A traveling SARS-CoV-2 laboratory as part of a pandemic response among vulnerable Brazilian populations.

BACKGROUND: Brazil has been dramatically hit by the SARS-CoV-2 pandemic and is a world leader in COVID-19 morbidity and mortality. Additionally, the largest country of Latin America has been a continuous source of SARS-CoV-2 variants and shows extraordinary variability of the pandemic strains probably related to the country´s outstanding position as a Latin American economical and transportation hub. Not all regions of the country show sufficient infrastructure for SARS-CoV-2 diagnosis and genotyping which can negatively impact the pandemic response. METHODS: Due to this reason and to disburden the diagnostic system of the inner São Paulo State, the Butantan Institute established the Mobile Laboratory (in Portuguese: LabMovel) for SARS-CoV-2 testing which started a trip of the most important "hotspots" of the most populous Brazilian region. The LabMovel initiated in two important cities of the State: Aparecida do Norte (an important religious center) and the Baixada Santista region which incorporates the port of Santos, the busiest in Latin America. The LabMovel was fully equipped with an automatized system for SARS-CoV-2 diagnosis and sequencing/genotyping. It also integrated the laboratory systems for patient records and results divulgation including in the Federal Brazilian Healthcare System. RESULTS: Currently,16,678 samples were tested, among them 1,217 from Aparecida and 4,564 from Baixada Santista. We tracked the delta introductio in the tested regions with its high diversification. The established mobile SARS-CoV-2 laboratory had a major impact on the Public Health System of the included cities including timely delivery of the results to the healthcare agents and the Federal Healthcare system, evaluation of the vaccination status of the positive individuals in the background of exponential vaccination process in Brazil and scientific and technological divulgation of the fieldwork to the most vulnerable populations. CONCLUSIONS: The SARS-CoV-2 pandemic has demonstrated worldwide the importance of science to fight against this viral agent and the LabMovel shows that it is possible to integrate researchers, clinicians, healthcare workers and patients to take rapid actions that can in fact mitigate this and other epidemiological situations.

SARS-COV-2 genomic monitoring in the state of São Paulo unveils two emerging AY.43 sublineages.

Delta VOC is highly diverse with more than 120 sublineages already described as of November 30, 2021. In this study, through active monitoring of circulating severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants in the state of São Paulo, southeast Brazil, we identified two emerging sublineages from the ancestral AY.43 strain which were classified as AY.43.1 and AY.43.2. These sublineages were defined by the following characteristic nonsynonymous mutations ORF1ab:A4133V and ORF3a:T14I for the AY.43.1 and ORF1ab:G1155C for the AY.43.2 and our analysis reveals that they might have a likely-Brazilian origin. Much is still unknown regarding their dissemination in the state of São Paulo and Brazil as well as their potential impact on the ongoing vaccination process. However, the results obtained in this study reinforce the importance of genomic surveillance activity for timely identification of emerging SARS-CoV-2 variants which can impact the ongoing SARS-CoV-2 vaccination and public health policies.

Leisure-time physical activity does not fully explain the higher body mass index in irregular-shift workers.

PURPOSE: To elucidate the influence of leisure-time physical activity on body mass index (BMI), appetite-related hormones, and sleep when working irregular shifts. METHODS: A cross-sectional study was undertaken of 57 male truck drivers, 31 irregular-shift workers and 26 day-shift workers. Participants completed the International Physical Activity Questionnaire and were assessed for BMI. Subjects also provided a fasting blood sample for analysis of appetite-related hormones and wore an actigraphy device for seven consecutive days. RESULTS: Although leisure-time physical activity (LTPA) was generally low (<150 min/week) in both groups, the irregular-shift workers were more physically active than day-shift workers (99 ± 166 vs. 23 ± 76 min/week, p < 0.01). In spite of this, mean BMI of irregular-shift workers was 2 kg/m² greater than day-shift workers (28.4 ± 3.8 vs. 26.4 ± 3.6 kg/m², p = 0.04). Mean leptin concentration was 61 % higher in irregular-shift workers (5,205 ± 4,181 vs. 3,179 ± 2,413 pg/ml, p = 0.04). Among obese individuals, irregular-shift workers had higher leptin concentration (p < 0.01) and shorter sleep duration (p = 0.01) than obese day-shift workers. CONCLUSION: Elevated BMI was associated with high leptin and low ghrelin levels in this population of irregular-shift workers. No influence of LTPA on appetite-related hormones or sleep duration was found. We conclude that moderate LTPA is insufficient to attenuate the higher BMI associated with this type of irregular-shift work in truck drivers.

