Lung function of patients hospitalized with COVID-19 at 45 days after hospital discharge: first report of a prospective multicenter study in Brazil.

OBJECTIVE: Because SARS-CoV-2 infection can severely affect the lungs and persistent functional changes can occur after severe disease, we aimed to determine lung function parameters of COVID-19 patients at 45 days after hospital discharge and compare changes according to the severity of the disease. METHODS: This was a prospective descriptive analytical multicenter study. The participants were allocated into three groups: ward admission (WA) group; ICU admission not on mechanical ventilation (ICU/MV-) group; and ICU admission on MV (ICU/MV+) group. Lung volumes, DLco, MIP, MEP, and six-minute walk distance (6MWD) were measured 45 days after discharge. RESULTS: The sample comprised 242 patients (mean age = 59.4 ± 14.8 years; 52.1% of males), and 232 (96%) had altered lung function. In the total cohort, restrictive disorder was observed in 96%, as well as reductions in DLco (in 21.2% of the patients), FEV1/FVC (in 39.7%), and PEmax (in 95.8%), with no differences between the groups. Comparing the groups, the ICU/MV+ group had reduced DLco in 50% of the patients (p < 0.001) and a lower mean 6MWD % of the predicted value (p = 0.013). Oxygen desaturation in the six-minute walk test was observed in 32.3% of the cohort and was less frequent in the IE group. CONCLUSIONS: This is the first South American study involving severe COVID-19 survivors whose lung function was assessed 45 days after hospital discharge. Changes were frequent, especially in those on MV, which highlights the importance of lung function evaluation after severe COVID-19.

O PERFIL DO MÉDICO APROVADO NA RESIDÊNCIA MÉDICA DE MINAS GERAIS EM 2019 / Minas Gerais 2019's medical residency: The approved physician's profile

Introdução: Os processos seletivos de residência médica (PSRM) estão progressivamente mais concorridos e carecem de análises do seu perfil de candidatos aprovados. Objetivos: Analisar o desempenho e perfil do aprovado no Processo Seletivo de Residência Médica do Estado de Minas Gerais (PSU-MG) nas quatro especialidades médicas mais comuns no Brasil. Métodos: Analisamos candidatos aprovados ou selecionados nos três hospitais de Belo Horizonte com maior oferta de vagas em Cirurgia Geral (CIR), Clínica Médica (CLM), Ginecologia e Obstetrícia (GOB) e Pediatria (PED). Utilizamos a publicação da primeira chamada do PSU-MG 2019 e a Plataforma Lattes para análise do currículo quanto à especialidade e hospital pretendidos, notas de prova e de currículo, sexo e instituições cursadas. Resultados: Foram analisados 1087 candidatos. Candidatos de escolas médicas públicas apresentaram maiores medianas de notas de prova e de currículo (63,9 e 8,42 versus 60,3 e 7,00 respectivamente; p<0,05), foram mais aprovados no PSU-MG (p < 0,05) e tiveram mais inscrições em CIR e CLM e menos em PED (p<0,05) do que alunos de escolas médicas pagas. Não houve associação significativa entre o sexo e aprovação no concurso, porém, encontrouse associação positiva entre sexo feminino e as especialidades de GOB e PED, e sexo masculino e CIR e CLM. Conclusões: A relação Candidato/vaga e a escola de graduação parecem influenciar o desempenho dos candidatos em PSRM. Estudos adicionais e mais amplos são necessários para elucidação dos fatores que interferem no desempenho nos PSRM.

Introduction: Medical Residency Selection Processes (MRSP) are increasingly competitive and lack of objective analysis concerning approved candidates. Objective: Analyze the profile of physicians approved in the largest MRSP in the state of Minas Gerais - Brazil in 2019 (PSU-MG) in each of the four most common Brazilian specialties. Methods: Our sample consisted of approved or selected candidates for the hospitals in Belo Horizonte which offered more vacancies in the Internal Medicine (INTMED), Gynecology and Obstetrics (OB/ GYN), Pediatrics (PEDS) and General Surgery (GS) specialties in the PSU-MG. We used the PSU-MG approved candidates list and the Lattes curriculum for data regarding specialty, selected hospital, test and curriculum grades, gender, and attended institutions. Results: A total of 1087 candidates were analyzed. Physicians who graduated at public medical colleges had higher test and curriculum scores medians (63.9 and 8.42 versus 60.3 and 7.00 respectively; p<0.05), were more approved at the MRSP (p<0.05) and were more enrolled in GS and INTMED (p<0.05) and less enrolled in PEDS than candidates from private schools. There was no significant association between gender and approval. Female candidates were more enrolled in OB/GYN and PEDS, and male candidates in GS and INTMED. Conclusion: Both the ratio between candidate and vacancy for medical residency and the medical school graduation funding type seem to influence the approved candidate's performance on MRSP. Further studies are needed to better elucidate factors that interfere on the performance in MRSP.