In less than four months, the total of confirmed cases of COVID-19 was 1,684,833 worldwide. Outcomes among the public of pregnant women with COVID-19 are still unclear. We performed a systematic review and meta-analysis to analyze whether COVID-19 in pregnant women is related to premature birth and birth weight, and to summarize the diagnostic results of neonates born to mothers with COVID-19 for investigating the possibility of vertical transmission. Searches were performed in PubMed, Scopus, LILACS, Web of Science, Google Scholar, Preprints, bioRxiv, and medRxiv. We used the odds ratio (OR) and mean difference (MD) as measure of analysis. Summary estimates were calculated using random effects models. 38 studies were included; data from 279 women were analyzed; 60 patients were diagnosed with COVID-19. The meta-analysis showed no significant association between COVID-19 and preterm delivery (OR = 2.25; 95%CI: 0.96, 5.31; p = 0.06; I² = 0%). No significant relationship was found between birth weight and COVID-19 (MD = -124.16; 95%CI: -260.54, 12.22; p = 0.07; I² = 0%). Among 432 newborns, 10 were reported with positive results for early SARS-CoV-2. Due to the characteristics of the studies, the level of evidence of this meta-analysis was considered very low. COVID-19 in pregnant women may not be associated with the occurrence of preterm deliveries or the birth weight of the newborn children, however the evidence to date is very uncertain. A few reports suggest vertical transmission of SARS-CoV-2 to newborn is possible, but evidence is still uncertain.

Resumo Objetivo: analisar casos confirmados e de óbitos por COVID-19 entre profissionais de enfermagem no Brasil. Métodos: estudo epidemiológico com uso de técnicas de geoprocessamento. Dados referentes ao período de 20 de março a 28 de maio de 2020 foram coletados do Conselho Federal de Enfermagem. Foram utilizados testes G, qui-quadrado e Mantel-Haenszel para associação entre óbitos e faixa etária, sexo e região geográfica de trabalho. Resultados: 17.414 casos suspeitos, 5.732 confirmados e 134 óbitos ocorreram no período. A região Sudeste apresentou o maior número de casos (46,35%) e de óbitos (44,78%). A faixa etária mais afetada para casos foi de 31-40 anos (n = 2.515) e para óbitos foi de 41-50 anos (n = 38). A taxa de letalidade foi maior nos homens. As variáveis “faixa etária”, “sexo” e “região geográfica de trabalho” estiveram significativamente associadas aos óbitos por COVID-19 (p < 0,05). Os estados do Amapá, Roraima e Bahia apresentaram a maior taxa de casos por 1.000 profissionais inscritos no conselho da categoria (6,28, 6,10 e 5,99, respectivamente). Conclusão: Os dados indicam a necessidade de um olhar crítico sobre o campo de trabalho de enfermagem como estratégia de enfrentamento da COVID-19.

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Objective: Estimating the potential number of COVID-19 deaths in Brazil for the coming months. Methods: The study included all confirmed cases of COVID-19 deaths, from the first confirmed death on March 17th to May 15th, 2020. These data were collected from an official Brazilian website of the Ministry of Health. The Boltzmann function was applied to a data simulation for each set of data regarding all states of the country. Results: The model data were well-fitted, with R2 values close to 0.999. Up to May 15th, 14,817 COVID-19 deaths have been confirmed in the country. Amazonas has the highest rate of accumulated cases per 1,000,000 inhabitants (321.14), followed by Ceará (161.63). Rio de Janeiro, Roraima, Amazonas, Pará, and Pernambuco are estimated to experience a substantial increase in the rate of cumulative cases until July 15th. Mato Grosso do Sul, Paraná, Minas Gerais, Rio Grande do Sul, and Santa Catarina will show lower rates per 1,000,000 inhabitants. Conclusion: We estimate a substantial increase in the rate of cumulative cases in Brazil over the next months. The Boltzmann function proved to be a simple tool for epidemiological forecasting that can assist in the planning of measures to contain COVID-19.

Objetivo: analisar as vivências de conforto e desconforto da mulher durante o trabalho de parto e parto. Método: estudo descritivo qualitativo realizado em três maternidades de Maceió-AL com 40 puérperas de julho a setembro de 2014 através de entrevista semiestruturada, tendo como referencial teórico a Teoria do Conforto de Katharine Kolcaba. Resultados: apesar do crescimento da humanização do parto, muitas mulheres estão aquém dessa realidade, sendo pouco ouvidas sobre o que lhe traria conforto ou desconforto no momento do seu parto. O nascimento do filho, a assistência dos profissionais, o acompanhante, a dor, a episiorrafia e o aumento das dores devido ao uso do “soro” estão entre as principais vivências de conforto e desconforto relatadas. Conclusão: conforto e/ou desconforto podem influenciar a satisfação da mulher durante o seu parto, requerendo por parte da equipe de saúde um olhar humanizado para efetivação do cuidado. . ABSTRACTObjective: to analyze the experiences of comfort and discomfort of women during labor and childbirth. Method: a qualitative descriptive study carried out in three maternity hospitals in Maceió-AL with 40 puerperal women, from July to September 2014, through semi-structured interviews, based on the theoretical framework of Katharine Kolcaba’s Theory of Comfort. Results: despite the increase in the humanization of childbirth, many women cannot live this reality, being little heard about what would bring comfort or discomfort to them at the time of their childbirth. The childbirth, the assistance, the companion, the pain, the episiotomy and the increase of pain due to the use of oxytocin are among the main experiences of comfort and discomfort reported. Conclusion: comfort and / or discomfort can influence the woman’s satisfaction during childbirth, requiring the health team a humanized look for effective care. RESUMENObjetivo: analizar las vivencias de comodidad y incomodidad de la mujer durante el trabajo de parto y parto. Método: estudio descriptivo cualitativo realizado en tres maternidades de Maceió-AL con 40 puérperas de julio a septiembre de 2014 a través de entrevista semiestructurada, teniendo como referencial teórico la Teoría del Confort de Katharine Kolcaba. Resultados: a pesar del crecimiento de la humanización del parto, muchas mujeres no viven esa realidad, siendo poco oídas sobre lo que le traería comodidad o incomodidad en el momento de su parto. El nacimiento del hijo, la asistencia de los profesionales, el acompañante, el dolor, la episiorrafia y el aumento de los dolores debido al uso del oxytocin, están entre las principales vivencias de copmodidad e incomodidad relatadas. Conclusión: comodidad y/o incomodidad pueden influenciar la satisfacción de la mujer durante su parto, requiriendo por parte del equipo de salud una mirada humanizada para la efectividad del cuidado. DOI: http://dx.doi.org/10.12957/reuerj.2017.14203

