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Gerk A, Naus A, Carroll M, Ponte L, Salgado LS, Marrazzo E, Secanho M, Botelho F, Mooney D, Ferreira R, Ferreira JL. Perceived Impact of Coronavirus Disease 2019 on Surgical Training: A Brazilian Survey. J Surg Res 2024; 295:619-630. [PMID: 38101108 DOI: 10.1016/j.jss.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/22/2023] [Accepted: 10/27/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Recent studies revealed that coronavirus disease 2019 (COVID-19) negatively impacted residency programs worldwide, particularly procedure-based programs. However, most studies are from high-income countries, with scarce data from low- and middle-income countries. Pandemic effects on surgical training were likely worse in strictly apprenticeship models relying heavily on surgical volume as opposed to competency-based programs. Notably, training programs in Brazil and other low- and middle-income countries follow these strict apprenticeship style frameworks. In this study, we aimed to evaluate the trainees' perceptions of the impact of COVID-19 on their Brazilian surgical programs. METHODS A cross-sectional study was performed using an anonymous survey in Portuguese, distributed via social media platforms to surgical residents enrolled in Brazilian surgery programs. Data collection took place from August 2021 to May 2022. The survey contained 30 questions on the perception of the impact of COVID-19 on surgical training. RESULTS One-hundred sixty-two residents from 17 different surgical specialties and all five regions of Brazil responded to the survey. Of 162 residents, 145 (89%) believed the pandemic negatively impacted their surgical training. Furthermore, of 162 residents, 153 (94%) reported that elective surgical volume decreased during the pandemic and 91 (56%) were redeployed to assist with COVID-19 management. As a result, 102 of 162 (63%) residents believed their surgical skills were negatively impacted by COVID-19. Yet, 95 of 162 (59%) residents reported their residency programs did not offer resources to mitigate the pandemic's impact on training. Of 162 residents, 57 (35%) reported they did not feel on track for graduation, with no statistical difference between responses by year of residency (P = 0.083). Additionally, 124 of 162 (77%) residents reported that the pandemic negatively affected their mental health, most commonly related to stress at work, stress about transmitting COVID-19, and loss in surgical training. CONCLUSIONS Most of the surveyed Brazilian surgical residents felt the COVID-19 pandemic negatively impacted their training. This leads to believe that the detrimental impacts of the pandemic exposed preexisting weaknesses in the Brazilian surgical training model's dependence on a strict apprenticeship model. Our findings suggest a crucial need to redesign surgical education programs to make residency programs more prepared for changes in surgical volume, evolve the apprenticeship model to competency-based approaches, and unify surgical training standards in low- and middle-income countries.
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Affiliation(s)
- Ayla Gerk
- Universidad Católica Argentina, Buenos Aires, Argentina; Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts
| | - Abbie Naus
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts; Boston Children's Hospital, Boston, Massachusetts
| | - Madeleine Carroll
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts
| | - Lucas Ponte
- School of Medicine, University of Fortaleza, Fortaleza, Ceará, Brazil
| | | | - Enzzo Marrazzo
- Faculty of Medicine, Institute of Biological Sciences, Pontifícia Universidade Católica de Minas Gerais Poços de Caldas, Poços de Caldas, Minas Gerais, Brazil
| | - Murilo Secanho
- Faculty of Medical Sciences of Botucatu, UNESP Botucatu, Botucatu, São Paulo, Brazil
| | - Fabio Botelho
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Childrens' Hospital, McGill University, Montreal, Quebec, Canada
| | - David Mooney
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts; Boston Children's Hospital, Boston, Massachusetts
| | - Roseanne Ferreira
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Júlia Loyola Ferreira
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Childrens' Hospital, McGill University, Montreal, Quebec, Canada.
