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1.
J Med Virol ; 94(1): 298-302, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34491581

RESUMO

For preventing the spread of the coronavirus disease 2019 (COVID-19) pandemic, measures like wearing masks, social distancing, and hand hygiene played crucial roles. These measures may also have affected the expansion of other infectious diseases like respiratory tract infections (RTI) and gastro-intestinal infections (GII). Therefore, we aimed to investigate non-COVID-19 related RTI and GII during the COVID-19 pandemic. Patients with a diagnosis of an acute RTI (different locations) or acute GII documented anonymously in 994 general practitioner (GP) or 192 pediatrician practices in Germany were included. We compared the prevalence of acute RTI and GII between April 2019-March 2020 and April 2020-March 2021. In GP practices, 715,440 patients were diagnosed with RTI or GII in the nonpandemic period versus 468,753 in the pandemic period; the same trend was observed by pediatricians (275,033 vs. 165,127). By GPs, the strongest decrease was observed for the diagnosis of influenza (-71%, p < 0.001), followed by acute laryngitis (-64%, p < 0.001), acute lower respiratory infections (bronchitis) (-62%, p < 0.001), and intestinal infections (-40%, p < 0.001). In contrast, the relatively rare viral pneumonia strongly increased by 229% (p < 0.001). In pediatrician practices, there was a strong decrease in infection diagnoses, especially influenza (-90%, p < 0.001), pneumonia (-73%, p < 0.001 viral; -76%, p < 0.001 other pneumonias), and acute sinusitis (-66%, p < 0.001). No increase was observed for viral pneumonia in children. The considerable limitations concerning social life implemented during the COVID-19 pandemic to combat the spread of SARS-CoV-2 also resulted in an inadvertent but welcome reduction in other non-Covid-19 respiratory tract and gastro-intestinal infections.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Gastroenteropatias/epidemiologia , Infecções Respiratórias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Alemanha/epidemiologia , Higiene das Mãos/métodos , Humanos , Masculino , Máscaras , Pessoa de Meia-Idade , Distanciamento Físico , Prevalência , Adulto Jovem
2.
J Med Virol ; 94(1): 366-371, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34546584

RESUMO

Co-epidemics happening simultaneously can generate a burden on healthcare systems. The co-occurrence of SARS-CoV-2 with vector-borne diseases (VBD), such as malaria and dengue in resource-limited settings represents an additional challenge to the healthcare systems. Herein, we assessed the coinfection rate between SARS-CoV-2 and VBD to highlight the need to carry out an accurate diagnosis and promote timely measures for these infections in Luanda, the capital city of Angola. This was a cross-sectional study conducted with 105 subjects tested for the SARS-CoV-2 and VBD with a rapid detection test in April 2021. The participants tested positive for SARS-CoV-2 (3.80%), malaria (13.3%), and dengue (27.6%). Low odds related to testing positivity to SARS-CoV-2 or VBD were observed in participants above or equal to 40 years (odds ratio [OR]: 0.60, p = 0.536), while higher odds were observed in male (OR: 1.44, p = 0.392) and urbanized areas (OR: 3.78, p = 0.223). The overall co-infection rate between SARS-CoV-2 and VBD was 11.4%. Our findings showed a coinfection between SARS-CoV-2 with malaria and dengue, which could indicate the need to integrate the screening for VBD in the SARS-CoV-2 testing algorithm and the adjustment of treatment protocols. Further studies are warranted to better elucidate the relationship between COVID-19 and VBD in Angola.


Assuntos
COVID-19/epidemiologia , Coinfecção/epidemiologia , Dengue/epidemiologia , Malária/epidemiologia , Doenças Transmitidas por Vetores/epidemiologia , Adolescente , Adulto , Fatores Etários , Angola/epidemiologia , Anticorpos Antiprotozoários/sangue , Anticorpos Antivirais/sangue , Teste para COVID-19 , Febre de Chikungunya/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , RNA Viral/sangue , SARS-CoV-2/isolamento & purificação , Fatores Sexuais , Adulto Jovem , Infecção por Zika virus/epidemiologia
3.
J Med Virol ; 94(1): 380-383, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34403142

RESUMO

The durability of infection-induced severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunity has crucial implications for reinfection and vaccine effectiveness. However, the relationship between coronavirus disease 2019 (COVID-19) severity and long-term anti-SARS-CoV-2 immunoglobulin G (IgG) antibody level is poorly understood. Here, we measured the longevity of SARS-CoV-2-specific IgG antibodies in survivors who had recovered from COVID-19 1 year previously. In a cohort of 473 survivors with varying disease severity (asymptomatic, mild, moderate, or severe), we observed a positive correlation between virus-specific IgG antibody titers and COVID-19 severity. In particular, the highest virus-specific IgG antibody titers were observed in patients with severe COVID-19. By contrast, 74.4% of recovered asymptomatic carriers had negative anti-SARS-CoV-2 IgG test results, while many others had very low virus-specific IgG antibody titers. Our results demonstrate that SARS-CoV-2-specific IgG persistence and titer depend on COVID-19 severity.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/patologia , Imunoglobulina G/sangue , SARS-CoV-2/imunologia , Índice de Gravidade de Doença , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Assintomáticas , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
4.
J Med Virol ; 94(1): 246-252, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34460118

