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Background: The death of women as a result of violent crime has become a major social and health problem worldwide. Most of these crimes are committed by their partners. The Covid-19 pandemic seems to have amplified the problem, given that measures to contain the spread of the disease have exposed women to more prolonged contact with their aggressors., Objective: To describe the epidemiological profile of lethal and intentional violent crimes committed against women in the state of Alagoas, Brazil, from March 2018 to February 2020 (before the pandemic) and from March 2020 to December 2021 (during the first two years of the Covid-19 pandemic)., Methods: This is an observational study involving all deaths of women due to lethal and intentional violent crimes. The data was obtained from the Alagoas State Secretariat for Public Security. The variables age, type of crime, means used, day of the week and time of the crime were analyzed. The specific mortality rate was calculated for the entire study period. Population data was obtained from the Brazilian Institute of Geography and Statistics (IBGE). Descriptive statistics were used to analyze the data., Results: There were 316 deaths during the study period. The mortality rate in 2020 (5.33/100,000) was higher than in the years prior to the pandemic (3.88/100,000 in 2018 and 4.84/100,000 in 2019). There was a predominance of the 18-29 (31.31%) and 30-39 (27.95%) age groups in both periods. The proportion of female homicides was 55.19% in the pre-pandemic period and 64.20% in the pandemic period. The proportion of beating deaths was 1.7 times higher in the pandemic period than in the non-pandemic period (15.23% vs. 8.97%). There was also an increase in beatings on Saturdays, with a proportion 1.60 times higher than in the pre-pandemic period (19.75% vs. 12.34%)., Conclusion: The victims were predominantly young women, the crimes classified as homicides and with the use of firearms. The study emphasizes that the context of the Covid-19 pandemic may have contributed to the increase in violent crimes against women in Alagoas, highlighting the urgency of preventive measures and support for victims., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Pentraxin 3 (PTX3) is an acute-phase protein that belongs to the pentraxin family, which plays an important role in the body's defense against pathogens. PTX3 levels have been associated with inflammatory processes, and it is a possible biomarker for the diagnosis and prognosis of different infectious diseases, including COVID-19. The objective of this study was to analyze the potential of PTX3 as a plasma biomarker for predicting death in patients hospitalized with COVID-19., Methods: The study included a total of 312 patients with COVID-19, admitted from July 2020 to August 2021 to hospital ward and intensive care unit beds at two hospitals in the Northeast Region of Brazil. PTX3 was measured using ELISA in samples collected within 24 h after hospital admission. Maximally selected rank statistics were used to determine the PTX3 cutoff point that best distinguished patients who died from those who survived. A receiver operating characteristic (ROC) curve was used to determine the performance of the biomarker. Survival analysis was performed using a Kaplan-Meier curve, and a Cox regression model was used to determine predictors associated with death., Results: Of the 312 patients included in the study, 233 recovered and 79 died. Patients who died had higher PTX3 levels at the time of admission, when compared to those who recovered (median: 52.84 versus 10.79 ng/mL; p < 0.001). PTX3 showed area under the ROC (AUC) = 0.834, higher than other markers used in clinical practice, such as C-reactive protein (AUC = 0.72) and D-dimer (AUC = 0.77). Furthermore, according to the Kaplan-Meier survival curve, patients with PTX3 concentrations above the cutoff point (27.3 ng/mL) had a lower survival rate (p = 0.014). In multivariate Cox regression, PTX3 > 27.3 ng/mL was an important predictor of death, regardless of other confounding factors (hazard ratio = 1.79; p = 0.027)., Conclusion: PTX3 can be considered as a potential biomarker for predicting death in patients hospitalized with COVID-19., (© 2024. The Author(s).)

