Resumen Introducción: El tratamiento del asma grave es un reto a nivel mundial, por su impacto en la calidad de vida y el riesgo de desenlaces graves como hospitalizaciones y muerte. El objetivo del presente estudio es caracterizar a los pacientes de un centro de atención especializada en manejo del asma grave en Colombia. Métodos: Estudio observacional, retrospectivo, en pacientes atendidos entre 2019 y 2022. Se realizó un análisis univariado con medidas de tendencia central y dispersión para variables cuantitativas; frecuencias absolutas y relativas para variables cualitativas; y análisis bivariado con pruebas chi cuadrado y t-student tomando como variable dependiente el estado de control del asma. Resultados: Se analizaron 377 pacientes, 78,5% mujeres, edad media de 57 años; 79,0% con 1 - 5 crisis el año previo al ingreso al programa, y 19,6% con al menos un ingreso a unidad de cuidados intensivos por crisis a lo largo de su vida. La terapia más frecuente fue biológico-corticoide inhalado/agonista β2 de acción prolongada-antagonista muscarínico de acción prolongada-antagonistas de los receptores de leucotrienos (14,3%). Se observó un tratamiento inadecuado en el 9,6%, solo con agonistas β2 de acción corta a necesidad, LTRA en monoterapia o una combinación de LAMA/LTRA. El estado de control del asma al ingreso presentó asociación estadística con encontrarse en terapia biológica. Conclusiones: Se caracterizó la población y se resalta la importancia del manejo adecuado de pacientes con asma grave por centros especializados buscando la mejor terapia posible, al menor costo y mayor impacto en el control de la enfermedad.

Abstract Introduction: The management of severe asthma is a worldwide challenge, due to its impact on quality of life and the risk of serious outcomes such as hospitalisations and death. This study aims to characterise patients in a centre specialising in managing severe asthma in Colombia. Methods: Observational, retrospective study in patients seen between 2019 and 2022. Univariate analysis was performed with measures of central tendency and dispersion for quantitative variables; absolute and relative frequencies for qualitative variables; and bivariate analysis with chi-square and t-student tests taking as dependent variable the asthma control status. Results: 377 patients were analysed, 78.5% female, mean age 57 years; 79.0% with 1-5 crises in the year before programme entry, and 19.6% with at least one-lifetime admission to the intensive care unit for crises. The most frequent therapy was biologic-inhaled corticosteroid/long-acting β2-agonist-long-acting muscarinic antagonist-leukotriene receptor antagonists (14.3%). Inadequate treatment was observed in 9.6%, with short-acting β2-agonist alone on an as-needed basis, LTRA monotherapy or a combination of LAMA/LTRA. Asthma control status at admission showed statistical association with being on biological therapy. Conclusions: The population was characterised and the importance of adequate management of patients with severe asthma by specialised centres seeking the best possible therapy, at the lowest cost and with the greatest impact on disease control is highlighted.

RESUMEN Objetivo: Describir el uso de pruebas de laboratorio por parte del personal médico adscrito al servicio de urgencias de un hospital en México. Materiales y métodos: Se llevó a cabo un estudio transversal descriptivo, con la recolección de datos de 351 usuarios de un servicio de urgencias en el periodo marzo-julio 2022. El muestreo fue no probabilístico por conveniencia. Se incluyó expedientes clínicos de personas mayores de 18 años, de ambos sexos, que tenían reporte de laboratorio y que habían recibido atención médica en el servicio de urgencias en los últimos siete días; se excluyó a gestantes, puérperas y personas en estado de choque. Las variables recolectadas del expediente fueron sexo, edad, diagnóstico, turno de ingreso, tipo de urgencia, analitos solicitados, registro en la nota médica del reporte de laboratorio, análisis a partir de estos resultados e inicio o cambio de conducta en el manejo médico como consecuencia. Se realizó estadística descriptiva utilizando frecuencias y proporciones para las variables cualitativas. Resultados: El principal motivo de consulta fue el dolor abdominal, que se observó en el 11,96 % de los expedientes clínicos revisados. Los analitos solicitados con mayor frecuencia fueron la biometría hemática (98 %), la química sanguínea (97 %) y los electrolitos séricos (88 %). No se registraron los resultados de laboratorio en la nota médica en el 63,8 % de los casos, tampoco hubo análisis de los resultados en el 68,9 % ni se utilizó dicha información para normar la conducta en el 72,1 %. Esto representó 57 529,34 pesos mexicanos, y no se justificó solicitar estudios de laboratorio. Conclusiones: En siete de cada diez expedientes no se identificó la utilidad de las pruebas de laboratorio para iniciar o modificar el manejo médico. Es necesario establecer estrategias para fomentar en el personal de salud de los servicios de urgencias el uso adecuado de los analitos. Estas acciones podrían incluir supervisiones, capacitación y retroalimentación al personal médico.

ABSTRACT Objective: To describe the use of laboratory tests by medical staff assigned to the emergency department of a hospital in Mexico. Materials and methods: A descriptive cross-sectional study was conducted from March to July 2022 with data from 351 users of an emergency department. A non-probability convenience sampling was used. The sample included medical records of individuals over 18 years of age, of both sexes, who had a laboratory report and received medical attention in the emergency department in the past seven days. Pregnant women, postpartum women and individuals in shock were excluded. The variables collected from the records included sex, age, diagnosis, admission shift, type of emergency, requested analytes, documentation of laboratory report in clinical notes, analysis of laboratory results, and initiation or modification of medical treatment based on the findings. Descriptive statistics were performed using frequencies and proportions for qualitative variables. Results: The most common reason for consultation was abdominal pain, found in 11.96 % of the reviewed medical records. The most frequently requested analytes were blood count (98 %), blood chemistry (97 %) and serum electrolytes (88 %). The laboratory results were not documented in the medical notes in 63.8 % of cases, not analyzed in 68.9 % and not used to guide medical treatment in 72.1 %. This resulted in an unjustified expenditure of 57,529.34 Mexican pesos on laboratory tests. Conclusions: In seven out of 10 medical records, the laboratory tests did not contribute to initiating or modifying medical treatments. Strategies are needed to promote the appropriate use of analytes, including measures such as supervision, training and feedback, among emergency department medical staff.

Abstract: Pediatric rapid response teams (PRRT) aim to detect the clinical deterioration of a patient and implement timely treatment, avoiding cardiopulmonary arrests (CPA) and in-hospital mortality. Objective: To describe the experience with PRRT led by the pediatrician in a high-complexity hospital. Patients and Methods: Descriptive, retrospective, longitudinal study. Hospitalized children under 18 years of age who had a PRRT activation between August 2015 and May 2022 were included. Patients who simultaneously had an activation of the emergency system (suspected CPA) were excluded. Demographic and clinical variables were analyzed through a descriptive analysis. Results: We analyzed 225 PRRT events with an activation rate of 17 per 1,000 admissions. Activations were more common in children under two years of age (50%), oncology patients (35%), general hospitalization (88%), the night shift (44%), and respiratory compromise (48%). Most evaluations occurred within the first five minutes (74%). The most frequent interventions were oxygen administration (45%), fluid bolus (43%), laboratory tests (40%), and X-rays (34%). Admission to the pediatric intensive care unit was 45%. The decrease in inpatient CRP was progressive during the time of the study. Conclusions: With the implementation of the PRRT, we found a tendency toward fewer CPA events in hospital wards. Most of the therapeutic interventions derived from the PRRT were of low or medium complexity, which supports the pediatrician as the team leader.

Resumen: Los equipos de respuesta rápida pediátricos (ERRP) buscan detectar el deterioro clínico de un paciente e implementar tratamientos oportunos, evitando paro cardiorrespiratorio (PCR) y mortalidad intrahospitalaria. Objetivo: describir la experiencia del ERRP liderado por el pediatra en un hospital de alta complejidad. Pacientes y Método: Estudio descriptivo, retrospectivo, longitudinal. Se incluyeron menores de 18 años hospitalizados que generaron la activación de un ERRP entre agosto 2015 y mayo 2022. Se excluyeron pacientes que simultáneamente tenían una activación del sistema de emergencia (sospecha de PCR). Se analizaron variables demográficas y clínicas mediante un análisis descriptivo. Resultados: Analizamos 225 eventos de ERRP, con una tasa de activación de 17 por 1.000 admisiones. Predominaron las activaciones en menores de dos años (50%), pacientes oncológicos (35%), hospitalización general (88%), turno nocturno (44%) y el compromiso respiratorio (48%). La mayoría de las evaluaciones se produjeron dentro de los primeros cinco minutos (74%). Las intervenciones más frecuentes fueron administración de oxígeno (45%), bolo de líquidos (43%), laboratorios (40%) y rayos-x (34%). La admisión a la UCI pediátrica fue de 45%. La disminución de las PCR en hospitalización fue progresiva durante el tiempo del estudio. Conclusiones: Con la implementación de los ERRP encontramos una tendencia a presentarse menos eventos por PCR en salas de hospitalización. La mayoría de las intervenciones terapéuticas derivadas del ERRP fueron de baja o mediana complejidad, lo que avala al pediatra de hospitalización como líder del equipo.