RESUMO

Recently, the coronavirus disease 2019 (COVID-19) has caused a global pandemic. Several studies indicate that the digestive system can also be affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Therefore, patients with digestive symptoms should have a capsule endoscopy (CE). COVID-19 patients with gastrointestinal (GI) symptoms who underwent CE were recruited from March 2020 to April 2020. We collected patients' data and performed a prospective follow-up study for 6 months. All 11 COVID-19 cases with GI symptoms who underwent CE presented gastritis. Eight cases (72.7%) had intestinal mucosa inflammation. Among them, two cases showed intestinal ulcers or erosions. Moreover, two cases displayed colonic mucositis. One case was lost during follow-up. At 3-6 months after hospital discharge, five patients underwent CE again, presenting gastrointestinal lesions. Five of the 10 cases had GI symptoms, such as abdominal pain, diarrhea, constipation, and others. Among these five cases, the GI symptoms of three patients disappeared at the last follow-up and two patients still presented diarrhea symptoms. Overall, we observed damaged digestive tract mucosa that could be caused by SARS-CoV-2. Moreover, after discharge, some patients still presented intestinal lesions and GI symptoms.


Assuntos
COVID-19/complicações , COVID-19/patologia , Endoscopia por Cápsula , Gastroenteropatias/diagnóstico , Trato Gastrointestinal/patologia , Adulto , Idoso , Feminino , Seguimentos , Gastrite/complicações , Gastrite/diagnóstico , Gastrite/patologia , Gastroenteropatias/complicações , Gastroenteropatias/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
5.
Esc. Anna Nery Rev. Enferm ; 26(spe): e20210179, 2022. ilus
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1292850

RESUMO

Objetivo: O estudo objetivou compreender as repercussões da pandemia da Covid-19 no cuidado de lactentes prematuros, na perspectiva de mães e profissionais de saúde. Método: Foram realizadas entrevistas semiestruturadas nos meses de junho e julho de 2020, por meio de ligação telefônica, com 14 mães e quatro profissionais de saúde do serviço de follow-up de uma maternidade pública da Paraíba, Brasil. Resultados: A partir da análise temática indutiva, os impactos da pandemia no cuidado ao lactente nascido prematuro, foram: sobrecarga e afastamento dos profissionais dos serviços de saúde, desativação temporária da unidade mãe canguru, descontinuidade da assistência ao prematuro, medo materno de expor a criança à Covid-19 e baixa condição socioeconômica. Foram elencadas estratégias de enfrentamento para o cuidado dos lactentes durante a pandemia, como: maior espaçamento das consultas, acompanhamento por meio telefônico e cumprimento das medidas de biossegurança. Conclusão e implicações para a prática: A pandemia exigi adaptações na assistência, tornando necessárias novas formas de cuidado a essas crianças, como exemplo, as consultas de acompanhamento remotas, a fim de garantir o seu direito à vida e saúde


Objective: The study aimed at understanding the repercussions of the Covid-19 pandemic in the care of premature infants, from the perspective of mothers and health professionals. Method: Semi-structured interviews were conducted in the months of June and July 2020, over the telephone, with 14 mothers and four health professionals from the follow-up service of a public maternity hospital in Paraíba, Brazil. Results: From the inductive thematic analysis, the impacts of the pandemic on the care of premature infants were as follows: overload and distancing of health service professionals, temporary deactivation of the Kangaroo mother unit, discontinuity of care for the premature infant, maternal fear of exposing the child to Covid-19 and low socioeconomic status. Coping strategies for the care of infants during the pandemic were listed, such as: greater spacing between consultations, phone follow-up and compliance with biosafety measures. Conclusion and implications for the practice: The pandemic required adaptations in care, which make new forms of care necessary for these children, such as remote follow-up consultations, in order to guarantee their right to life and health