SARS-CoV-2 virus emerged as a new threat to humans and spread around the world, leaving a large death toll. As of January 2023, Brazil is among the countries with the highest number of registered deaths. Nonpharmacological and pharmacological interventions have been heterogeneously implemented in the country, which, associated with large socioeconomic differences between the country regions, has led to distinct virus spread dynamics. Here, we investigate the spatiotemporal dispersion of SARS-CoV-2 lineages in the Pernambuco state (Northeast Brazil) throughout the distinct epidemiological scenarios that unfolded in the first 2 years of the pandemic. We generated a total of 1,389 new SARS-CoV-2 genomes from June 2020 to August 2021. This sampling captured the arrival, communitary transmission, and the circulation of the B1.1, B.1.1.28, and B.1.1.33 lineages; the emergence of the former variant of interest P.2; and the emergence and fast replacement of all previous variants by the more transmissible variant of concern P.1 (Gamma). Based on the incidence and lineage spread pattern, we observed an East-to-West to inner state pattern of transmission, which is in agreement with the transmission of more populous metropolitan areas to medium- and small-size country-side cities in the state. Such transmission patterns may be partially explained by the main routes of traffic across municipalities in the state. Our results highlight that the fine-grained intrastate analysis of lineages and incidence spread can provide actionable insights for planning future nonpharmacological intervention for air-borne transmissible human pathogens.IMPORTANCEDuring the COVID-19 pandemic, Brazil was one of the most affected countries, mainly due its continental-size, socioeconomic differences among regions, and heterogeneous implementation of intervention methods. In order to investigate SARS-CoV-2 dynamics in the state of Pernambuco, we conducted a spatiotemporal dispersion study, covering the period from June 2020 to August 2021, to comprehend the dynamics of viral transmission during the first 2 years of the pandemic. Throughout this study, we were able to track three significant epidemiological waves of transmission caused by B1.1, B.1.1.28, B.1.1.33, P.2, and P.1 lineages. These analyses provided valuable insights into the evolution of the epidemiological landscape, contributing to a deeper understanding of the dynamics of virus transmission during the early years of the pandemic in the state of Pernambuco., Competing Interests: The authors declare no conflict of interest.

The pandemic caused by Covid-19 is still present around the world. Despite advances in combating the disease, such as vaccine development, identifying infected individuals is still essential to optimize the control of human-to-human transmission of the virus. The main technique for detecting the virus is the RT-PCR method, which, despite its high relative cost, has a high accuracy in detecting the coronavirus. Given this, a method capable of performing the identification quickly, accurately, and inexpensively is necessary. Thus, this work aimed to analyze the feasibility of a new technique for identifying SARS-CoV-2 through the use of optical spectroscopy in the visible and near-infrared range (Vis-NIR) combined with machine learning algorithms. Spectral signals were obtained from nasopharyngeal swab samples previously analyzed using the RT-PCR method. The specimens were provided by the Molecular Diagnosis Laboratory of Covid-19 at Univasf. A total of 314 samples were analyzed, comprising 42 testing positive and 272 testing negative for Covid-19. Digital signal processing techniques, such as Savitzky-Golay filters and statistical methods were used to eliminate spurious elements from the original data and extract relevant features. Supervised machine learning algorithms such as SVM, Random Forest, and Naive Bayes classifiers were used to perform automatic sample identification. To evaluate the performance of the models, a 5-fold cross-validation technique was applied. With the proposed methodology, it was possible to achieve an accuracy of 75%, a sensitivity of 80%, and a specificity of 70%, in addition to an area under the ROC curve of 0.81, in the identification of nasopharyngeal swab samples from previously diagnosed individuals. From these results, it was possible to conclude that Vis-NIR spectroscopy is a promising, fast and relatively low cost technique to identify the SARS-CoV-2., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