12-week melatonin administration had no effect on diabetes risk markers and fat intake in overweight women night workers.

Introduction: Interactions between circadian clocks and key mediators of chronic low-grade inflammation associated with fat consumption may be important in maintaining metabolic homeostasis and may pose a risk for the development of obesity-associated comorbidities, especially type 2 diabetes (T2DM). Objective: The aims of the present study were to evaluate the effects of melatonin administration on diabetes risk markers according to dietary lipid profile (pro-inflammatory versus anti-inflammatory) in excessive weight night workers, and to determine the effect of administration on fat consumption profile. Methods: A randomized, controlled, double-blind, crossover clinical trial involving 27 nursing professionals working permanent night shifts under a 12×36-hour system. The melatonin group (12 weeks) used synthetic melatonin (3 mg) only on days off and between shifts, while the placebo group (12 weeks) was instructed to take a placebo, also on days off and between shifts. For inflammatory characteristics, participants were divided into pro-inflammatory (saturated fats, trans fats and cholesterol) and anti-inflammatory (monounsaturated, polyunsaturated fats and EPA + DHA) groups according to fatty acid determinations. At baseline and at the end of each phase, blood glucose, insulin, glycosylated hemoglobin plasma concentrations were collected, and HOMA-IR was calculated. Conclusion: Melatonin administration for 12 weeks had no effect on T2DM risk markers according to dietary lipid profile (pro-inflammatory or anti-inflammatory potential) in excessive weight night workers. Among the limitations of the study include the fact that the low dose may have influenced the results expected in the hypothesis, and individual adaptations to night work were not evaluated. The insights discussed are important for future research investigating the influence of melatonin and fats considered anti- or pro-inflammatory on glucose and insulin homeostasis related to night work.

Epidemiology of the SARS-CoV-2 Omicron Variant Emergence in the Southeast Brazilian Population.

The aim of this study was to describe epidemiological characteristics and perform SARS-CoV-2 genomic surveillance in the southeastern region of São Paulo State. During the first months of 2022, we compared weekly SARS-CoV-2 infection prevalence considering age, Ct value, and variants' lineages. An increase in the number of SARS-CoV-2-positive cases until the fourth epidemiological week of 2022 was observed. From the fourth epidemiological week onwards, the number of tests for SARS-CoV-2 diagnosis began to decrease, but the number of positive samples for SARS-CoV-2 remained high, reaching its most expressive level with a rate of 60% of infected individual cases. In this period, we observed a progressive increase in SARS-CoV-2 infection within the 0-10 age group throughout the epidemiological weeks, from 2.8% in the first epidemiological week to 9.2% in the eighth epidemiological week of 2022. We further observed significantly higher Ct values within younger patient samples compared to other older age groups. According to lineage assignment, SARS-CoV-2 (BA.1) was the most prevalent (74.5%) in the younger group, followed by BA.1.1 (23%), BA.2 (1.7%), and Delta (1%). Phylogenetic analysis showed that BA.2 sequences clustered together, indicating sustained transmission of this Omicron VOC sub-lineage by that time. Our results suggest the initial dissemination steps of the Omicron's sub-linage BA.2 into the younger group, due to specific genomic features of the detected sequences. These data provide interesting results related to the spread, emergence, and evolution of the Omicron variant in the southeast Brazilian population.

Organizational Risk Factors for Aircrew Health: A Systematic Review of Observational Studies.

