A nationwide survey of dentists was carried out in Brazil, a new pandemic epicenter, to analyze how dental care coverage has been affected in public versus private networks, changes in routine and burdens, and how local prevalence of COVID-19 affects dental professionals. Dentists were recruited via email and Instagram®. Responses to a pre-tested questionnaire were collected May 15–24, 2020. COVID-19 case/death counts in the state where respondents work was used to test associations between contextual status and decreases in weekly appointments, fear of contracting COVID-19 at work, and current work status (α = 0.05). Over 10 days, 3,122 responses were received (response rate ~2.1%) from all Brazilian states. Work status was affected for 94%, with less developed regions being more impacted. The pandemic impact on clinical routine was high/very high for 84%, leading to varied changes to clinic infrastructure, personal protective equipment use, and patient screening, as well as increased costs. COVID-19 patients had been seen by 5.3% of respondents; 90% reported fearing contracting COVID-19 at work. Multilevel models showed that greater case and death rates (counted as 1000 cases and 100 deaths per million inhabitants) in one’s state increased the odds of being fearful of contracting the disease (18% and 25%). For each additional 1000 cases/100 deaths, the odds of currently not working or treating only emergencies increased by 36% and 58%. The reduction in patients seen weekly was significantly greater in public (38.7±18.6) than in private clinics (22.5±17.8). This study provides early evidence of three major impacts of the pandemic on dentistry: increasing inequalities due to coverage differences between public and private networks; the adoption of new clinical routines, which are associated with an economic burden for dentists; and associations of regional COVID-19 incidence/mortality with fear of contracting the disease at work.

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We performed a retrospective study of Covid-19 in people with HIV (PWH). PWH with Covid-19 demonstrated severe lymphopenia and decreased CD4+ T cell counts. Levels of inflammatory markers, including C-reactive protein, fibrinogen, D-dimer, interleukin-6, interleukin-8, and TNF-alpha were commonly elevated. In all, 19/72 hospitalized individuals (26.4%) died and 53 (73.6%) recovered. PWH who died had higher levels of inflammatory markers and more severe lymphopenia than those who recovered. These findings suggest that PWH remain at risk for severe manifestations of Covid-19 despite ART and that those with increased markers of inflammation and immune dysregulation are at risk for worse outcomes.

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A nationwide survey of dentists was carried out in Brazil, a new pandemic epicenter, to analyze how dental coverage has been affected (public versus private networks), changes in routine and burdens, and how the local prevalence of COVID-19 affects dental professionals. Dentists were recruited via email and an Instagram campaign. Responses to an online questionnaire were collected May 15-24, 2020. COVID-19 case/death counts in the state where respondents work was used to test associations between contextual status and decreases in weekly appointments, fear of contracting COVID-19 at work, and current work status (alpha=0.05). Over 10 days, 3,122 responses were received, with region, gender, and age distributions similar to those of dentists in Brazil. Work status was affected for 94% of dentists, with less developed regions being more impacted. The impact on routine was high or very high for 84%, leading to varied changes to clinic infrastructure, personal protective equipment use, patient screening, and increased costs. COVID-19 patients had been seen by 5.3% of respondents, and 90% reported fearing contracting COVID-19 at work. Multilevel statistics showed that greater case and death rates (1000 cases or 100 deaths per million inhabitants) in one's state increased the odds of being fearful of contracting the disease (by 18% and 25%). For each additional 1000 cases or 100 deaths, the odds of currently not working or treating emergencies increased by 36% and 58%. The reduction in patients seen weekly per dentist was greater in public (38.7+/-18.6) than in private clinics (22.5+/-17.8). This study provides early evidence of three major impacts of the pandemic on dentistry in Brazil: increasing inequalities due to coverage differences between public and private networks; adoption of new clinical routines, which are associated with an economic burden; and associations of regional COVID-19 incidence and mortality with fear of contracting the disease at work.