Abstract Objective To evaluate the effects of rosacea on ocular surface changes such as alterations in dry eye parameters, corneal densitometry, and aberrations, in comparison with healthy controls. Methods A total of 88 eyes of 44 patients diagnosed with rosacea and 88 eyes of 44 healthy controls were enrolled in this cross-sectional study. All participants underwent a comprehensive dermatologic and ophthalmic examination and Tear Break-Up Time (TBUT) and Schirmer-1 tests were performed. The rosacea subtype and Demodex count and OSDI scores of all participants were recorded. Corneal topographic, densitometric, and aberrometric measurements were obtained using the Scheimpflug imaging system. Results The mean age of the 44 patients was 41.2 ± 11.0 years of whom 31 (70.5%) were female. The mean TBUT and Schirmer-1 test values were significantly decreased and OSDI scores were significantly increased in the rosacea group compared to healthy controls (p < 0.01 for all). The most common subtype of rosacea was erythematotelangiectatic rosacea (70.4%). The severity grading of rosacea revealed that 18 (40.9%) patients had moderate erythema. The median (min-max) Demodex count was 14.0 (0-120) and the disease duration was 24.0 (5-360) months. The comparison of the corneal densitometry values revealed that the densitometry measurements in all concentric zones, especially in central and posterior zones were higher in rosacea patients. Corneal aberrometric values in the posterior surface were also lower in the rosacea group compared to healthy controls. The topographic anterior chamber values were significantly lower in the rosacea group. Study limitations Relatively small sample size, variable time interval to hospital admission, and lack of follow-up data are among the limitations of the study. Future studies with larger sample sizes may also enlighten the mechanisms of controversial anterior segment findings by evaluating rosacea patients who have uveitis and those who do not. Conclusion Given the fact that ocular signs may precede cutaneous disease, rosacea is frequently underrecognized by ophthalmologists. Therefore, a comprehensive examination of the ocular surface and assessment of the anterior segment is essential. The main priority of the ophthalmologist is to treat meibomian gland dysfunction and Demodex infection to prevent undesired ocular outcomes. parameters aberrations 8 4 crosssectional cross sectional study BreakUp Break Up (TBUT Schirmer1 Schirmer 1 Schirmer- performed recorded densitometric system 412 41 2 41. 110 11 0 11. 3 70.5% 705 70 5 (70.5% female p 001 01 0.0 all. . all) 70.4%. 704 70.4% (70.4%) 40.9% 409 40 9 (40.9% erythema minmax min max (min-max 140 14 14. 0120 120 (0-120 240 24 24. 5360 360 (5-360 months size admission followup follow up not ophthalmologists Therefore essential outcomes 70.5 7 (70.5 00 0. 70.4 (70.4% 40.9 (40.9 012 12 (0-12 536 36 (5-36 70. (70. (70.4 40. (40. (0-1 53 (5-3 (70 (40 (0- (5- (7 (4 (0 (5 (

RESUMEN Introducción: La Comisión Nacional de Residencias Médicas (CONAREM) es el principal sistema de admisión para la tutoría clínica de residencias médicas en Paraguay, avalado por Ministerio de Salud Pública y Bienestar Social. Objetivos. Determinar la relación entre el puntaje final obtenido y el promedio de grado en postulantes a convocatorias CONAREM 2019-2023. Metodología: Estudio transversal con variables sociodemográficas, académicas, puntajes del examen y puntaje final. Se aplicaron métodos descriptivos y pruebas de Kolmogórov-Smirnov, t de Student, U de Mann-Whitney, Kruskal-Wallis y correlación de Spearman; utilizando software Stata© 17.0 de StataCorp LLC. Se consideraron significativos cuando p<0.05. Resultados: De 2019 a 2023, 4.768 médicos postularon examen CONAREM. 62,12 % eran mujeres, 34,51 % tenían entre 22 y 25 años y 95,30 % estaban solteros. El promedio de grado fue 3,56 0, 49. La mayoría (69,09 %) provenían de universidades privadas. En las especialidades preferidas, clínica médica fue más común (20,31 %), luego cirugía general y pediatría (ambas 14,30 %), 39,14 % pudo acceder a especialidad preferida. El puntaje final promedio fue 67,92 (RIC 60,78 - 76,76) con diferencias significativas según edad, universidad de procedencia y año de examen. Con modelo de regresión logística se demostró que promedio de grado, edad, universidad pública y primera participación en examen estaban asociados con mayor probabilidad de obtener mejores puntajes. El modelo tenía coeficiente de ajuste de 0, 318, indicando que solo predice el 32 % de resultados. La correlación fue moderada y significativa entre puntaje final y promedio general de grado. Según universidad, la correlación fue baja y no significativa para universidades extranjeras, mientras que universidades públicas y privadas mostraron correlación moderada pero significativa. Discusión. Los mejores promedios de grado se correlacionan moderadamente con mayor probabilidad de puntajes altos y acceder a especialidades de preferencia de los médicos recientemente graduados, provenientes de universidades públicas que hayan rendido por primera vez el examen de la CONAREM.

ABSTRACT Introduction: The National Commission of Medical Residencies (CONAREM) is the main admission system for clinical tutoring of medical residencies in Paraguay, endorsed by the Ministry of Public Health and Social Welfare. Objectives: Determine the relationship between the final score obtained and the average degree in applicants to CONAREM calls 2019-2023. Methods: Cross-sectional study with sociodemographic and academic variables, exam scores and final score. Descriptive methods and tests of Kolmogorov-Smirnov, Student's t, Mann-Whitney U, Kruskal-Wallis and Spearman's correlation were applied; using Stata© 17.0 software from StataCorp LLC. They were considered significant when p<0.05. Results: From 2019 to 2023, 4,768 doctors applied for the CONAREM exam. 62.12% had a female female, 34.51% from 22 to 25, and 95.30% were single. The grade point average was 3.56(0.49. The majority (69.09%) came from private universities. As for preferred specialties, medical clinic was more common (20.31%), then general surgery and pediatrics (both 14.30%). 39.14% could access preferred specialty. The average final score was 67.92 and significant differences were found according to age, university of origin and year of examination. With logistic regression model, it was shown that average grade, age, public university and first participation in the exam were associated with a higher probability of obtaining better scores. The model had an adjustment coefficient of 0.318, indicating that it only predicts 32% of outcomes. The correlation was moderate and significant between final score and overall grade point average. By type of university, the correlation was low and not significant for foreign universities, while public and private universities showed moderate but significant correlation. Discussion: The best grade point averages correlate moderately with higher probability of high scores and access to specialties of preference and are associated with recently graduated doctors from public universities and took the exam for the first time.

