ABSTRACT Background: The prevalence of malnourished patients before transplantation and the influence of malnutrition on graft and patient outcomes remain underestimated, despite being associated with higher postoperative morbidity and mortality. This study aimed to develop an easy nutritional screening tool and evaluate the impact of nutritional status on clinical outcome, graft survival (GS) and mortality risk in kidney transplant patients (KTP). Methods: In this retrospective cohort study including 451 KTP, we developed a score by using anthropometric, clinical, and laboratory measures performed in the pretransplant evaluation. The patients were stratified into 3 groups according to the final score: G1 (0 or 1 point)=low risk, G2 (2 to 4 points)=moderate risk, and G3 (>5 points)=high risk of malnutrition. The patients were monitored after transplantation at least 1 to 10 years. Results: Stratifying the 451 patients based on the pretransplant risk score, G1, G2, and G3 were composed of 90, 292, and 69 patients, respectively. Patients from G1 maintained the lowest serum creatinine levels at hospital discharge when compared with others (p = 0.012). The incidence of infection in the patients from G3 was higher than patients from G1 and G2 (p = 0.030). G3 recipients showed worse GS than G1 patients (p = 0.044). G3 patients showed almost threefold higher risk for graft loss (HR 2.94, 95% CI 1.084-7.996). Conclusions: KTP with higher malnutrition risk score were associated with worse outcomes and GS. The nutritional screening tool is easy to be used in clinical practice to evaluate the patient in preparation for kidney transplant.

RESUMO Antecedentes: A prevalência de pacientes desnutridos antes do transplante e a influência da desnutrição nos desfechos do enxerto e do paciente permanecem subestimadas, embora estejam associadas a maior morbimortalidade pós-operatória. Este estudo buscou desenvolver uma ferramenta simples de triagem nutricional e avaliar o impacto do estado nutricional no desfecho clínico, sobrevida do enxerto (SE) e risco de mortalidade em pacientes transplantados renais (PTR). Métodos: Neste estudo de coorte retrospectivo incluindo 451 PTR, desenvolvemos um escore usando medidas antropométricas, clínicas e laboratoriais tomadas na avaliação pré-transplante. Os pacientes foram estratificados em 3 grupos segundo a pontuação final: G1 (0-1 ponto) = baixo risco, G2 (2-4 pontos) = risco moderado e G3 (>5 pontos) = alto risco de desnutrição. Eles foram monitorados por pelo menos 1 a 10 anos após o transplante. Resultados: Os 451 pacientes foram estratificados em G1, G2 e G3, que consistiram em 90, 292 e 69 pacientes, respectivamente. Os pacientes do G1 mantiveram os menores níveis de creatinina sérica na alta hospitalar em relação aos demais (p = 0,012). A incidência de infecção nos pacientes do G3 foi maior que nos pacientes do G1 e G2 (p = 0,030). Os pacientes do G3 apresentaram SE pior do que os pacientes do G1 (p = 0,044) e um risco quase três vezes maior de perda do enxerto (HR 2,94; IC 95% 1,084-7,996). Conclusões: PTR com maior escore de risco de desnutrição foram associados a piores desfechos e menor SE. A ferramenta de triagem nutricional é fácil de usar na prática clínica para avaliar pacientes em preparação para transplante renal.

Toads of the Rhinella genus have a pair of paratoid glands that store biological secretions of high toxicity and varied chemical composition, rich in biologically active compounds. The present work aimed to carry out the investigation of the metabolomic profile and evaluation of the biological potential of the secretion paratoid glands (PGS) from Rhinella granulosa. The paratoid secretion was collected in the Piauí state (Brazil), extracted with methanol and the extract was analyzed by ultra-performance liquid chromatography with quadrupole time-of-flight mass spectrometry. Fifty chemical constituents were identified. The extract showed cytotoxicity against tumor cell lines of the central nervous system (half maximal inhibitory concentration (IC50) = 1.9 µg mL-1) and prostate (IC50 = 1.6 µg mL-1), unsatisfactory antimicrobial potential (minimal inhibitory concentration (MIC) > 312 µg mL-1) and inhibited the enzyme acetylcholinesterase (IC50 = 5.119 mg mL-1). The results presented relevant information about the PGS and contributed to the understanding of the metabolomic and biological potential of R. granulosa.

