Background No treatment for COVID-19 is yet available; therefore, providing access to information about SARS-CoV-2, the transmission route of the virus, and ways to prevent the spread of infection is a critical sanitary measure worldwide. Serious games have advantages in the dissemination of reliable information during the pandemic; they can provide qualified content while offering interactivity to the user, and they have great reach over the internet. Objective This study aimed to develop a serious game with the purpose of providing science-based information on the prevention of COVID-19 and personal care during the pandemic while assessing players’ knowledge about COVID-19–related topics. Methods The study was conducted with the interdisciplinary collaboration of specialists in health sciences, computing, and design at the Federal University of Minas Gerais, Brazil. The health recommendations were grouped into six thematic blocks, presented in a quiz format. The software languages were based on the progressive web app development methodology with the Ionic framework, JavaScript, HTML5, cascading style sheets, and TypeScript (Angular). Open data reports of how users interact with the serious game were obtained using the Google Analytics application programming interface. The visual identity, logo, infographics, and icons were carefully developed by considering a selection of colors, typography, sounds, and images that are suitable for young audiences. Cards with cartoon characters were introduced at the end of each thematic topic to interact with the player, reinforcing their correct answers or alerting them to the need to learn more about the disease. The players’ performance was assessed by the rate of incorrect and correct answers and analyzed by linear correlation coefficient over 7 weeks. The agile SCRUM development methodology enabled quick and daily interactions of developers through a webchat and sequential team meetings. Results The game “COVID-19–Did You Know?” was made available for free on a public university website on April 1, 2020. The game had been accessed 17,571 times as of September 2020. Dissemination actions such as reports on social media and television showed a temporal correspondence with the access number. The players’ error rate in the topic “Mask” showed a negative trend (r=–.83; P=.01) over the weeks of follow-up. The other topics showed no significant trend over the weeks. Conclusions The gamification strategy for health education content on the theme of COVID-19 reached a young audience, which is considered to be a priority in the strategy of orientation toward social distancing. Specific educational reinforcement measures were proposed and implemented based on the players’ performance. The improvement in the users’ performance on the topic about the use of masks may reflect an increase in information about or adherence to mask use over time.

Chagas disease (CD) continues to be a major public health burden in Latina America. Information on the interplay between COVID-19 and CD is lacking. Our aim was to assess clinical characteristics and in-hospital outcomes of patients with CD and COVID-19, and to compare it to non-CD patients. Consecutive patients with confirmed COVID-19 were included from March to September 2020. Genetic matching for sex, age, hypertension, diabetes mellitus and hospital was performed in a 4:1 ratio. Of the 7018 patients who had confirmed COVID-19, 31 patients with CD and 124 matched controls were included (median age 72 (64–80) years-old, 44.5% were male). At baseline, heart failure (25.8% vs. 9.7%) and atrial fibrillation (29.0% vs. 5.6%) were more frequent in CD patients than in the controls (p < 0.05). C-reactive protein levels were lower in CD patients compared with the controls (55.5 [35.7, 85.0] vs. 94.3 [50.7, 167.5] mg/dL). In-hospital management, outcomes and complications were similar between the groups. In this large Brazilian COVID-19 Registry, CD patients had a higher prevalence of atrial fibrillation and chronic heart failure compared with non-CD controls, with no differences in-hospital outcomes. The lower C-reactive protein levels in CD patients require further investigation.

Background Birth plans are meant to be a declaration of the expectations and preferences of pregnant woman regarding childbirth. The My Prenatal Care app engages pregnant women in an educational intervention for a healthy pregnancy. We hypothesized that users’ positive perception of an in-app birth plan is a relevant step for establishing direct communication between pregnant women and the health care team, based on an online report available on the app. Objective This study aimed to evaluate pregnant women’s perception about the communicability of birth-plan preparation using a mobile app. Methods This was an observational, exploratory, descriptive study. The methodology was user centered, and both qualitative and quantitative approaches were employed. The tools of the communicability evaluation method were applied. Overall, 11 pregnant women evaluated their experience of using a birth-plan prototype interface. The evaluation was performed in a controlled environment, with authorized video recording. There were 8 task-oriented interactions proposed to evaluate interface communicability with users when using the Birth Plan menu. For evaluating perceptions and experiences, a survey with structured and open-ended questions in addition to the free expression of participants was conducted. The primary outcomes assessed were interface communicability and user’s perception of the Birth Plan prototype interface in the My Prenatal Care mobile app. Secondarily, we involved users in the prototyping phase of the interface to identify bottlenecks for making improvements in the app. Results Regarding users’ performance in accomplishing previously prepared tasks, we found that 10 of 11 (91%) women were capable of completing at least 6 of 8 (75%) tasks. A positive relationship was found between the number of communicability problems and the success of completing the tasks. An analysis of the records revealed three communicability breakdowns related to the data entry, save, and scrollbar functions. The participants freely expressed suggestions for improvements such as for the save function and the process of sharing the birth-plan form upon completion. Conclusions Users had a positive perception of the Birth Plan menu of the My Prenatal Care app. This user-centered validation enabled the identification of solutions for problems, resulting in improvements in the app.

