Objectives Little is currently known about vaccine effectiveness (VE) for either two doses of Oxford-AstraZeneca (ChAdOx1) viral vector vaccine or CoronaVac inactivated viral vaccine followed by a third dose of mRNA vaccine (Pfizer/BioNTech) among healthcare workers (HCWs). Methods We conducted a retrospective cohort study among HCWs (aged ≥18 years) working in a private healthcare system in Brazil from January to December 2021. VE was defined as 1-IRR (incidence rate ratio), with IRR determined using Poisson models with the occurrence of laboratory-confirmed COVID-19 infection as the outcome, adjusting for age, sex, and job type. We compared those receiving viral vector or inactivated viral primary series (two doses) to those who received an mRNA booster. Results A total of 11,427 HCWs met the inclusion criteria. COVID-19 was confirmed in 31.5% of HCWs receiving two doses of CoronaVac vaccine vs. 0.9% of HCWs receiving two doses of CoronaVac vaccine with mRNA booster (p < 0.001), and 9.8% of HCWs receiving two doses of ChAdOx1 vaccine vs. 1% among HCWs receiving two doses of ChAdOx1 vaccine with mRNA booster (p < 0.001). In the adjusted analyses, the estimated VE was 92.0% for two CoronaVac vaccines plus mRNA booster, and 60.2% for two ChAdOx1 vaccines plus mRNA booster, when compared to those with no mRNA booster. Of 246 samples screened for mutations, 191 (77.6%) were Delta variants. Conclusions While two doses of ChAdOx1 or CoronaVac vaccines prevent COVID-19, the addition of a Pfizer/BioNTech booster provided significantly more protection.
Objectives: We aimed to investigate real-world vaccine effectiveness (VE) for Oxford-AstraZeneca (ChAdOx1) and CoronaVac against laboratory-confirmed COVID-19 infection among healthcare workers (HCWs). Methods: We conducted a retrospective cohort study among HCWs (aged ≥18 years) working in a private healthcare system in Brazil between January 1, 2021 and August 3, 2021. To assess VE, we calculated VE=1-RR (rate ratio), with RR determined by adjusting Poisson models with the occurrence of COVID-19 infection as the outcome, and the vaccination status as the main exploratory variable. We used the logarithmic link function and simple models adjusting for sex, age and job types. Results: 13,813 HCWs met the inclusion criteria for this analysis. 6,385 (46.2%) received the CoronaVacvaccine, 5,916 (42.8%) received the ChAdOx1 vaccine, and 1,512 (11.0%) were not vaccinated. Overall, COVID-19 infection cases happened in 6% of unvaccinated HCWs, 3% of HCWs receiving two doses of CoronaVacvaccine, and 0.7% of HCWs receiving two doses of ChAdOx1 vaccine (p-value< 0.001). In the adjusted analyses, the estimated VE was 51.3% for CoronaVac, and 88.1% for ChAdOx1 vaccine. Both vaccines reduced the number of hospitalizations, the length of hospital stay, and the need of mechanical ventilation. Nineteen SARSCoV-2 samples from nineteen HCWs were screened for mutations of interest. Eighteen out of nineteen of those samples were Gamma SARS-CoV-2 variant. Conclusions: While both COVID-19 vaccines (viral vector and inactivated virus) can significantly prevent COVID-19 infection among HCWs, CoronaVac was much less effective. The COVID-19 vaccines were also effective even against a dominant Gamma variant.
Objective: To determine risk factors for the development of long coronavirus disease 2019 (COVID-19) in healthcare personnel (HCP). Methods: We conducted a case–control study among HCP who had confirmed symptomatic COVID-19 working in a Brazilian healthcare system between March 1, 2020, and July 15, 2022. Cases were defined as those having long COVID according to the Centers for Disease Control and Prevention definition. Controls were defined as HCP who had documented COVID-19 but did not develop long COVID. Multiple logistic regression was used to assess the association between exposure variables and long COVID during 180 days of follow-up. Results: Of 7,051 HCP diagnosed with COVID-19, 1,933 (27.4%) who developed long COVID were compared to 5,118 (72.6%) who did not. The majority of those with long COVID (51.8%) had 3 or more symptoms. Factors associated with the development of long COVID were female sex (OR, 1.21; 95% CI, 1.05–1.39), age (OR, 1.01; 95% CI, 1.00–1.02), and 2 or more SARS-CoV-2 infections (OR, 1.27; 95% CI, 1.07–1.50). Those infected with the SARS-CoV-2 δ (delta) variant (OR, 0.30; 95% CI, 0.17–0.50) or the SARS-CoV-2 o (omicron) variant (OR, 0.49; 95% CI, 0.30–0.78), and those receiving 4 COVID-19 vaccine doses prior to infection (OR, 0.05; 95% CI, 0.01–0.19) were significantly less likely to develop long COVID. Conclusions: Long COVID can be prevalent among HCP. Acquiring >1 SARS-CoV-2 infection was a major risk factor for long COVID, while maintenance of immunity via vaccination was highly protective.
