e atualizada no final de março de 2022. Ao final, foram incluídos 19 artigos, sendo 58% estudos de coortes, 21% estudos transversais e 21% estudos de relato e série de casos. Foram identificados 9 biomarcadores: cadeia leve de neurofilamentos (NfL) em 14 estudos, proteína ácida glial fibrilar (GFAp) em 6 estudos, proteína tau em 6 estudos, proteína beta-amilóide (ßA) em 2, e ubiquitina C-terminal hidrolase L1 (UCH-L1), proteína S100B, forma solúvel do receptor desencadeado expresso nas células mielóides 2 (sTREM2), cadeia pesada de neurofilamentos (NfH) e enolase neuroespecífica (NSE) em 1 estudo cada. Cinquenta e oito por cento dos estudos utilizaram apenas amostras de sangue/plasma, enquanto 26% utilizaram líquido cefalorraquidiano (LCR) e 16% ambas as amostras. No total foram 897 pacientes com COVID-19 incluídos nos estudos. Hipertensão e diabetes foram as comorbidades mais relatadas (68% dos estudos cada) e os sintomas neurológicos inespecíficos, como dor de cabeça (53% dos estudos e 14% dos pacientes), desordens dos sentidos (53%) e prejuízos cognitivos (53%) foram mais prevalentes entre os estudos. De acordo com a avaliação de qualidade metodológica de estudos transversais e coorte pela escala de Newcastle-Ottawa (NOS), 32% apresentaram baixa qualidade, 26% média e 16% alta qualidade. Os biomarcadores identificados têm seus níveis alterados com o envelhecimento, e níveis de biomarcadores neurológicos NfL e GFAp, principalmente, possuem correlações significativas (p < 0.05) com piores desfechos de fase aguda e manifestações neurológicas da COVID-19 como dor de cabeça, delírio, encefalopatia e fadiga, com níveis de NfL também aumentados em pacientes que posteriormente tiveram complicações pós COVID-19. Porém, mais estudos precisam ser realizados com um maior número amostral, de tempo de seguimento e com melhor padronização de tempos de coleta de amostras, a fim de fornecerem dados para avaliações mais robustas das complicações após fase aguda e da COVID longa. Abstract: COVID-19 is a current pandemic disease caused by the SARS-CoV-2 virus that, due to its infection and transmission profile, has quickly become a global public health problem. This virus, in addition to affecting the airways, also affects other organs, being capable of altering and causing damage to the central and peripheral nervous system, through various pathophysiological mechanisms related to inflammation and structural damage due to the neurotropism of the virus and its ability to cross the blood-brain barrier. In the clinical routine of COVID-19, several biomarkers are screened in patient fluids, and neurologic damage biomarkers have been found in blood and cerebrospinal fluid. In this scenario, the mapping and characterization of these biomarkers are relevant in order to verify the association of laboratory changes and neurological symptoms as a result of infection by the new coronavirus. Based on the Evidence-Based Health (SBE) approach, the present work is a systematic review of observational studies, following the recommendations of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement) and the Cochrane Collaboration (PROSPERO registry: CRD42021266995), with a search performed in Pubmed and Scopus and updated at the end of March 2022. In the end, 19 articles were included, 58% of which were cohort studies, 21% cross-sectional studies and 21% report and series studies of cases. Nine biomarkers were identified: neurofilament light chain (NfL) in 14 studies, glial fibrillary acidic protein (GFAp) in 6 studies, tau protein in 6 studies, beta-amyloid protein (ßA) in 2, and C-terminal ubiquitin hydrolase L1 (UCH-L1), S100B protein, soluble form of the triggered receptor expressed in myeloid cells 2 (sTREM2), neurofilament heavy chain (NfH) and neurospecific enolase (NSE) in 1 study each. Fifty-eight percent of the studies used only blood/plasma samples, while 26% used cerebrospinal fluid (CSF) and 16% used both samples. In total, 897 patients with COVID-19 were included in the studies. Hypertension and diabetes were the most reported comorbidities (68% of studies each) and nonspecific neurological symptoms such as headache (53% of studies and 14% of patients), sensory disorders (53%) and cognitive impairment (53%) were more prevalent across studies. According to the methodological quality assessment of cross-sectional and cohort studies using the Newcastle-Ottawa (NOS) scale, 32% had low quality, 26% medium and 16% high quality. The identified biomarkers have their levels altered with aging, and levels of neurological biomarkers NfL and GFAp, mainly, have significant correlations (p < 0.05) with worse acute phase outcomes and neurological manifestations of COVID- 19 such as headache, delirium, encephalopathy and fatigue, with NfL levels also increased in patients who later had post-COVID-19 complications. However, more studies need to be carried out with a larger sample number, follow-up time and with better standardization of sample collection times, in order to provide data for more robust assessments of complications after the acute phase and long COVID.

This paper deals with the mathematical modeling and numerical simulations related to the coronavirus dynamics. A description is developed based on the framework of the susceptible-exposed-infectious-removed model. Initially, a model verification is carried out calibrating system parameters with data from China, Italy, Iran, and Brazil. Results show the model capability to predict infectious evolution. Afterward, numerical simulations are performed in order to analyze different scenarios of COVID-19 in Brazil. Results show the importance of the governmental and individual actions to control the number and the period of the critical situations related to the pandemic.