Survey on COVID-19-related mortality associated with occupational infection during the first phase of the pandemic: A systematic review

Zoonotic spillover and viral mutations from low and middle-income countries: improving prevention strategies and bridging policy gaps

The increasing frequency of zoonotic spillover events and viral mutations in low and middle-income countries presents a critical global health challenge. Contributing factors encompass cultural practices like bushmeat consumption, wildlife trade for traditional medicine, habitat disruption, and the encroachment of impoverished settlements onto natural habitats. The existing "vaccine gap" in many developing countries exacerbates the situation by allowing unchecked viral replication and the emergence of novel mutant viruses. Despite global health policies addressing the root causes of zoonotic disease emergence, there is a significant absence of concrete prevention-oriented initiatives, posing a potential risk to vulnerable populations. This article is targeted at policymakers, public health professionals, researchers, and global health stakeholders, particularly those engaged in zoonotic disease prevention and control in low and middle-income countries. The article underscores the importance of assessing potential zoonotic diseases at the animal-human interface and comprehending historical factors contributing to spillover events. To bridge policy gaps, comprehensive strategies are proposed that include education, collaborations, specialized task forces, environmental sampling, and the establishment of integrated diagnostic laboratories. These strategies advocate simplicity and unity, breaking down barriers, and placing humanity at the forefront of addressing global health challenges. Such a strategic and mental shift is crucial for constructing a more resilient and equitable world in the face of emerging zoonotic threats.

Morbimortality profile by COVID-19 in telework and on-site work in an oil and gas company in Brazil

BACKGROUND

As a reflection of the health emergency caused by COVID-19, many countries adopted guidelines, which included activity restrictions. As a result, some companies maintained their activities with on-site work and telework.

OBJECTIVE

Analyzing the morbidity and mortality profile due to COVID-19 of workers in telework and on-site work in an oil and gas company.

METHODS

Cross-sectional, quantitative, and analytical study that included 8,394 workers diagnosed with COVID-19 at an oil and gas company in Brazil, from June 2020 to June 2021. The company's Surveillance Program database was used as an information source.

RESULTS

The total prevalence of cases was 21.7% . For teleworking and face-to-face workers, they were 20.7% and 23.3%, respectively. There was a predominance of women (19.7%), white ethnicity/colour (64.7%), higher level position (52.6%), age group over 40 years (36.7%), married (53, 8%), working at the company for a period that ranges from 7 to 10 years (17%), administrative activity (68.5%), and a higher number of symptomatic workers and deaths in telework compared to on-site work.

CONCLUSIONS

The results suggest that testing is important to refrain the virus spread in the company's work environments, as it allowed asymptomatic workers to be diagnosed with COVID-19. The study suggested that on-site work was not a transmission facilitator in the occupational environment, which points out the importance of preventive measures in the workplace and the adoption of remote work for the largest possible number of workers to improve the safety of employees, workers who remained in the on-site work modality.

Comorbities and mental health among healthcare workers in Brazil. The impact of the COVID-19 pandemic

This is an original article that addresses the healthcare workforce (HW) in Brazil, as well as comorbidities and mental health changes during the COVID-19 pandemic. This study was conducted by the Oswaldo Cruz Foundation and collected data through an online questionnaires from a total of 36,612 participants, health professionals (HP, with higher education level), and invisible healthcare workers (IHW, with a technical mid-level education). The overall prevalence of comorbidities in Brazil was 26.1% and 23.9%; the highest was arterial hypertension (27.4% and 31.9%), followed by obesity (18.4% and 15.1%), chronic respiratory diseases (15.7% and 12.9%), diabetes mellitus (10.3% and 10.4%), and depression/anxiety (9.1% and 11.7%), in the HW and IHW, respectively. The region with the highest frequency was the southeast, where the largest contingent of workers is located. The HW, affected with a high burden of non-communicable chronic diseases and exposed to SARS-CoV-2, proved to be vulnerable to illness and death. Mental symptoms and intense psychological suffering have been reported. These results allow us to estimate the impacts upon physical and mental health, as well as upon living and working conditions of the HW. The health and life of workers, leading role in facing health challenges of the pandemic, are a high priority in public policies.