Resumo Fundamento Fibrilação atrial nova (FAN) ocorre em pacientes internados por COVID-19. Há controvérsias quanto ao valor preditivo de dados clínicos e laboratoriais à admissão hospitalar para ocorrência de FAN. Objetivos Analisar, à admissão hospitalar, variáveis com potencial preditivo para ocorrência de FAN em pacientes com pneumonia por COVID-19. Método Estudo observacional, retrospectivo, caso-controle. Foram avaliados prontuários eletrônicos de pacientes consecutivos ≥ 60 anos, hospitalizados com pneumonia por COVID-19 entre 1º de março e 15 de julho de 2020. Comparações feitas pelos testes `t’ de Student ou qui-quadrado. Foi empregado modelo de risco proporcional de Cox para identificação de preditores de FAN. Considerou-se o valor de p < 0,05 como estatisticamente significativo. Resultados Entre 667 pacientes internados por COVID-19, 201 (30,1%) foram incluídos. FAN foi documentada em 29 pacientes (14,4%) (grupo 1). Grupo 2 foi composto por 162 pacientes que não apresentaram FAN. Dez pacientes excluídos por estarem em FA na admissão hospitalar. Houve diferenças entre os grupos 1 e 2, respectivamente, no tempo de permanência em UTI (11,1±10,5 dias vs. 4,9±7,5 dias; p=0,004), necessidade de ventilação invasiva (82,9% e 32,7%; p<0,001) e mortalidade hospitalar (75,9% vs. 32,1%; p<0,001). No modelo de Cox, idade > 71 anos (hazard ratio [HR]=6,8; p<0,001), leucometria ≤ 7.720 cels.μL-1 (HR=6,6; p<0,001), natremia ≤ 137 mEq.L-1 (HR=5,0; p=0,001), escore SAPS3 > 55 (HR=5,6; p=0,002) e desorientação (HR=2,5; p=0,04) foram preditores independentes de FAN. Conclusões FAN é uma arritmia comum em idosos hospitalizados com pneumonia por COVID-19. Parâmetros clínicos e laboratoriais avaliados na admissão são preditores de FAN durante internação. (FAN COVID19. COVID19 COVID 19. 19 Analisar observacional retrospectivo casocontrole. casocontrole caso controle. controle caso-controle 6 COVID-1 º 2020 `t t quiquadrado. quiquadrado qui quadrado. quadrado qui-quadrado Considerouse Considerou se 005 0 05 0,0 significativo 66 COVID19, 19, 20 30,1% 301 30 (30,1% incluídos 14,4% 144 14 4 (14,4% grupo 1. . 1) 16 respectivamente 11,1±10,5 111105 11 10 5 (11,1±10, vs 4975 9 7 4,9±7, p=0,004, p0004 p=0,004 , 004 p=0,004) 82,9% 829 82 (82,9 32,7% 327 32 p<0,001 p0001 001 75,9% 759 75 (75,9 32,1% 321 p<0,001. hazard HR=6,8 HR68 HR =6,8 8 [HR]=6,8 p<0,001, 7720 720 7.72 cels.μL1 celsμL1 celsμL cels.μL cels μL cels.μL- HR=6,6 HR66 (HR=6,6 13 mEq.L1 mEqL1 mEqL mEq.L mEq L mEq.L- HR=5,0 HR50 (HR=5,0 p=0,001, p=0,001 p=0,001) SAPS HR=5,6 HR56 (HR=5,6 p=0,002 p0002 002 HR=2,5 HR25 (HR=2,5 p=0,04 p004 04 internação COVID1 COVID- 202 00 0, 30,1 3 (30,1 14,4 (14,4 11,1±10, 11110 (11,1±10 497 4,9±7 p000 p=0,00 82,9 (82, 32,7 p<0,00 75,9 (75, 32,1 HR=6, HR6 68 =6, [HR]=6, 772 72 7.7 μL1 (HR=6, L1 HR=5, HR5 (HR=5, HR=2, HR2 (HR=2, p=0,0 p00 30, (30, 14, (14, 11,1±10 1111 (11,1±1 49 4,9± 82, (82 32, p<0,0 75, (75 HR=6 =6 [HR]=6 77 7. (HR=6 HR=5 (HR=5 HR=2 (HR=2 p=0, p0 (30 (14 11,1±1 111 (11,1± 4,9 (8 p<0, (7 HR= = [HR]= (HR= p=0 (3 (1 11,1± (11,1 4, ( p<0 [HR] (HR p= 11,1 (11, p< [HR 11, (11

Abstract Background New-onset atrial fibrillation (NOAF) occurs in patients hospitalized due to COVID-19. It is still unknown whether clinical and laboratory data assessed upon hospital admission have predictive value for NOAF. Objectives To analyze, upon hospital admission, variables with predictive potential for the occurrence of NOAF in patients with COVID-19 pneumonia. Methods Observational, retrospective, case-control study. Electronic medical reports of consecutive patients, 60 years of age or older, hospitalized due to COVID-19 pneumonia between March 1st and July 15th, 2020, were reviewed. Non-paired Student or chi-squared tests compared variables. A Cox proportional hazard model was employed to identify independent predictors of NOAF. P value < 0.05 was considered statistically significant. Results Among 667 patients hospitalized due to COVID-19, 201 (30.1%) fulfilled the inclusion criteria. NOAF was documented in 29 patients (14.4%), composing group 1. Group 2 was composed of 162 patients without NOAF. Ten patients were excluded due to the AF rhythm upon hospital admission. In groups 1 and 2, there were differences in overall in-hospital survival rate (24.1 % vs. 67.9%; p<0.001), length of stay in ICU (11.1 ± 10.5 days vs. 4.9 ± 7.5 days; p=0.004) and need for mechanical ventilation rate (82.9% vs. 32.7%; p<0.001). In the Cox model, age > 71 y/o (HR=6.8; p<0.001), total leukocyte count ≤ 7,720 cels.μL-¹ (HR=6.6; p<0.001), serum [Na+] ≤ 137 mEq.L-¹ (HR=5.0; p=0.001), SAPS3 score > 55 (HR=5.6; p=0.002), and disorientation (HR=2.5; p=0.04) on admission were independent predictors of NOAF. Conclusion NOAF is a common arrhythmia in elderly hospitalized patients with COVID-19 pneumonia. Clinical and laboratory parameters evaluated on admission have a predictive value for the occurrence of NOAF during hospitalization. Newonset New onset (NOAF COVID19. COVID19 COVID 19. 19 analyze COVID-1 Observational retrospective casecontrol case control study 6 older st 15th th 2020 reviewed Nonpaired Non paired chisquared chi squared 005 0 05 0.0 significant 66 COVID19, 19, 20 30.1% 301 30 (30.1% criteria 14.4%, 144 14.4% , 14 4 (14.4%) 16 inhospital 24.1 241 24 (24. vs 67.9% 679 67 9 p<0.001, p0001 p p<0.001 001 p<0.001) 11.1 111 11 (11. 105 10 5 10. 49 4. 75 7 7. p=0.004 p0004 004 82.9% 829 82 (82.9 32.7% 327 32 p<0.001. . yo y o HR=6.8 HR68 HR 8 (HR=6.8 7720 720 7,72 cels.μL¹ celsμL¹ celsμL cels.μL ¹ cels μL cels.μL- HR=6.6 HR66 (HR=6.6 Na+ Na [Na+ 13 mEq.L¹ mEqL¹ mEqL mEq.L mEq L mEq.L- HR=5.0 HR50 (HR=5.0 p=0.001, p=0.001 p=0.001) SAPS HR=5.6 HR56 (HR=5.6 p=0.002, p0002 p=0.002 002 p=0.002) HR=2.5 HR25 (HR=2.5 p=0.04 p004 04 hospitalization COVID1 COVID- 202 00 0. 30.1 3 (30.1 14.4 (14.4% 24. (24 67.9 p000 p<0.00 11. (11 p=0.00 82.9 (82. 32.7 HR=6. HR6 (HR=6. 772 72 7,7 μL¹ [Na L¹ HR=5. HR5 (HR=5. HR=2. HR2 (HR=2. p=0.0 p00 30. (30. 14. (14.4 (2 67. p<0.0 (1 82. (82 32. HR=6 (HR=6 77 7, HR=5 (HR=5 HR=2 (HR=2 p=0. p0 (30 (14. ( p<0. (8 HR= (HR= p=0 (3 (14 p<0 (HR p= p<

RESUMEN: Objetivo: Estimar la prevalencia y los factores asociados a la realización de una consulta de enfermería de ingreso específica para SARS-CoV-2 en personas privadas de libertad con COVID-19 en unidades penitenciarias del Centro de Brasil. Método: Estudio analítico transversal realizado entre mayo y septiembre de 2020 mediante entrevistas individuales y pruebas de inmunocromatografía de flujo lateral para detección de anticuerpos IgM/IgG contra SARS-CoV-2. El análisis se realizó mediante las pruebas de Chi-cuadrado o exacta de Fischer, considerando como resultado la consulta de enfermería específica de ingreso por SARS-CoV-2. Resultados: Entre los 1.272 investigados, el 21,3%; (IC del 95%: 19,1-23,6) probaron reactivos para detectar anticuerpos contra el SARS-CoV-2. De ellos, el 10,3% (IC 95%: 7,0-14,6) realizó alguna consulta de enfermería específica por SARS-CoV-2. Los signos y síntomas más prevalentes fueron disminución del gusto (33,2%) y del olfato (32,8%), dolores corporales (28,8%) y fiebre (28,4%). El análisis mostró asociaciones entre el contacto con un caso sintomático de COVID-19 (p=0,039), el contacto en el patio con un preso con COVID-19 (p=0,012) y el dolor de garganta (p=0,010) con el desenlace. Conclusiones: La baja prevalencia de consultas específicas de enfermería por SARS-CoV-2 y la alta prevalencia de COVID-19 refuerzan la necesidad de la implementación obligatoria de esta estrategia en grupos que viven en ambientes cerrados. Además, se debe adoptar como medida de salud pública la consulta de enfermería basada en el proceso de enfermería.