Abstract: The COVID-19 death rate in Northeast Brazil is much higher when compared to the national average, demanding a study into the prognosis of the region for planning control measures and preventing the collapse of the health care system. We estimated the potential total cumulative cases of COVID-19 in the region for the next three months. Our study included all confirmed cases, from March 8 until April 28, 2020, collected from the official website that reports the situation of COVID-19 infections in Brazil. The Boltzmann function was applied to a data simulation for each set of data regarding different states. The model data were well fitted, with R2 values close to 0.999. Up to April 28, 20,665 cases were confirmed in the region. The state of Ceará has the highest rate of accumulated cases per 100,000 inhabitants (75.75), followed by Pernambuco. We estimated that the states of Ceará, Sergipe and Paraíba will experience a dramatic increase in the rate of cumulative cases until July 31. Maranhão, Pernambuco, Rio Grande do Norte and Piauí showed a more discreet increase in the model. For Bahia and Alagoas, a 4.7 and 6.6-fold increase in the rate was estimated, respectively. We estimate a substantial increase in the rate of cumulative cases per 100,000 inhabitants in the region within three months, especially for Ceará, Sergipe and Paraíba. The Boltzmann function proved to be a simple tool for epidemiological forecasting that can help planning the measures to contain COVID-19.

O novo coronavírus causador da Síndrome Respiratória Aguda Grave (SARS-CoV-2), se expandiu rapidamente no Brasil e no mundo. Os serviços de saúde apontam que o grupo de maior vulnerabilidade à infecção grave pelo COVID-19 são os idosos. Medidas de isolamento social embora protegerem contra o contágio, acarretam impactos diretos na funcionalidade de idosos, principalmente em variáveis psicológicas e físicas como força, equilíbrio, marcha e capacidade cardiorrespiratória, fundamentais para a realização de atividades diárias. Objetivo do estudo foi descrever os impactos do isolamento social na funcionalidade de idosos durante a pandemia da COVID-19 numa perspectiva baseada na Classificação Internacional de Funcionalidade (CIF). Trata-se de uma revisão integrativa. Foram incluídos estudos que mencionassem os descritores “idosos” e “COVID-19” e que abordassem o tema isolamento social e/ou funcionalidade e/ou comorbidades. Não houve restrição do desenho de estudo, idioma e ano de publicação. As bases de dados consultadas foram PubMed, Scopus, Science Direct e Google Scholar. Foram identificados 5057 estudos, 42 elegidos pelo título e resumo. Após leitura rigorosa na íntegra, 7 atenderam aos objetivos e foram sintetizados em tabela. O isolamento social apresentou implicações psicológicas, comportamento sedentário e redução da funcionalidade de idosos. O isolamento social em virtude da pandemia da COVID-19 tornou a população idosa com hábitos sedentários, alterações psicológicas e funcionais que interferem nas Atividades cotidianas. A atividade física orientada pode ser uma alternativa importante para minimizar impactos funcionais de idosos e auxiliar nos aspectos biopsicossociais preconizados pela Classificação Internacional de Funcionalidade.

Objective: To evaluate the effect of the distance between the place of residence and the specialized treatment service on the survival time of people living with HIV/Aids in Alagoas, Northeast Brazil. Methods: Data from the notification and mortality systems related to individuals aged 13 years or older diagnosed with the infection between 2007 and 2013 were used. The cases were observed for a period of follow-up until December 2017. For the analyses, the Pearson's χ2 test, Kaplan-Meier method, and Cox regression were adopted according to the outcome of the case, place of residence, distance to the health unit, population size of the municipality of residence, sex, skin color/ethnicity, and age. Results: Of the 2,732 analyzed cases, 760 individuals died of Aids-related causes. The average estimate of survival time for individuals residing in the capital was 98.6 months (95%CI 96.1–101). Among residents of inland cities, the estimate was 92.7 months (95%CI 89.3–96.1). There was a significant difference in curves throughout the period. The group residing in inland municipalities and those traveling a distance of >70 km had a higher average relative risk of death (RR=1.21, 95%CI 1.05–1.4 and RR=1.18, 95%CI 1.01–1.39, respectively). Conclusion: Living in or near the capital decreases the average relative risk of death. In order to increase the survival time of HIV/Aids patients in Alagoas, it is suggested to decentralize specialized health care, that is, to create regional centers to care for these people.