Objetivo: El estudio tuvo como objetivo comprender las repercusiones de la pandemia de Covid-19 en la atención de bebés prematuros, desde la perspectiva de las madres y los profesionales de la salud. Método: Se realizaron entrevistas semiestructuradas en los meses de junio y julio de 2020, por medio de llamadas telefónicas, a 14 madres y cuatro profesionales de la salud del servicio de seguimiento de una maternidad pública en Paraíba, Brasil. Resultados: A partir del análisis temático inductivo, los efectos de la pandemia en la atención de bebés prematuros fueron los siguientes: sobrecarga y distanciamiento de profesionales de los servicios de salud, inhabilitación temporal de la unidad Madre Canguro, discontinuidad de la atención al bebé prematuro, miedo materno a exponer al niño al Covid-19 y nivel socioeconómico bajo. Se enumeraron estrategias de afrontamiento para la atención infantil durante la pandemia, tales como: mayor intervalo entre consultas, seguimiento telefónico y cumplimiento de medidas de bioseguridad. Conclusión e implicaciones para la práctica: La pandemia requirió adaptaciones en la atención, que hacen necesarias nuevas formas de atención para estos niños, como las consultas de monitoreo remoto, para garantizar su derecho a la vida y a la salud


Assuntos
Humanos , Feminino , Lactente , Adulto , Pessoa de Meia-Idade , Recém-Nascido Prematuro/crescimento & desenvolvimento , Pessoal de Saúde , Serviços de Saúde Materno-Infantil , COVID-19 , Cuidado do Lactente , Mães , Carga de Trabalho/psicologia , Consulta Remota , Pesquisa Qualitativa , Cobertura Vacinal , Medo , Método Canguru , Higiene das Mãos , Distanciamento Físico , COVID-19/prevenção & controle
6.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 29(Special Issue): 1287-1291, 2021 Aug.
Artigo em Russo | MEDLINE | ID: mdl-34792879

RESUMO

INTRODUCTION: Liver cirrhosis is a major but preventable cause of health loss worldwide. The era of «big data¼ allows us to evaluate this nosology in a new format. PURPOSE: Evaluation of the registered population of patients with cirrhosis of the liver of cirrhosis of various etiology in Moscow. Moscow. MATERIALS AND METHODS: Based on the data of the Moscow Department of Healthcare for the drug provision for the period from 2017 to 2019. Тhe population of patients with an established diagnosis of liver (other etiology) was characterized according to ICD-10 code K.74 (K74.0-74.6) according to the International Statistical Classification of Diseases and Related Health Problems of the 10th revision. RESULTS: Over a 4-year period, more than 2 thousand patients with established diagnosis of liver cirrhosis received preferential drug provision in Moscow. The largest part of the population of patients with liver cirrhosis receiving preferential drug provision in Moscow is represented by the patients of age groups 40-59 years old and 60-79 years old, the groups 30-39 years old and 80-99 years old were comparable annually. There was a decrease in the number of patients with liver cirrhosis in the age groups of 30-39 and 18-19 years compared with the base year (2017) by 37% and 57%, respectively. At the same time, in pediatric patients (from the neonatal period to 17 years), there was an intensive increase in patients from 52 to 550% compared to the baseline year (2017).


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Adulto , Criança , Humanos , Recém-Nascido , Classificação Internacional de Doenças , Cirrose Hepática/epidemiologia , Pessoa de Meia-Idade , Moscou/epidemiologia
7.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 29(Special Issue): 1343-1349, 2021 Aug.
Artigo em Russo | MEDLINE | ID: mdl-34792888

RESUMO

The article presents an analysis of the work of the largest children's COVID-19 center in Moscow, organized on the basis of the Children's City Clinical Hospital named after Z. A. Bashlyaeva of the Moscow City Health Department. From March to November 2020 at the COVID-19 Center were hospitalized 2,837 patients with suspected/confirmed diagnosis of COVID-19, in total in 2020 1,876 children with a confirmed diagnosis of COVID-19 were treated, 58 (3%) children were in serious condition in the intensive care unit, of which children 11-18 years old were 25%. At the 2020 neonatal COVID-19 center, 215 newborns were observed with suspected COVID-19 diagnosis. The diagnosis of COVID-19 was confirmed in 18 children, while 8 newborns came from the home of COVID-19. In the Center for rehabilitation, where children aged 0 to 3 years old who were born with very low and extremely low body weight are observed, dispensary observation for children who have undergone COVID-19 is organized. 45 children who were observed fell ill with the new coronavirus infection. There were no deaths among children with COVID-19.


Assuntos
Teste para COVID-19 , COVID-19 , Adolescente , Criança , Pré-Escolar , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Estudos Retrospectivos , SARS-CoV-2
8.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 29(Special Issue): 1388-1394, 2021 Aug.
Artigo em Russo | MEDLINE | ID: mdl-34792894

RESUMO

The article provides information that allows you to form an idea of the health status of children of different age groups living in Moscow. The sources of information were data on the population size, federal statistical observation form No. 12 «Information on the number of diseases registered in patients living in the service area of a medical organization¼ for the period from 2016 to 2020. The morbidity analysis was carried out by age groups 0-4, 5-9, 10-14, 0-14, 15-17 years per 100,000 of the corresponding population.