Abstract Objectives: This study aims to investigate the pattern of immunoexpression of proteins p16, p53 and Ki-67 in RRP, as well as to evaluate its influence on the number of surgeries that patients have undergone to date and to analyze the benefit of immunohistochemistry in this disease. Methods: Clinical-demographic data and tumor samples were obtained from 33 patients with RRP. The expression of proteins p16, p53 and Ki-67 was analyzed by immunohistochemical method. Results: Most patients had already undergone more than one surgery. The p16 marker was negative in 24.2% of the cases, with little positivity in 27.3% of the cases, moderate in 36.4% and intense in 12.1%. The p53 marker was positive in all cases, with little immunoexpression in 39.4% of cases, moderate in 36.4% and intense in 24.2%. The Ki-67 marker showed nuclear positivity in all lesions, although in varying degrees, with a mean proliferative index ±SD (standard deviation) of 51.7±26. Conclusions: The papillomatous lesions had varying degrees of immunoexpression of proteins p16, p53 and Ki-67, but no specific immunohistochemical pattern was observed. It was found, with statistical difference, that the number of surgeries was higher in cases with greater intensity of p53 expression, without correlation with the other markers. The benefit of immunohistochemistry in recurrent respiratory papillomatosis may lie in the prognostic assessment. However, further studies are needed to evaluate the use of this technique for this purpose. Level of evidence:: 4.

Abstract Physiological and yield evaluation of perennial forage plants grown in intercropping in the semiarid region is indispensable in the search for higher efficiency of the agricultural and livestock production systems. In this context, an experiment was carried out at the Experimental Station of the National Institute of the Semiarid Region - INSA, in the municipality of Campina Grande, Paraíba, Brazil, to evaluate the physiological efficiency and yield of prickly pear and gliricidia in intercropping. Treatments were distributed in randomized blocks, with six replicates, being represented by four spacings between gliricidia plants: S1 (1.0 m), S2 (1.5 m), S3 (2.0 m) and S4 (3.0 m) x 2.30 m between rows. Prickly pear was planted in double rows of 1.5 m x 0.8 m x 0.5 m. The analyzed variables were initial, maximum and variable fluorescence chlorophyll a, variable/initial fluorescence ratio, potential quantum yield and the fresh matter yield of both crops. Density planting of gliricidia up to 4,348 plants ha-1 increases its photochemical efficiency and yield, but reduces light energy capture by prickly pear in intercropping, whereas its yield is not influenced by cultivation density. Regardless of gliricidia density, prickly pear yield was not influenced.

Abstract Production and sale of botanical insecticides depend on knowing the potential opportunities for these products. Essential oils from plants secondary metabolism can control pests, especially in agricultural systems where synthetic insecticides are limited, as in organic agriculture. The objective of this study was to evaluate the toxicity of essential oils to Diaphania hyalinata (Lepidoptera: Crambidae) and to show regions with the potential to use Cinnamomum zeylanicum, Citrus sinensis, and Syzygium aromaticum in the formulation and commercialization of insecticides to control this insect. The C. zeylanicum oil was more toxic to larvae and pupae and the S. aromaticum to eggs of D. hyalinata. Essential oils are an alternative for the management of D. hyalinata. The production of pesticides from essential oils of C. zeylanicum, C. sinensis, and S. aromaticum to control D. hyalinata has high potential in America. Also, Asia, Africa, Europe, the Middle East, and Asia can extract these plants to formulate insecticide molecules for the America countries. products pests limited agriculture Lepidoptera (Lepidoptera Crambidae sinensis insect C S D Also Africa Europe East countries