Evaluation of a prototype local ventilation system to mitigate retail store worker exposure to airborne particles

The objective of this study is to evaluate a prototype local ventilation system (LVS) intended to reduce retail store workers' exposure to aerosols. The evaluation was carried out in a large aerosol test chamber where relatively uniform concentrations of polydisperse sodium chloride and glass-sphere particles were generated to test the system with nano- and micro-size particles. In addition, a cough simulator was constructed to mimic aerosols released by mouth breathing and coughing. Particle reduction efficiencies of the LVS were determined in four different experimental conditions using direct reading instruments and inhalable samplers. The particle reduction efficiency (%) depended on the position beneath the LVS, but the percentage was consistently high at the LVS center as follows: (1) > 98% particle reduction relative to background aerosols; (2) > 97% in the manikin's breathing zone relative to background aerosols; (3) > 97% during mouth breathing and coughing simulation; and (4) > 97% with a plexiglass barrier installation. Lower particle reduction (<70%) was observed when the LVS airflow was disturbed by background ventilation airflow. The lowest particle reduction (<20%) was observed when the manikin was closest to the simulator during coughing.

Effects of air pollution and weather on the initial COVID-19 outbreaks in United States, Italy, Spain, and China: A comparative study

Contrasting effects have been identified in association of weather (temperature and humidity) and pollutant gases with COVID-19 infection, which could be derived from the influence of lockdowns and season change. The influence of pollutant gases and climate during the initial phases of the pandemic, before the closures and the change of season in the northern hemisphere, is unknown. Here, we used a spatial-temporal Bayesian zero-inflated-Poisson model to test for short-term associations of weather and pollutant gases with the relative risk of COVID-19 disease in China (first outbreak) and the countries with more cases during the initial pandemic (the United States, Spain and Italy), considering also the effects of season and lockdown. We found contrasting association between pollutant gases and COVID-19 risk in the United States, Italy, and Spain, while in China it was negatively associated (except for SO₂ ). COVID-19 risk was positively associated with specific humidity in all countries, while temperature presented a negative effect. Our findings showed that short-term associations of air pollutants with COVID-19 infection vary strongly between countries, while generalized effects of temperature (negative) and humidity (positive) with COVID-19 was found. Our results show novel information about the influence of pollution and weather on the initial outbreaks, which contribute to unravel the mechanisms during the beginning of the pandemic.

Evaluation of Cardiovascular Activity and Emotional Experience in Healthcare Workers (HCWs) Operating in COVID-19 Wards

The new 2019 coronavirus or SARS-CoV-2 has been the first biological agent to generate, in this millennium, such a global health emergency as to determine the adoption of public health measures. During this sanitary emergency, the emotional experience of healthcare workers (HCWs) has been hugely tested by several factors. In fact, HCWs have been exposed to greatly tiring physical, psychological and social conditions. The authors investigated the cardiocirculatory activity of a group of HCWs as well as how they perceived stress while working in COVID-19 wards. In particular, every HCW underwent a medical check, an electrocardiographic base exam, systolic and diastolic pressure measurement, and cardio frequency measurement. Furthermore, each HCW was provided with a cardiac Holter device (HoC) and a pressure Holter (Hop). Some psychological factors were considered in order to quantify the stress perceived by each HCW while at work through the administration of two questionnaires: the "Social Stigma towards Patients due to COVID Scale (SSPCS)" and the "Professional Quality of Life Scale (ProQOL)". The HoC and HoP analysis results for HCWs working in COVID-19 OU wards showed significant variations in cardiocirculatory activity. From the analysis of the SSPCS questionnaire answers, it is clear that all of them showed a sense of duty towards their patients. The analysis of the ProQOL questionnaire answers showed that the prevailing attitude is fear; however, HCWs did not absolutely discriminate against those who had COVID-19 nor did they refuse to help those in need. Continuous monitoring of these employees, also carried out through occupational medicine surveillance, allows for the detection of critical conditions and the implementation of actions aimed at preventing chronic processes.