Assuntos
COVID-19 , Pandemias , Criança , Humanos , Incidência , Recém-Nascido , Morbidade , SARS-CoV-2
9.
An Pediatr (Engl Ed) ; 95(5): 382.e1-382.e8, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34728170

RESUMO

Since the COVID-19 pandemic was declared in March 2020, we have learned a lot about the SARS-CoV-2 coronavirus, and its role in pediatric pathology. Children are infected in a rate quite similar to adults, although in most cases they suffer mild or asymptomatic symptoms. Around 1% of those infected require hospitalization, less than 0.02% require intensive care, and mortality is very low and generally in children with comorbidities. The most common clinical diagnoses are upper or lower respiratory infections, gastrointestinal infection and, more seriously, multisystemic inflammatory syndrome (MIS-C). Most episodes do not require treatment, except for MIS-C. Remdesivir has been widely used as a compassionate treatment and its role has yet to be defined. The newborn can become infected, although vertical transmission is very low (<1%) and it has been shown that the baby can safely cohabit with its mother and be breastfed. In general, neonatal infections have been mild. Primary care has supported a very important part of the management of the pandemic in pediatrics. There has been numerous collateral damage derived from the difficulty of access to care and the isolation suffered by children. The mental health of the pediatric population has been seriously affected. Although it has been shown that schooling has not led to an increase in infections, but rather the opposite. It is essential to continue maintaining the security measures that make schools a safe place, so necessary not only for children's education, but for their health in general.


Assuntos
COVID-19 , Pandemias , Adulto , COVID-19/complicações , Criança , Feminino , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , SARS-CoV-2 , Síndrome de Resposta Inflamatória Sistêmica
11.
Taiwan J Obstet Gynecol ; 60(6): 1043-1046, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34794735

RESUMO

OBJECTIVES: Aim of this study is to evaluate the prognosis of pregnant women having SARS-CoV-2 infection and investigate whether there was a difference in perinatal outcomes between pregnant women who had SARS-CoV-2 infection and those who did not. MATERIALS AND METHODS: This prospective observational study was conducted with 116 singleton pregnancies. Cases enrolling in the study were divided into two groups. While those in the first group had a history of SARS-CoV-2 infection (n = 46) the second group consisted of healthy pregnant women (n = 70). RESULTS: Emergency Cesarean section was performed on three SARS-CoV-2 infected pregnancies (30, 33 and 34 gestational weeks). Intensive care unit admission was required for all three cases after delivery and two of them died. Among the pregnancies that had an infection in the third trimester, 71.4% (n = 20) of them had delivery in 14 days after diagnosis and 17.4% (n = 8) of their newborns were followed up at newborn intensive care unit. Overall, only one newborn had a positive swab test result for SARS-CoV-2. There was no statistically significant difference between groups regarding their delivery week (37.02 ± 5.85 vs 38.5 ± 2.33). Similarly, there was no significant difference between groups, concerning mean age, parity, and birth weight (P = 0.707, P = 0.092, P = 0.334; P < 0.05). Furthermore, the difference between SARS-CoV-2 infected pregnancies that were followed up as inpatient or outpatient with respect to the delivery week and birth weight was not significant (p > 0.05). Also, APGAR 5 scores of hospitalized women (9.3 ± 1.1) were found to be lower than the outpatient group (9.8 ± 0.8) (P = 0.043; p < 0.05). CONCLUSION: No significant difference was detected between groups in terms of the delivery week, birth weight, and APGAR scores. The inpatient group was found to have lower APGAR 5 scores.


Assuntos
COVID-19/diagnóstico , Cesárea/estatística & dados numéricos , Parto Obstétrico , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez/mortalidade , Gestantes/psicologia , Aborto Espontâneo/epidemiologia , Peso ao Nascer , COVID-19/mortalidade , COVID-19/terapia , COVID-19/virologia , Feminino , Humanos , Recém-Nascido , Pandemias , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/terapia , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez , Nascimento Prematuro/epidemiologia , SARS-CoV-2
12.
Goiânia; SES-GO; 11 nov. 2021. 1-7 p. ilus.
Não convencional em Português | LILACS, Coleciona SUS, CONASS, SES-GO | ID: biblio-1343731

RESUMO

Apesar do termo "passaporte de vacinas" estar sendo amplamente discutido desde a aprovação das primeiras vacinas contra COVID-19, alguns autores reforçam que esta seria a nova versão de uma antiga ferramenta (SHARIF, 2021) utilizada na aplicação de outros imunizantes. Em relação à COVID-19, até o momento a Organização Mundial de Saúde (OMS) não recomenda às autoridades sanitárias nacionais a exigência de certificados de vacinação para viagens internacionais (WHO, 2021), entretanto em alguns países como Israel, Reino Unido e membros da União Europeia (UE), o passaporte foi instituído não só para embarque e desembarque de pessoas de outros países, como também para uso doméstico. No Brasil, até o momento, esta medida não foi implementada pelo Ministério da Saúde.