Objectives: We aimed to determine risk factors for the development of long coronavirus disease (COVID) in healthcare workers (HCWs). Methods: We conducted a case-control study among HCWs who had confirmed COVID-19 infection working in a Brazilian healthcare system between March 1, 2020 and July 15, 2022. Cases were defined as those having long COVID per the Centers for Disease Control and Prevention definition. Controls were defined as HCWs who had documented COVID-19 infection but did not develop long COVID. Multiple logistic regression was used to assess the association between exposure variables and long COVID during 180 days of follow-up. Results: Of 7,051 HCWs diagnosed with COVID-19 infection, 1,933 (27.4%) who developed long COVID were compared to 5,118 (72.6%) who did not. The majority of those with long COVID (51.8%) had 3 or more symptoms. Factors associated with development of long COVID were female sex (OR 1.21 [CI95 1.05-1.39]), age (OR 1.01 [CI95 1.00-1.02]), and two or more COVID-19 infections (1.27 [CI95 1.07-1.50]). Those infected with the Delta variant (OR 0.30 [CI95 0.17-0.50]) or the Omicron variant (OR 0.49 [CI95 0.30-0.78]), and those receiving four COVID-19 vaccine doses prior to infection (OR 0.05 [CI95 0.01-0.19]) were significantly less likely to develop long COVID. Conclusions: Long COVID can be prevalent among HCWs. We found that acquiring more than one COVID-19 infection was a major risk factor for long COVID, while maintenance of immunity via vaccination was highly protective.
Introdução: O trabalho em serviços de saúde tem sido associado à grande sobrecarga psíquica, com elevado número de afastamentos em razão de transtornos mentais. Estes agravos à saúde, especialmente em trabalhadores da enfermagem causam prejuízos não só aos profissionais, mas também às instituições empregadoras e assistenciais em todo o mundo. No Brasil, os transtornos mentais estão entre as principais causas de dias perdidos no trabalho, ocupando nos últimos anos o terceiro principal motivo de concessão de benefício auxílio-doença por incapacidade laborativa. Objetivo: Identificar as causas que levam trabalhadores de Enfermagem ao Afastamento Previdenciário por Transtornos Mentais. Método: Trata-se de uma pesquisa bibliográfica descritiva. Foram utilizados como descritores (DeCS) específicos "Transtornos Mentais", "Estresse psicológico" e "Saúde Mental", cruzando com os descritores (DeCS) gerais: "Profissionais de Enfermagem, "Previdência Social", no Idioma Português, Artigos disponíveis gratuitamente na íntegra, utilizando o limite de "Adulto", publicados entre janeiro de 2014 e julho de 2019. A coleta de dados foi realizada nos meses de setembro e outubro de 2019 após a aprovação do projeto pela Comissão Científica do Curso de Enfermagem da Faculdade de Ciências Médicas da Santa Casa de São Paulo-FCMSCSP. Resultados: As causas foram categorizadas em 2 fatores: os inerentes ao trabalhador de enfermagem: Síndrome de Burnout, depressão, ansiedade e alterações de humor, estresse, uso de álcool e outras drogas, dificuldades de lidar com a morte, dor e sofrimento do outro, falta de tempo para atividades de lazer e vida pessoal, ausência de cuidado de si, prevalentemente no sexo feminino e os fatores relacionados ambiente de trabalho: baixo poder de decisão, falta de apoio social, falta de suporte psicossocial, falta de valorização e aprimoramento profissional, sobrecargas física, emocional e profissional, relacionamento interpessoal ineficaz, acúmulo de tarefas, número insuficiente de
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