Articles

Global coalition to accelerate COVID-19 clinical research in resource-limited settings

To address challenges posed by the pandemic and accelerate the research needed in resource-limited settings, we propose an international research coalition that brings together existing multinational, multidisciplinary expertise and clinical trial capacity. The coalition will synergise with existing initiatives, such as the COVID-19 Therapeutics Accelerator, the Coalition for Epidemic Preparedness Innovations (CEPI), and the SARS-CoV-2 Diagnostic Pipeline. Our objective is to use our existing research capabilities to support, promote, and accelerate multicentre trials of the safety, efficacy, and effectiveness of interventions against COVID-19 in resource-limited settings. For therapeutics, research in such settings should focus primarily on evaluation of affordable repurposed medicines—ie, those already developed and approved for other indications—and implementable supportive measures. If applicable, testing of new diagnostic tools, vaccines, and other potentially beneficial strategies will be added to the trials.

The COVID-19 Pandemic: Global Asymmetries and Challenges for the Future of Health

Social  and  economic  inequality  between  countries, territories,  and  population  groups  has  increased  during the  pandemic.  Its  impacts  are  unevenly  distributed, revealing  the  interface  between  the  biological, economic,  and  social  worlds.  There  is  a  threat  of  a humanitarian  crisis  due  to  the  concrete  differences between  those  who  have  full  access  to  products, services,  and  health  and  those  who  can  be  left  behind.

Safeguarding people living in vulnerable conditions in the COVID-19 era through universal health coverage and social protection

The COVID-19 pandemic is unprecedented. The pandemic not only induced a public health crisis, but has led to severe economic, social, and educational crises. Across economies and societies, the distributional consequences of the pandemic have been uneven. Among groups living in vulnerable conditions, the pandemic substantially magnified the inequality gaps, with possible negative implications for these individuals' long-term physical, socioeconomic, and mental wellbeing. This Viewpoint proposes priority, programmatic, and policy recommendations that governments, resource partners, and relevant stakeholders should consider in formulating medium-term to long-term strategies for preventing the spread of COVID-19, addressing the virus's impacts, and decreasing health inequalities.

Influence of age on the effectiveness and duration of protection in Vaxzevria and CoronaVac vaccines

Background High rates of virus transmission and the presence of variants of concern can affect vaccine effectiveness (VE). Both conditions occur in low-income countries, which primarily use viral vector or inactivated virus vaccine technologies. Such countries conducted few VE analyses, and most lack the power to evaluate effectiveness in subgroups.

Younger Brazilians hit by COVID-19 – What are the implications?

By the first week of June, Brazil had reached almost 17 million cases and a little more than 472,000 deaths. A notable demographic change has been observed within this period, in which young and middle-aged adults representing an increasing share of patients in wards and intensive care units (ICU).

Epidemiology, Biodiversity, and Technological Trajectories in the Brazilian Amazon: From Malaria to COVID-19

The Amazon biome is under severe threat due to increasing deforestation rates and loss of biodiversity and ecosystem services while sustaining a high burden of neglected tropical diseases. Approximately two thirds of this biome are located within Brazilian territory. There, socio-economic and environmental landscape transformations are linked to the regional agrarian economy dynamics, which has developed into six techno-productive trajectories (TTs).

Non-communicable diseases: a challenge for global cooperation

In current times, it’s easy to forget that over 70% of deaths worldwide are due to non-communicable diseases. How can we tackle their rise? The theory of epidemiological transition (or the changing patterns of population age distributions, mortality, fertility, life expectancy, and causes of death) offers a valuable framework for understanding how different types of diseases can occur simultaneously in a population. 

A control framework to optimize public health policies in the course of the COVID‑19 pandemic

The SARS-CoV-2 pandemic triggered substantial economic and social disruptions. Mitigation policies varied across countries based on resources, political conditions, and human behavior. In the absence of widespread vaccination able to induce herd immunity, strategies to coexist with the virus while minimizing risks of surges are paramount, which should work in parallel with reopening societies. 

The impacts of climate change on homeless populations after the pandemic

The notion that health crises unfairly and disproportionately affect vulnerable populations was observed and documented during the greatest health crisis of this century. Furthermore, studies have shown that the distribution of COVID-19 is unequal among different ethnic and socioeconomic groups (Horta, 2020 and Wang, 2020). 

Reduced neutralization of SARS-CoV-2 B.1.617 by vaccine and convalescent serum

SARS-CoV-2 has undergone progressive change with variants conferring advantage rapidly becoming dominant lineages e.g. B.1.617. With apparent increased transmissibility variant B.1.617.2 has contributed to the current wave of infection ravaging the Indian subcontinent and has been designated a variant of concern in the UK. 

Predictability of COVID-19 worldwide lethality using permutation-information theory quantifiers

This paper examines the predictability of COVID-19 worldwide lethality considering 43 countries. Based on the values inherent to Permutation entropy (Hs) and Fisher information measure (Fs), we apply the Shannon-Fisher causality plane (SFCP), which allows us to quantify the disorder an evaluate randomness present in the time series of daily death cases related to COVID-19 in each country.