RESUMO: Objetivo: Estimar a prevalência e fatores associados à realização da consulta de enfermagem admissional específica para o SARS-CoV-2 em indivíduos privados de liberdade com COVID-19 em unidades prisionais do Brasil Central. Método: Estudo transversal analítico conduzido entre maio a setembro de 2020 por meio de entrevistas individuais e testes de imunocromatografia de fluxo lateral para detecção de anticorpos IgM/IgG para SARS-CoV-2. A análise foi realizada por meio dos testes Qui-quadrado ou Exato de Fischer, sendo considerado desfecho a consulta de enfermagem admissional específica para oSARS-CoV-2. Resultados: Entre os 1.272 investigados, 21,3%; (IC 95%: 19,1-23,6) testaram reagentes para anticorpos contra o SARS-CoV-2. Destes, 10,3% (IC 95%: 7,0-14,6) realizaram a consulta de enfermagem específica para SARS-CoV-2. Os sinais e sintomas mais prevalentes foram diminuição do paladar (33,2%) e do olfato (32,8%), dores no corpo (28,8%) e febre (28,4%).A análise apontou associações entre contato com caso sintomático para COVID-19 (p=0,039), contato no pátio com preso com COVID-19 (p=0,012) e dor de garganta (p=0,010), com o desfecho. Conclusões: A baixa prevalência de consulta de enfermagem específica para o SARS-CoV-2 e a alta prevalência de COVID-19 reforçam a necessidade de implementação obrigatória dessa estratégia em grupos que vivem em ambientes fechados. Ademais, a consulta de enfermagem baseada no processo de enfermagem deve ser adotada como medida de saúde pública.

ABSTRACT: Objective: To estimate the prevalence and factors associated with the performance of specific admission nursing consultations for SARS-CoV-2 in individuals deprived of liberty with COVID-19 in prison units in Central Brazil. Method: Analytical cross-sectional study conducted between May and September 2020 through individual interviews and lateral flow immunochromatography tests to detect IgM/IgG antibodies for SARS-CoV-2. The analysis was performed using the Chi-square or Fischer’s exact tests, with the outcome being the specific admission nursing consultation for SARS-CoV-2. Results: Among the 1,272 individuals investigated, 21.3% (95% CI: 19.1-23.6) tested positive for antibodies against SARS-CoV-2. Of these, 10.3% (95% CI: 7.0-14.6) underwent a specific nursing consultation for SARS-CoV-2. The most prevalent signs and symptoms were loss of taste (33.2%) and smell (32.8%), body aches (28.8%), and fever (28.4%). The analysis indicated associations between contact with symptomatic COVID-19 case (p=0.039), contact in the yard with a prisoner with COVID-19 (p=0.012), and sore throat (p=0.010), with the outcome. Conclusions: The low prevalence of specific nursing consultations for SARS-CoV-2 and the high prevalence of COVID-19 reinforce the need for mandatory implementation of this strategy in groups living in closed environments. Furthermore, nursing consultations based on the nursing process must be adopted as a public health measure.

RESUMEN Objetivo: Describir la serie histórica de internaciones, en la Unidad de Cuidados Intensivos, de ancianos con fractura de fémur, y verificar la asociación entre la edad y las características y tratamiento de la lesión, carga de trabajo de enfermería, gravedad y evolución clínica en la unidad. Método: Cohorte retrospectiva de 295 ancianos (edad ≥60 años) ingresados en la Unidad de Cuidados Intensivos de un hospital de São Paulo, entre 2013 y 2019, y que presentaron fractura de fémur como principal causa de hospitalización. Se analizaron variables relativas a características demográficas, causa y tipo de fractura, tratamiento realizado, gravedad, carga de trabajo de enfermería y evolución clínica de los pacientes. Se aplicaron las pruebas de Shapiro-Wilk, Wilcoxon-Mann-Whitney, Kruskal-Wallis y correlación de Pearson. Resultados: Hubo aumento de hospitalizaciones de ancianos en Unidad de Cuidados Intensivos desde 2017. Las pacientes del sexo femenino con fracturas de fémur distal que murieron en la Unidad de Cuidados Intensivos tuvieron mediana de edad significativamente (p < 0,05) más alta que los hombres, los pacientes con fracturas de diáfisis o de fémur proximal y los supervivientes. Conclusión: Los hallazgos del estudio resaltan información esencial para estructurar la atención de los ancianos con fracturas femorales que requieren tratamiento intensivo.

RESUMO Objetivos: Descrever a série histórica das internações, na Unidade de Terapia Intensiva, de idosos com fratura de fêmur, e verificar a associação entre idade e as características e tratamento da lesão, carga de trabalho de enfermagem, gravidade e evolução clínica na unidade. Método: Coorte retrospectiva de 295 idosos (idade ≥60 anos) admitidos na Unidade de Terapia Intensiva de hospital em São Paulo, entre 2013 e 2019, e que apresentaram fratura de fêmur como causa principal da internação. Variáveis sobre características demográficas, causa e tipo da fratura, tratamento realizado, gravidade, carga de trabalho de enfermagem e desfecho clínico dos pacientes foram analisadas. Os testes de Shapiro-Wilk, Wilcoxon-Mann-Whitney, Kruskal-Wallis e correlação de Pearson foram aplicados. Resultados: Houve aumento das internações de idosos na Unidade de Terapia Intensiva a partir de 2017. Pacientes do sexo feminino, com fratura distal de fêmur e que morreram na Unidade de Terapia Intensiva apresentaram significativamente (p < 0,05) maior mediana de idade do que homens, pacientes com fratura de diáfise ou proximal do fêmur e sobreviventes. Conclusão: Os achados do estudo evidenciam informações essenciais para estruturação dos cuidados ao idoso com fratura de fêmur que necessita de tratamento intensivo.

ABSTRACT Objectives: To describe the historical series of admissions to the Intensive Care Unit of older adults with femoral fractures, and verify the association between age and injury characteristics and treatment, nursing workload, severity, and clinical evolution in the unit. Method: Retrospective cohort of 295 older adults (age ≥60 years) admitted to the Intensive Care Unit of a hospital in São Paulo, between 2013 and 2019, and who presented with a femur fracture as the main cause of hospitalization. Variables regarding demographic characteristics, cause, and type of fracture, treatment provided, severity, nursing workload, and medical outcome of patients were analyzed. The Shapiro-Wilk, Wilcoxon-Mann-Whitney, Kruskal-Wallis tests and Pearson correlation were applied. Results: There was an increase in older adults admission to the Intensive Care Unit from 2017 on. Female patients with distal femur fractures who died in the Intensive Care Unit had significantly (p < 0.05) higher median age than men, patients with shaft or proximal femur fractures, and survivors. Conclusion: The study findings highlight essential information for structuring care for older adults with femoral fractures who require intensive care.