COVID-19 is an infectious respiratory disease caused by SARS-CoV-2. Pentraxin 3 (PTX3) is involved in the activation and regulation of the complement system, demonstrating an important role in the pathogenesis of COVID-19. The aim was to evaluate the association of single nucleotide polymorphisms in PTX3 and its plasma levels with the severity of COVID-19. This is a retrospective cohort study, carried out between August 2020 and July 2021, including patients with confirmed COVID-19 hospitalized in 2 hospitals in the Northeast Region of Brazil. Polymorphisms in PTX3 (rs1840680 and rs2305619) were determined by real-time PCR. PTX3 plasma levels were measured by ELISA. Serum levels of interleukin (IL)-6, IL-8, and IL-10 were determined by flow cytometry. A multivariate logistic regression model was used to identify parameters independently associated with COVID-19 severity. P values  < 0.05 were considered significant. The study included 496 patients, classified as moderate (n = 267) and severe (n = 229) cases. The PTX3 AA genotype (rs1840680) was independently associated with protection against severe COVID-19 (P = 0.037; odds ratio = 0.555). PTX3 plasma levels were significantly associated with COVID-19 severity and mortality (P < 0.05). PTX3 levels were significantly correlated with IL-6, IL-8, IL-10, C-reactive protein, total leukocytes, neutrophil-to-lymphocyte ratio, urea, creatinine, ferritin, length of hospital stay, and higher respiratory rate (P < 0.05). Our results revealed a protective effect of the PTX3 AA genotype (rs1840680) on the development of severe forms of COVID-19. Additionally, PTX3 plasma levels were associated with the severity of COVID-19. The results of this study provide evidence of an important role of PTX3 in the immunopathology of COVID-19., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Schistosomiasis remains a serious public health concern in Brazil and the Schistosomiasis Control Program (PCE) was elaborated to assist in the control of the disease. Nevertheless, the irruption of the COVID-19 pandemic may have impacted the program. Herein, we assessed the impact of the pandemic on PCE actions in an endemic area in the region with the highest positivity rate for schistosomiasis in Brazil. We conducted an ecological, population-based study using data from the PCE of the state of Alagoas, between 2015 and 2021, to calculate the percentage of change. The temporal trend analysis was performed using the segmented log-linear regression model. To evaluate the spatial distribution of the data, choropleth maps were made showing the values of the% of change. Moran maps was elaborated to indicate the critical areas. Our analysis showed a decrease in the population surveyed in 2020 (-41.00%) and 2021 (-18.42%). Likewise, there was a reduction in the number of Kato-Katz tests performed (2020 = -43.45%; and in 2021 = -19.63%) and, consequently, a drop in the rate of positive tests (-37.98% in 2020 and -26.14% in 2021). Importantly, treatment of positive cases was lower than 80% (77.44% in 2020 and 77.38% in 2021). Additionally, spatial clusters with negative percentage values of up to -100% of the PCE indicators were identified mostly in the municipalities of the coastal areas that are historically most affected by schistosomiasis. Taken together, our analyzes corroborate that PCE actions in endemic municipalities of Alagoas were impacted by the COVID-19 pandemic., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Patients with severe coronavirus disease 2019 (COVID-19) often present with coagulopathies and have high titres of circulating antibodies against viral proteins., Objectives: Herein, we evaluated the association between D-dimer and circulating immunoglobulin levels against viral proteins in patients at different clinical stages of COVID-19., Methods: For this, we performed a cross-sectional study involving patients of the first wave of COVID-19 clinically classified as oligosymptomatic (n = 22), severe (n = 30), cured (n = 27) and non-infected (n = 9). Next, we measured in the plasma samples the total and fraction of immunoglobulins against the nucleoprotein (NP) and the receptor-binding domain (RBD) of the spike proteins by enzyme-linked immunosorbent assay (ELISA) assays., Findings: Patients with severe disease had a coagulation disorder with high levels of D-dimer as well as circulating IgG against the NP but not the RBD compared to other groups of patients. In addition, high levels of D-dimer and IgG against the NP and RBD were associated with disease severity among the patients in this study., Main Conclusions: Our data suggest that IgG against NP and RBD participates in the worsening of COVID-19. Although the humoral response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is partially understood, and more efforts are needed to clarify gaps in the knowledge of this process.

