Sleep quality during home distancing in the COVID-19 pandemic in the Western Amazon

Introduction: the COVID-19 pandemic incited unprecedented global restrictions on society’s behavior. Home detachment and isolation measures applied during the COVID-19 pandemic can result in problems with sleep quality. It is an important measure to reduce the risk of infection from the COVID-19 outbreak. Objective: to investigate the existence of a difference between the quality of sleep before and during the home distance imposed by the Covid-19 pandemic. Methods: cross-sectional web-based survey was sent using different conventional social media to collect data from the study population. The evaluated group was composed of 124 subjects, 57 of whom were male and 67 were female from the city of Rio Branco / AC. For this study, the Pittsburgh Sleep Quality Index questionnaire (PSQI-BR) and a socio-demographic questionnaire were used. The volunteers received a link along with the description and purpose of the study. Finally, data analysis was performed using SPSS 22.0 software. Results: sleep quality worsened significantly during home distance in four sleep components (subjective sleep quality, sleep latency, sleep drowsiness and overall PSQI score). During social distance, poor sleep was greater among respondents (OR = 5.68; 95% CI = 1.80–17.82; p = 0.70). Conclusion: the results indicated that there was a significant difference between the quality of sleep before and during home detachment and sleep disturbance and the subjective quality of sleep before and during the period of the outbreak of COVID-19 were the components that most worsened in the state of sleep

Evolution of mortality and lethality due to covid-19 in the state of Roraima, Brazil, from march 2020 to july 2021

Introduction: the context of the Covid-19 pandemic in the Brazilian North region is worrying. There is a lack of resources for Public Health, a low human development index, and poverty indicators above the national average. Objective: to analyze mortality and lethality from COVID-19 in the State of Roraima, Brazil. Methods: this is an ecological time-series study of secondary data on COVID-19 in Roraima, Northern Brazil, from March 2020 to July 2021. The incidence, mortality, and lethality rates due to COVID-19 were calculated. The Prais-Winsten regression model was used to calculate the time series trends. Trends were classified as increasing, decreasing, or stationary. The trend was considered static when the p-value was not significant (p>0.05). Results: in the state of Roraima, from March 2020 to July 2021, there were 123,125 cases and 1,903 accumulated deaths due to COVID-19. The first wave (March 2020 to October 2021) of COVID-19 recorded the incidence rate (2,995.30 new cases per 100,000 inhabitants - July 2020) and mortality (56.32 deaths per 100,000 inhabitants - June 2020) higher lethality. However, in the second wave (November 2020 to July 2021), the highest lethality rate was observed (3.47% - February 2021). It was observed that during the first wave, the incidence rate of COVID-19 showed increasing trends. During this period, the mortality rate had a stationary tendency (p>0.05) and the percentage lethality with a decreasing trend (p<0.05). During the second wave, there was a more aggravating scenario for lethality, which changed from a daily reduction rate of 0.90% to stationary trends. Conclusion: the pandemic in the state of Roraima is not yet under control, so it is necessary to strengthen strategies to mitigate the spread of the pandemic in the region and prevent the formation of new waves.

Performance of early literacy students in cognitive-linguistic skills during the pandemic

Introduction: The Covid-19 pandemic made discrepancies between the different educational realities more evident for schoolchildren in the beginning of literacy. Objective: to characterize the performance of cognitive-linguistic skills of students in early literacy phases during the pandemic. Methods: Twenty-two elementary school students participated in this study, distributed in GI 1st year students and 2nd year GII students, submitted to the application of the Cognitive-Linguistic Skills Assessment Protocol for students in the initial stage of literacy. Results: Students from GI and GII showed average performance for writing the name and writing the alphabet in sequence. The GI presented a refusal response for the subtests of word dictation, pseudoword dictation and picture dictation, word repetition and visual sequential memory of shapes and poor performance for alphabet recognition in random order and average performance for alphabet recognition in sequence. GII showed lower performance for the subtests of word dictation, pseudoword dictation, picture dictation and superior performance for alphabet recognition in random order, alphabet in sequence and visual sequential memory of shapes. Discussion: The appropriation of the letter-sound relationship mechanism raises questions, since it evidenced the difficulty of all students in cognitive-linguistic skills necessary for the full development of reading and writing in an alphabetic writing system such as Brazilian Portuguese . Conclusion: Students in the 1st and 2nd years showed lower performance in cognitive-linguistic skills important for learning reading and writing.