Resumo Fundamento: A (-)-carvona é um monoterpeno encontrado em óleos essenciais com atividade antioxidante e anti-inflamátoria. Objetivos: O objetivo deste estudo foi analisar a propriedade antiarrítmica da (-)-carvona no coração de rato e seus efeitos sobre a sinalização de Ca+2 intracelular. Métodos: Os efeitos da (-)-carvona foram avaliados sobre a contratilidade atrial (0,01 – 4 mM) e ventricular (0,5 mM), e no eletrocardiograma (0,5mM). A fração de encurtamento, a corrente de cálcio do tipo L (ICa,L) e a sinalização de Ca+2 foram medidas no cardiomiócito isolado (0,5 mM). O efeito antiarrítmico foi avaliado no modelo de arritmia induzida por sobrecarga de cálcio (0,5 mM) (n = 5). Um p < 0,05 foi adotado como nível de significância estatística. Resultados: No átrio, a (-)-carvona causou inotropismo negativo de maneira concentração-dependente (EC50 0,44 ± 0,11 mM) e diminuiu o inotropismo positivo induzido pelo CaCl2 (0,1 – 8,0 mM) e BAY K8644 (5 - 500 nM), um agonista de canal de cálcio do tipo L. Em coração isolado, a (-)-carvona (0,5mM) reduziu a contratilidade ventricular em 73% e a frequência cardíaca (em 46%), aumentou o Pri (30,7%, tempo desde o início da onda P até a onda R) e o QTc (9,2%, uma medida de despolarização e repolarização dos ventrículos), sem mudar a duração do complexo QRS. A (-)-carvona diminuiu a fração de encurtamento (61%), a (ICa,L) (79%) e o transiente intracelular de Ca+2 (38%). Além disso, a (-)-carvona apresentou ação antiarrítmica, identificada pela redução do escore de arritmia (85%) e ocorrência de fibrilação ventricular. Conclusão: A (-)-carvona reduz a entrada de Ca+2 através de canais de Ca+2 do tipo L e, assim, diminui a contratilidade cardíaca e o Ca+2 intracelular e apresenta promissora atividade antiarrítmica no coração de ratos.

Abstract Background: (-)-Carvone is a monoterpene found in essential oils with antioxidant and anti-inflammatory activity. Objective: The aim of this paper was to analyze the antiarrhythmic property of (-)-carvone in the rat heart and its effects on the intracellular Ca2+ signaling. Methods: The effects of (-)-carvone were evaluated on the ventricular (0.5 mM) and atrial contractility (0.01 – 4 mM) and on electrocardiogram (0.5 mM). Fractional shortening, L-type calcium current (ICa,L) and Ca2+ signaling were measured in the isolated cardiomyocyte (0.5 mM). Antiarrhythmic effect was evaluated in arrhythmia model induced by calcium overload (0.5 mM) (n = 5). P < 0.05 was used as the significance level. Results: In the atrium, (-)-carvone evoked negative inotropism that was concentration-dependent (EC50 0.44 ± 0.11 mM) and decreased the positive inotropism evoked by CaCl2 (0.1 to 8.0 mM) or BAY K8644 (5 to 500 nM), an agonist of L-type Ca2+ channel. In isolated heart, (-)-carvone (0.5 mM) promoted reduction of ventricular contractility (73%) and heart rate (46%), increased PRi (30.7%, time from the onset of the P wave until the R wave) and QTc (9.2%, a measure of the depolarization and repolarization of the ventricles) without changing the QRS complex duration. (-)-Carvone decreased the fractional shortening (61%), ICa,L (79%) and Ca2+ intracellular transient (38%). Furthermore, (-)-carvone showed antiarrhythmic action, verified by decrease of the arrhythmia score (85%) and occurrence of ventricular fibrillation. Conclusion: (-)-Carvone decreases Ca2+ entry through L-type Ca2+ channels, reducing the cardiac contractility and intracellular Ca2+, and, therefore, presenting promising antiarrhythmic activity in the rat hearts.

This study verified the differences in richness, density and species composition of the seed bank under the canopy s tree species and the adjacent field area and the relationship of total stem height and crown area to density and richness bank seeds. The seed bank was collected under the canopy of 10 individuals of each species (Curatella americana L., Luetzelburgia auriculata (Allemão) Duckee, Copernicia prunifera (Mill.) H.E.Moore)), and at 10 points in an adjacent field area. The density and richness of the seed bank was larger under the crowns of the species. The total stem height showed a positive relationship with richness and density of the seed bank, and a canopy area negative relationship. The tree species studied enhance the generation of seed bank, increasing its richness and density. They also influence species distribution and local diversity.

Este estudo verificou as diferenças na riqueza, densidade e composição de espécies do banco de sementes sob a copa es espécies arbóreas e a área de campo adjacentes e a relação entre altura total do caule e área da copa com a densidade e riqueza do banco de sementes. Foram coletados o banco de sementes sob a copa de 10 indivíduos de cada espécies (Curatella americana L., Luetzelburgia auriculata (Allemão) Duckee, Copernicia prunifera (Mill.) H.E.Moore)), e em 10 pontos em área de campo adjacente. A densidade e riqueza do banco de sementes foram maiores sob as copas das espécies. A altura do caule apresentou relação positiva com riqueza e densidade do banco de sementes e, área da copa relação negativa. As espécies arbóreas estudadas potencializam a formação de banco de sementes, aumentando a riqueza e densidade. Também influenciam na distribuição das espécies e na diversidade local.

