Inequitable access to the fruits of research during the COVID-19 pandemic highlights the urgency — and feasibility — of overhauling the R&D system.
Español/English/Português Esta Hoja de ruta de investigación de las Naciones Unidas para la recuperación de COVID-19 proporciona un marco para aprovechar el potencial de la Ciencia en apoyo de una recuperación socioeconómica más afectiva, y un futuro más equitativo, resiliente y sostenible. Diseñado para complementar el Marco de la ONU para la respuesta socioeconómica inmediata ante COVID-19 (abril de 2020), esta Hoja de Ruta en Investigación se desarrolló rápidamente, en diez semanas, a través de un proceso participativo global que se basó en los conocimientos de investigadores/as, fuentes de financiación de investigación, legisladores/as gubernamentales, sociedad civil, y personas líderes y/o funcionarios/as de la ONU de todo el mundo. Vea el Diálogo abierto con el Secretario General Adjunto de la ONU sobre Ciencia para el Desarrollo en el contexto de COVID-11 (disponible en inglés). El diálogo fue copatrocinado por los Institutos Canadienses de Investigación en Salud y la Oficina de las Naciones Unidas para las Asociaciones de Colaboración. ¿Cómo puede la Ciencia contribuir a una recuperación más equitativa, resiliente y sostenible de la pandemia de COVID-19? Estrategias para mejorar la colaboración entre los organismos de financiación de la investigación, las instituciones de investigación y las Naciones Unidas del mundo.
PRE-PRINT: The effectiveness of Vaxzevria and CoronaVac vaccines: A nationwide longitudinal retrospective study of 61 million Brazilians (VigiVac-COVID19)by Thiago Cerqueira-Silva et al.
Both vaccines demonstrated overall effectiveness against severe COVID-19 up to 80 years of age. Our results suggest that individuals aged 90 years or older may benefit from an expedited third booster dose. Ongoing evaluations, including any additional vaccines authorized, are crucial to monitoring long-term vaccine effectiveness.
PRE-PRINT: Effectiveness of the CoronaVac Vaccine in Prevention of Symptomatic and Progression to Severe COVID-19 in Pregnant Women in Brazilby Enny S. Paixão et al.
A complete regimen of CoronaVac in pregnant women was effective in preventing symptomatic Covid-19, and highly effective against severe illness in a setting that combines high disease burden and elevated Covid-19 related maternal deaths.
Two-dose ChAdOx1 nCoV-19 vaccine protection against COVID-19 hospital admissions and deaths over time: a retrospective, population-based cohort study in Scotland and Brazilby Srinivasa Vittal Katikireddi et al.
We found waning vaccine protection of ChAdOx1 nCoV-19 against COVID-19 hospital admissions and deaths in both Scotland and Brazil, this becoming evident within three months of the second vaccine dose. Consideration needs to be given to providing booster vaccine doses for people who have received ChAdOx1 nCoV-19.
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.
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 protectionby Gabriela Cuevas Barron et al.
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 vaccinesby Thiago Cerqueira-Silva et al.
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.
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-19by Claudia Codeço et al.
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).
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 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).
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.
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 citiesby Luisa Massarani et al.
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.
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.
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.
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.by Thiago Souza et al.
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 Antibodiesby Matheus Ferraz et al.
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.
In vitro antiviral activity of the anti-HCV drugs daclatasvir and sofosbuvir against SARS-CoV-2, the aetiological agent of COVID-19by Carolina Q Sacramento et al.
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.
Coronaviruses can cause a diverse array of clinical manifestations, from fever with symptoms of the common cold to highly lethal Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). SARS-CoV-2, the coronavirus discovered in Hubei province, China, at the end of 2019, became known worldwide for causing COVID-19.
The dynamics underlying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection remain poorly understood. We identified a small cluster of patients in Brazil who experienced 2 episodes of coronavirus disease (COVID-19) in March and late May 2020. In the first episode, patients manifested an enhanced innate response compared with healthy persons, but neutralizing humoral immunity was not fully achieved. The second episode was associated with different SARS-CoV-2 strains, higher viral loads, and clinical symptoms. Our finding that persons with mild COVID-19 may have controlled SARS-CoV-2 replication without developing detectable humoral immunity suggests that reinfection is more frequent than supposed, but this hypothesis is not well documented.
The global spread of new SARS-CoV-2 variants of concern underscore an urgent need of simple deployed molecular tools that can differentiate these lineages. Several tools and protocols have been shared since the beginning of the COVID-19 pandemic, but they need to be timely adapted to cope with SARS-CoV-2 evolution.
COVID-19 en América Latina y Caribe: Determinación de prioridades en investigación y llamado a la acciónby Nicole Feune de Colombi et al.
The Global Health Network (www.tghn.org) established in January 2020 a community of practice to address research on COVID-19 in low/middle-income countries.
The SARS-CoV-2 lineage B.1.1.28 has been evolving in Brazil since February 2020, but the recent emergence of sub-lineages with convergent mutations in the spike (S) protein raises concern about the potential impact on viral infectivity and immune escape. The lineage P.1 (alias of B.18.104.22.168) is an emerging variant that harbours several amino acid mutations including S:K417T, S:E484K, and S:N501Y. This report describes the first confirmed case of reinfection with the P.1 lineage in a 29-years-old female resident in the Amazonas state, Brazil, previously infected with a B.1 lineage virus.