Guillain-Barre syndrome related to COVID-19: muscle and nerve biopsy findings

Background: The involvement of the peripheral nervous system (PNS) in COVID-19 is rare and, to date, morphological aspects from muscle and nerve biopsies have not been reported. Here, we describe a case of Guillain-Barré Syndrome (GBS) related to COVID-19 and demonstrate findings from peripheral nerve and skeletal muscle biopsies. A 79-year-old man presented with progressive weakness in both legs over one-week, evolving to both arms and urinary retention within 6 days. Four days earlier, he had a cough, febrile sensation and mild respiratory discomfort. On admission, his was afebrile, and without respiratory distress. A neurological examination disclosed asymmetric proximal weakness, diminished reflexes and no sensitive abnormalities. Three days later, the patient presented with bilateral facial weakness and proximal muscle strength worsened. Deep tendon reflexes and plantar responses were absent. Both superficial and profound sensitivity were decreased. From this point, oxygen saturation worsened, and the patient was placed on mechanical ventilation. CSF testing revealed one cell and protein 185 mg/dl. A chest CT showed the presence of ground-glass opacities and RT-PCR for SARS-CoV-2 was positive. The muscle biopsy revealed moderate neuromyopathic findings with positive expression for MHC-class I, C5b9, CD8 and CD68. The nerve biopsy showed inflammatory infiltrates predominantly with endoneurial compound formed by CD45 and CD68. The patient was treated with Oseltamivir for 9 days followed by IVIG for 5 days and died three days later of septic shock. Discussion: This is the first documented case of GBS associated with COVID-19 with a muscle and nerve anatomopathological study. A systematic review about neurological complications caused by COVID-19 described 11 patients with GBS. The morphological features reported in our patient showed signs of involvement of the immune system, suggesting that direct viral invasion could have played a role in the pathogenesis of peripheral nerve injury. Hereafter, further research will be necessary to understand the triggers for these cells migrating into the peripheral nerve.

Lethality and mortality of COVID-19 in an important industrial center in latin america, region of grande abc, São Paulo, Brazil

Introduction: the new coronavirus (COVID-19) disease has been causing economic and health system impacts worldwide, triggering humanitarian crises in vulnerable regions, marked by high mortality rates of the disease. Brazil has been suffering an increase in the number of cases, characteristic of the formation of a second wave, with great epidemiological differences observed in the most diverse regions of the country. Many studies illustrate the behaviour of COVID-19 in the state of São Paulo, but there are gaps in the scientific literature on the epidemiology of COVID-19 in municipalities of the São Paulo metropolitan region that constitute an important industrial pole in Latin America, such as the region of Grande ABC. Objective: to evaluate mortality and lethality trends of COVID-19 during the period March 2020 to July 2021, in municipalities on region of Grande ABC, metropolitan region of São Paulo, Brazil, divided into two periods (March to November 2020 and December to July 2021). Methods: we conducted an ecological time series study with population data from the Brazilian Ministry of Health. We collected the number of cases and deaths confirmed for COVID-19 in the municipalities that make up the region of Grande ABC (Diadema, Mauá, Rio Grande da Serra, Ribeirão Pires, Santo André, São Bernardo do Campo, and São Caetano do Sul) from March 2020 to July 2021. Prais-Winsten linear regression was performed, and the percentage of daily change was calculated. Differences were considered significant when p<0.05. Results: in region of Grande ABC, in the period analysed, 217,264 cases and 10,004 deaths of COVID-19 were recorded. Although the mortality rate remained stationary during the first wave (March to November 2020) and the second wave (December 2020 to July 2021); lethality transitioned from decreasing during the first wave to increasing during the second wave, with rates varying according to municipality. Conclusion: trend analyses in incidence, mortality, and lethality rates assist in understanding the behaviour of the COVID-19 Pandemic in the region known as Grande ABC. Efforts must be maintained throughout the region to control the Pandemic.

Analysis of COVID-19 mortality and case-fatality in a low- income region: an ecological time-series study in Tocantins, Brazilian Amazon

Introduction: Inserted in the vulnerable context of the Brazilian Amazon, the state of Tocantins has suffered damages with the dissemination of COVID-19 in its territory; however, little evidence is published from this state. Objective: This study aims to analyze the case-fatality, mortality, and incidence of COVID-19 in Tocantins. Methods: This is an ecological study, population-based, time-series analysis of COVID-19 cases and deaths in the state of Tocantins from March 2020 to August 2021. Results: During the examined period, 219,031 COVID-19 cases, and 3,594 deaths were registered due to disease. Two possible occurrence peaks were characterized in this time-series analysis. Remarkably, the Second Wave had the highest lethality rates (3.02% - April 2021), mortality (39.81 deaths per 100,000 inhabitants – March 2021), and incidence (1,938.88 cases per 100,000 inhabitants – March 2021). At the end of the period, mortality, incidence, and lethality showed flat trends, suggesting a positive outcome of the vaccination program. Conclusion: The prevention, surveillance, and control actions of COVID-19 cases in Tocantins State have been directed to mitigate the deleterious effects of the pandemic. Nevertheless, efforts are still needed to decrease lethality, mortality, and incidence trends, and ultimately to achieve control of the COVID-19 pandemic in the region.

