Impact of Gamma COVID-19 variant on the prognosis of hospitalized pregnant and postpartum women with cardiovascular disease.

OBJECTIVE: The aim of the study was to assess the impact of the Gamma coronavirus disease 2019 (COVID-19) variant on pregnant and postpartum women with Cardiovascular Disease (CVD). METHODS: The Influenza Epidemiological Surveillance System database (SIVEP-Gripe), a compulsory notification system for cases of Severe Acute Respiratory Syndrome (SARS), was investigated for notified cases of pregnant and postpartum women with reported CVD and SARS due to COVID-19 between February 16, 2020 and May 1, 2021 (when vaccination began), was investigated. In this retrospective cohort, two groups were formed based on symptom onset date, according to the predominance of the variants: original (group 2020) and Gamma (group 2021). Cases with missing information on the presence or absence of CVD were excluded. The comparative analysis was controlled for confounding variables. RESULTS: Among 703 COVID-19 cases notified with CVD (406 patients in 2020 and 297 patients in 2021), compared to 2020, cases in 2021 had more respiratory symptoms (90.6 % vs. 80.1 %, p < 0.001), greater ventilatory support need (75.3 % vs. 53.9 %, p < 0.001), more ICU admission (46.6 % vs. 34.3 %, p = 0.002), longer duration (20.59 ± 14.47 vs. 16.52 ± 12.98 days, p < 0.001), higher mortality (25.6 % vs. 15.5 %, p < 0.001), with more than two-times mortality likelihood in the third trimester (adjusted OR = 2.41, 95 % CI 1.50-3.88, p < 0.001) or puerperium periods (adjusted_OR = 2.15, 95 % CI 1.34-3.44, p = 0.001). CONCLUSIONS: In Brazil, pregnant and postpartum women with CVDs in the Gamma variant phase have higher morbidity and mortality than those affected by the original variant of Coronavirus-19.

Sexual Violence against Adolescents in the State of Espírito Santo, Brazil: An Analysis of Reported Cases.

OBJECTIVE: We describe the prevalence of the reported cases of sexual violence against adolescents and analyze their associated factors. METHODS: A cross-sectional analytical study (n = 561) was conducted with reported data on sexual violence against adolescents in the state of Espírito Santo registered in SINAN between 2011 and 2018 to understand the prevalence and predictors of sexual violence against adolescent victims, as well as to describe the perpetrators and the nature of the aggression. Variables to characterize the victim, aggression, and perpetrator were used. Bivariate analyses were performed using chi-square (χ2) and Fisher's exact tests, and multivariate analyses were conducted using log-binomial models; the results were presented with prevalence ratios. All analyses were stratified by sex. RESULTS: The prevalence of sexual violence was 32.6%, and 93% of the victims were female. In both males and females, the reported sexual violence was associated with a younger age (10-12 years old), living at home, being related to the perpetrator, and a history of sexual violence. In females, the reported sexual violence was also associated with the number of perpetrators, and in males, with the perpetrator's age. CONCLUSIONS: Our findings show the high frequency of reporting of sexual violence and the characteristics of the victim, the aggression, and the aggressor as factors associated with its occurrence in both sexes. The importance of health information systems for disseminating data and the need for measures to prevent and treat the violence among adolescents is urgent.

The Effect of Being Pregnant during Respiratory Pandemics: A Comparison between 2009/10 Flu and 2020/21 COVID-19 Pandemic in Brazil.

Pregnant women undergo physiological changes that make them a challenging group of patients during pandemic respiratory diseases, as previously found during H1N1 2009 pandemic and recently ratified in COVID-19 pandemic. We conducted a retrospective cohort analysis on 5888 hospitalized women for H1N1 flu pandemic (2190 pregnant and 3698 non-pregnant) and 64,515 hospitalized women for COVID-19 pandemic (5151 pregnant and 59,364 non-pregnant), from the Brazilian national database, to compare demographic profile, clinical aspects, and mortality in childbearing aged women during both pandemics. Additionally, the effect of being pregnant was compared between both pandemics. In both pandemics, pregnant women were younger than non-pregnant women. Overall, pregnant women had lower frequencies of comorbidities and were less symptomatic. Among hospitalized women, pregnant women presented lower mortality rates than non-pregnant women (9.7% vs. 12.6%, p = 0.002 in the H1N1 pandemic and 9.7% vs. 17.4%, p < 0.001 in the COVID-19 pandemic) and this difference was statistically more pronounced in the COVID-19 pandemic, even after balancing pregnant and non-pregnant groups regarding age and chronic diseases.

Demographic and epidemiological characteristics of pregnant and postpartum women who died from severe acute respiratory syndrome in Brazil: A retrospective cohort study comparing COVID-19 and nonspecific etiologic causes.