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da Silva BC, Cordioli RL, dos Santos BFC, Guerra JCDC, Rodrigues RDR, de Souza GM, Ashihara C, Midega TD, Campos NS, Carneiro BV, Campos FND, Guimarães HP, de Matos GFJ, de Aranda VF, Ferraz LJR, Corrêa TD. COVID-19-associated coagulopathy and acute kidney injury in critically ill patients. EINSTEIN-SAO PAULO 2023; 21:eAO0119. [PMID: 37729353 PMCID: PMC10501765 DOI: 10.31744/einstein_journal/2023ao0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 02/07/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE The incidence of thrombotic events and acute kidney injury is high in critically ill patients with COVID-19. We aimed to evaluate and compare the coagulation profiles of patients with COVID-19 developing acute kidney injury versus those who did not, during their intensive care unit stay. METHODS Conventional coagulation and platelet function tests, fibrinolysis, endogenous inhibitors of coagulation tests, and rotational thromboelastometry were conducted on days 0, 1, 3, 7, and 14 following intensive care unit admission. RESULTS Out of 30 patients included, 13 (43.4%) met the criteria for acute kidney injury. Comparing both groups, patients with acute kidney injury were older: 73 (60-84) versus 54 (47-64) years, p=0.027, and had a lower baseline glomerular filtration rate: 70 (51-81) versus 93 (83-106) mL/min/1.73m2, p=0.004. On day 1, D-dimer and fibrinogen levels were elevated but similar between groups: 1780 (1319-5517) versus 1794 (726-2324) ng/mL, p=0.145 and 608 (550-700) versus 642 (469-722) g/dL, p=0.95, respectively. Rotational thromboelastometry data were also similar between groups. However, antithrombin activity and protein C levels were lower in patients who developed acute kidney injury: 82 (75-92) versus 98 (90-116), p=0.028 and 70 (52-82) versus 88 (78-101) µ/mL, p=0.038, respectively. Mean protein C levels were lower in the group with acute kidney injury across multiple time points during their stay in the intensive care unit. CONCLUSION Critically ill patients experiencing acute kidney injury exhibited lower endogenous anticoagulant levels. Further studies are needed to understand the role of natural anticoagulants in the pathophysiology of acute kidney injury within this population.
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Affiliation(s)
- Bruno Caldin da Silva
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Ricardo Luiz Cordioli
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | | | | | - Roseny dos Reis Rodrigues
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Guilherme Martins de Souza
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Carolina Ashihara
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Thais Dias Midega
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Niklas Söderberg Campos
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Bárbara Vieira Carneiro
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Flávia Nunes Dias Campos
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Hélio Penna Guimarães
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | | | - Valdir Fernandes de Aranda
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Leonardo José Rolim Ferraz
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Thiago Domingos Corrêa
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
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Cribari-Neto F. A beta regression analysis of COVID-19 mortality in Brazil. Infect Dis Model 2023; 8:309-317. [PMID: 36945696 PMCID: PMC9988698 DOI: 10.1016/j.idm.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/26/2023] [Accepted: 02/26/2023] [Indexed: 03/09/2023] Open
Abstract
Brazil was one of the countries most impacted by the COVID-19 pandemic, with a cumulative total of nearly 700,000 deaths by early 2023. The country's federative units were unevenly affected by the pandemic and adopted mitigation measures of different scopes and intensity. There was intense conflict between the federal government and state governments over the relevance and extent of such measures. We build a simple regression model with good predictive power on state COVID-19 mortality rates in Brazil. Our results reveal that the federative units' urbanization rate and per capita income are important for determining their mean mortality rate and that the number of physicians per 100,000 inhabitants is important for modeling the mortality rate precision. Based on the fitted model, we obtain approximations for the levels of administrative efficiency of local governments in dealing with the pandemic.