Trust, attitudes, information: a study on the perception of the COVID-19 pandemic in 12 Brazilian cities

In this study, we analyze the perception of Brazilians about COVID-19 in 12 cities in the country. Issues about the severity and dangers of the disease, sources of information and reliability, checking information, attitudes, precautions and priorities for coping and trusting relationships in science were addressed. 

Comments and recommendations for regulating the Nagoya Protocol in Brazil

Abstract Brazil deposited at the UN Secretariat its ratification of Nagoya Protocol on March 4, 2021. 90 (ninety) days from this date, the country becomes a member of the Nagoya Protocol, assuming rights and duties. This paper aims to contribute to the challenge that the country will have in harmonizing the Nagoya Protocol and its internal legal framework (Law 13.123/2015 regulated by Decree 8.772 /2016)

Effectiveness of COVID-19 vaccines against hospital admission with the Delta (B.1.617.2) variant

We recently reported vaccine effectiveness (VE) estimates against symptomatic disease with the Delta (B.1.617.2) variant.(1) After a full course, VE reached 88% with the Pfizer/BioNTech BNT162b2 vaccine and 67% with the AstraZeneca ChAdOx1 AZD1222 vaccine. This provided important evidence that despite modest reductions in protection, vaccines remain effective against Delta. However, the very recent emergence of the variant and the relatively low case numbers meant that it was not possible to estimate VE against severe disease.

Covid-19 pandemic implications for food and nutrition security in Brazil

The emergence of COVID-19 in Brazil further explained the massive discrepancy between different social realities coexisting in the country, rekindling the discussions about food and nutrition security, similarly to what has been happening in other countries facing the same pandemic situation. In this paper, we argue that the risks to hunger and food security in Brazil have been present since 2016 and are now being exacerbated due to the emergence of the COVID-19 epidemic. 

COVID-19 in Amazonas, Brazil, was driven by the persistence of endemic lineages and P.1 emergence

The northern state of Amazonas is among the regions in Brazil most heavily affected by the COVID-19 epidemic and has experienced two exponentially growing waves, in early and late 2020. Through a genomic epidemiology study based on 250 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes from different Amazonas municipalities sampled between March 2020 and January 2021, we reveal that the first exponential growth phase was driven mostly by the dissemination of lineage B.1.195, which was gradually replaced by lineage B.1.1.28 between May and June 2020. 

Human endogenous retrovirus K activation in the lower respiratory tract of severe COVID-19 patients associates with early mortality.

Critically ill 2019 coronavirus disease patients (COVID-19) under invasive mechanical ventilation (IMV) are 10- to 40-times more likely to die than the general population. Although progression from mild to severe COVID-19 has been associated with hypoxia, uncontrolled inflammation and coagulopathy, the mechanisms involved in progression to severity are poorly understood. By analyzing the virome from tracheal aspirates (TA) of 25 COVID-19 patients under IMV, we found higher levels and differential expression of human endogenous retrovirus K (HERV-K) genes compared to nasopharyngeal swabs from mild cases and TA from non-COVID patients. Proteomic analysis and RT-PCR confirmed the presence of HERV-K in these patients.   

Immune Evasion of SARS-CoV-2 Variants of Concern is Driven by Low Affinity to Neutralizing Antibodies

Abstract SARS-CoV-2 VOCs immune evasion is mainly due to lower cross-reactivity from previously elicited class I/II neutralizing antibodies, while increased affinity to hACE2 plays a minor role. The affinity between antibodies and VOC is impacted by remodeling of the electrostatic surface potential of the Spike RBDs. P.3 variant is a putative VOC.

Lying in wait: the resurgence of dengue virus after the Zika epidemic in Brazil

After the Zika virus (ZIKV) epidemic in the Americas in 2016, both Zika and dengue incidence declined to record lows in many countries in 2017–2018, but in 2019 dengue resurged in Brazil, causing ~2.1 million cases. In this study we use epidemiological, climatological and genomic data to investigate dengue dynamics in recent years in Brazil. First, we estimate dengue virus force of infection (FOI) and model mosquito-borne transmission suitability since the early 2000s. Our estimates reveal that DENV transmission was low in 2017–2018, despite conditions being suitable for viral spread. 

In vitro antiviral activity of the anti-HCV drugs daclatasvir and sofosbuvir against SARS-CoV-2, the aetiological agent of COVID-19

Current approaches of drug repurposing against COVID-19 have not proven overwhelmingly successful and the SARS-CoV-2 pandemic continues to cause major global mortality. SARS-CoV-2 nsp12, its RNA polymerase, shares homology in the nucleotide uptake channel with the HCV orthologue enzyme NS5B. Besides, HCV enzyme NS5A has pleiotropic activities, such as RNA binding, that are shared with various SARS-CoV-2 proteins.