RESUMO Introdução: o choque hemorrágico é a principal causa reversível de morte no trauma no Brasil e no mundo. Objetivo: comparar o valor de BE ao do lactato na admissão da UTI e vinte e quatro horas após o internamento na identificação de hipoperfusão tecidual e predição de mortalidade Método: coorte histórica de pacientes traumatizados, maiores de dezoito anos, submetidos à estratégia de controle de danos na admissão hospitalar, seguido de internamento em UTI. Foram coletados e analisados ISS, mecanismo e tipo de trauma, necessidade de terapia de substituição renal e transfusão maciça; BE, lactato, pH e bicarbonato coletados na admissão da UTI e vinte e quatro horas após, e a mortalidade. Os pacientes foram divididos em grupos conforme valores de BE (≥-6 e <-6mmol/L) já descritos na literatura como preditores de gravidade, e após redivididos de acordo com os valores de melhor acurácia encontrados nesta amostra, além de realização de regressão logística binária multivariada. Os dados foram comparados através de diversos testes estatísticos devido a diversidade e conforme a indicação para cada variável. Resultados: houve alterações perfusionais impactantes já na admissão da UTI. BE manteve-se com valor estatisticamente significativo para predição de mortalidade tanto quando utilizado os valores já conhecidos da literatura como quando aplicados os valores neste estudo identificados. Conclusão: valores de BE e de lactato foram capazes de predizer hipoperfusão tecidual e mortalidade nos dois momentos estudados, quando comparados, o BE tem boa performance como preditor de mortalidade, com rápido resultado e ampla disponibilidade. Introdução mundo Objetivo Método traumatizados anos hospitalar ISS maciça ≥6 6 ≥ (≥- <6mmol/L 6mmolL mmolL < 6mmol/L 6mmol L mmol <-6mmol/L gravidade amostra multivariada variável Resultados mantevese manteve se identificados Conclusão estudados disponibilidade (≥ (

ABSTRACT Introduction: hemorrhagic shock is a significant cause of trauma-related deaths in Brazil and worldwide. This study aims to compare BE and lactate values at ICU admission and twenty-four hours after in identifying tissue hypoperfusion and mortality. Methods: examines a historical cohort of trauma patients over eitheen years old submittet to damage control resuscitation approch upon hospital admission and were then admitted to the ICU. We collected and analyzed ISS, mechanism and type of trauma, need for renal replacement therapy, massive transfusion. BE, lactate, pH, bicarbonate at ICU admission and twenty-four hours later, and mortality data. The patients were grouped based on their BE values (≥-6 and <-6mmol/L), which were previously identified in the literature as predictors of severity. They were subsequently redivided using the most accurate values found in this sample. In addition to performing multivariate binary logistic regression. The data were compared using several statistical tests due to diversity and according to the indication for each variable. Results: there were significant changes in perfusion upon admission to the Intensive Care Unit. BE is a statistically significant value for predicting mortality, as determined by using values from previous literature and from this study. Conclusion: the results demonstrate the importance of monitoring BE levels in the prediction of ICU mortality. BE proves to be a valuable bedside marker with quick results and wide availability. Introduction traumarelated related worldwide twentyfour twenty four Methods ISS therapy transfusion pH later ≥6 6 ≥ (≥- <6mmol/L, 6mmolL mmolL < 6mmol/L , 6mmol L mmol <-6mmol/L) severity sample regression variable Results Unit Conclusion availability (≥ <6mmol/L <-6mmol/L (

RESUMO Objetivos: Descrever a série histórica das internações, na Unidade de Terapia Intensiva, de idosos com fratura de fêmur, e verificar a associação entre idade e as características e tratamento da lesão, carga de trabalho de enfermagem, gravidade e evolução clínica na unidade. Método: Coorte retrospectiva de 295 idosos (idade ≥60 anos) admitidos na Unidade de Terapia Intensiva de hospital em São Paulo, entre 2013 e 2019, e que apresentaram fratura de fêmur como causa principal da internação. Variáveis sobre características demográficas, causa e tipo da fratura, tratamento realizado, gravidade, carga de trabalho de enfermagem e desfecho clínico dos pacientes foram analisadas. Os testes de Shapiro-Wilk, Wilcoxon-Mann-Whitney, Kruskal-Wallis e correlação de Pearson foram aplicados. Resultados: Houve aumento das internações de idosos na Unidade de Terapia Intensiva a partir de 2017. Pacientes do sexo feminino, com fratura distal de fêmur e que morreram na Unidade de Terapia Intensiva apresentaram significativamente (p < 0,05) maior mediana de idade do que homens, pacientes com fratura de diáfise ou proximal do fêmur e sobreviventes. Conclusão: Os achados do estudo evidenciam informações essenciais para estruturação dos cuidados ao idoso com fratura de fêmur que necessita de tratamento intensivo. Objetivos lesão unidade Método 29 60 ≥6 anos Paulo 201 2019 internação demográficas realizado analisadas ShapiroWilk, ShapiroWilk Shapiro Wilk, Wilk Shapiro-Wilk WilcoxonMannWhitney, WilcoxonMannWhitney Wilcoxon Mann Whitney, Whitney Wilcoxon-Mann-Whitney KruskalWallis Kruskal Wallis aplicados Resultados 2017 feminino p 0,05 005 0 05 homens sobreviventes Conclusão intensivo 2 6 ≥ 20 0,0 00 0,

RESUMEN Objetivo: Describir la serie histórica de internaciones, en la Unidad de Cuidados Intensivos, de ancianos con fractura de fémur, y verificar la asociación entre la edad y las características y tratamiento de la lesión, carga de trabajo de enfermería, gravedad y evolución clínica en la unidad. Método: Cohorte retrospectiva de 295 ancianos (edad ≥60 años) ingresados en la Unidad de Cuidados Intensivos de un hospital de São Paulo, entre 2013 y 2019, y que presentaron fractura de fémur como principal causa de hospitalización. Se analizaron variables relativas a características demográficas, causa y tipo de fractura, tratamiento realizado, gravedad, carga de trabajo de enfermería y evolución clínica de los pacientes. Se aplicaron las pruebas de Shapiro-Wilk, Wilcoxon-Mann-Whitney, Kruskal-Wallis y correlación de Pearson. Resultados: Hubo aumento de hospitalizaciones de ancianos en Unidad de Cuidados Intensivos desde 2017. Las pacientes del sexo femenino con fracturas de fémur distal que murieron en la Unidad de Cuidados Intensivos tuvieron mediana de edad significativamente (p < 0,05) más alta que los hombres, los pacientes con fracturas de diáfisis o de fémur proximal y los supervivientes. Conclusión: Los hallazgos del estudio resaltan información esencial para estructurar la atención de los ancianos con fracturas femorales que requieren tratamiento intensivo. Objetivo internaciones lesión unidad Método 29 60 ≥6 años Paulo 201 2019 hospitalización demográficas realizado ShapiroWilk, ShapiroWilk Shapiro Wilk, Wilk Shapiro-Wilk WilcoxonMannWhitney, WilcoxonMannWhitney Wilcoxon Mann Whitney, Whitney Wilcoxon-Mann-Whitney KruskalWallis Kruskal Wallis Pearson Resultados 2017 p 0,05 005 0 05 hombres supervivientes Conclusión intensivo 2 6 ≥ 20 0,0 00 0,

ABSTRACT Objectives: To describe the historical series of admissions to the Intensive Care Unit of older adults with femoral fractures, and verify the association between age and injury characteristics and treatment, nursing workload, severity, and clinical evolution in the unit. Method: Retrospective cohort of 295 older adults (age ≥60 years) admitted to the Intensive Care Unit of a hospital in São Paulo, between 2013 and 2019, and who presented with a femur fracture as the main cause of hospitalization. Variables regarding demographic characteristics, cause, and type of fracture, treatment provided, severity, nursing workload, and medical outcome of patients were analyzed. The Shapiro-Wilk, Wilcoxon-Mann-Whitney, Kruskal-Wallis tests and Pearson correlation were applied. Results: There was an increase in older adults admission to the Intensive Care Unit from 2017 on. Female patients with distal femur fractures who died in the Intensive Care Unit had significantly (p < 0.05) higher median age than men, patients with shaft or proximal femur fractures, and survivors. Conclusion: The study findings highlight essential information for structuring care for older adults with femoral fractures who require intensive care. Objectives workload severity unit Method 29 60 ≥6 years Paulo 201 2019 hospitalization provided analyzed ShapiroWilk, ShapiroWilk Shapiro Wilk, Wilk Shapiro-Wilk WilcoxonMannWhitney, WilcoxonMannWhitney Wilcoxon Mann Whitney, Whitney Wilcoxon-Mann-Whitney KruskalWallis Kruskal Wallis applied Results on p 0.05 005 0 05 men survivors Conclusion 2 6 ≥ 20 0.0 00 0.

