Excess mortality according to group of causes in the first year of the COVID-19 pandemic in Brazilby Raphael Mendonça Guimarães et al.
Objective: To estimate excess mortality by cause of death in Brazil and states in 2020. Methods: We estimated the expected number of deaths considering a linear trend analysis with the number of deaths between 2015 and 2019 for each group of causes and each federative unit. We calculated standardized mortality ratios (SMR) and 95% confidence intervals for each SMR assuming a Poisson distribution. We performed the analyses in the R program, version 4.1.3. Results: We observed a 19% excess in deaths in 2020 (SMR=1.19; 95%CI=1.18–1.20). The Infectious and Parasitic Diseases group stood out among the defined causes (SMR=4.80; 95%CI 4.78–4.82). The ill-defined causes showed great magnitude in this period (SMR=6.08; 95%CI 6.06–6.10). Some groups had lower-than-expected deaths: respiratory diseases (10% lower than expected) and external causes (4% lower than expected). In addition to the global analysis of the country, we identified significant heterogeneity among the federative units. States with the highest SMR are concentrated in the northern region, and those with the lowest SMR are concentrated in the southern and southeastern regions. Conclusion: Excess mortality occurs during the COVID-19 pandemic. This excess results not only from COVID-19 itself, but also from the social response and the management of the health system in responding to a myriad of causes that already had a trend pattern before it.
Effectiveness of an inactivated Covid-19 vaccine with homologous and heterologous boosters against Omicron in Brazilby Otavio T. Ranzani et al.
Abstract The effectiveness of inactivated vaccines (VE) against symptomatic and severe COVID-19 caused by omicron is unknown. We conducted a nationwide, test-negative, case-control study to estimate VE for homologous and heterologous (BNT162b2) booster doses in adults who received two doses of CoronaVac in Brazil in the Omicron context. Analyzing 1,386,544 matched-pairs, VE against symptomatic disease was 8.6% (95% CI, 5.6–11.5) and 56.8% (95% CI, 56.3–57.3) in the period 8–59 days after receiving a homologous and heterologous booster, respectively. During the same interval, VE against severe Covid-19 was 73.6% (95% CI, 63.9–80.7) and 86.0% (95% CI, 84.5–87.4) after receiving a homologous and heterologous booster, respectively. Waning against severe Covid-19 after 120 days was only observed after a homologous booster. Heterologous booster might be preferable to individuals with completed primary series inactivated vaccine.
Effectiveness of CoronaVac, ChAdOx1 nCoV-19, BNT162b2, and Ad26.COV2.S among individuals with previous SARS-CoV-2 infection in Brazil: a test-negative, case-control studyby Thiago Cerqueira-Silva et al.
Using national COVID-19 notification, hospitalisation, and vaccination datasets from Brazil, we did a testnegative, case-control study to assess the effectiveness of four vaccines (CoronaVac [Sinovac], ChAdOx1 nCoV-19 [AstraZeneca], Ad26.COV2.S [Janssen], and BNT162b2 [Pfizer-BioNtech]) for individuals with laboratory-confirmed previous SARS-CoV-2 infection. We matched cases with RT-PCR positive, symptomatic COVID-19 with up to ten controls with negative RT-PCR tests who presented with symptomatic illnesses, restricting both groups to tests done at least 90 days after an initial infection. We used multivariable conditional logistic regression to compare the odds of test positivity and the odds of hospitalisation or death due to COVID-19, according to vaccination status and time since first or second dose of vaccines.
COVID-19, vaccine hesitancy and child vaccination: Challenges from Brazilby Michelle Fernandez, Gustavo Matta, Ester Paiva
In the world, the governments' policy decisions in response to COVID-19 were very different. Many countries, including in the Americas, political polarisation in health policies has been used as a tool for ideological dispute, draining out the debate around the right to social protection and health. During 2021, these strategies were used in vaccination policies. The consequences of the dissemination of misinformation about COVID-19 vaccines overflows distrust and hesitation into an entire public health project.
Reboot biomedical R&D in the global public interestby Soumya Swaminathan et al.
Inequitable access to the fruits of research during the COVID-19 pandemic highlights the urgency — and feasibility — of overhauling the R&D system.
Hoja de ruta de investigación de las Naciones Unidas para la recuperación de COVID-19by Naciones Unidas/United Nations
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.
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.
Younger Brazilians hit by COVID-19 – What are the implications?by Raphael Guimarães et al.
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).
The impacts of climate change on homeless populations after the pandemicby Luiz Galvão et al.
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).
Predictability of COVID-19 worldwide lethality using permutation-information theory quantifiersby Leonardo Fernandes et al.
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.
Effectiveness of COVID-19 vaccines against hospital admission with the Delta (B.1.617.2) variantby Julia Stowe et al.
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 Brazilby Rita de Cássia Ribeiro-Silva et al.
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.
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.
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.
Gender, race, and health workers in the COVID-19 pandemicby Gabriella Lotta et al.
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.
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
Psycho-Neuroendocrine-Immune Interactions in COVID-19: Potential Impacts on Mental Healthby Ícaro Raony, Camila Saggioro de Figueiredo, Pablo Pandolfo, Elizabeth Giestal-de-Araujo, Priscilla Oliveira-Silva Bomfim, Wilson Savino
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 global spread of 2019-nCoV: a molecular evolutionary analysisby Domenico Benvenuto, Marta Giovanetti, Marco Salemi, Mattia Prosperi, Cecilia De Flora, Luiz Carlos J
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.