COVID-19 mortality and lethality in the State of Pará, legal Amazon, Brazil

Introduction: the growth of coronavirus indices in the North region highlights the region’s historical social inequalities and the problems in accessing citizenship. Objective: to analyze the mortality and lethality of COVID-19 in the state of Pará, Brazil. Methods: this is an ecological study with a time series design of secondary data. All registered cases and deaths reported by COVID-19 in the period from March 2020 to June 2021, in the state of Pará, Brazil, were considered. The incidence and mortality and lethality rates were used. The daily percentage variation and their respective 95% confidence intervals were estimated. Results: the total number of confirmed cases and deaths from COVID-19 in the state of Pará was 552,937 and 15,469, respectively, from March 2020 to June 2021. Incidence and mortality rates from March 2020 to June 2021 were, respectively, 6,407.9 and 179.3 per 100,000 inhabitants and the lethality was 43.3. Regarding the analysis of the daily trend of rates in the period from March 2020 to June 2021, both mortality and incidence increased. Conclusion: it was found that the behavior of the trend of rates in the first wave was increasing in the incidence of confirmed cases and the lethality decreasing, and in the second wave, the mortality and lethality rates were increasing.

Evolution of COVID-19 during the epidemiological week 16 to 53 of 2020 in the state of Acre Western Amazonia, Brazil

Introduction: coronavirus is part of a group of RNA viruses belonging to the Coronaviridae family, widely distributed in humans and other mammals. Currently, it has been seriously affecting the whole world, without a definitive cure yet. Objective: to analyse the association between the HDI and confirmed cumulative cases of COVID-19 that occurred during epidemiological week 16 to 53 of 2020, in the State of Acre. Methods: this is an ecological study of descriptive time series, evaluating the State of Acre and its 22 municipalities affected by COVID-19, in the period corresponding to the epidemiological weeks 16 to 53 of 2020. The State of Acre and its municipalities are aggregated by five regions with a total of approximately 881 thousand inhabitants, with an HDI of 0.663. Rio Branco is the state capital with 407,000 inhabitants. The 22 municipalities were analyzed, relating the HDI variables, confirmed cases per day and number of inhabitants to each other. Results: it was observed that the population evaluated, affected by COVID-19 during SE 16 to 53 of 2020, in the State of Acre, had as predominant general characteristics brown skin color, male sex, and the evolution to death from the disease was related with older age and comorbidity. Acre had a mortality rate (deaths per 100,000 inhabitants) of 90.9 and a lethality rate of 1.9%, with the highest mortality rate observed in the municipality of Rio Branco (121.3/100,000 inhabitants) and lethality in Rodrigues Alves (2.9%). The incidence of COVID-19 in Acre was 4,759.9 cases per 100,000 inhabitants, the municipalities of Assis Brasil and Xapuri had the highest incidences in the state with 10273.7 and 9330.8 new cases per 100,000 inhabitants, respectively. Conclusion: although the accumulated numbers of cases are different for the same day, the behavior is very similar, that is, the curves vary in the same way over time, regardless of the municipality observed.

Three urgent needs in the battle against COVID-19: specific medications, information and acceptance of Pandemic

The first confirmed case of COVID-19 was notified to the Brazilian Ministry of Health on February 26, 2020. On November 20, 2021, by the end of Epidemiological Week-46 (EW-46) 257,168,692 confirmed cases of COVID-19 reported worldwide. Among the countries with the highest number of accumulated cases the United States of America ranks number one (47,701,872), followed by India (34,510,413), Brazil (22,012,150), the United Kingdom (9,857,658), and Russia (9,135,149). Concerning deaths, 5,146,467 were confirmed worldwide until November 20, 2021. The United States was the country with the highest accumulated number of deaths (771,013), followed by Brazil (612,587), India (465,662), Mexico (292,145), and Russia (257,891).

Mental health status and quality of life of people with disabilities in social isolation

Introduction: at this critical moment of the COVID -19 pandemic, we observe the social withdrawal and the break from the routine of individuals in society, for people with disabilities who need adequate support and a routine of more intense and effective activities may feel a greater need for care and attention of family support for solving everyday problems. Objective: to identify factors associated with the impact of the pandemic on the quality of life of individuals with disabilities and their caregivers. Methods: a virtual survey was carried out with parents and caregivers of people with disabilities to identify the main factors associated with the impact of the Pandemic on daily life and social relationships between family and community. Results: of the parents and caregivers we had access to and answered the questionnaire, 90% are residents of the ABC region of São Paulo. Their children and adolescents with disabilities are between 4 and 18 years old. The main scores of caregivers on difficulties in care during the pandemic, 70% felt helpless at some point, 17% had difficulties in performing self-care activities, 42% had anguish and fear during the period, 83% have the greatest responsibility for household decisions, and about 50% can share those decisions. Conclusion: the main complaints about the care of people with disabilities during the COVID-19 pandemic are related to the feeling of fear and anguish that affects decision-making and family relationships, which influences self-care activities and mental health of this population.