Addressing the field of health and safety at work, the primary objective of the present systematic review was to analyze the organizational risk factors for aircrew health according to professional category (flight attendants and pilots/co-pilots) and their consequences. The secondary objective was to identify the countries in which studies were carried out, focusing on the quality of content of the publications. The Medline/Pubmed, Cochrane, Web of Science, and Scopus databases were searched for eligible studies according to PRISMA statements. The risk of bias and the methodological quality of the studies were assessed using the Newcastle-Ottawa scale and Loney tools. Of the 3230 abstracts of articles screened, 36 studies met the inclusion criteria. Most of the research conducted on risk factors for the work organization of aircrew was carried out in the United States and the European Union and had moderate or low-quality methodology and evidence. However, the findings are homogeneous and allow the most prevalent organizational risk factors for the health of aircrew to be determined, namely, high work demand, long hours, and night work. Consequently, the most pervasive health problems were sleep disturbances, mental health disorders, musculoskeletal disorders, and fatigue. Thus, the regulation of the aircrew profession must prioritize measures that minimize these risk factors to promote better health and sleep for these professionals and, consequently, to provide excellent safety for workers and passengers.

Aircrew Health: A Systematic Review of Physical Agents as Occupational Risk Factors.

The primary objective of this systematic review was to analyze the main physical agents representing risk factors for commercial aircrew, together with their consequences. The secondary objective was to identify the countries in which studies on the topic were conducted, as well as the quality of the publications available. Thirty-five articles, published between 1996 and 2020, were selected for the review, having met all inclusion criteria. The majority of studies were conducted in the United States, Germany, and Finland and had moderate or low methodological quality of evidence. The main risk factors for aircrew identified in publications were exposure to abnormal air pressure, cosmic radiation, noise, and vibrations. Hypobaric pressure was explored in response to demands for studies on this agent, a factor which may lead to otic and ear barotraumas, as well as acceleration of atherosclerosis of the carotid artery. However, there is a dearth of research exploring this phenomenon.

Retrospective Insights of the COVID-19 Epidemic in the Major Latin American City, São Paulo, Southeastern Brazil.

São Paulo is the financial center of Brazil, with a population of over 12 million, that receives travelers from all over the world for business and tourism. It was the first city in Brazil to report a case of COVID-19 that rapidly spread across the city despite the implementation of the restriction measures. Despite many reports, much is still unknown regarding the genomic diversity and transmission dynamics of this virus in the city of São Paulo. Thus, in this study, we provide a retrospective overview of the COVID-19 epidemic in São Paulo City, Southeastern, Brazil, by generating a total of 9995 near-complete genome sequences from all the city's different macro-regions (North, West, Central, East, South, and Southeast). Our analysis revealed that multiple independent introduction events of different variants (mainly Gamma, Delta, and Omicron) occurred throughout time. Additionally, our estimates of viral movement within the different macro-regions further suggested that the East and the Southeast regions were the largest contributors to the Gamma and Delta viral exchanges to other regions. Meanwhile, the North region had a higher contribution to the dispersion of the Omicron variant. Together, our results reinforce the importance of increasing SARS-CoV-2 genomic monitoring within the city and the country to track the real-time evolution of the virus and to detect earlier any eventual emergency of new variants of concern that could undermine the fight against COVID-19 in Brazil and worldwide.

Evaluation of truck driver rest locations and sleep quality.

Objectives: Truck drivers' work organization requires that rest and sleep be taken in various locations, where sleep quality might be affected by the discomfort of these environments. The purpose of this study was to evaluate truck drivers' rest locations and their association with sleep quality utilizing an ergonomic approach. Material and Methods: The sleep quality of 81 truck drivers was assessed using the Pittsburgh sleep quality index (PSQI). An adapted version of the ergonomics workplace analysis (EWA) instrument was used to evaluate 44 rest locations. Results: Half of the workers preferred sleeper berths (51.2%) as a rest place. Sleep was classified as poor by 71.6% of the drivers. Dorms were rated more positively (p<0.001) by truck drivers (2.0±1.1) than by the analyst (2.6±0.6). Sleeper berths and dorms were rated statistically different by truck drivers (p=0.002), as well as by the analyst (p=0.003). No correlation was found between EWA evaluations and total score for sleep quality. Separate analyses of dorms and truck berths showed very few correlations. The higher the noise of roommates in dorms, the worse the sleep quality. Conversely, noise in corridors or outside the room positively impacted sleep quality. Conclusion: Noise in the rest place may affect sleep in both directions, negatively or positively. Sleep was classified as poor regardless of resting place. The quality of resting places seemed to have little effect on sleep quality of truck drivers. Factors other than rest place, such as work scheduling, are probably more important for promoting good sleep quality.

