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Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
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Fink, Thais T.
; Marques, Heloisa H.S.
; Gualano, Bruno
; Lindoso, Livia
; Bain, Vera
; Astley, Camilla
; Martins, Fernanda
; Matheus, Denise
; Matsuo, Olivia M.
; Suguita, Priscila
; Trindade, Vitor
; Paula, Camila S.Y.
; Farhat, Sylvia C.L.
; Palmeira, Patricia
; Leal, Gabriela N.
; Suzuki, Lisa
; Odone Filho, Vicente
; Carneiro-Sampaio, Magda
; Duarte, Alberto José S.
; Antonangelo, Leila
; Batisttella, Linamara R.
; Polanczyk, Guilherme V.
; Pereira, Rosa Maria R.
; Carvalho, Carlos Roberto R.
; Buchpiguel, Carlos A.
; Latronico, Ana Claudia
; Seelaender, Marilia
; Silva, Clovis Artur
; Pereira, Maria Fernanda B.
; Sallum, Adriana M. E.
; Brentani, Alexandra V. M.
; Neto, Álvaro José S.
; Ihara, Amanda
; Santos, Andrea R.
; Canton, Ana Pinheiro M.
; Watanabe, Andreia
; Santos, Angélica C. dos
; Pastorino, Antonio C.
; Franco, Bernadette D. G. M.
; Caruzo, Bruna
; Ceneviva, Carina
; Martins, Carolina C. M. F.
; Prado, Danilo
; Abellan, Deipara M.
; Benatti, Fabiana B.
; Smaria, Fabiana
; Gonçalves, Fernanda T.
; Penteado, Fernando D.
; Castro, Gabriela S. F. de
; Gonçalves, Guilherme S.
; Roschel, Hamilton
; Disi, Ilana R.
; Marques, Isabela G.
; Castro, Inar A.
; Buscatti, Izabel M.
; Faiad, Jaline Z.
; Fiamoncini, Jarlei
; Rodrigues, Joaquim C.
; Carneiro, Jorge D. A.
; Paz, Jose A.
; Ferreira, Juliana C.
; Ferreira, Juliana C. O.
; Silva, Katia R.
; Bastos, Karina L. M.
; Kozu, Katia
; Cristofani, Lilian M.
; Souza, Lucas V. B.
; Campos, Lucia M. A.
; Silva Filho, Luiz Vicente R. F.
; Sapienza, Marcelo T.
; Lima, Marcos S.
; Garanito, Marlene P.
; Santos, Márcia F. A.
; Dorna, Mayra B.
; Aikawa, Nadia E.
; Litvinov, Nadia
; Sakita, Neusa K.
; Gaiolla, Paula V. V.
; Pasqualucci, Paula
; Toma, Ricardo K.
; Correa-Silva, Simone
; Sieczkowska, Sofia M.
; Imamura, Marta
; Forsait, Silvana
; Santos, Vera A.
; Zheng, Yingying
.
OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.
2.
Aquatic life protection index of an urban river Bacanga basin in northern Brazil, São Luís - MA
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Duarte-dos-Santos, A. K.
; Cutrim, M. V. J.
; Ferreira, F. S.
; Luvizotto-Santos, R.
; Azevedo-Cutrim, A. C. G.
; Araújo, B. O.
; Oliveira, A. L. L.
; Furtado, J. A.
; Diniz, S. C. D.
.
Resumo A Bacia Hidrográfica do rio Bacanga (BHRB) apresenta problemas ambientais relacionados a urbanização e lançamentos de esgoto in natura que comprometem a qualidade desse ecossistema. Devido ao reduzido número de estudos associados à avaliação da qualidade da água no local, este estudo teve como objetivo avaliar a situação atual desse ecossistema por meio do Índice de Proteção da Vida Aquática. Seis amostragens bimestrais foram realizadas em seis pontos ao longo da bacia, coletando parâmetros físico-químicos para a aplicação do Índice de Estado Trófico e Índice de Parâmetros Mínimos para a Proteção da Vida Aquática, relacionando-os com a resolução Conselho Nacional do Meio Ambiente - CONAMA/357. Os resultados revelaram alterações significativas na qualidade da água da BHRB, o aumento de nutrientes e das concentrações de clorofila-a conduziram ao um estado geral de eutrofização. Os valores de surfactantes foram altos colocando em risco a biota aquática e as taxas de oxigênio dissolvido estiveram abaixo do permitido pela resolução na maioria dos pontos amostrados. A situação atual da qualidade da água para proteção da vida aquática é péssima em 61,92% dos pontos amostrados.
Abstract Bacanga River Basin faces environmental problems related to urbanization and discharge of untreated domestic sewage, which compromise its ecosystem health. Due to the small number of studies that assessed its water quality, the present study aimed to assess the current status of this ecosystem based on the aquatic life protection index. Samples were carried out every two months, in a total of six events, in six sites along the basin, where the water samples were collected to assess physicochemical parameters and calculate the trophic state index and the index of minimum parameters for the protection of aquatic communities. The data were also compared with values determined by the resolution National Environment Council - CONAMA 357/05. Our results reveal significant changes in the water quality of Bacanga River Basin. An increase in nutrients and chlorophyll-a concentration led it to eutrophication. The surfactant values were high and put in danger the aquatic biota. Dissolved oxygen rates were below the values allowed by the resolution in most sites sampled. The current water quality is terrible for the protection of aquatic life in 61.92% of the sites sampled.
https://doi.org/10.1590/1519-6984.01016
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