Phylogenetic relationship of SARS-CoV-2 sequences from Amazonas with emerging Brazilian variants harboring mutations E484K and N501Y in the Spike proteinby Felipe Naveca et al.
Here we report a preliminary genomic analysis of SARS-CoV-2 B.1.1.28 lineage circulating in the Brazilian Amazon region and their evolutionary relationship with emerging and potential emerging SARS-CoV-2 Brazilian variants harboring mutations in the RBD of Spike (S) protein. Phylogenetic analysis of 69 B.1.1.28 sequences isolated in the Amazonas state revealed the existence of two major clades that have evolved locally without unusual mutations in the S protein from April to November 2020.
Viral Genetic Evidence and Host Immune Response of a Small Cluster of Individuals with Two Episodes of SARS-CoV-2 Infectionby Natalia Fintelman-Rodrigues et al.
The dynamics underlying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection remains poorly understood. We added to the registered case reports of reinfection in USA, Belgium/Netherlands, Ecuador and Hong Kong, a small cluster of individuals with two episodes of 2019 coronavirus disease (COVID-19). Virus genomic analysis and the host immune response were used to characterize this group.
Emerging complexities and rising omission: Contrasts among socio-ecological contexts of infectious diseases, research and policy in Brazilby Leandro Giatti et al.
In this article, we explore elements that highlight the interdependent nature of demands for knowledge production and decision-making related to the appearance of emerging diseases. To this end, we refer to scientific production and current contextual evidence to verify situations mainly related to the Brazilian Amazon, which suffers systematic disturbances and is characterized as a possible source of pathogenic microorganisms.
Depression, Anxiety, and Lifestyle Among Essential Workers: A Web Survey From Brazil and Spain During the COVID-19 Pandemicby Raquel Brandini De Boni, et al.
Essential workers have been shown to present a higher prevalence of positive screenings for anxiety and depression during the COVID-19 pandemic. Individuals from countries with socioeconomic inequalities may be at increased risk for mental health disorders.
Covid-19 Confinement and Changes of Adolescent’s Dietary Trends in Italy, Spain, Chile, Colombia and Brazilby María Belén Ruiz-Roso et al.
Confinement due to the COVID-19 pandemic can influence dietary profiles, especially those of adolescents, who are highly susceptible to acquiring bad eating habits. Adolescents’ poor dietary habits increase their subsequent risk of degenerative diseases such as obesity, diabetes, cardiovascular pathologies, etc. Our aim was to study nutritional modifications during COVID-19 confinement in adolescents aged 10 to 19 years, compare them with their usual diet and dietary guidelines, and identify variables that may have influenced changes.
The neuropeptides VIP and PACAP inhibit SARS-CoV-2 replication in monocytes and lung epithelial cells, decrease the production of proinflammatory cytokines, and VIP levels are associated with survivalby Jairo R. Temerozo et al.
Epidemiological and clinical characteristics of the first 557 successive patients with COVID-19 in Pernambuco state, Northeast Brazilby Jurandy Júnior Ferraz deMagalhães et al.
PRE-PRINT: Non-permissive SARS-CoV-2 infection of neural cells in the developing human brain and neurospheresby Carolina da S. G. Pedrosa et al.
Coronavirus disease 2019 (COVID-19) was initially described as a viral infection of the respiratory tract. It is now known, however, that many other biological systems are affected, including the central nervous system (CNS). Neurological manifestations such as stroke, encephalitis, and psychiatric conditions have been reported in COVID-19 patients, but its neurotropic potential is still debated. Here, we investigate the presence of SARS-CoV-2 in the brain from an infant patient deceased from COVID-19. FULL TEXT
Coronavirus disease 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The impacts of the disease may be beyond the respiratory system, also affecting mental health. Several factors may be involved in the association between COVID-19 and psychiatric outcomes, such as fear inherent in the pandemic, adverse effects of treatments, as well as financial stress, and social isolation.
The COVID‐19 epidemic through a gender lens: what if a gender approach had been applied to inform public health measures to fight the COVID‐19 pandemic?by Cristina Enguita‐Fernàndez, Elena Marbán-Castro, Olivia Manders, Lauren Maxwell, Gustavo Correa Matta
Data is becoming ever more critical and valuable for both scientists and health authorities searching for answers to the COVID-19 crisis. Due to difficulties in diagnosing this infection in populations around the world, initiatives supported by digital technologies have been developed by governments or private companies which enable the tracking of the public’s symptoms, contacts and movements.
The global spread of the 2019-nCoV is continuing and is fast moving, as indicated by the WHO raising the risk assessment to high. In this article, we provide a preliminary phylodynamic and phylogeographic analysis of this new virus. A Maximum Clade Credibility tree has been built using the 29 available whole genome sequences of 2019-nCoV and two whole genome sequences that are highly similar sequences from Bat SARS-like Coronavirus available in GeneBank.