During the COVID-19 pandemic, a reduction in vaccination coverage of children and adolescents was observed in several countries. The aim of this study was to assess the impact of the pandemic, in the first two years, on human rotavirus vaccine (HRV) coverage in Brazil compared with previous years. The number of doses of HRV administered in the period from January 2015 to December 2021 and its annual vaccination coverage were analyzed. The vaccination coverage decreased to 77.3% in 2020 and to 70.4% in 2021, substantially lower than the minimum that would be expected (89.2%); the decline was more pronounced in the second year of the pandemic despite the fact that in this period, the circulation restrictions were already less tight. Of the five Brazilian macro-regions, the northeast had the largest decline, and the south had the smallest impact on coverage. At the municipal level, less than half of the Brazilian municipalities managed to achieve vaccination coverage above 90% in either pandemic year. Although there was already a downward trend in coverage in the pre-pandemic years, the present study shows that the values recorded in 2020 and 2021 were significantly lower. Monitoring of vaccination coverage in the coming years should be carried out continuously in order to avoid a possible resurgence of rotavirus-induced diarrhea.

Background: Transmembrane serine protease type 2 (TMPRSS2) and angiotensin-converting enzyme 2 (ACE2) are the main molecules involved in the entry of SARS-CoV-2 into host cells. Changes in TMPRSS2 expression levels caused by single nucleotide polymorphisms (SNPs) may contribute to the outcome of COVID-19. The aim was to investigate the association between TMPRSS2 gene polymorphisms and the risk of death in hospitalized patients with COVID-19., Methods: We included patients with confirmed COVID-19, recruited from two hospitals in northeastern Brazil from August 2020 to July 2021. Two functional polymorphisms (rs2070788 and rs12329760) in TMPRSS2 were evaluated by real-time PCR. The Kaplan-Meier method was used to estimate death. The Cox's proportional hazards model was used to adjust for potentially confounding factors., Results: A total of 402 patients were followed prospectively. Survival analysis demonstrated that older patients carrying the rs2070788 GG genotype had shorter survival times when compared to those with AG or AA genotypes ( p = 0.009). In multivariable analysis, the GG genotype was a factor independently associated with the risk of death in older individuals (hazard ratio = 4.03, 95% confidence interval 1.49 to 10.84)., Conclusions: The rs2070788 polymorphism in TMPRSS2 increases risk of death four-fold in older patients hospitalized with COVID-19., Competing Interests: The authors declare no conflict of interest.

This study analyzed the impact of the COVID-19 pandemic on the detection of new cases of leprosy in the state of Bahia, Brazil. The periods January-September 2019 and January-September 2020 were compared. There was a 44.40% reduction in the diagnosis of leprosy when comparing the two periods (1,705 in 2019 and 948 in 2020). There was a reduction in the number of municipalities with reported cases: 251 municipalities in 2019 and 202 in 2020, expressing a reduction of 24.25%. Considering only the months following the arrival of the virus (April-September), the reduction was 51.10%. An inverse correlation was observed between the number of new cases of leprosy and the cumulative number of cases of COVID-19 (Spearman's correlation coefficient = -0.840; P < 0.001) and the number of new monthly cases of COVID-19 (Spearman's correlation coefficient = -0.817; P < 0.001). A slight increase was also observed in the proportion of multibacillary cases in the state (70.38% in 2019 and 72.69% in 2020) as well as in the proportion of individuals with the degree of physical disability not assessed at diagnosis, whose proportion rose from 16.39% in 2019 to 22.53% in 2020. The negative impact of COVID-19 in tackling leprosy should be seen as a warning sign for health and political authorities., (© 2021 the International Society of Dermatology.)