SUMMARY Euglycemic diabetic ketoacidosis (DKA) is a rare complication of diabetes mellitus (DM) characterized by metabolic acidosis, ketosis, and blood glucose levels < 250 mg/dL. The prevalence of euglycemic DKA is increasing with the popularity of ketogenic (low-carbohydrate) diets. We present herein the case of a patient with newly diagnosed type 1 DM who developed euglycemic DKA following a ketogenic diet. A 22-year-old woman presented to the emergency department with malaise, fatigue, nausea, and vomiting. She had no family history of DM. She had consulted her primary care physician 2 weeks before due to hair loss, numbness, and tingling sensation in her fingertips. Her fasting blood glucose was 205 mg/dL at that time. Reluctant to use medication to control her blood glucose levels, she started a ketogenic diet. On admission, she was conscious, oriented, cooperative, and tachycardic. Her body mass index was 17.6 kg/m2. Laboratory tests showed fasting blood glucose of 86 mg/dL, glycated hemoglobin of 10.3%, and elevated insulin levels. Ketone levels in urine and blood were high, indicating ketosis. High anion-gap metabolic acidosis was detected, with a pH of 7.10 and serum bicarbonate level of 12 mEq/L. A diagnosis of new-onset DM and euglycemic DKA was established. She was treated with a modified DKA protocol that included intravenous dextrose-containing serum as fluid therapy, and intravenous insulin infusion was delayed until blood glucose levels increased above 250 mg/dL. The development of euglycemic DKA in our patient was attributed to severe carbohydrate restriction. This case underscores the importance of considering dietary risk factors, particularly ketogenic diets, in the management of DM. (DKA (DM ketosis 25 mgdL mg dL lowcarbohydrate low (low-carbohydrate diets diet 22yearold yearold 22 year old malaise fatigue nausea vomiting loss numbness fingertips 20 time admission conscious oriented cooperative tachycardic 176 17 6 17. kgm2 kgm kg m2 m kg/m2 8 103 10 3 10.3% high aniongap anion gap detected 710 7 7.1 mEqL mEq L mEq/L newonset new onset established dextrosecontaining dextrose containing therapy restriction factors kg/m 10.3 71 7. 10.

ABSTRACT Yellow fever vaccine (YFV) is a live attenuated vaccine that can cause a mild infection in immunocompetent patients. However, it may not be self-limiting in patients with inborn errors of immunity (IEI) and may be the first and most severe presentation in these patients. A 10-month-old female infant sought emergency care presenting fever for three days and diffuse exanthema. She was a previous healthy child of consanguineous parents. The child had received YFV 28 days before the onset of symptoms. Upon hospital admission, petechial rash on the limbs and hepatosplenomegaly were noted on physical exam. Laboratory tests showed thrombocytopenia, increased serum aminotransferases and elevated gamma-glutamyl transferase (GGT) and alkaline phosphatase levels. During hospitalization she developed hypoactivity, drowsiness, and hypotonia. The possibility of viscerotropic and neurotropic vaccine associated disease was suspected and a possible primary immunodeficiency disease considered. The patient was tested for antibodies against the yellow fever virus (MAC ELISA) on serum and cerebrospinal fluid (CSF) samples, showing positive IgM results. Immunophenotyping showed low levels of lymphocytes and absence of T-cell receptor excision circles (TREC), leading to diagnose of severe combined immunodeficiency disease (SCID). Despite treatment, after 35 days of hospitalization, she evolved to cardiorespiratory arrest and death. Serious adverse events after administration of the YFV are rare and associated with neurological or visceral involvement in most cases. The unfavorable outcome highlights the importance of neonatal screening for SCID and the clinical suspicion of primary immunodeficiencies in infants who have serious adverse events to live virus vaccines. (YFV However selflimiting self limiting IEI (IEI 10monthold monthold 10 month old exanthema parents 2 symptoms admission exam thrombocytopenia gammaglutamyl gamma glutamyl GGT (GGT hypoactivity drowsiness hypotonia considered MAC ELISA CSF (CSF samples results Tcell T cell TREC, TREC , (TREC) SCID. . (SCID) treatment 3 death cases vaccines 1 (TREC (SCID

Os sintomas persistentes da síndrome pós-COVID-19 acarretam impactos negativos na saúde, qualidade de vida e produtividade. O objetivo deste trabalho foi descrever os sintomas persistentes da síndrome pós-COVID-19, principalmente neurológicos, e as repercussões cognitivas, emocionais, motoras, de qualidade de vida e de custos indiretos, 12 meses após a infecção. Pacientes com primeiros sintomas entre janeiro e junho de 2021 evoluíram com síndrome pós-COVID-19 e procuraram atendimento na unidade da Rede SARAH de Hospitais de Reabilitação em Fortaleza, Ceará, Brasil. As informações foram obtidas no início do acompanhamento e por entrevista telefônica após 12 meses da infecção. Participaram do estudo 58 pessoas, com idade média de 52,8 anos (±10,5) e 60% permaneceram em UTI. Os sintomas mais frequentes na admissão foram: fadiga (64%), artralgia (51%) e dispneia (47%); e após 12 meses: fadiga (46%) e alteração de memória (39%). Foram identificadas alterações nas escalas/testes funcionais: PCFS, MoCA, HAD, FSS, SF-36, TLS5x, Timed up and go, caminhada de 6 minutos e preensão manual. Os custos indiretos totais foram de USD 227.821,00, com 11.653 dias de absenteísmo; 32% dos pacientes não voltaram a trabalhar. Melhores resultados de TLS5x e SF-36, nas dimensões capacidade funcional, aspecto físico, vitalidade e dor, demonstraram associação com retorno laboral (p ≤ 0,05). Os sintomas persistentes mais frequentes foram: fadiga, artralgia, dispneia, ansiedade e depressão, com repercussões negativas na funcionalidade cognitiva, emocional, motora e qualidade de vida. Esses sintomas perduraram por mais de um ano, principalmente fadiga e alteração de memória, sendo esta última mais relatada tardiamente. Houve dificuldade importante de retorno laboral e custos indiretos de USD 4.847,25 por pessoa/ano.

Síntomas persistentes del síndrome post-COVID-19 provocan impactos negativos en la salud, calidad de vida y productividad. El objetivo fue describir los síntomas persistentes del síndrome post-COVID-19, sobre todo neurológicos, y las repercusiones cognitivas, emocionales, motoras, de calidad de vida y los costos indirectos, 12 meses tras la infección. Pacientes que tuvieron los primeros síntomas entre enero y junio de 2021, desarrollaron síndrome post-COVID-19 y buscaron atención en la unidad de la Red SARAH de Hospitales de Rehabilitación en Fortaleza, Ceará, Brasil. Las informaciones se obtuvieron al inicio del seguimiento y por entrevista telefónica 12 meses tras la infección. Participaron 58 personas, con edad de 52,8±10,5 años y el 60% permaneció en la UTI. Los síntomas más frecuentes al ingreso fueron: fatiga (64%), artralgia (51%) y disnea (47%); tras 12 meses fueron: fatiga (46%) y alteración de memoria (39%). Se identificaron alteraciones en las escalas/testes funcionales: PCFS, MoCA, HAD, FSS, SF-36, TLS5x, timed up and go, caminar por 6 minutos y prensión manual. Los costos indirectos totales fueron USD 227.821,00, con 11.653 días de absentismo. El 32% de los pacientes no volvió a trabajar. Mejor TLS5x y SF-36 en las dimensiones capacidad funcional, aspecto físico, vitalidad y dolor demostraron una asociación con el retorno al trabajo (p ≤ 0,05). Los síntomas persistentes más frecuentes fueron fatiga, artralgia, disnea, ansiedad y depresión, con repercusiones negativas en la funcionalidad cognitiva, emocional, motora y calidad de vida. Estos síntomas continuaron por más de un año, sobre todo la fatiga y la alteración de la memoria, siendo esta última reportada con más frecuencia tardíamente. Hubo una dificultad importante en el retorno al trabajo y costos indirectos de USD 4.847,25 persona/año.