The objective of this study is to compare the demographic characteristics and symptoms in pregnant and postpartum women who died from Severe Acute Respiratory Syndrome (SARS) caused by COVID-19 or by nonspecific cause in different states of Brazil. This is a retrospective cohort study and the analysis was conducted on SARS death records between 02/16/2020 and 04/17/2021, obtained from the Information System for the Epidemiological Surveillance of Influenza (Sistema de Informação da Vigilância Epidemiológica da Gripe, SIVEP-Gripe). Pregnant and postpartum women, aged between 10 and 55 years, who died from SARS, were included and classified into two groups: SARS due to confirmed COVID-19 or SARS due to nonspecific cause. The cases were analyzed according to the women's demographic and epidemiological characteristics, clinical symptoms, risk factors and disease evolution. As results, 19,333 pregnant and postpartum women were identified. From these, 1,279 died (1,026 deaths from COVID-19 and 253 deaths from SARS with nonspecific cause). The groups showed significant differences in age, education, race, and occurrence of obesity and chronic lung disease. The group of women who died from confirmed COVID-19 presented a significantly higher frequency of symptoms of fever, cough, fatigue, loss of taste, and loss of smell, as well as a higher rate of admission to the intensive care unit (ICU). Data analysis draws attention to the high number of cases of SARS without a causal diagnosis, the low access to ICU and orotracheal intubation (OTI), which might be explained by the demographic and regional inequalities in the access to healthcare.

Self-inflicted injuries among adolescents: Prevalence and associated factors, Espírito Santo, Brazil / Lesión autoprovocada entre adolescentes: prevalencia y factores asociados, Espírito Santo, Brasil / Lesão autoprovocada entre adolescentes: prevalência e fatores associados, Espírito Santo, Brasil

Objetivo: identificar a prevalência de lesão autoprovocada notificada entre adolescentes no Espírito Santo e analisar os fatores associados. Materiais e métodos: estudo analítico do tipo transversal, com os dados notificados de violência autoprovocada entre adolescentes no Espírito Santo registrados no Sistema de Informação de Agravos e Notificação de 2011 a 2018. Análises bivariadas consideraram o teste Qui-Quadrado (χ²) e o exato de Fisher. A análise multivariada considerou o modelo log-binomial, e os resultados do ajuste foram apresentados em razão de prevalência. Resultados: a prevalência de lesão autoprovocada notificada foi 33 % e, desse total, 79,8 % ocorreram entre adolescentes do sexo feminino. Houve maior prevalência em adolescentes com idade de 13 a 17 anos (sexo feminino) e de 18 a 19 anos (sexo masculino), e entre aqueles com deficiência ou transtorno. Maiores prevalências foram encontradas na residência e na habitação coletiva, e entre aqueles que não consumiram álcool no evento. No sexo feminino, também houve associação com a zona urbana (p < 0,05). Conclusões: percebe-se a alta prevalência de lesão autoprovocada notificada entre os adolescentes no Espírito Santo e os fatores associados a esse fenômeno. Constata-se a importância da adoção de medidas de promoção, prevenção e recuperação contra o agravo.

Objetivo: identificar la prevalencia de lesiones autoprovocadas notificadas entre adolescentes en Espírito Santo, Brasil, y analizar los factores asociados. Materiales y métodos: estudio analítico de tipo transversal, a partir de datos notificados de violencia autoprovocada entre adolescentes en Espírito Santo registrados en el Sistema de Información de Problemas de Salud y Notificación entre 2011 y 2018. En los análisis bivariados se consideraron las pruebas de chi-cuadrado (χ²) y exacta de Fisher. El análisis multivariado adoptó el modelo log-binomial, y los resultados del ajuste se presentaron a partir de la razón de prevalencia. Resultados: la prevalencia de lesiones autoprovocadas notificadas fue del 33 % y, de este total, el 79,8 % ocurrió entre adolescentes del género femenino. La prevalencia fue mayor en adolescentes de 13 a 17 años (sexo femenino) y de 18 y 19 años (sexo masculino), y entre aquellos con alguna discapacidad o trastorno. Se encontraron valores de prevalencia más elevados en la vivienda y en alojamiento compartido, y entre aquellos que no consumieron alcohol en el evento en cuestión. En el sexo femenino, también se registró una asociación con el área urbana (p < 0,05). Conclusiones: se percibe la elevada prevalencia de lesiones autoprovocadas notificadas entre los adolescentes en Espírito Santo y los factores asociados a este fenómeno. Se evidencia la importancia de adoptar medidas de promoción, prevención y recuperación del problema.

Objective: To identify the prevalence of notified self-inflicted injuries among adolescents in Espírito Santo and to analyze the associated factors. Materials and methods: A cross-sectional and analytical study, with the notified data of self-inflicted violence among adolescents in Espírito Santo registered in the Notifiable Diseases Information System from 2011 to 2018. The bivariate analyses considered the Chi-square (χ²) and Fisher's Exact tests. The multivariate analysis considered the log-binomial model, and the adjustment results were presented as prevalence ratio. Results: The prevalence of notified self-inflicted injuries was 33 % and, of this total, 79.8 % occurred among female adolescents. Prevalence was higher among adolescents aged from 13 to 17 years old (female gender) and from 18 to 19 years old (male gender), as well as among those with some disability or disorder. Higher prevalence values were found in the residence and in collective housing, as well as among those who did not consume alcohol at the event in question. In the female gender, there was also an association with the urban area (p < 0.05). Conclusions: High prevalence of notified self-inflicted injuries is perceived among adolescents in Espírito Santo, as well as of the factors associated to this phenomenon. The importance of adopting promotion, prevention and recovery measures for the problem is verified.