ABSTRACT This cross-sectional seroepidemiological survey presents the seroprevalence of SARS-CoV-2 in a population living in 15 Long-Term Care Facilities (LTCFs), after two intra-institutional outbreaks of COVID-19 in the city of Botucatu, Sao Paulo State, Brazil. Residents were invited to participate in the serological survey performed in June and July 2020. Sociodemographic and clinical characterization of the participants as well as the LTCF profile were recorded. Blood samples were collected, processed and serum samples were tested using the rapid One Step COVID-19 immunochromatography test to detect IgM and IgG anti-SARS-CoV-2. Among 209 residents, the median of age was 81 years old, 135 (64.6%) were female and 171 (81.8%) self-referred as being white. An overall seroprevalence of 11.5% (95% CI: 7.5% – 16.6%) was found. The highest seroprevalences of 100% and 76.9% were observed in LTCFs that had experienced COVID-19 outbreaks. Most residents with positive immunochromatography tests (70.8%) referred previous contact with a confirmed COVID-19 case. Although there was a relatively low seroprevalence of COVID-19 in the total number of elderly people, this population is highly vulnerable and LTCFs are environments at higher risk for COVID-19 dissemination. A well-established test for COVID-19 policies, the adequate characterization of the level of interaction between residents and the healthcare provider team and the level of complexity of care are crucial to monitor and control the transmission of SARS-CoV-2 in these institutions.

ABSTRACT Annual vaccination is the most effective way to prevent seasonal influenza illness. Instituto Butantan (IB) performed clinical studies with its 2013, 2014 and 2015 seasonal trivalent influenza vaccines (inactivated split-virion). Prospective cohort studies were carried out to describe the safety and immunogenicity of Instituto Butantan influenza vaccines, in healthy adults and elderly, from 2013 to 2015. Immediately after the informed consent was signed, participants underwent blood collection followed by vaccination. On study days 1, 2 and 3 post-vaccination participants were contacted by the staff to evaluate the occurrence of solicited (local and systemic) and non-solicited adverse reactions. On study day 21 (+7) subjects returned to the clinical site for final safety assessments and blood collection to evaluate post-vaccination immunogenicity. The immunogenicity analyses were performed by means of hemagglutination inhibition (HI) assay. The immunogenicity endpoints were: seroprotection (SPR) and seroconversion (SCR) rates and the geometric mean HI antibody titer ratio (GMTR). The 2013 study was conducted at the Centro de Referência para Imunobiológicos Especiais (CRIE) and at the Centro de Pesquisa Clínica do Instituto da Criança, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo while the 2014 and 2015 studies were conducted at CRIE. The vaccine composition followed the WHO recommendation for the Southern hemisphere seasonal influenza vaccine. Forty-seven healthy adults and 13 elderly participated in the 2013 study, 60 healthy adults and 60 elderly in the 2014 study, and 62 healthy adults and 57 elderly in the 2015 study. In the 2013, 2014 and 2015 studies, pain was the most frequent local adverse reaction and headache the most frequent systemic adverse reaction. All observed adverse reactions were classified as mild or moderate and none as severe. SPR >70% and SPR >60% were observed in adults and elderly, respectively, for the three vaccine viruses, in the 2013, 2014 and 2015 studies. SCR >40% was observed in adults, for the three vaccine viruses, only in the 2014 study and SCR >30% was observed in the elderly, for the three vaccine viruses, only in the 2013 and 2014 studies. GMTR >2.5 among adults, for the three vaccine viruses was only observed in the 2013 study and GMTR >2.0 was observed among elderly, for the three vaccine viruses, in the 2013, 2014 and 2015 studies. The 2013, 2014 and 2015 seasonal influenza vaccines produced by Instituto Butantan were safe and immunogenic according to the immunogenicity criteria defined by the European Medicines Agency (EMA).

JUSTIFICATIVA E OBJETIVOS: A prevalência de queda e dor crônica é elevada em idosos com importantes consequências para a qualidade de vida. Verificar associação entre estes dois agravos pode ajudar a prevenir incapacidades e sofrimentos. O objetivo deste estudo foi identificar a prevalência de quedas entre idosos com dor há mais de um ano e avaliar a associação entre a ocorrência de quedas e a localização, intensidade e frequência da dor. MÉTODO: Estudo transversal utilizando dados do projeto Saúde, Bem Estar e Envelhecimento. As variáveis dependentes foram: ocorrência e número de queda nos últimos 12 meses. As variáveis independentes foram: a localização, intensidade e frequência da dor que "mais incomoda" com duração de mais de um ano. Para verificação de associação, realizou-se o teste de associação de Rao Scott, indicado para amostra populacional. RESULTADOS: Foram analisados 213 idosos acima de 60 anos com dor há mais de um ano e que responderam sobre ocorrência de quedas no último ano. A sua prevalência foi 56,29%. Resultados apontaram que idosos com dor há mais de um ano, intensa ou moderada, relataram maior número de quedas do que os idosos com dores leves. Não foram encontradas associações entre local e frequência dos episódios de dor e relato de quedas no último ano. CONCLUSÃO: Melhor controle da dor pode diminuir risco de quedas em idosos com dores crônicas, estes dois agravos precisam ser adequadamente avaliados e controlados pelos profissionais de saúde.

