Introduction: Five months after the first confirmed case of COVID-19 in Brazil, the country has the second highest number of cases in the world. Without any scientifically proven drug or vaccine available combined with COVID-19's high transmissivity, slowing down the spread of the infection is a challenge. In an attempt to save the economy, the Brazilian government is slowly beginning to allow nonessential services to reopen for in-person customers. Methods: In this study, we analyze, based on data analysis and statistics, how other countries evolve and under which conditions they decided to resume normal activity. In addition, due to the heterogeneity of Brazil, we explore Brazilian data of COVID-19 from the State Health Secretaries to evaluate the situation of the pandemic within the states. Results: Results show that while other countries have flattened their curves and present low numbers of active cases, Brazil continues to see an increase in COVID-19 patients. Furthermore, a number of important states are easing restrictions despite a high percentage of confirmed cases. Conclusions: All analyses show that Brazil is not ready for reopening, and the premature easing of restrictions may increase the number of COVID-19-related deaths and cause the collapse of the public health system.
The Brazilian Policy of Comprehensive Care for People with Rare Diseases (BPCCPRD) was established by the Ministry of Health to reduce morbidity and mortality and improve the quality of life of people with rare diseases (RD). Several laboratory tests, most using molecular genetic technologies, have been incorporated by the Brazilian Public Health System, and 18 specialised centres have so far been established at university hospitals (UH) in the capitals of the Southern, Southeastern and Northeastern regions. However, whether the available human and technological resources in these services are appropriate and sufficient to achieve the goals of care established by the BPCCPRD is unknown. Despite great advances in diagnosis, especially due to new technologies and the recent structuring of clinical assessment of RD in Brazil, epidemiological data are lacking and when available, restricted to specific disorders. This position paper summarises the performance of a nationally representative survey on epidemiology, clinical status, and diagnostic and therapeutic resources employed for individuals with genetic and non-genetic RD in Brazil. The Brazilian Rare Disease Network (BRDN) is under development, comprising 40 institutions, including 18 UH, 17 Rare Diseases Reference Services and five Newborn Screening Reference Services. A retrospective study will be initially conducted, followed by a prospective study. The data collection instrument will use a standard protocol with sociodemographic data and clinical and diagnostic aspects according to international ontology. This great collaborative network is the first initiative of a large epidemiological data collection of RD in Latin America, and the results will increase the knowledge of RD in Brazil and help health managers to improve national public policy on RD in Brazil.
Brazil is a large developing country that requires attention to regionalized behaviors regarding the dissemination of COVID-19. To deal with this complexity, the COVID-19 Brazil observatory was developed. The Portal aims to monitor and analyze data from different sources. Therefore, with a detailed audit, we centralized this information on the evolution of the disease, allowing for territorial and temporal monitoring. The daily publication of numbers about COVID-19 allowed anyone to follow the current scenario in several Brazilian cities. With about 1,7 million accesses, the Portal offers clarity and an easy understanding of the pandemic data in the country.
The COVID-19 pandemic is caused by the worldwide spread of the RNA virus SARS-CoV-2. Because of its mutational rate, wide geographical distribution, and host response variance this coronavirus is currently evolving into an array of strains with increasing genetic diversity. Most variants apparently have neutral effects for disease spread and symptom severity. However, in the viral spike protein, which is responsible for host cell attachment and invasion, the D614G variant, containing the amino acid substitution D to G in position 614, was suggested to increase viral infection capability. Here we propose a novel method to test the epidemiological impact of emergence of a new variant, by a combination of epidemiological curves (for new cases) and the temporal variation of relative frequencies of the variants through a logistic regression model. We applied our method to temporal distributions of SARS-CoV-2 D614 or G614, in two geographic areas: USA (East Coast versus West Coast) and Europe-Asia (East Countries versus West Countries). Our analysis shows that the D614G prevalence and the growth rates of COVID-19 epidemic data curves are correlated at the early stages and not correlated at the late stages, in both the USA and ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 20 (4): gmr18960 F. Antoneli et al. 2Europe-Asia scenarios. These results show that logistic models can reveal the potential selective advantage of D614G, which can explain, at least in part, the impact of this variant on COVID-19 epidemiology.
RIBEIRÃO PRETO 2014RESUMO O trabalho apresenta o risco de óbito, baseado no estudo da comorbidade, nos pacientes internados nos hospitais gerais que oferecem assistência hospitalar na região de Ribeirão Preto adstrita ao Departamento Regional de Saúde XIII -DRS XIII. O risco de óbito foi estimado por meio do cálculo do Índice de Comorbidade de Charlson (ICC). O ICC emprega pesos de 0 a 6 a comorbidades selecionadas, ponderando o risco de morrer. Quanto maior for a pontuação do estrato do paciente, maior a chance de morrer. Para análise, foi desenvolvida uma ferramenta computacional que automatiza o cálculo do índice a fim de auxiliar os gestores na tomada de decisão. Assim, obtivemos a distribuição dos casos estudados por estrato ICC e ICCI -outra abordagem do índice ICC, quando a idade é considerada junto ao vetor de comorbidades -para o ano de 2011. Notamos que para o cálculo do ICC, a curva de risco de óbito não seguiu o previsto por Charlson, cuja mortalidade deveria aumentar à medida que a pontuação do estrato aumenta, porém, a distribuição de casos por ICCI seguiu esse conceito. Por fim, estudamos a distribuição espacial dos casos de alta gravidade que nos mostrou as cidades pólos e subpólos da região em assistência hospitalar. O indicador e a automatização de seu cálculo apresentou-se um bom auxílio na tomada de decisão nas questões de saúde. ABSTRACTThe work presents the risk of death, based on the study of comorbidity in hospitalized patients in general hospitals that offer hospital care in the region of Ribeirao Preto enrolled in Regional Department of Health 13th -DRS XII. The risk of death was estimated by means of the calculation of the Index of Charlson Comorbidity (ICC). The ICC employs weights from 0 to 6 the comorbidities selected, considering the risk of dying. The higher the score on the stratum of the patient, the greater the chance of dying. For analysis, a computational tool that automates the calculation of the index was developed, in order to assist managers in decision making. Thus, we obtained the distribution of cases studied by stratum ICC and ICCIanother approach to the ICC index, when the age is considered along the vector of comorbidities -for the year 2011. We note that for the calculation of the ICC, the curve of risk of death did not follow the prescribed by the Charlson index, whose mortality should increase as the score of the stratum increases, however, the distribution of cases by ICCI followed this concept. The indicator and the automation of its calculation proved to be a good aid in decision-making on health issues.
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