The persistent symptoms of post-COVID-19 syndrome negatively impact health, quality of life, and productivity. This study aimed to describe the persistent symptoms of post-COVID-19 syndrome (especially neurological ones) and their 12-month post-infection cognitive, emotional, motor, quality of life, and indirect cost repercussions. Patients showing the first symptoms of COVID-19 from January to June 2021 who developed post-COVID-19 syndrome and sought care at the Fortaleza Unit (Ceará, Brazil) of the SARAH Network of Rehabilitation Hospitals were included in this study. Information was obtained at the baseline follow-up and by telephone interview 12 months post-infection. In total, 58 people participated in this study with an average age of 52.8±10.5 years, of which 60% required an ICU. The most frequent symptoms on admission included fatigue (64%), arthralgia (51%), and dyspnea (47%), whereas, after 12 months, fatigue (46%) and memory impairment (39%). The following scales/functional tests showed alterations: PCFS, MoCA, HAD, FSS, SF-36, TLS5x, timed up and go, 6-minute walk, and handgrip. Indirect costs totaled USD 227,821.00, with 11,653 days of absenteeism. Moreover, 32% of patients were unable to return to work. Better TLS5x and higher SF-36 scores in the functional capacity, physical functioning, vitality, and pain dimensions were associated with return to work (p ≤ 0.05). The most frequent persistent symptoms referred to fatigue, arthralgia, dyspnea, anxiety, and depression, which negatively affected cognitive, emotional, and motor function and quality of life. These symptoms lasted for over a year, especially fatigue and memory alteration, the latter of which being the most reported after COVID-19 infections. Results also show a significant difficulty returning to work and indirect costs of USD 4,847.25 per person/year.

RESUMO Objetivo: Estimar a prevalência de diagnóstico e internações hospitalares por COVID-19 e avaliar seus correlatos entre adultos no Brasil. Métodos: Um estudo transversal, com dados secundários do Inquérito Telefônico de Fatores de Risco para Doenças Crônicas não Transmissíveis em tempos de Pandemia — Covitel 2022 foi realizado. O estudo Covitel utiliza amostragem por conglomerados, realizada a partir de discagem aleatória de dígitos para linhas telefônicas fixas e celulares, entre pessoas de 18 anos ou mais. O desfecho “diagnóstico de COVID-19” foi baseado no autorrelato de um caso confirmado, por meio de exames laboratoriais ou diagnósticos médicos. Para aqueles que relataram COVID-19, foi questionado sobre a necessidade de internação hospitalar devido à COVID-19. As variáveis independentes incluíram sexo, idade, escolaridade, região, comorbidade, plano de saúde privado, autoavaliação de saúde e situação profissional. A razão de chances foi estimada por regressão logística considerando o desenho amostral complexo. Resultados: A partir da amostra de 9000 pessoas obteve-se prevalência de diagnóstico de COVID-19 de 25,4% (IC95% 23,8–27,1%), variando de 23,0% (IC95% 20,0–26,3%) na região Nordeste a 28,5% (IC95% 25,3–31,7%) na região Sul. Adultos entre 35–44 anos tiveram a maior prevalência de diagnóstico de COVID-19. Quanto maior a escolaridade, maior foi a prevalência do diagnóstico de COVID-19. Conclusão: A prevalência do diagnóstico de COVID-19 é marcadamente diferente daquela da infecção por SARS-CoV-2 a nível populacional. As diferenças socioeconômicas no acesso aos testes são a explicação provável. Idosos e pessoas com comorbidades tiveram maior probabilidade de serem internados em hospital devido à COVID-19 no Brasil. Objetivo COVID19 COVID 19 COVID-1 Brasil Métodos transversal 202 realizado conglomerados celulares 1 mais confirmado médicos COVID19, 19, COVID19. 19. sexo idade escolaridade comorbidade privado profissional complexo Resultados 900 obtevese obteve se 254 25 4 25,4 IC95% IC95 IC (IC95 23,8–27,1%, 238271 23,8–27,1% , 23 8 27 23,8–27,1%) 230 0 23,0 20,0–26,3% 200263 20 26 3 285 28 5 28,5 25,3–31,7% 253317 31 7 Sul 3544 35 44 35–4 Conclusão SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- populacional provável COVID1 COVID- 90 25, IC9 (IC9 23827 23,8–27,1 23, 20,0–26,3 20026 28, 25,3–31,7 25331 354 35– SARS-CoV 9 (IC 2382 23,8–27, 20,0–26, 2002 25,3–31, 2533 238 23,8–27 20,0–26 200 25,3–31 253 23,8–2 20,0–2 25,3–3 23,8– 20,0– 25,3– 23,8 20,0 25,3 20,

ABSTRACT Objective: To estimate the prevalence of COVID-19 diagnosis and hospital admissions, and to evaluate their correlates in a nationwide Brazilian sample. Methods: A cross-sectional study was carried out with secondary data from the Telephone Survey of Risk Factors for Chronic Noncommunicable Diseases in Times of Pandemic – Covitel 2022. The Covitel study uses cluster sampling, carried out through random digit dialing on landlines and cell phones, among people aged 18 years or over. The outcome of the “diagnosis of COVID-19” was based on a self-report of a confirmed case through laboratory tests or medical diagnoses. Those who reported COVID-19 were asked about the need for hospital admission due to COVID-19. Independent variables included sex, age, level of education, region, comorbidity, private health insurance plan, self-rated health, and employment status. The odds ratio was estimated using logistic regression models considering the complex sample design. Results: From the sample of 9000 people, the prevalence of COVID-19 diagnosis was 25.4% (95%CI 23.8–27.1%), ranging from 23.0% (95%CI 20.0–26.3%) in the Northeast region to 28.5% (95%CI 25.3–31.7%) in the South region. Middle-aged adults (35–44 years old) had the highest prevalence of COVID-19 diagnosis. The higher the level of education, the higher the prevalence of COVID-19 diagnosis. Conclusion: The prevalence of COVID-19 diagnosis is markedly different from that of SARS-CoV-2 infection at the population level. Socioeconomic differences in access to testing are the likely explanation. Older adults and people with comorbidities were more likely to be admitted to hospital due to COVID-19 in Brazil. Objective COVID19 COVID 19 COVID-1 admissions Methods crosssectional cross sectional 2022 sampling phones 1 over selfreport self report diagnoses COVID19. 19. sex age education comorbidity plan selfrated rated status design Results 900 254 25 4 25.4 95%CI 95CI CI 95 23.8–27.1%, 238271 23.8–27.1% , 23 8 27 23.8–27.1%) 230 0 23.0 20.0–26.3% 200263 20 26 3 285 28 5 28.5 25.3–31.7% 253317 31 7 Middleaged Middle 35–44 3544 35 44 (35–4 old Conclusion SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- explanation Brazil COVID1 COVID- 202 90 25. 9 23827 23.8–27.1 23. 20.0–26.3 20026 28. 25.3–31.7 25331 35–4 354 (35– SARS-CoV 2382 23.8–27. 20.0–26. 2002 25.3–31. 2533 35– (35 238 23.8–27 20.0–26 200 25.3–31 253 (3 23.8–2 20.0–2 25.3–3 ( 23.8– 20.0– 25.3– 23.8 20.0 25.3 20.