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Affiliation(s)
- Francisco Cribari-Neto
- Department of Statistics, Federal University of Pernambuco, Recife, PE, 50670-901, Brazil
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de Macedo PM, Benko LMP, Falcão EMM, Nosanchuk JD, Almeida-Paes R, do Valle ACF. COVID-19 in patients with paracoccidioidomycosis. PLoS Negl Trop Dis 2023; 17:e0011322. [PMID: 37155708 DOI: 10.1371/journal.pntd.0011322] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/18/2023] [Accepted: 04/20/2023] [Indexed: 05/10/2023] Open
Abstract
INTRODUCTION In 2020, we reported the first patient with concomitant COVID-19 and paracoccidioidomycosis (PCM). Since then, no other cases have been recorded in the literature. We aim to update information on the occurrence of COVID-19 in patients with PCM followed at a reference center for infectious diseases at Rio de Janeiro, Brazil. METHODS We reviewed the medical records from patients diagnosed with PCM who presented with clinical symptoms, radiological findings, and/or laboratory diagnosis of COVID-19 at any time during their acute or follow-up care. The clinical profiles of these patients were described. RESULTS Between March 2020 and September 2022, we identified six individuals with COVID-19 among the 117 patients with PCM evaluated. The median age was 38 years and the male to female ratio 2:1. Most patients (n = 5) presented for evaluation due to acute PCM. The severity of COVID-19 ranged from mild to severe in acute PCM and only the single patient with chronic PCM died. CONCLUSIONS There is a range of disease severity in COVID-19 and PCM co-infection and concomitant disease may represent a severe association, especially in the chronic type of the mycosis with pulmonary involvement. As COVID-19 and chronic PCM share similar clinical aspects and PCM is neglected, it is probable that COVID-19 has been hampering simultaneous PCM diagnosis, which can explain the absence of new co-infection reports. With the continued persistence of COVID-19 globally, these findings further suggest that more attention by providers is necessary to identify co-infections with Paracoccidioides.
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Affiliation(s)
- Priscila Marques de Macedo
- Laboratory of Clinical Research on Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Lorena Macedo Pestana Benko
- Laboratory of Clinical Research on Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Eduardo Mastrangelo Marinho Falcão
- Laboratory of Clinical Research on Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Joshua D Nosanchuk
- Departments of Medicine and Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Rodrigo Almeida-Paes
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Antonio Carlos Francesconi do Valle
- Laboratory of Clinical Research on Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
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Charles CM, Munezero A, Bahamondes LG, Pacagnella RC. Comparison of contraceptive sales before and during the COVID-19 pandemic in Brazil. EUR J CONTRACEP REPR 2022; 27:115-120. [PMID: 35156489 DOI: 10.1080/13625187.2022.2027364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of the study was to assess the impact of the COVID-19 pandemic on sales of modern contraceptive methods in Brazil. METHODS Monthly sales data were analysed of short-acting reversible contraceptive methods and long-acting reversible contraceptive (LARC) methods (implants and intrauterine contraception) and COVID-19 related deaths. Contraceptive methods were grouped as follows: emergency contraception (EC); oral contraception, vaginal rings and transdermal patches; injectable contraception; LARC methods including the copper intrauterine device (Cu-IUD); and LARC methods excluding the Cu-IUD. RESULTS Contraceptive sales showed a non-significant increase in 2020 compared with the previous year; average sales ranged from 12.8 to 13.0 million units per month. Sales of injectable contraceptives increased between March and June 2020 and EC pills between June and July 2020; the variation in sales of pills, patches and rings was not significant. Sales of the levonorgestrel-releasing intrauterine system (LNG-IUS) and the etonogestrel (ENG) implant showed three patterns: a decrease in sales between February and May 2020 (coinciding with the closure of family planning services), an increase in sales after May 2020 (coinciding with the first COVID-19-related deaths), and a further increase in sales after July 2020 (corresponding to the increasing number of deaths from COVID-19). CONCLUSION The COVID-19 pandemic has disrupted the Brazilian health care system. Since many family planning clinics were closed, sales of most modern contraceptives fell during 2020; however, the increase in sales of the LNG-IUS and ENG implant in the private sector indicates inequitable access to modern contraceptive methods.