Although the term "vaccine passport" has been widely discussed since the approval of the first vaccines against COVID-19, some authors emphasize that this would be the new version of an old tool (SHARIF, 2021) used in the application of other immunizing agents. Regarding COVID-19, so far the World Health Organization (WHO) does not recommend to national health authorities the requirement of vaccination certificates for international travel (WHO, 2021), however in some countries such as Israel, United Kingdom and members of the European Union (EU), the passport was instituted not only for embarking and disembarking people from other countries, but also for domestic use. In Brazil, so far, this measure has not been implemented by the Ministry of Health.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Vacinas contra COVID-19/normas , COVID-19/prevenção & controle
13.
Ital J Pediatr ; 47(1): 220, 2021 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-34742332

RESUMO

Coronavirus disease 2019 (COVID-19) affects all components of the respiratory system, including the neuromuscular breathing apparatus, conducting and respiratory airways, pulmonary vascular endothelium, and pulmonary blood flow. In contrast to other respiratory viruses, children have less severe symptoms when infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A minority of children experience a post-infectious inflammatory syndrome, the pathology and long-term outcomes of which are poorly understood. The reason for the lower burden of symptomatic disease in children is not yet clear, but several pathophysiological characteristics are postulated. The SARS-CoV-2 pandemic has brought distinct challenges to the care of children globally. Proper recommendations have been proposed for a range of non-asthmatic respiratory disorders in children, including primary ciliary dyskinesia and cystic fibrosis. These recommendations involve the continuation of the treatment during this period and ways to maintain stability. School closures, loss of follow-up visit attendance, and loss of other protective systems for children are the indirect outcomes of measures to mitigate the COVID-19 pandemic. Moreover, COVID-19 has reshaped the delivery of respiratory care in children, with non-urgent and elective procedures being postponed, and distancing imperatives have led to rapid scaling of telemedicine. The pandemic has seen an unprecedented reorientation in clinical trial research towards COVID-19 and a disruption in other trials worldwide, which will have long-lasting effects on medical science. In this narrative review, we sought to outline the most recent findings on the direct and indirect effects of SARS-CoV-2 pandemic on pediatric respiratory chronic diseases other than asthma, by critically revising the most recent literature on the subject.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis/organização & administração , Atenção à Saúde/organização & administração , Doenças Respiratórias/terapia , Adolescente , COVID-19/prevenção & controle , COVID-19/transmissão , Criança , Pré-Escolar , Doença Crônica , Humanos , Lactente , Recém-Nascido , Doenças Respiratórias/complicações
14.
BMC Pregnancy Childbirth ; 21(1): 767, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34772364

RESUMO

BACKGROUND: The COVID-19 pandemic led to regional or nationwide lockdowns as part of risk mitigation measurements in many countries worldwide. Recent studies suggest an unexpected and unprecedented decrease in preterm births during the initial COVID-19 lockdowns in the first half of 2020. The objective of the current study was to assess the effects of the two months of the initial national COVID-19 lockdown period on the incidence of very and extremely preterm birth in the Netherlands, stratified by either spontaneous or iatrogenic onset of delivery, in both singleton and multiple pregnancies. METHODS: Retrospective cohort study using data from all 10 perinatal centers in the Netherlands on very and extremely preterm births during the initial COVID-19 lockdown from March 15 to May 15, 2020. Incidences of very and extremely preterm birth were calculated using an estimate of the total number of births in the Netherlands in this period. As reference, we used data from the corresponding calendar period in 2015-2018 from the national perinatal registry (Perined). We differentiated between spontaneous versus iatrogenic onset of delivery and between singleton versus multiple pregnancies. RESULTS: The incidence of total preterm birth < 32 weeks in singleton pregnancies was 6.1‰ in the study period in 2020 versus 6.5‰ in the corresponding period in 2015-2018. The decrease in preterm births in singletons was solely due to a significant decrease in iatrogenic preterm births, both < 32 weeks (OR 0.71; 95%CI 0.53 to 0.95) and < 28 weeks (OR 0.53; 95%CI 0.29 to 0.97). For multiple pregnancies, an increase in preterm births < 28 weeks was observed (OR 2.43; 95%CI 1.35 to 4.39). CONCLUSION: This study shows a decrease in iatrogenic preterm births during the initial COVID-19-related lockdown in the Netherlands in singletons. Future studies should focus on the mechanism of action of lockdown measures and reduction of preterm birth and the effects of perinatal outcome.