RESUMEN El nopal forrajero Oreja de Elefante Mexicano está ampliamente incorporado a la cadena productiva animal de la región noreste de Brasil. Sin embargo, faltan estudios sobre la dinámica fisiológica de este cactus. Por lo anterior, se realizó este estudio en la Estação Experimental Prof. Ignácio Salcedo del Instituto Nacional do Semiárido (INSA), en Campina Grande, estado de Paraíba, Brasil. El objetivo del estudio fue evaluar la absorción de CO2 y los niveles de eficiencia en el uso del agua in Opuntia stricta (Haw.) durante diferentes estaciones e horas de evaluación. Los tratamientos se distribuyeron utilizando un arreglo factorial de 24×2, que correspondió a la evaluación de los procesos de intercambio de gases durante 24 horas en la época de lluvias (junio) y sequía (diciembre). Los parámetros evaluados fueron la conductancia estomática, la tasa de transpiración y absorción de CO2, la concentración interna de CO2, la eficiencia instantánea de uso del agua y la eficiencia intrínseca de uso del agua. Los resultados revelaron que el intercambio de gases en el nopal forrajero son más intensos durante la estación de lluvias, con buena estabilidad, que los bajos niveles de intercambio durante la estación época de sequía. Independientemente de la estación, la absorción de CO2 alcanzó su pico entre las 24:00 y las 2:00. Además, este intervalo de tiempo es el más adecuado para realizar análisis en condiciones de campo.

ABSTRACT The forage cactus Mexican Elephant Ear is widely incorporated into the animal productive chain of the northeast region of Brazil. However, there is a lack of studies on the physiological dynamics of this cactus. Therefore, this study was conducted at the Estação Experimental Prof. Ignácio Salcedo of the Instituto Nacional do Semiárido (INSA), in Campina Grande, State of Paraíba, Brazil. The aim of this study was to evaluate CO2 uptake and water-use efficiency levels in Opuntia stricta (Haw.) during different seasons and evaluation times. The treatments were distributed using a 24×2 factorial arrangement, which corresponded to the evaluation of gas exchange processes for 24 hours in the rainy (June) and dry (December) seasons. The evaluated parameters were stomatal conductance, transpiration and CO2 uptake rate, internal CO2 concentration,instantaneous water-use efficiency and intrinsic water-use efficiency. The results revealed that gas exchange in the forage cactus was more intense during the rainy season, with good stability, than the low exchange levels during the dry season. Regardless of the season, the CO2 uptake peaked between 24:00 and 02:00. In addition, this range of time is the most suitable to conduct analyses under field conditions.

ABSTRACT Introduction: The objectives of this study are to experimentally evaluate the haemostatic effects of two organic substances, a membrane of chitosan and a collagen sponge coated with thrombin and human fibrinogen (TachoSil®), in sealing 7-0 needle stitches holes on the femoral arteries of rats as well as to evaluate local histological reactions. Methods: Twenty-four rats were included, and four holes were made in each common femoral artery. In the control group, haemostasis was achieved only by compression with gauze sponge; and in the two other groups, haemostasis was achieved with application of one of these two substances. Results: Membrane of chitosan and TachoSil® showed a power to reduce the time to achieve haemostasis compared with the control group (P=0.001), and the haemostatic effects of these two substances were comparable. There was lower blood loss in the groups where these two substances were used when compared with the control group, but no difference was found comparing the two substances. Conclusion: The use of these sealants did not promote more adhesion or local histological reactions when compared to the control group. Since chitosan is easy to find in nature, has a positive effect to promote haemostasis, and did not bring considerable local reactions, it might be used as a sealant in cardiovascular surgery.

RESUMO Este estudo verificou as diferenças na riqueza, densidade e composição de espécies do banco de sementes sob a copa es espécies arbóreas e a área de campo adjacentes e a relação entre altura total do caule e área da copa com a densidade e riqueza do banco de sementes. Foram coletados o banco de sementes sob a copa de 10 indivíduos de cada espécies (Curatella americana L., Luetzelburgia auriculata (Allemão) Duckee, Copernicia prunifera (Mill.) H.E.Moore)), e em 10 pontos em área de campo adjacente. A densidade e riqueza do banco de sementes foram maiores sob as copas das espécies. A altura do caule apresentou relação positiva com riqueza e densidade do banco de sementes e, área da copa relação negativa. As espécies arbóreas estudadas potencializam a formação de banco de sementes, aumentando a riqueza e densidade. Também influenciam na distribuição das espécies e na diversidade local.

