Evaluation of Environmental Contamination by Heavy Metals and Relationship with Cardiovascular Risk in a Population of Barcarena-PA.

Heavy metals are widely used to sustain the living standards of the modern world. Due to their prevalence, the risk of human exposure is an increasing threat to public health as they can cause negative health effects, such as cardiovascular diseases (CVDs). In this study, the objective was to evaluate clinical-epidemiological and biochemical parameters in relation to the overall risk score (ERG) of developing CVDs in 112 individuals aged 30 to 74 years living in the city of Barcarena-PA. The results of heavy metal contamination and biochemical parameters were applied in the ERG calculation. A significance level of p < 0.05 was adopted in the statistical tests. The values were high for chromium (Cr) (45.8%) and aluminum (Al) (98.6%). As for the ERG for CVDs, they obtained low risk (42%), medium risk (40%), and high risk (18%). In individuals with high ERG, a significant association was detected with increasing age group, in individuals ≥ 60 years (p < 0.0001). The relationship between concomitant Al and Cr intoxication and increased ERG was also significant (p = 0.0016). The probability of high cardiovascular risk among individuals contaminated by Al + Cr is higher than that of individuals contaminated by Al alone (p = 0.0074). Such evidence indicates that continuous environmental monitoring in the municipality of Barcarena is of extreme importance, since the population is in a situation of vulnerability in relation to their health.

Characteristics and outcomes of severe COVID-19 in hospitalized patients with cardiovascular diseases in the Amazonian region of Brazil: a retrospective cohort.

The northern region of Brazil is already vulnerable to other infectious diseases and it was no different in COVID-19. However, cardiovascular diseases still lead the causes of death. Thus, the objective of this study is to identify the clinical predictors and outcome of severe COVID-19 in hospitalized patients with and without CVD in this region of the Amazon. A retrospective cohort, referring to the notifications from January 1 to December 31, 2020, including cases confirmed by molecular testing. The study consisted of 9223 confirmed cases for COVID-19. Of these, 6011 (65.17%) did not have cardiovascular disease and 3212 (34.83%) had some cardiovascular disease. The significance of deaths was in the age group of < 1 to 59 CVD carriers (< 0.001). Predictor of mortality were invasive ventilation for patients with CVD, (OR 23,688 CI 18,180-30,866), followed by chronic kidney disease (OR 2442 CI 1568-3740), dyspnea (OR 2312 CI 1817-3941), respiratory distress (OR 1523 CI 1210-2919), cough (OR 1268 CI 1005-1599), Lower oxygen saturation 95% (OR 1281 CI 1039-1579), diabetes mellitus (OR 1267 CI 1050-1528) and age (OR 1051 CI 1044-1058). Carriers of CVD had a lower survival rate (< 0.0001). The order of the predictors of death differed among the non-carriers, as well as the high odds ratio in the predictors of CVD, only cough was an independent predictor. The age group under 59 years was associated with deaths. We also show the shorter survival in CVD carriers, as well as the higher cardiovascular morbidity rate than other studies in the literature.

Risk factors associated with the severity of COVID-19 in a region of the Brazilian Amazon.

The Brazilian Northern region registered a high incidence of COVID-19 cases, particularly in the state of Pará. The present study investigated the risk factors associated with the severity of COVID-19 in a Brazilian Amazon region of 100,819 cases. An epidemiological, cross-sectional, analytical and demographic study, analyzing data on confirmed cases for COVID-19 available at the Brazilian Ministry of Health's surveillance platform, was conducted. Variables such as, municipalities of residence, age, gender, signs and symptoms, comorbidities were included and associated with COVID-19 cases and outcomes. The spatial distribution was performed using the ArcGIS program. A total of 100,819 cases were evaluated. Overall, patients had the mean age of 42.3 years, were female (51.2%) and with lethality reaching 4.79% of cases. Main symptoms included fever (66.5%), cough (61.9%) and sore throat (39.8%). Regarding comorbidities, most of the patients presented cardiovascular disease (5.1%) and diabetes (4.2%). Neurological disease increased risk of death by nearly 15 times, followed by obesity (5.16 times) and immunodeficiency (5.09 time). The municipalities with the highest incidence rate were Parauapebas, Canaã dos Carajás and Jacareacanga. Similarity between the Lower Amazon, Marajó and Southwest mesoregions of Pará state were observed concerning the highest morbidity rates. The obtained data demonstrated that the majority of cases occurred among young adults, females, with the classic influenza symptoms and chronic diseases. Finally, data suggest that the highest incidences were no longer in the metropolitan region of the state. The higher lethality rate than in Brazil may be associated with the greater impacts of the disease in this Amazonian population, or factors associated with fragile epidemiological surveillance in the notification of cases of cure.

Monitoring mercury exposure in reproductive aged women inhabiting the Tapajós river basin, Amazon.

Among Amazonian communities, exposure to methylmercury is associated mainly with fish consumption that may affect fetal development in pregnant women. Therefore a temporal assessment was performed to assess the exposure of reproductive aged women to mercury who reside in the riparian communities of São Luís do Tapajós and Barreiras located in the Tapajós basin of the Brazilian Amazon from 1999 to 2012. The total mercury concentration in the 519 hair samples was assessed by cold vapor atomic absorption spectrometry. Data analysis showed that the average total mercury concentration decreased from 1.066 to 0.743 µg/g in those years. In 1999 the proportion of volunteers with mercury levels ≥ 10 µg/g was approximately 68 %. In general, exposure to mercury decreased among women of reproductive age, but the potential risks to reproduction and human health is still an issue as 22 % of the woman continued showing high mercury levels (≥ 10 µg/g) in 2012.