BACKGROUND AND OBJECTIVES: The prevalence of falls and chronic pain is high among the elderly with major consequences for quality of life. Checking the association between these two problems may help preventing incapacities and distress. This study aimed at identifying the prevalence of falls among the elderly with pain lasting more than one year and at evaluating the association of falls and pain location, intensity and frequency. METHOD: This was a transversal study using data from the Health, Wellbeing and Ageing project. Dependent variables were: occurrence and number of falls in the last 12 months. Independent variables were: location, intensity and frequency of the "most uncomfortable" pain lasting more than one year. Rao Scott test, indicated for population sampling, was used to check the association. RESULTS: We evaluated 213 elderly people above 60 years of age with pain lasting more than one year and who answered about falls in the last year. Its prevalence was 56.29%. Results have shown that elderly people with severe or moderate pain lasting more than one year have reported a higher number of falls as compared to elderly people with mild pain. No association was found between site and frequency of pain episodes and falls in the last year. CONCLUSION: Better pain control may decrease the risk of falls in the elderly population with chronic pain; these two problems have to be adequately evaluated and controlled by health professionals.

A prevalência de dor crônica entre pacientes com transtornos psiquiátricos é, possivelmente, no mínimo igual à encontrada entre a população geral. Para estimar a prevalência de dor crônica em pacientes com esquizofrenia, comparar os grupos com e sem dor crônica e caracterizar a dor foi realizado um estudo transversal, com uma amostra probabilística de 205 pacientes adultos, com diagnóstico de esquizofrenia (idade média 37 anos; 65% homens; média de escolaridade de nove anos; 87% sem companheiro(a); 65% residentes com os pais), atendidos em hospital público do Município de São Paulo, Brasil. A prevalência de dor foi de 36,6%; a dor foi mais presente no abdômen (30,7%), seguida da dor de cabeça, face e boca (24%) e região lombar, sacra e cóccix (14,7%). Com relação à freqüência, 24% dos entrevistados referiram ter dor todos os dias. O tempo médio de dor foi de 41 meses, com intensidade moderada. A prevalência de dor crônica em pacientes esquizofrênicos foi semelhante à encontrada para a população geral, e o quadro álgico foi significativo em termos de duração, intensidade e freqüência dos episódios dolorosos.

Chronic pain may be at least as prevalent in psychiatric patients as in the general population. To estimate the prevalence of chronic pain in schizophrenic patients, compare the groups with and without chronic pain, and characterize the pain, a cross-sectional study was performed on a probabilistic sample of 205 adult patients with a diagnosis of schizophrenia (mean age 37 years; 65% men; mean schooling nine years; 87% single; 65% living with parents), treated at a public hospital in the city of São Paulo, Brazil. Prevalence of pain was 36.6%, and the most frequent sites were abdomen (30.7%), head, face, and mouth (24%), and lower back (14.7%). Twenty-four percent of patients reported feeling pain every day. Mean duration of pain was 41 months, with moderate intensity. Prevalence of chronic pain in schizophrenic patients was similar to that in the general population, and the clinical course was significant in terms of duration, intensity, and frequency.

A prevalência de dor crônica entre pacientes com transtornos psiquiátricos é, possivelmente, no mínimo igual à encontrada entre a população geral. Para estimar a prevalência de dor crônica em pacientes com esquizofrenia, comparar os grupos com e sem dor crônica e caracterizar a dor foi realizado um estudo transversal, com uma amostra probabilística de 205 pacientes adultos, com diagnóstico de esquizofrenia (idade média 37 anos; 65% homens; média de escolaridade de nove anos; 87% sem companheiro(a); 65% residentes com os pais), atendidos em hospital público do Município de São Paulo, Brasil. A prevalência de dor foi de 36,6%; a dor foi mais presente no abdômen (30,7%), seguida da dor de cabeça, face e boca (24%) e região lombar, sacra e cóccix (14,7%). Com relação à freqüência, 24% dos entrevistados referiram ter dor todos os dias. O tempo médio de dor foi de 41 meses, com intensidade moderada. A prevalência de dor crônica em pacientes esquizofrênicos foi semelhante à encontrada para a população geral, e o quadro álgico foi significativo em termos de duração, intensidade e freqüência dos episódios dolorosos.

Chronic pain may be at least as prevalent in psychiatric patients as in the general population. To estimate the prevalence of chronic pain in schizophrenic patients, compare the groups with and without chronic pain, and characterize the pain, a cross-sectional study was performed on a probabilistic sample of 205 adult patients with a diagnosis of schizophrenia (mean age 37 years; 65% men; mean schooling nine years; 87% single; 65% living with parents), treated at a public hospital in the city of São Paulo, Brazil. Prevalence of pain was 36.6%, and the most frequent sites were abdomen (30.7%), head, face, and mouth (24%), and lower back (14.7%). Twenty-four percent of patients reported feeling pain every day. Mean duration of pain was 41 months, with moderate intensity. Prevalence of chronic pain in schizophrenic patients was similar to that in the general population, and the clinical course was significant in terms of duration, intensity, and frequency.