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Affiliation(s)
- Charles M'Poca Charles
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil.,Provincial Health Administration, DPS Manica, Chimoio, Mozambique
| | - Aline Munezero
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Luis G Bahamondes
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Rodolfo C Pacagnella
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
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Gorjão R, Hirabara S, Masi L, Serdan T, Gritte R, Hatanaka E, Souza-Siqueira T, Pithon-Curi A, Lima TD, Pithon-Curi T, Marchini J, Machado M, Souza H, Curi R. Poor prognosis indicators of type-2 diabetic COVID-19 patients. Braz J Med Biol Res 2022; 55:e11819. [PMID: 35766706 PMCID: PMC9224823 DOI: 10.1590/1414-431x2022e11819] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/17/2022] [Indexed: 12/24/2022] Open
Abstract
Diabetes is associated with a worse prognosis and a high risk of morbidity and mortality in COVID-19 patients. We aimed to evaluate the main factors involved in the poor prognosis in diabetic patients. A total of 984 patients diagnosed with COVID-19 admitted to the hospital were included in this study. Patients were first divided into type-2 diabetic (DM+) and non-diabetic (DM–) groups. The participants were analyzed based on the National Early Warning Score (NEWS) and on the Quick-Sequential Organ Failure Assessment (qSOFA) to find the best prognostic risk score for our study. The DM+ and DM– groups were divided into non-severe and severe groups. Comparative and correlative analyses were used to identify the physiological parameters that could be employed for creating a potential risk indicator for DM+ COVID-19 patients. We found a poorer prognosis for the DM+ COVID-19 patients with a higher ICU admission rate, mechanical ventilation rate, vasopressor use, dialysis, and longer treatment times compared with the DM– group. DM+ COVID-19 patients had increased plasma glucose, lactate, age, urea, NEWS, and D-dimer levels, herein referred to as the GLAUND set, and worse prognosis and outcomes when compared with infected DM– patients. The NEWS score was a better indicator for assessing COVID-19 severity in diabetic patients than the q-SOFA score. In conclusion, diabetic COVID-19 patients should be assessed with the NEWS score and GLAUND set for determining their prognosis COVID-19 prognosis.
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Affiliation(s)
- R. Gorjão
- Universidade Cruzeiro do Sul, Brasil
| | | | - L.N. Masi
- Universidade Cruzeiro do Sul, Brasil
| | - T.D.A. Serdan
- Universidade Cruzeiro do Sul, Brasil; New York University, USA
| | | | | | | | | | | | | | | | | | | | - R. Curi
- Universidade Cruzeiro do Sul, Brasil; Instituto Butantan, Brasil
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Truche P, Campos LN, Marrazzo EB, Rangel AG, Bernardino R, Bowder AN, Buda AM, Faria I, Pompermaier L, Rice HE, Watters D, Dantas FLL, Mooney DP, Botelho F, Ferreira RV, Alonso N. Association between government policy and delays in emergent and elective surgical care during the COVID-19 pandemic in Brazil: a modeling study. ACTA ACUST UNITED AC 2021; 3:100056. [PMID: 34725652 PMCID: PMC8552244 DOI: 10.1016/j.lana.2021.100056] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/09/2021] [Accepted: 08/12/2021] [Indexed: 12/01/2022]
Abstract
Background The impact of public health policy to reduce the spread of COVID-19 on access to surgical care is poorly defined. We aim to quantify the surgical backlog during the COVID-19 pandemic in the Brazilian public health system and determine the relationship between state-level policy response and the degree of state-level delays in public surgical care. Methods Monthly estimates of surgical procedures performed per state from January 2016 to December 2020 were obtained from Brazil's Unified Health System Informatics Department. Forecasting models using historical surgical volume data before March 2020 (first reported COVID-19 case) were constructed to predict expected monthly operations from March through December 2020. Total, emergency, and elective surgical monthly backlogs were calculated by comparing reported volume to forecasted volume. Linear mixed effects models were used to model the relationship between public surgical delivery and two measures of health policy response: the COVID-19 Stringency Index (SI) and the Containment & Health Index (CHI) by state. Findings Between March and December 2020, the total surgical backlog included 1,119,433 (95% Confidence Interval 762,663–1,523,995) total operations, 161,321 (95%CI 37,468–395,478) emergent operations, and 928,758 (95%CI 675,202–1,208,769) elective operations. Increased SI and CHI scores were associated with reductions in emergent surgical delays but increases in elective surgical backlogs. The maximum government stringency (score = 100) reduced emergency delays to nearly zero but tripled the elective surgical backlog. Interpretation Strong health policy efforts to contain COVID-19 ensure minimal reductions in delivery of emergent surgery, but dramatically increase elective backlogs. Additional coordinated government efforts will be necessary to specifically address the increased elective backlogs that accompany stringent responses.