Assuntos
COVID-19/prevenção & controle , Trabalho de Parto Induzido/tendências , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Feminino , Política de Saúde , Humanos , Doença Iatrogênica/epidemiologia , Incidência , Lactente Extremamente Prematuro , Recém-Nascido , Modelos Logísticos , Países Baixos/epidemiologia , Gravidez , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/tendências , Fatores de Proteção , Estudos Retrospectivos , Fatores de Risco
15.
JAMA Netw Open ; 4(11): e2132563, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34730817

RESUMO

Importance: Although several studies have provided information on short-term clinical outcomes in children with perinatal exposure to SARS-CoV-2, data on the immune response in the first months of life among newborns exposed to the virus in utero are lacking. Objective: To characterize systemic and mucosal antibody production during the first 2 months of life among infants who were born to mothers infected with SARS-CoV-2. Design, Setting, and Participants: This prospective cohort study enrolled 28 pregnant women who tested positive for SARS-CoV-2 infection and who gave birth at Policlinico Umberto I in Rome, Italy, from November 2020 to May 2021, and their newborns. Maternal and neonatal systemic immune responses were investigated by detecting spike-specific antibodies in serum, and the mucosal immune response was assessed by measuring specific antibodies in maternal breastmilk and infant saliva 48 hours after delivery and 2 months later. Exposures: Maternal infection with SARS-CoV-2 in late pregnancy. Main Outcomes and Measures: The systemic immune response was evaluated by the detection of SARS-CoV-2 IgG and IgA antibodies and receptor binding domain-specific IgM antibodies in maternal and neonatal serum. The mucosal immune response was assessed by measuring spike-specific antibodies in breastmilk and in infant saliva, and the presence of antigen-antibody spike IgA immune complexes was investigated in breastmilk samples. All antibodies were detected using an enzyme-linked immunosorbent assay. Results: In total, 28 mother-infant dyads (mean [SD] maternal age, 31.8 [6.4] years; mean [SD] gestational age, 38.1 [2.3] weeks; 18 [60%] male infants) were enrolled at delivery, and 21 dyads completed the study at 2 months' follow-up. Because maternal infection was recent in all cases, transplacental transfer of virus spike-specific IgG antibodies occurred in only 1 infant. One case of potential vertical transmission and 1 case of horizontal infection were observed. Virus spike protein-specific salivary IgA antibodies were significantly increased (P = .01) in infants fed breastmilk (0.99 arbitrary units [AU]; IQR, 0.39-1.68 AU) vs infants fed an exclusive formula diet (0.16 AU; IQR, 0.02-0.83 AU). Maternal milk contained IgA spike immune complexes at 48 hours (0.53 AU; IQR, 0.25-0.39 AU) and at 2 months (0.09 AU; IQR, 0.03-0.17 AU) and may have functioned as specific stimuli for the infant mucosal immune response. Conclusions and Relevance: In this cohort study, SARS-CoV-2 spike-specific IgA antibodies were detected in infant saliva, which may partly explain why newborns are resistant to SARS-CoV-2 infection. Mothers infected in the peripartum period appear to not only passively protect the newborn via breastmilk secretory IgA but also actively stimulate and train the neonatal immune system via breastmilk immune complexes.


Assuntos
COVID-19/imunologia , Imunoglobulina A/imunologia , Leite Humano/imunologia , Complicações Infecciosas na Gravidez/imunologia , Adulto , COVID-19/sangue , COVID-19/transmissão , Teste Sorológico para COVID-19 , Feminino , Humanos , Imunoglobulina A/isolamento & purificação , Imunoglobulina G/imunologia , Imunoglobulina G/isolamento & purificação , Lactente , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Masculino , Gravidez , Complicações Infecciosas na Gravidez/sangue , Estudos Prospectivos , SARS-CoV-2 , Saliva/imunologia , Glicoproteína da Espícula de Coronavírus/imunologia
16.
BMC Pregnancy Childbirth ; 21(1): 761, 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34758778

RESUMO

BACKGROUND: The ongoing spread coronavirus disease worldwide has caused major disruptions and led to lockdowns. Everyday lifestyle changes and antenatal care inaccessibility during the coronavirus disease 2019 (COVID-19) pandemic have variable results that affect pregnancy outcomes. This study aimed to assess the alterations in stillbirth, neonatal-perinatal mortality, preterm birth, and birth weight during the COVID-19 national lockdown. METHODS: We used the data from the Jordan stillbirths and neonatal death surveillance system to compare pregnancy outcomes (gestational age, birth weight, small for gestational age, stillbirth, neonatal death, and perinatal death) between two studied periods (11 months before the pandemic (May 2019 to March 2020) vs. 9 months during the pandemic (April 2020 to March 1st 2020). Separate multinomial logistic and binary logistic regression models were used to compare the studied outcomes between the two studied periods after adjusting for the effects of mother's age, income, education, occupation, nationality, health sector, and multiplicity. RESULTS: There were 31106 registered babies during the study period; among them, 15311 (49.2%) and 15795 (50.8%) births occurred before and during the COVID-19 lockdown, respectively. We found no significant differences in preterm birth and stillbirth rates, neonatal mortality, or perinatal mortality before and during the COVID-19 lockdown. Our findings report a significantly lower incidence of extreme low birth weight (ELBW) infants (<1kg) during the COVID-19 lockdown period than that before the lockdown (adjusted OR 0.39, 95% CI 0.3-0.5: P value <0.001) CONCLUSIONS: During the COVID-19 lockdown period, the number of infants born with extreme low birth weight (ELBW) decreased significantly. More research is needed to determine the impact of cumulative socio-environmental and maternal behavioral changes that occurred during the pandemic on the factors that contribute to ELBW infants.