The Effect of Exogenous Melatonin on Eating Habits of Female Night Workers with Excessive Weight.

BACKGROUND AND AIMS: Melatonin is a pineal hormone that plays an important role as an endogenous synchronizer of circadian rhythms and energy metabolism. As this circadian component has been closely related to eating behavior, an important question on this topic would be whether melatonin administration could influence eating habits. However, this topic has been rarely studied in the literature in individuals with excessive weight and chronic circadian misalignment, such as shift workers. Therefore, the present study aims to evaluate the effects of exogenous melatonin administration on the quali/quantitative aspects and temporal distribution of food intake in female night workers with excessive weight (overweight and obesity). An additional aim is to evaluate the association of the referred outcomes with circadian misalignment and chronotype. METHODS: A randomized, double-blind, placebo-controlled, crossover clinical trial was conducted with 27 female nursing professionals with excessive weight who worked permanent night shifts. The protocol was implemented under real-life conditions for 24 weeks, in two randomly allocated conditions (12 weeks of melatonin and 12 weeks of placebo). The quali/quantitative aspects of food intake (NOVA classification, total energy intake and the proportion of calories from macronutrients) and meal timing were assessed using food diaries. Timing for every meal recorded in the diaries was assessed to evaluate the temporal distribution of food intake. Generalized estimating equations were performed for each dependent variable. RESULTS: No significant modifications in total energy intake, macronutrient distribution, types of foods consumed, and meal timing were observed after melatonin administration. Different levels of circadian misalignment and chronotype did not interfere with these results. CONCLUSION: Eating habits of female night workers with excessive weight remained unchanged after melatonin administration, and no association of these results with circadian misalignment and chronotype was found. These results suggest that the metabolic effects of melatonin may occur independently of food intake.

Dynamics of SARS-CoV-2 Variants of Concern in Vaccination Model City in the State of Sao Paulo, Brazil.

From a country with one of the highest SARS-CoV-2 morbidity and mortality rates, Brazil has implemented one of the most successful vaccination programs. Brazil's first model city vaccination program was performed by the CoronaVac vaccine (Sinovac Biotech) in the town of Serrana, São Paulo State. To evaluate the vaccination effect on the SARS-CoV-2 molecular dynamics and clinical outcomes, we performed SARS-CoV-2 molecular surveillance on 4375 complete genomes obtained between June 2020 and April 2022 in this location. This study included the period between the initial SARS-CoV-2 introduction and during the vaccination process. We observed that the SARS-CoV-2 substitution dynamics in Serrana followed the viral molecular epidemiology in Brazil, including the initial identification of the ancestral lineages (B.1.1.28 and B.1.1.33) and epidemic waves of variants of concern (VOC) including the Gamma, Delta, and, more recently, Omicron. Most probably, as a result of the immunization campaign, the mortality during the Gamma and Delta VOC was significantly reduced compared to the rest of Brazil, which was also related to lower morbidity. Our phylogenetic analysis revealed the evolutionary history of the SARS-CoV-2 in this location and showed that multiple introduction events have occurred over time. The evaluation of the COVID-19 clinical outcome revealed that most cases were mild (88.9%, 98.1%, 99.1% to Gamma, Delta, and Omicron, respectively) regardless of the infecting VOC. In conclusion, we observed that vaccination was responsible for reducing the death toll rate and related COVID-19 morbidity, especially during the gamma and Delta VOC; however, it does not prevent the rapid substitution rate and morbidity of the Omicron VOC.