Development of Harmonized COVID-19 Occupational Questionnaires

Harmonized tools and approaches for data collection can help to detect similarities and differences within and between countries and support the development, implementation, and assessment of effective and consistent preventive strategies. We developed open source occupational questionnaires on COVID-19 within COVID-19 working groups in the OMEGA-NET COST action (Network on the Coordination and Harmonisation of European Occupational Cohorts, omeganetcohorts.eu), and the EU funded EPHOR project (Exposome project for health and occupational research, ephor-project.eu). We defined domains to be included in order to cover key working life aspects of the COVID-19 pandemic. Where possible, we selected questionnaire items and instruments from existing questionnaire resources. Both a general occupational COVID-19 questionnaire and a specific occupational COVID-19 questionnaire are available. The general occupational COVID-19 questionnaire covers key working life aspects of the COVID-19 pandemic, including the domains: COVID-19 diagnosis and prevention, Health and demographics, Use of personal protective equipment and face covering, Health effects, Work-related effects (e.g. change in work schedule and work-life balance), Financial effects, Work-based risk factors (e.g. physical distancing, contact with COVID-19-infected persons), Psychosocial risk factors, Lifestyle risk factors, and Personal evaluation of the impact of COVID-19. For each domain, additional questions are available. The specific occupational COVID-19 questionnaire focusses on occupational risk factors and mitigating factors for SARS-CoV2 infection and COVID-19 disease and includes questions about the type of job, amount of home working, social distancing, human contact (colleagues, patients, and members of the public), commuting, and use of personal protective equipment and face coverings. The strength of this initiative is the broad working life approach to various important issues related to SARS-CoV-2 infection, COVID-19 disease, and potentially future pandemics. It requires further work to validate the questionnaires, and we welcome collaboration with researchers willing to do this. A limitation is the moderate number of questions for each of the domains in the general questionnaire. Only few questions on general core information like ethnicity, demographics, lifestyle factors, and general health status are included, but the OMEGA-NET questionnaires can be integrated in existing questionnaires about sociodemographic and health-related aspects. The questionnaires are freely accessible from the OMEGA-NET and the EPHOR homepages.

Longwise Cluster Analysis for the Prediction of COVID-19 Severity within 72 h of Admission: COVID-DATA-SAVE-LIFES Cohort

The use of routine laboratory biomarkers plays a key role in decision making in the clinical practice of COVID-19, allowing the development of clinical screening tools for personalized treatments. This study performed a short-term longitudinal cluster from patients with COVID-19 based on biochemical measurements for the first 72 h after hospitalization. Clinical and biochemical variables from 1039 confirmed COVID-19 patients framed on the “COVID Data Save Lives” were grouped in 24-h blocks to perform a longitudinal k-means clustering algorithm to the trajectories. The final solution of the three clusters showed a strong association with different clinical severity outcomes (OR for death: Cluster A reference, Cluster B 12.83 CI: 6.11−30.54, and Cluster C 14.29 CI: 6.66−34.43; OR for ventilation: Cluster-B 2.22 CI: 1.64−3.01, and Cluster-C 1.71 CI: 1.08−2.76), improving the AUC of the models in terms of age, sex, oxygen concentration, and the Charlson Comorbidities Index (0.810 vs. 0.871 with p < 0.001 and 0.749 vs. 0.807 with p < 0.001, respectively). Patient diagnoses and prognoses remarkably diverged between the three clusters obtained, evidencing that data-driven technologies devised for the screening, analysis, prediction, and tracking of patients play a key role in the application of individualized management of the COVID-19 pandemics.

Symptomatology, prognosis and clinical findings of STEMI as a ramification of COVID-19: A systematic review and proportion meta-analysis

Background

There is an increasing COVID-19 population with concurrent STEMI. SARS-CoV-2 poses a significant risk of hypercoagulable and/or prothrombotic events due to the disturbance in hemostasis by affecting all three components of the Virchow's triad. These abnormalities in hemostasis are an increased risk factor for cardiovascular events, including acute thrombotic occlusion of coronary arteries leading to myocardial infarction.

Objective

The objective of this study is to collate the prognosis, symptomatology and clinical findings of COVID-19 adverse events causing STEMI.

Methods

Databases were queried with various keyword combinations to find applicable articles. Cardiovascular risk factors, symptomatology, mortality and rates of PCI were analyzed using random-effect model.

Results

15 studies with a total of 379 patients were included in the final analysis. Mean age of patients was 62.82 ± 36.01, with a male predominance (72%, n = 274). Hypertension, dyslipidemia and diabetes mellitus were the most common cardiovascular risk factors among these patients, with a pooled proportion of 72%, 59% and 40% respectively. Dyspnea (61%, n = 131) was the most frequent presenting symptom, followed by chest pain (60%, n = 101) and fever (56%, n = 104). 62% of the patients had obstructive CAD during coronary angiography. The primary reperfusion method used in the majority of cases was percutaneous coronary intervention (64%, n = 124). Mortality, which is the primary outcome in our study, was relatively high, with a rate of 34% across studies.

Conclusion

Our findings show that most cases have been found in males, while the most common risk factors were Hypertension and Diabetes Mellitus. In most COVID-19 cases with ST-segment myocardial infarction, most hospitalized patients underwent primary percutaneous coronary intervention instead of fibrinolysis. The in-hospital mortality was significantly higher, making this report significant. As the sample size and reported study are considerably less, it warrants a further large-scale investigation to generalize it.