Quality management of the periodic medical examination at a university hospital, from the workers' perspective.

Introduction: Implementation of quality assessment methodologies at healthcare services enables the results achieved to be monitored in terms of established objectives and standards of care delivery. Objectives: To assess the quality of the processes involved in provision of periodic medical examinations at a University Hospital, from the workers' perspective. Methods: This is a cross-sectional study using questionnaires to conduct quality assessment of the periodic medical examination processes, including Net Promoter Score satisfaction questions. Statistical analysis of the results was performed using SPSS version 18. Data on categorical variables are expressed as absolute frequencies and data on continuous variables as means and standard deviations. Chi-square tests and analysis of variance were used to identify associations. A significance level of 0.05 was adopted to determine the statistical relevance of findings. Results: A total of 381 respondents with a mean age of 45.25 years were included, 66% of whom were female. There was a statistically significant (p < 0.001) association between duration of consultations and the number of items assessed in the periodic medical examination. In general, the findings from application of the Net Promoter Score for self-scheduling (45%) and service at reception (42%) indicate a need for process improvement, whereas clinical care (50%) rated as a quality process. Conclusions: This study identified a set of information that can be used to describe, analyze, and improve the care delivered by the institution's occupational health service and to identify opportunities for improvement of periodic medical examination processes.

Heart failure secondary to myocarditis after SARS-CoV-2 reinfection: a case report.

INTRODUCTION: Cardiac involvement in COVID-19 can range from mild damage to severe myocarditis. The precise mechanism by which COVID-19 causes myocardial injury is still unknown. Myocarditis following administration of COVID-19 vaccines, especially those based on mRNA, has also been described. However, no reports of heart failure following reinfection with SARS-CoV-2 in patients immunized with an inactivated vaccine have been identified. CASE DESCRIPTION: The patient was a 47-year-old male construction worker of African descent, with type II diabetes and a history of infection by SARS-CoV-2 in December 2020 and May 2021, confirmed by RT-PCR. He received two doses of an inactivated vaccine against COVID-19. Between the two COVID-19 episodes with positive RT-PCR, he had two episodes of bacterial lung infection. After the second episode of SARS-CoV-2 infection, he was diagnosed with severe heart failure as a sequela of myocarditis. CONCLUSION: It is essential to perform a thorough follow-up after infection with SARS-CoV-2 since, even with proper immunization, it is possible that the patient was reinfected and suffered severe cardiac sequelae as a consequence. The hypothesis of an etiology associated with the use of an inactivated vaccine against COVID-19, with a potential immune enhancement mechanism following reinfection with SARS-CoV-2, cannot be rejected.

Reduction in COVID-19 prevalence in healthcare workers in a university hospital in southern Brazil after the start of vaccination.

INTRODUCTION: The quick spread of SARS-CoV-2 led to the development of vaccines that are capable of reducing infection and the number of more severe COVID-19 cases. AIM: To assess COVID-19 prevalence among healthcare workers (HCWs) after vaccination against SARS-CoV-2. METHODS: This was a cross-sectional study on the prevalence of COVID-19 diagnosis among 7523 HCWs vaccinated against SARS-CoV-2 with CoronaVac and ChAdOx1 nCoV-19 in a university hospital, in southern Brazil, between January 18 and March 18, 2021.The variables evaluated were: sex, age, work area, role, source of infection, previous diagnosis of COVID-19, date of vaccine administration, type of vaccine, and need for hospitalization. The statistical analysis used Poisson regression and Fisher's exact test with SPSS software version 25, and a level of significance set at 5%. RESULTS: 813 vaccinated HCWs showed symptoms suggestive of COVID-19, of whom 35.4% (288) had a detectable result after undergoing RT-PCR for SARS-CoV-2. There was a reduction of 62% in new cases of COVID-19 among HCWs in the institution 7 weeks after the start of vaccine rollout. CONCLUSION: Our data suggest that the vaccines used by the institution reduced the number of COVID-19 cases among healthcare workers, demonstrating the effectiveness of the vaccines.