RESUMO: Objetivo: Estimar a prevalência e fatores associados à realização da consulta de enfermagem admissional específica para o SARS-CoV-2 em indivíduos privados de liberdade com COVID-19 em unidades prisionais do Brasil Central. Método: Estudo transversal analítico conduzido entre maio a setembro de 2020 por meio de entrevistas individuais e testes de imunocromatografia de fluxo lateral para detecção de anticorpos IgM/IgG para SARS-CoV-2. A análise foi realizada por meio dos testes Qui-quadrado ou Exato de Fischer, sendo considerado desfecho a consulta de enfermagem admissional específica para oSARS-CoV-2. Resultados: Entre os 1.272 investigados, 21,3%; (IC 95%: 19,1-23,6) testaram reagentes para anticorpos contra o SARS-CoV-2. Destes, 10,3% (IC 95%: 7,0-14,6) realizaram a consulta de enfermagem específica para SARS-CoV-2. Os sinais e sintomas mais prevalentes foram diminuição do paladar (33,2%) e do olfato (32,8%), dores no corpo (28,8%) e febre (28,4%).A análise apontou associações entre contato com caso sintomático para COVID-19 (p=0,039), contato no pátio com preso com COVID-19 (p=0,012) e dor de garganta (p=0,010), com o desfecho. Conclusões: A baixa prevalência de consulta de enfermagem específica para o SARS-CoV-2 e a alta prevalência de COVID-19 reforçam a necessidade de implementação obrigatória dessa estratégia em grupos que vivem em ambientes fechados. Ademais, a consulta de enfermagem baseada no processo de enfermagem deve ser adotada como medida de saúde pública. RESUMO Objetivo SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- COVID19 COVID 19 COVID-1 Central Método 202 IgMIgG IgM IgG SARSCoV2. 2. Quiquadrado Qui quadrado Fischer oSARSCoV2. oSARSCoV2 oSARSCoV oSARS oSARS-CoV-2 Resultados 1272 1 272 1.27 investigados 21,3% 213 21 3 IC 95% 95 19,123,6 191236 19,1 23,6 23 6 19,1-23,6 Destes 103 10 10,3 7,014,6 70146 7,0 14,6 7 0 14 7,0-14,6 33,2% 332 33 (33,2% 32,8%, 328 32,8% , 32 8 (32,8%) 28,8% 288 28 (28,8% 28,4%.A 284A 28,4% .A 4 p=0,039, p0039 p p=0,039 039 (p=0,039) p=0,012 p0012 012 (p=0,012 p=0,010, p0010 p=0,010 010 (p=0,010) Conclusões fechados Ademais pública SARS-CoV COVID1 COVID- 20 oSARS-CoV- 127 27 1.2 21,3 9 123 19,123, 19123 191 19, 236 23, 19,1-23, 10, 014 7,014, 7014 70 7, 146 14, 7,0-14, 33,2 (33,2 32,8 (32,8% 28,8 (28,8 284 28,4 p003 p=0,03 03 (p=0,039 p=0,01 p001 01 (p=0,01 (p=0,010 oSARS-CoV 12 1. 21, 19,123 1912 19,1-23 7,014 701 7,0-14 33, (33, 32, (32,8 28, (28, p00 p=0,0 (p=0,03 (p=0,0 19,12 19,1-2 7,01 7,0-1 (33 (32, (28 p0 p=0, (p=0, 19,1- 7,0- (3 (32 (2 p=0 (p=0 ( p= (p= (p

RESUMEN: Objetivo: Estimar la prevalencia y los factores asociados a la realización de una consulta de enfermería de ingreso específica para SARS-CoV-2 en personas privadas de libertad con COVID-19 en unidades penitenciarias del Centro de Brasil. Método: Estudio analítico transversal realizado entre mayo y septiembre de 2020 mediante entrevistas individuales y pruebas de inmunocromatografía de flujo lateral para detección de anticuerpos IgM/IgG contra SARS-CoV-2. El análisis se realizó mediante las pruebas de Chi-cuadrado o exacta de Fischer, considerando como resultado la consulta de enfermería específica de ingreso por SARS-CoV-2. Resultados: Entre los 1.272 investigados, el 21,3%; (IC del 95%: 19,1-23,6) probaron reactivos para detectar anticuerpos contra el SARS-CoV-2. De ellos, el 10,3% (IC 95%: 7,0-14,6) realizó alguna consulta de enfermería específica por SARS-CoV-2. Los signos y síntomas más prevalentes fueron disminución del gusto (33,2%) y del olfato (32,8%), dolores corporales (28,8%) y fiebre (28,4%). El análisis mostró asociaciones entre el contacto con un caso sintomático de COVID-19 (p=0,039), el contacto en el patio con un preso con COVID-19 (p=0,012) y el dolor de garganta (p=0,010) con el desenlace. Conclusiones: La baja prevalencia de consultas específicas de enfermería por SARS-CoV-2 y la alta prevalencia de COVID-19 refuerzan la necesidad de la implementación obligatoria de esta estrategia en grupos que viven en ambientes cerrados. Además, se debe adoptar como medida de salud pública la consulta de enfermería basada en el proceso de enfermería. RESUMEN Objetivo SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- COVID19 COVID 19 COVID-1 Brasil Método 202 IgMIgG IgM IgG SARSCoV2. 2. Chicuadrado Chi cuadrado Fischer Resultados 1272 1 272 1.27 investigados 21,3% 213 21 3 IC 95% 95 19,123,6 191236 19,1 23,6 23 6 19,1-23,6 ellos 103 10 10,3 7,014,6 70146 7,0 14,6 7 0 14 7,0-14,6 33,2% 332 33 (33,2% 32,8%, 328 32,8% , 32 8 (32,8%) 28,8% 288 28 (28,8% 28,4%. 284 28,4% . 4 (28,4%) p=0,039, p0039 p p=0,039 039 (p=0,039) p=0,012 p0012 012 (p=0,012 p=0,010 p0010 010 (p=0,010 desenlace Conclusiones cerrados Además SARS-CoV COVID1 COVID- 20 127 27 1.2 21,3 9 123 19,123, 19123 191 19, 236 23, 19,1-23, 10, 014 7,014, 7014 70 7, 146 14, 7,0-14, 33,2 (33,2 32,8 (32,8% 28,8 (28,8 28,4 (28,4% p003 p=0,03 03 (p=0,039 p=0,01 p001 01 (p=0,01 12 1. 21, 19,123 1912 19,1-23 7,014 701 7,0-14 33, (33, 32, (32,8 28, (28, (28,4 p00 p=0,0 (p=0,03 (p=0,0 19,12 19,1-2 7,01 7,0-1 (33 (32, (28 p0 p=0, (p=0, 19,1- 7,0- (3 (32 (2 p=0 (p=0 ( p= (p= (p

ABSTRACT: Objective: To estimate the prevalence and factors associated with the performance of specific admission nursing consultations for SARS-CoV-2 in individuals deprived of liberty with COVID-19 in prison units in Central Brazil. Method: Analytical cross-sectional study conducted between May and September 2020 through individual interviews and lateral flow immunochromatography tests to detect IgM/IgG antibodies for SARS-CoV-2. The analysis was performed using the Chi-square or Fischer’s exact tests, with the outcome being the specific admission nursing consultation for SARS-CoV-2. Results: Among the 1,272 individuals investigated, 21.3% (95% CI: 19.1-23.6) tested positive for antibodies against SARS-CoV-2. Of these, 10.3% (95% CI: 7.0-14.6) underwent a specific nursing consultation for SARS-CoV-2. The most prevalent signs and symptoms were loss of taste (33.2%) and smell (32.8%), body aches (28.8%), and fever (28.4%). The analysis indicated associations between contact with symptomatic COVID-19 case (p=0.039), contact in the yard with a prisoner with COVID-19 (p=0.012), and sore throat (p=0.010), with the outcome. Conclusions: The low prevalence of specific nursing consultations for SARS-CoV-2 and the high prevalence of COVID-19 reinforce the need for mandatory implementation of this strategy in groups living in closed environments. Furthermore, nursing consultations based on the nursing process must be adopted as a public health measure. ABSTRACT Objective SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- COVID19 COVID 19 COVID-1 Brazil Method crosssectional cross sectional 202 IgMIgG IgM IgG SARSCoV2. 2. Chisquare Chi square Fischers Fischer s Results 1272 1 272 1,27 investigated 213 21 3 21.3 95% 95 (95 CI 19.123.6 191236 19.1 23.6 23 6 19.1-23.6 these 103 10 10.3 7.014.6 70146 7.0 14.6 7 0 14 7.0-14.6 33.2% 332 33 (33.2% 32.8%, 328 32.8% , 32 8 (32.8%) 28.8%, 288 28.8% 28 (28.8%) 28.4%. 284 28.4% . 4 (28.4%) p=0.039, p0039 p p=0.039 039 (p=0.039) p=0.012, p0012 p=0.012 012 (p=0.012) p=0.010, p0010 p=0.010 010 (p=0.010) Conclusions environments Furthermore measure SARS-CoV COVID1 COVID- 20 127 27 1,2 21. 9 (9 123 19.123. 19123 191 19. 236 23. 19.1-23. 10. 014 7.014. 7014 70 7. 146 14. 7.0-14. 33.2 (33.2 32.8 (32.8% 28.8 (28.8% 28.4 (28.4% p003 p=0.03 03 (p=0.039 p001 p=0.01 01 (p=0.012 (p=0.010 12 1, ( 19.123 1912 19.1-23 7.014 701 7.0-14 33. (33. 32. (32.8 28. (28.8 (28.4 p00 p=0.0 (p=0.03 (p=0.01 19.12 19.1-2 7.01 7.0-1 (33 (32. (28. p0 p=0. (p=0.0 19.1- 7.0- (3 (32 (28 p=0 (p=0. (2 p= (p=0 (p= (p