Introduction: Coronavirus disease 2019 (COVID-19) is the disease caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the ongoing obesity pandemic, its coexistence with COVID-19 becomes worrying and has a less favorable outcome., Objective: This study aimed to describe the clinical and epidemiological profiles of confirmed cases of COVID-19 in individuals with obesity in the state of Alagoas., Methods: The observational cross-sectional study involving 138 confirmed cases of COVID-19 who had obesity as a comorbidity reported at the time of notification of the disease. The data were collected from the COVID-19 database in the state of Alagoas, and the variables analyzed were sex, age (and age group), race/color, outcome, clinical manifestations, and associated comorbidities. The Kolmogorov-Smirnov, Mann-Whitney U, χ², or Fisher's exact tests were performed as appropriate. The significance was set at 5 and 95% confidence intervals., Results: There was a predominance of females (55.1%; n=76), aged <60 years (70.3%; n=97) and brown race/color (n=76; 55.1%). The most prevalent symptoms were cough (n=84; 60.9%), fever (n=78; 56.5%), headache (n=36; 26.1%), and adynamia (n=28; 20.3%). The median age was 49 years, with no difference between genders (p=0.340). The lethality rate was 17.4% (n=24), being higher in the male population (22.6% in males and 13.2% in females). Of the 24 deaths, 13 (54.2%) were recorded in the elderly people. In addition to obesity, 54.3% (n=75) had systemic arterial hypertension and 30.4% (n=42) had diabetes mellitus. There was no difference in the prevalence of comorbidity between genders., Conclusions: The profile studied demonstrates that obesity represents a challenge for coping with COVID-19.

This study showed a spatial association between COVID-19 and poor living conditions in a population in Northeast Brazil. The case fatality rate was 1.42 times higher in the municipalities with very high social deprivation. Priority municipalities have been identified for intervention by the public authorities. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) was confirmed in Brazil in February 2020. Since then, the disease has spread throughout the country, reaching the poorest areas. This study analyzes the relationship between COVID-19 and the population's living conditions. We aimed to identify social determinants related to the incidence, mortality, and case fatality rate of COVID-19 in Brazil, in 2020. Methods: This is an ecological study evaluating the relationship between COVID-19 incidence, mortality, and case fatality rates and 49 social indicators of human development and social vulnerability. For the analysis, bivariate spatial correlation and multivariate and spatial regression models (spatial lag model and spatial error models) were used, considering a 95% confidence interval and a significance level of 5%. Results: A total of 44.8% of municipalities registered confirmed cases of COVID-19 and 14.7% had deaths. We observed that 56.2% of municipalities with confirmed cases had very low human development (COVID-19 incidence rate: 59.00/100 000; mortality rate: 36.75/1 000 000), and 52.8% had very high vulnerability (COVID-19 incidence rate: 41.68/100 000; mortality rate: 27.46/1 000 000). The regression model showed 17 indicators associated with transmission of COVID-19 in Brazil. Conclusions: Although COVID-19 first arrived in the most developed and least vulnerable municipalities in Brazil, it has already reached locations that are farther from large urban centers, whose populations are exposed to a context of intense social vulnerability. Based on these findings, it is necessary to adopt measures that take local social aspects into account in order to contain the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 is a major public health concern in this century. The causative agent SARS-CoV-2, is highly contagious and spreads continuously across territories. Spatial analysis is of enormous importance in the process of understanding the disease and its transmission mechanisms. We aimed to identify the risk areas for COVID-19 and analyze their association with social vulnerability in Maceió, Alagoas. The study was conducted in 2020. Methodology: This is an ecological study to evaluate the incidence, mortality and case fatality rate of COVID-19 and their relationship with 12 indicators of human development and social vulnerability. Multivariate and spatial statistics were applied. A 95% confidence interval and a 5% confidence level were considered. Results: The spatial scan statistic revealed the existence of six high-risk clusters for the incidence of COVID-19. The regression model showed that social indicators, such as literacy of people, residents of private households, households with more than four residents, and resident brown population, were associated with COVID-19 transmission in Maceió-AL. The disease affected localities whose populations are exposed to a context of intense socioeconomic vulnerability. Conclusions: Based on the results, it is necessary to adopt measures that take into account the social determinants of health in order to minimize the damage caused by the pandemic. [ABSTRACT FROM AUTHOR]