The Divergent Pattern of SARS-CoV-2 Variant Predominance and Transmission Dynamics in the Brazilian Island of Ilhabela.

Our effort in SARS-CoV-2 genomic surveillance in Brazil has detected the Alpha Variant of Concern with a predominance higher than 75% in the population of Ilhabela island (São Paulo State) at a time when the Gamma VOC was already predominating the mainland raised concerns for closer surveillance on this island. Therefore, we intensified the surveillance for 24 weeks by generating data from 34% of local positive cases. Our data show that the patterns of VOC predominance dynamics and infection rates were in general distinct from the mainland. We report here the first known case of Alpha predominance in a Brazilian population, a delay greater than 3 months for the Gamma to dominate the previous variants compared to the mainland, and a faster dispersion rate of Gamma and Delta VOCs compared to the mainland. Phylogenetic analysis revealed the SARS-CoV-2 transmission dynamics in Ilhabela were characterized by multiple independent introduction events of Gamma and Delta, with a few events of Alpha introduction, two of them followed by community transmission. This study evidenced the peculiar behavior of SARS-CoV-2 variants in an isolated population and brought to light the importance of specific programs for SARS-CoV-2 genomic surveillance in isolated populations.

Genomic epidemiology reveals the impact of national and international restrictions measures on the SARS-CoV-2 epidemic in Brazil.

Brazil has experienced some of the highest numbers of COVID-19 cases and deaths globally and from May 2021 made Latin America a pandemic epicenter. Although SARS-CoV-2 established sustained transmission in Brazil early in the pandemic, important gaps remain in our understanding of virus transmission dynamics at the national scale. Here, we describe the genomic epidemiology of SARS-CoV-2 using near-full genomes sampled from 27 Brazilian states and a bordering country - Paraguay. We show that the early stage of the pandemic in Brazil was characterised by the co-circulation of multiple viral lineages, linked to multiple importations predominantly from Europe, and subsequently characterized by large local transmission clusters. As the epidemic progressed under an absence of effective restriction measures, there was a local emergence and onward international spread of Variants of Concern (VOC) and Variants Under Monitoring (VUM), including Gamma (P.1) and Zeta (P.2). In addition, we provide a preliminary genomic overview of the epidemic in Paraguay, showing evidence of importation from Brazil. These data reinforce the usefulness and need for the implementation of widespread genomic surveillance in South America as a toolkit for pandemic monitoring that provides a means to follow the real-time spread of emerging SARS-CoV-2 variants with possible implications for public health and immunization strategies.

Genomic monitoring of the SARS-CoV-2 B1.1.7 (WHO VOC Alpha) in the Sao Paulo state, Brazil.

The SARS-CoV-2 alpha VOC (also known as lineage B.1.1.7) initially described in the autumn, 2020 in UK, rapidly became the dominant lineage across much of Europe. Despite multiple studies reporting molecular evidence suggestive of its circulation in Brazil, much is still unknown about its genomic diversity in the state of São Paulo, the main Brazilian economic and transportation hub. To get more insight regarding its transmission dynamics into the State we performed phylogenetic analysis on all alpha VOC strains obtained between February and August 2021 from the Sao Paulo state Network for Pandemic Alert of Emerging SARS-CoV-2 variants. The performed phylogenetic analysis showed that most of the alpha VOC genomes were interspersed with viral strains sampled from different Brazilian states and other countries suggesting that multiple independent Alpha VOC introductions from Brazil and overseas have occurred in the São Paulo State over time. Nevertheless, large monophyletic clusters were also observed especially from the Central-West part of the São Paulo State (the city of Bauru) and the metropolitan region of the São Paulo city. Our results highlight the Alpha VOC molecular epidemiology in the São Paulo state and reinforce the need for continued genomic surveillance strategies for the real-time monitoring of potential emerging SARS-CoV-2 variants during the ever-growing vaccination process.

Genomic epidemiology of the SARS-CoV-2 epidemic in Brazil.