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Affiliation(s)
- Paul Truche
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States
| | | | - Enzzo Barrozo Marrazzo
- Institute of Biological Sciences, Faculty of Medicine Pontifícia Universidade Católica de Minas Gerais Poços de Caldas, MG, Brazil
| | - Ayla Gerk Rangel
- Faculty of Medical Sciences, Universidad Católica Argentina, Buenos Aires, Argentina
| | - Ramon Bernardino
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Alexis N Bowder
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States
| | - Alexandra M Buda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States
| | - Isabella Faria
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Laura Pompermaier
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States
| | - Henry E Rice
- Duke University Medical Center and Duke Global Health Institute, Durham, NC, United States
| | - David Watters
- Deakin University and Barwon Health, Melbourne, Australia
| | | | | | | | | | - Nivaldo Alonso
- Department of Plastic Surgery, University of São Paulo, São Paulo, Brazil
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Montagna E, Donohoe J, Zaia V, Duggan E, O'Leary P, Waddington J, O'Tuathaigh C. Transition to clinical practice during the COVID-19 pandemic: a qualitative study of young doctors' experiences in Brazil and Ireland. BMJ Open 2021; 11:e053423. [PMID: 34551956 PMCID: PMC8460523 DOI: 10.1136/bmjopen-2021-053423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To explore and compare the perspectives of junior doctors in Brazil and Ireland regarding transition and professional socialisation during the COVID-19 pandemic, with the purpose of identifying better ways to support doctors as they assume their new professional role. DESIGN 27 semistructured interviews. Transcripts were analysed using qualitative thematic analysis. Cruess' framework of professional socialisation in medicine supported the interpretation of these data. SETTING Public health hospitals across four Brazilian states (Santa Catarina, São Paulo, Ceará, Paraíba) and County Cork in the South of Ireland. PARTICIPANTS Twenty-seven male and female medical junior doctors who had graduated between November 2019 and April 2020. RESULTS Fourteen Brazilian and 13 Irish junior doctors were interviewed for this study. Entry to clinical practice during the pandemic had a significant impact on factors influencing the professional socialisation of junior doctors. This impact was reflected across the following six thematic areas: lack of preparedness; disrupted trajectory of role adaptation; fewer opportunities for experiential learning; solidarity and isolation; altered interactions with patients; challenges to health and well-being. CONCLUSIONS Transition to clinical practice is an important stage in junior doctors' professional socialisation and identity formation. The COVID-19 pandemic created the opportunity for medical graduates to enter the workforce earlier than usual. Entering the workforce during this period created a lack of confidence among junior doctors concerning the boundaries of their new role and responsibilities, while simultaneously disrupting their social integration. Priorities to mitigate the impact of COVID-19 and future pandemics on this transition are presented.
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Affiliation(s)
- Erik Montagna
- Faculdade de Medicina do ABC (FMABC), Centro Universitário Saúde ABC, São Paulo, Brazil
| | | | - Victor Zaia
- Faculdade de Medicina do ABC (FMABC), Centro Universitário Saúde ABC, São Paulo, Brazil
| | - Eileen Duggan
- School of Medicine, University College Cork, Cork, Ireland
| | - Paula O'Leary
- School of Medicine, University College Cork, Cork, Ireland
| | - John Waddington
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and College of Pharmaceutical Sciences, Soochow University, Suzhou, Jiangsu, China
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Fischer R, Bortolini T, Pilati R, Porto J, Moll J. Values and COVID-19 worries: The importance of emotional stability traits. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021; 182:111079. [PMID: 34538995 PMCID: PMC8439713 DOI: 10.1016/j.paid.2021.111079] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/29/2022]
Abstract
We examined the relationship between emotional stability as a more stable personality trait and COVID-related worries with basic human values in a Brazilian sample (N = 578) that is strongly affected by COVID-19. We tested whether emotional stability would moderate the effect of infection and economic worries on personal values. In line with predictions, we found that infection worries were more strongly related to Security values, especially among individuals with less emotional stability, whereas economic worries were more strongly correlated with Power values, in particular among individuals with less emotional stability. Findings for Achievement values suggested perceived behavioral control effects for individuals high in Emotional Stability. Our findings provide insights into possible longer-term psychological effects of the current pandemic. Emotional dynamics in connection with worries created by the pandemic could influence values of importance for societal functioning in the short to medium term.