Objective: Chagas disease (CD) continues to be a major public health burden in Latina America, where co-infection with SARS-CoV-2 can occur. However, information on the interplay between COVID-19 and Chagas disease is lacking. Our aim was to assess clinical characteristics and in-hospital outcomes of patients with CD and COVID-19, and to compare it to non-CD patients. Methods: Patients with COVID-19 diagnosis were selected from the Brazilian COVID-19 Registry, a prospective multicenter cohort, from March to September, 2020. CD diagnosis was based on hospital record at the time of admission. Study data were collected by trained hospital staff using Research Electronic Data Capture (REDCap) tools. Genetic matching for sex, age, hypertension, DM and hospital was performed in a 4:1 ratio. Results: Of the 7,018 patients who had confirmed infection with SARS-CoV-2 in the registry, 31 patients with CD and 124 matched controls were included. Overall, the median age was 72 (64.-80) years-old and 44.5% were male. At baseline, heart failure (25.8% vs. 9.7%) and atrial fibrillation (29.0% vs. 5.6%) were more frequent in CD patients than in the controls (p<0.05 for both). C-reactive protein levels were lower in CD patients compared with the controls (55.5 [35.7, 85.0] vs. 94.3 [50.7, 167.5] mg/dL). Seventy-two (46.5%) patients required admission to the intensive care unit. In-hospital management, outcomes and complications were similar between the groups. Conclusions: In this large Brazilian COVID-19 Registry, CD patients had a higher prevalence of atrial fibrillation and chronic heart failure compared with non-CD controls, with no differences in-hospital outcomes. The lower C-reactive protein levels in CD patients require further investigation.

Resumo Introdução: A comunicação entre os profissionais de saúde e seus pacientes tem se beneficiado da popularização dos dispositivos móveis. Essa análise tem por objetivo apresentar um aplicativo direcionado para mulheres durante a gravidez, parto e puerpério e os resultados da sua disseminação na sociedade. Metodologia: Caracterizado como pesquisa extensionista, o projeto APP-Meu Pré-natal é uma ação acadêmica voltada para sociedade. O desenvolvimento do software foi conduzido por uma equipe multidisciplinar da área das ciências da saúde e da computação. O conteúdo elaborado e validado disponibilizou textos de base cientifica em português, inglês e espanhol com linguagem acessível ao público leigo, imagens e vídeo, através de interface para navegação fácil e intuitiva entre seus módulos. O software de desenvolvimento híbrido foi disponibilizado gratuitamente em lojas de aplicativos na Internet. Resultados: Entre outubro de 2016 a junho de 2017 o aplicativo foi baixado 19.364 vezes. A maior parte a partir de dispositivos de comunicação do tipo Android: 14.791 (76,4%). Os usuários foram provenientes de 81 países. Conclusões: A rápida popularização e o alcance do aplicativo deixam claro a importância desse canal de comunicação para propostas de educação em saúde e a valorização da certificação acadêmica de seu conteúdo pelo usuário. Palavras-chave: dispositivos móveis; educação em saúde; pré-natal; relações comunidade-instituição.

A pandemia do novo coronavírus tem sobrecarregado os sistemas de saúde ao limite da capacidade de atendimento. Nosso objetivo foi avaliar a eficácia de um chatbot desenvolvido para triagem de pacientes, antes de teleconsulta, para identificar sintomas de COVID-19. Sintomas informados no diálogo foram comparados com os relatados aos médicos, em um serviço de urgência. Em 96 pacientes, dispneia foi o sintoma mais frequente (16,6%) e o único que mostrou concordância moderada com a história registrada em prontuário eletrônico (Kappa=0,605). Concluindo, a tecnologia mostrou-se útil para detectar um dos sintomas graves da COVID-19, mas não foi possível evidenciar sua eficácia em relação aos sintomas menores.

Background: The Birth Plan (BP) is supposed to be a declaration of expectations and preferences of the pregnant woman regarding childbirth. Although several mobile applications (apps) have been developed to offer support during pregnancy, only a few offer the BP. An academic team developed an app named My-PrenatalCare, to provide scientific information directly to women about healthy habits and practices during pregnancy, delivery, and puerperium. More recently, a questionnaire was introduced to facilitate the development of a BP as a strategy for childbirth, and to provide a new channel of communication between her and the maternity team. Objective: To validate a template for BP preparation mediated by a mobile app, based on perceptions of pregnant users. Methods: This was an observational, exploratory, and descriptive study. The methodology of the evaluation was user-centered, and both qualitative and quantitative approaches were employed. Participation in the study was voluntary, and data were collected in a Brazilian public and university health unit for prenatal care. Eleven pregnant women evaluated their experience of using the BP prototype interface. Eight tasks were proposed to measure the users' efficiency and the effectiveness of the interface. Tests of communicability intended to identify communication problems. The evaluation took place in a controlled environment, with authorized video recording. Data collected from a survey with structured and free questions, in addition to free expression of participants' perceptions and

A pandemia do novo coronavírus tem sobrecarregado os sistemas de saúde ao limite da capacidade de atendimento. Nosso objetivo foi avaliar a eficácia de um chatbot desenvolvido para triagem de pacientes, antes de teleconsulta, para identificar sintomas de COVID-19. Sintomas informados no diálogo foram comparados com os relatados aos médicos, em um serviço de urgência. Em 96 pacientes, dispneia foi o sintoma mais