The high numbers of COVID-19 cases and deaths in Brazil have made Latin America an epicentre of the pandemic. SARS-CoV-2 established sustained transmission in Brazil early in the pandemic, but important gaps remain in our understanding of virus transmission dynamics at a national scale. We use 17,135 near-complete genomes sampled from 27 Brazilian states and bordering country Paraguay. From March to November 2020, we detected co-circulation of multiple viral lineages that were linked to multiple importations (predominantly from Europe). After November 2020, we detected large, local transmission clusters within the country. In the absence of effective restriction measures, the epidemic progressed, and in January 2021 there was emergence and onward spread, both within and abroad, of variants of concern and variants under monitoring, including Gamma (P.1) and Zeta (P.2). We also characterized a genomic overview of the epidemic in Paraguay and detected evidence of importation of SARS-CoV-2 ancestor lineages and variants of concern from Brazil. Our findings show that genomic surveillance in Brazil enabled assessment of the real-time spread of emerging SARS-CoV-2 variants.

Correction: Lesbon et al. Nucleocapsid (N) Gene Mutations of SARS-CoV-2 Can Affect Real-Time RT-PCR Diagnostic and Impact False-Negative Results. Viruses 2021, 13, 2474.

The authors hereby request the inclusion of two authors (Olivia Teixeira and Maria Cristina Nonato) in the recently published article in Viruses entitled "Nucleocapsid (N) gene mutations of SARS-CoV-2 can affect real-time RT-PCR diagnostic and impact false-negative results" [...].

Eating habits, sleep, and a proxy for circadian disruption are correlated with dyslipidemia in overweight night workers.

OBJECTIVE: The aim of this study was to evaluate the relationship between proxy for circadian disruption, eating habits, sleep characteristics, and dyslipidemic parameters. METHODS: This was a randomized, double-blind, crossover controlled clinical trial, and for this study, only baseline data were used. The sample was composed of 36 overweight female nurses who worked on a fixed night shift (12 × 36 h). Linear regression models were used to assess the relationship between the mentioned variables. RESULTS: The participants' average age was 39.4 y (Standard error (SE) 1 y) and the average nighttime sleep duration was 5.76 h (SE 0.16 h). The average chronotype indicated a moderate early type (03:03 h; SE 20 min) and the average social jetlag was 03:42 h (SE 10 min). It was found that 1 h less of nighttime sleep increased very-low-density lipoprotein cholesterol levels by 2.75 mg/dL and triacylglyceride levels by 3.62 mg/dL. Additionally, higher social jetlag was associated with higher low-density lipoprotein cholesterol levels. On the other hand, each additional hour in the chronotype increased high-density lipoprotein cholesterol levels by 3.06 mg/dL and a time interval >2 h between the last meal and sleep onset was associated with higher high-density lipoprotein cholesterol levels. CONCLUSION: Short duration of nighttime sleep and high social jetlag are risk factors for dyslipidemia, whereas the late type and the longer time interval between the last meal and sleep onset appear to be protective factors for dyslipidemia.

Social Jetlag Is Associated With Impaired Metabolic Control During a 1-Year Follow-Up.

Previous studies have identified social jetlag (SJL) as a risk factor for non-communicable chronic diseases (NCCDs), but its association with metabolic control over time is unclear in the literature. Therefore, we examined the influence of SJL on metabolic parameters and blood pressure (BP) in patients with NCCDs over a 1-year follow-up. This retrospective, longitudinal study included 625 individuals (age: 56.0 +12.0 years; 76% female) with NCCDs [type 2 diabetes mellitus (TD2), systemic arterial hypertension (SHA), obesity, or dyslipidemia]. SJL was calculated based on the absolute difference between mid-sleep time on weekends and weekdays. Current metabolic parameters and BP of the patients were compared with data from a year prior. Generalized estimating equations (GEE) and multiple linear regression analyses were used to examine the association among SJL, metabolic parameters, and BP. Multiple linear regression analyses adjusted for confounders showed that SJL was positively associated with the delta difference of fasting glucose (ß = 0.11, p = 0.02) and triglyceride levels (ß = 0.09, p = 0.04) among all subjects with NCCDs, and with fasting glucose (ß = 0.30, p = 0.0001) and triglyceride levels (ß = 0.22, p = 0.01) in the TD2 group. GEE analysis demonstrated an isolated effect of SJL on diastolic BP. High SJL impaired clinical and metabolic control in individuals with NCCDs, leading to a worse profile after a 1-year follow-up, particularly among type II diabetics.