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Affiliation(s)
- Ronald Fischer
- Instituto D'Or de Pesquisa & Ensino, Brazil.,Victoria University of Wellington, New Zealand
| | | | | | | | - Jorge Moll
- Instituto D'Or de Pesquisa & Ensino, Brazil
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Tang Y, Serdan TDA, Alecrim AL, Souza DR, Nacano BRM, Silva FLR, Silva EB, Poma SO, Gennari-Felipe M, Iser-Bem PN, Masi LN, Tang S, Levada-Pires AC, Hatanaka E, Cury-Boaventura MF, Borges FT, Pithon-Curi TC, Curpertino MC, Fiamoncini J, Leandro CG, Gorjao R, Curi R, Hirabara SM. A simple mathematical model for the evaluation of the long first wave of the COVID-19 pandemic in Brazil. Sci Rep 2021; 11:16400. [PMID: 34385538 PMCID: PMC8361144 DOI: 10.1038/s41598-021-95815-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 07/23/2021] [Indexed: 12/03/2022] Open
Abstract
We propose herein a mathematical model to predict the COVID-19 evolution and evaluate the impact of governmental decisions on this evolution, attempting to explain the long duration of the pandemic in the 26 Brazilian states and their capitals well as in the Federative Unit. The prediction was performed based on the growth rate of new cases in a stable period, and the graphics plotted with the significant governmental decisions to evaluate the impact on the epidemic curve in each Brazilian state and city. Analysis of the predicted new cases was correlated with the total number of hospitalizations and deaths related to COVID-19. Because Brazil is a vast country, with high heterogeneity and complexity of the regional/local characteristics and governmental authorities among Brazilian states and cities, we individually predicted the epidemic curve based on a specific stable period with reduced or minimal interference on the growth rate of new cases. We found good accuracy, mainly in a short period (weeks). The most critical governmental decisions had a significant temporal impact on pandemic curve growth. A good relationship was found between the predicted number of new cases and the total number of inpatients and deaths related to COVID-19. In summary, we demonstrated that interventional and preventive measures directly and significantly impact the COVID-19 pandemic using a simple mathematical model. This model can easily be applied, helping, and directing health and governmental authorities to make further decisions to combat the pandemic.
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Affiliation(s)
- Yuanji Tang
- Applied NanoFemto Technologies, LLC, Lowell, MA, USA
| | - Tamires D A Serdan
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Amanda L Alecrim
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Diego R Souza
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Bruno R M Nacano
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Flaviano L R Silva
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Eliane B Silva
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Sarah O Poma
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Matheus Gennari-Felipe
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Patrícia N Iser-Bem
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Laureane N Masi
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Sherry Tang
- Kaiser Southern California Permanente Medical Group, Riverside, CA, 92505, USA
| | - Adriana C Levada-Pires
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Elaine Hatanaka
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Maria F Cury-Boaventura
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Fernanda T Borges
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Tania C Pithon-Curi
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Marli C Curpertino
- Medical School, Faculdade Dinâmica do Vale do Piranga, Ponte Nova, MG, Brazil.,Laboratory of Epidemiological and Computational Methods in Health, Department of Medicine and Nursing, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | - Jarlei Fiamoncini
- School of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil.,Food Research Center (FoRC), Sao Paulo, Brazil
| | | | - Renata Gorjao
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil
| | - Rui Curi
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil.,Butantan Institute, Sao Paulo, Brazil
| | - Sandro Massao Hirabara
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Rua Galvao Bueno, 868, Liberdade, Sao Paulo, SP, 01506-000, Brazil.
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11
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Prediction studies of the epidemic peak of coronavirus disease in Brazil via new generalised Caputo type fractional derivatives. ALEXANDRIA ENGINEERING JOURNAL 2021; 60:3189-3204. [PMCID: PMC7859676 DOI: 10.1016/j.aej.2021.01.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/03/2021] [Accepted: 01/08/2021] [Indexed: 05/22/2023]
Abstract
The first reported case of coronavirus disease (COVID-19) in Brazil was confirmed on 25 February 2020 and then the number of symptomatic cases produced day by day. In this manuscript, we studied the epidemic peaks of the novel coronavirus (COVID-19) in Brazil by the successful application of Predictor–Corrector (P-C) scheme. For the proposed model of COVID-19, the numerical solutions are performed by a model framework of the recent generalized Caputo type non-classical derivative. Existence of unique solution of the given non-linear problem is presented in terms of theorems. A new analysis of epidemic peaks in Brazil with the help of parameter values cited from a real data is effectuated. Graphical simulations show the obtained results to classify the importance of the classes of projected model. We observed that the proposed fractional technique is smoothly work in the coding and very easy to implement for the model of non-linear equations. By this study we tried to exemplify the roll of newly proposed fractional derivatives in mathematical epidemiology. The main purpose of this paper is to predict the epidemic peak of COVID-19 in Brazil at different transmission rates. We have also attempted to give the stability analysis of the proposed numerical technique by the reminder of some important lemmas. At last we concluded that when the infection rate increases then the nature of the diseases changes by becoming more deathly to the population.