Assuntos
COVID-19/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Adulto , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Jordânia , Mortalidade Perinatal , Gravidez , Nascimento Prematuro/epidemiologia , Natimorto/epidemiologia
17.
J Korean Med Sci ; 36(44): e309, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34783218

RESUMO

BACKGROUND: We assessed maternal and neonatal outcomes of critically ill pregnant and puerperal patients in the clinical course of coronavirus disease 2019 (COVID-19). METHODS: Records of pregnant and puerperal women with polymerase chain reaction positive COVID-19 virus who were admitted to our intensive care unit (ICU) from March 2020 to August 2021 were investigated. Demographic, clinical and laboratory data, pharmacotherapy, and neonatal outcomes were analyzed. These outcomes were compared between patients that were discharged from ICU and patients who died in ICU. RESULTS: Nineteen women were included in this study. Additional oxygen was required in all cases (100%). Eight patients (42%) were intubated and mechanically ventilated. All patients that were mechanically ventilated have died. Increased levels of C-reactive protein (CRP) was seen in all patients (100%). D-dimer values increased in 15 patients (78.9%); interleukin-6 (IL-6) increased in 16 cases (84.2%). Sixteen patients used antiviral drugs. Eleven patients were discharged from the ICU and eight patients have died due to complications of COVID-19 showing an ICU mortality rate of 42.1%. Mean number of hospitalized days in ICU was significantly lower in patients that were discharged (P = 0.037). Seventeen patients underwent cesarean-section (C/S) (89.4%). Mean birth week was significantly lower in patients who died in ICU (P = 0.024). Eleven preterm (57.8%) and eight term deliveries (42.1%) occurred. CONCLUSION: High mortality rate was detected among critically ill pregnant/parturient patients followed in the ICU. Main predictors of mortality were the need of invasive mechanical ventilation and higher number of days hospitalized in ICU. Rate of C/S operations and preterm delivery were high. Pleasingly, the rate of neonatal death was low and no neonatal COVID-19 occurred.


Assuntos
COVID-19/mortalidade , Complicações Infecciosas na Gravidez/mortalidade , Transtornos Puerperais/mortalidade , SARS-CoV-2 , Adulto , Antivirais/uso terapêutico , COVID-19/sangue , COVID-19/diagnóstico por imagem , COVID-19/terapia , Cesárea , Terapia Combinada , Estado Terminal/mortalidade , Parto Obstétrico/estatística & dados numéricos , Feminino , Mortalidade Hospitalar , Humanos , Recém-Nascido , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Pulmão/diagnóstico por imagem , Oxigenoterapia , Gravidez , Resultado da Gravidez , Respiração Artificial , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
18.
MMWR Morb Mortal Wkly Rep ; 70(46): 1603-1607, 2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34793421

RESUMO

During October 3, 2020-January 9, 2021, North Carolina experienced a 400% increase in daily reported COVID-19 cases (1). To handle the increased number of cases and rapidly notify persons receiving a positive SARS-CoV-2 test result (patients), North Carolina state and local health departments moved from telephone call notification only to telephone call plus automated text and email notification (digital notification) beginning on December 24, 2020. Overall, among 200,258 patients, 142,975 (71%) were notified by telephone call or digital notification within the actionable period (10 days from their diagnosis date)* during January 2021, including at least 112,543 (56%) notified within 24 hours of report to North Carolina state and local health departments, a significantly higher proportion than the 25,905 of 175,979 (15%) notified within 24 hours during the preceding month (p<0.001). Differences in text notification by age, race, and ethnicity were observed. Automated digital notification is a feasible, rapid and efficient method to support timely outreach to patients, provide guidance on how to isolate, access resources, inform close contacts, and increase the efficiency of case investigation staff members.