Association between chronotype and psychomotor performance of rotating shift workers.

It is known that the chronotype potentially mediates the performance and tolerance to work in shifts and that shift rotation is associated with negative effects on psychomotor performance. This study aimed to evaluate the effect of chronotype on psychomotor performance throughout a complete shift rotation schedule. Thirty males working in clockwise rotating shifts from a mining company were evaluated under a real-life condition over the following shift schedule: 2 days of day work, 2 days of evening work and 2 days of night work. The chronotype was determined using the Munich Chronotype Questionnaire adapted for shift workers and the obtained scores were categorized by tertiles (early-type, intermediate-type and late-type). Work performance was evaluated by Psychomotor Vigilance Test (PVT) daily just before shift starts and after shift ends. Sleep duration was evaluated by actigraphy over the whole shift. No isolated effect of the shift or interaction between shift and chronotype was found in the performance variables evaluated. A significant isolated effect of the chronotype showed that the early-type individuals had higher values of pre- and post-work Mean of Reaction Time (MRT) (308.77 ± 10.03 ms and 306.37 ± 8.53 ms, respectively) than the intermediate-type (257.61 ± 6.63 ms and 252.91 ± 5.97 ms, respectively, p < 0.001) and the late-type (273.35 ± 6.96 ms and 262.88 ± 6.05 ms, respectively, p < 0.001). In addition, late individuals presented a greater number of lapses of attention (5.00 ± 0.92; p < 0.05) than early (1.94 ± 0.50, p < 0.05) and intermediate (1.33 ± 0.30, p < 0.001) ones. We concluded that, compared with intermediates, late-type workers had a greater number of lapses of attention on the shift schedule as a whole, while early-type workers showed the highest pre- and post-work MRT. These findings show that the psychomotor performance of rotating shift workers seems to be influenced by the chronotype, but not by the shift rotation.

Nucleocapsid (N) Gene Mutations of SARS-CoV-2 Can Affect Real-Time RT-PCR Diagnostic and Impact False-Negative Results.

The current COVID-19 pandemic demands massive testing by Real-time RT-PCR (Reverse Transcription Polymerase Chain Reaction), which is considered the gold standard diagnostic test for the detection of the SARS-CoV-2 virus. However, the virus continues to evolve with mutations that lead to phenotypic alterations as higher transmissibility, pathogenicity or vaccine evasion. Another big issue are mutations in the annealing sites of primers and probes of RT-PCR diagnostic kits leading to false-negative results. Therefore, here we identify mutations in the N (Nucleocapsid) gene that affects the use of the GeneFinder COVID-19 Plus RealAmp Kit. We sequenced SARS-CoV-2 genomes from 17 positive samples with no N gene detection but with RDRP (RNA-dependent RNA polymerase) and E (Envelope) genes detection, and observed a set of three different mutations affecting the N detection: a deletion of 18 nucleotides (Del28877-28894), a substitution of GGG to AAC (28881-28883) and a frameshift mutation caused by deletion (Del28877-28878). The last one cause a deletion of six AAs (amino acids) located in the central intrinsic disorder region at protein level. We also found this mutation in 99 of the 14,346 sequenced samples by the Sao Paulo state Network for Pandemic Alert of Emerging SARS-CoV-2 variants, demonstrating the circulation of the mutation in Sao Paulo, Brazil. Continuous monitoring and characterization of mutations affecting the annealing sites of primers and probes by genomic surveillance programs are necessary to maintain the effectiveness of the diagnosis of COVID-19.