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12
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Manoharan L, Cattrall JWS, Harris C, Newell K, Thomson B, Pritchard MG, Bannister PG, Sigfrid L, Solomon T, Horby PW, Carson G, Olliaro P. Evaluating clinical characteristics studies produced early in the Covid-19 pandemic: A systematic review. PLoS One 2021; 16:e0251250. [PMID: 34003850 PMCID: PMC8130955 DOI: 10.1371/journal.pone.0251250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 04/22/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Clinical characterisation studies have been essential in helping inform research, diagnosis and clinical management efforts, particularly early in a pandemic. This systematic review summarises the early literature on clinical characteristics of patients admitted to hospital, and evaluates the quality of evidence produced during the initial stages of the pandemic. METHODS MEDLINE, EMBASE and Global Health databases were searched for studies published from January 1st 2020 to April 28th 2020. Studies which reported on at least 100 hospitalised patients with Covid-19 of any age were included. Data on clinical characteristics were independently extracted by two review authors. Study design specific critical appraisal tools were used to evaluate included studies: the Newcastle Ottawa scale for cohort and cross sectional studies, Joanna Briggs Institute checklist for case series and the Cochrane collaboration tool for assessing risk of bias in randomised trials. RESULTS The search yielded 78 studies presenting data on 77,443 people. Most studies (82%) were conducted in China. No studies included patients from low- and middle-income countries. The overall quality of included studies was low to moderate, and the majority of studies did not include a control group. Fever and cough were the most commonly reported symptoms early in the pandemic. Laboratory and imaging findings were diverse with lymphocytopenia and ground glass opacities the most common findings respectively. Clinical data in children and vulnerable populations were limited. CONCLUSIONS The early Covid-19 literature had moderate to high risk of bias and presented several methodological issues. Early clinical characterisation studies should aim to include different at-risk populations, including patients in non-hospital settings. Pandemic preparedness requires collection tools to ensure observational studies are methodologically robust and will help produce high-quality data early on in the pandemic to guide clinical practice and public health policy. REVIEW REGISTRATION Available at https://osf.io/mpafn.
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Affiliation(s)
- Lakshmi Manoharan
- International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Global Support Centre, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Jonathan W. S. Cattrall
- Liverpool University Hospitals NHS Foundation Trust, University of Liverpool, Liverpool, United Kingdom
| | - Carlyn Harris
- Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Katherine Newell
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Blake Thomson
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom
| | - Mark G. Pritchard
- International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Global Support Centre, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Peter G. Bannister
- School of Medicine, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Louise Sigfrid
- International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Global Support Centre, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Tom Solomon
- National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- Walton Centre National Health Service, Foundation Trust, Liverpool, United Kingdom
| | - Peter W. Horby
- International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Global Support Centre, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Gail Carson
- International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Global Support Centre, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Piero Olliaro
- International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Global Support Centre, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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13
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Teaching Online during the COVID-19 Pandemic: A Phenomenological Study of Physical Therapist Faculty in Brazil, Cyprus, and The United States. EDUCATION SCIENCES 2021. [DOI: 10.3390/educsci11030130] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The COVID-19 pandemic led to a global transition from in-person to online instruction leaving many higher education faculty with little time or training for this responsibility. Physical therapist education programs were especially impacted since a large part of the development of skills rely on face-to-face onsite practice. This phenomenological study explored the perceptions of physical therapist educators in three countries—Brazil, Cyprus, and the United States, who transitioned to an entirely virtual medium of teaching during the pandemic. Sixteen faculty participated in 1:1 semi-structured interviews. Trustworthiness of qualitative inquiry was ascertained using triangulation, thick descriptions, and peer reviews. Four major themes emerged from analysis of participants’ interview data: adapting pedagogy in real-time, expected excellence, limitations of the medium, and informing future teaching practice. All participants described teaching during the pandemic as one of the most challenging experiences of their professional careers. Despite available resources, faculty noted challenges in making authentic connections with students, adapting to technological interruptions, assessment of student understanding of content, and managing work-life balance. Despite the challenges, faculty worked collaboratively with peers to innovate new approaches of creating social, cognitive, and teaching presence. Unique opportunities arose from the pandemic to enhance future teaching practice.