Assuntos
Automação , COVID-19/diagnóstico , Correio Eletrônico , Envio de Mensagens de Texto , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Teste para COVID-19 , Criança , Pré-Escolar , Notificação de Doenças/métodos , Notificação de Doenças/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , North Carolina/epidemiologia , Fatores de Tempo , Adulto Jovem
19.
BMJ ; 375: e066768, 2021 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-34732390

RESUMO

OBJECTIVE: To estimate the changes in life expectancy and years of life lost in 2020 associated with the covid-19 pandemic. DESIGN: Time series analysis. SETTING: 37 upper-middle and high income countries or regions with reliable and complete mortality data. PARTICIPANTS: Annual all cause mortality data from the Human Mortality Database for 2005-20, harmonised and disaggregated by age and sex. MAIN OUTCOME MEASURES: Reduction in life expectancy was estimated as the difference between observed and expected life expectancy in 2020 using the Lee-Carter model. Excess years of life lost were estimated as the difference between the observed and expected years of life lost in 2020 using the World Health Organization standard life table. RESULTS: Reduction in life expectancy in men and women was observed in all the countries studied except New Zealand, Taiwan, and Norway, where there was a gain in life expectancy in 2020. No evidence was found of a change in life expectancy in Denmark, Iceland, and South Korea. The highest reduction in life expectancy was observed in Russia (men: -2.33, 95% confidence interval -2.50 to -2.17; women: -2.14, -2.25 to -2.03), the United States (men: -2.27, -2.39 to -2.15; women: -1.61, -1.70 to -1.51), Bulgaria (men: -1.96, -2.11 to -1.81; women: -1.37, -1.74 to -1.01), Lithuania (men: -1.83, -2.07 to -1.59; women: -1.21, -1.36 to -1.05), Chile (men: -1.64, -1.97 to -1.32; women: -0.88, -1.28 to -0.50), and Spain (men: -1.35, -1.53 to -1.18; women: -1.13, -1.37 to -0.90). Years of life lost in 2020 were higher than expected in all countries except Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea. In the remaining 31 countries, more than 222 million years of life were lost in 2020, which is 28.1 million (95% confidence interval 26.8m to 29.5m) years of life lost more than expected (17.3 million (16.8m to 17.8m) in men and 10.8 million (10.4m to 11.3m) in women). The highest excess years of life lost per 100 000 population were observed in Bulgaria (men: 7260, 95% confidence interval 6820 to 7710; women: 3730, 2740 to 4730), Russia (men: 7020, 6550 to 7480; women: 4760, 4530 to 4990), Lithuania (men: 5430, 4750 to 6070; women: 2640, 2310 to 2980), the US (men: 4350, 4170 to 4530; women: 2430, 2320 to 2550), Poland (men: 3830, 3540 to 4120; women: 1830, 1630 to 2040), and Hungary (men: 2770, 2490 to 3040; women: 1920, 1590 to 2240). The excess years of life lost were relatively low in people younger than 65 years, except in Russia, Bulgaria, Lithuania, and the US where the excess years of life lost was >2000 per 100 000. CONCLUSION: More than 28 million excess years of life were lost in 2020 in 31 countries, with a higher rate in men than women. Excess years of life lost associated with the covid-19 pandemic in 2020 were more than five times higher than those associated with the seasonal influenza epidemic in 2015.


Assuntos
COVID-19/mortalidade , Países Desenvolvidos/estatística & dados numéricos , Saúde Global/tendências , Expectativa de Vida/tendências , Mortalidade Prematura/tendências , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
Ital J Pediatr ; 47(1): 217, 2021 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-34736495

RESUMO

BACKGROUND: We investigated the volume and the characteristics of pediatric eye emergency department (PEED) consultations performed at our tertiary eye center during the early months of the COVID-19 pandemic and we compared them to those carried out in the same time interval of the previous three years. METHODS: Ophthalmic emergency examinations of patients aged ≤18 years old and done during the national COVID-19 lockdown (March 9th, 2020 - May 3rd, 2020) and in the corresponding date range of the previous three years (2017, 2018, and 2019) have been considered and reviewed. The following features were retrieved and analyzed: age, gender, duration and type of accused symptoms, traumatic etiology, and the discharge diagnosis. RESULTS: 136, 133, and 154 PEED visits have been performed respectively in 2017, 2018, and 2019, while 29 patients presented in 2020. Therefore, the volume of PEED activity decreased by 79.4% (p < 0.0001). Demographical and clinical characteristics were comparable to those of the pre-COVID period. Despite the absolute reduction in the number of traumas, urgent conditions increased significantly from 30.7 to 50.7% (p = 0.024). CONCLUSIONS: PEED activity decreased consistently after the onset of the pandemic and it was mainly attended by those children whose conditions required prompt assistance, reducing the number of patients diagnosed with milder pathologies. At the end of the emergency, better use of PEED could avoid overcrowding and minimize waste, allowing resource optimization for the management of urgent cases.


Assuntos
COVID-19/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Oftalmopatias/epidemiologia , Fatores Etários , COVID-19/prevenção & controle , COVID-19/transmissão , Criança , Pré-Escolar , Controle de Doenças Transmissíveis , Emergências , Oftalmopatias/diagnóstico , Oftalmopatias/terapia , Utilização de Instalações e Serviços , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos
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