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14
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Pedersini P, Tovani-Palone MR, Villafañe JH, Corbellini C. COVID-19 Pandemic: A Physiotherapy Update. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2020. [DOI: 10.29333/ejgm/8574] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Waisberg DR, Abdala E, Nacif LS, Haddad LB, Ducatti L, Santos VR, Gouveia LN, Lazari CS, Martino RB, Pinheiro RS, Arantes RM, Terrabuio DR, Malbouisson LM, Galvao FH, Andraus W, Carneiro-D'Albuquerque LA. Liver transplant recipients infected with SARS-CoV-2 in the early postoperative period: Lessons from a single center in the epicenter of the pandemic. Transpl Infect Dis 2020; 23:e13418. [PMID: 32667716 PMCID: PMC7404440 DOI: 10.1111/tid.13418] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/02/2020] [Accepted: 07/05/2020] [Indexed: 12/13/2022]
Abstract
The impact of coronavirus disease‐19 (COVID‐19) in liver recipients remains largely unknown. Most data derive from small retrospective series of patients transplanted years ago. We aimed to report a single‐center case series of five consecutive patients in the early postoperative period of deceased‐donor liver transplantation who developed nosocomial COVID‐19. Two patients presented important respiratory discomfort and eventually died. One was 69 years old and had severe coronary disease. She rapidly worsened after COVID‐19 diagnosis on 9th postoperative day. The other was 67 years old with non‐alcoholic steatohepatitis, who experienced prolonged postoperative course, complicated with cytomegalovirus infection and kidney failure. He was diagnosed on 36th postoperative day and remained on mechanical ventilation for 20 days, ultimately succumbing of secondary bacterial infection. The third, fourth, and fifth patients were diagnosed on 10th, 11th, and 18th postoperative day, respectively, and presented satisfactory clinical evolution. These last two patients were severely immunosuppressed, since one underwent steroid bolus for acute cellular rejection and another also used anti‐thymocyte globulin for treating steroid‐resistant rejection. Our novel experience highlights that COVID‐19 may negatively impact the postoperative course, especially in elder and obese patients with comorbidities, and draws attention to COVID‐19 nosocomial spread in the early postoperative period.
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Affiliation(s)
- Daniel Reis Waisberg
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Edson Abdala
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Department of Infectious and Parasitic diseases, Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Lucas Souto Nacif
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Luciana Bertocco Haddad
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Liliana Ducatti
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Vinicius Rocha Santos
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Larissa Nunes Gouveia
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Department of Infectious and Parasitic diseases, Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Carolina Santos Lazari
- Division of Central Laboratory, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Rodrigo Bronze Martino
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Rafael Soares Pinheiro
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Rubens Macedo Arantes
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Debora Raquel Terrabuio
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Luiz Marcelo Malbouisson
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Flavio Henrique Galvao
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Wellington Andraus
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
| | - Luiz Augusto Carneiro-D'Albuquerque
- Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Medical Investigation 37 (LIM-37), Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), São Paulo, Brazil
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16
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Tang Y, Serdan TDA, Masi LN, Tang S, Gorjao R, Hirabara SM. Epidemiology of COVID-19 in Brazil: using a mathematical model to estimate the outbreak peak and temporal evolution. Emerg Microbes Infect 2020; 9:1453-1456. [PMID: 32552473 PMCID: PMC7473191 DOI: 10.1080/22221751.2020.1785337] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Yuanji Tang
- Applied NanoFemto Technologies, LLC, Lowell, MA, USA
| | - Tamires D A Serdan
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
| | - Laureane N Masi
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
| | - Sherry Tang
- Kaiser Southern California Permanente Medical Group, Riverside, CA, USA
| | - Renata Gorjao
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
| | - Sandro M Hirabara
- Interdisciplinary Program of Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
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