ABSTRACT This study verified the differences in richness, density and species composition of the seed bank under the canopy s tree species and the adjacent field area and the relationship of total stem height and crown area to density and richness bank seeds. The seed bank was collected under the canopy of 10 individuals of each species (Curatella americana L., Luetzelburgia auriculata (Allemão) Duckee, Copernicia prunifera (Mill.) H.E.Moore)), and at 10 points in an adjacent field area. The density and richness of the seed bank was larger under the crowns of the species. The total stem height showed a positive relationship with richness and density of the seed bank, and a canopy area negative relationship. The tree species studied enhance the generation of seed bank, increasing its richness and density. They also influence species distribution and local diversity.

ABSTRACT BACKGROUND: Although there is a growing body of research pointing towards the need to investigate how different movement behaviors, such as physical activity and sleep, influence each other, the joint relationship between these factors and insomnia has been little explored among adolescents in developing countries. OBJECTIVES: To investigate the association between daily physical activity and insomnia in a national sample of Brazilian adolescents, according to the Human Development Index (HDI) of each Brazilian region. DESIGN AND SETTINGS: Cross-sectional study on 102,072 Brazilian students aged 11 to 19 years, selected from all regions of the country. METHODS: Information on insomnia and physical activity was self-reported by adolescents. RESULTS: Our analyses revealed that girls who accumulated at least 60 minutes/day of physical activity on up to three days/week were less prone to present insomnia. This pattern of association was maintained only for those who lived in high HDI regions (odds ratio, 0.87; 95% confidence interval, 0.75-0.99). For boys, there was a positive association between the number of active days and protection against insomnia, especially for those who lived in high HDI regions. CONCLUSION: Even amounts of physical activity that were lower than the weekly guidelines, were associated with better sleep quality for Brazilian adolescents, especially girls, and even for those who lived in regions with greater social and economic vulnerability.

Abstract Background: The resistance against antimalarial drugs represents a global challenge in the fight and control of malaria. The Brazilian biodiversity can be an important tool for research and development of new medicinal products. In this context, toxinology is a multidisciplinary approach on the development of new drugs, including the isolation, purification, and evaluation of the pharmacological activities of natural toxins. The present study aimed to evaluate the cytotoxicity, as well as the antimalarial activity in silico and in vitro of four compounds isolated from Rhinella marina venom as potential oral drug prototypes. Methods: Four compounds were challenged against 35 target proteins from P. falciparum and screened to evaluate their physicochemical properties using docking assay in Brazilian Malaria Molecular Targets (BraMMT) software and in silico assay in OCTOPUS® software. The in vitro antimalarial activity of the compounds against the 3D7 Plasmodium falciparum clones were assessed using the SYBR Green I based assay (IC50). For the cytotoxic tests, the LD50 was determined in human pulmonary fibroblast cell line using the [3(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] (MTT) assay. Results: All compounds presented a ligand-receptor interaction with ten Plasmodium falciparum-related protein targets, as well as antimalarial activity against chloroquine resistant strain (IC50 = 3.44 μM to 19.11 μM). Three of them (dehydrobufotenine, marinobufagin, and bufalin) showed adequate conditions for oral drug prototypes, with satisfactory prediction of absorption, permeability, and absence of toxicity. In the cell viability assay, only dehydrobufotenin was selective for the parasite. Conclusions: Dehydrobufotenin revealed to be a potential oral drug prototype presenting adequate antimalarial activity and absence of cytotoxicity, therefore should be subjected to further studies.

Abstract Aim: This study aimed to examine the association between physical activity (PA) indicators and TV viewing as a function of the Human Development Index (HDI). Method: This cross-sectional study was based on data from the National School Health Survey, which was composed of 102,072 students (14.28±1.03; 51.3% girls). Total PA, active commuting to school (ACS) and TV viewing were assessed by questionnaires and classified through a gradual scale ranging from “F” (low) to “A+” (high). The correlation between total PA, ACS, TV viewing and HDI was verified by Spearman’s Correlation and presented in rs. Results: HDI was positively associated with total PA [girls: rs = 0.572 (p < 0.001); boys: rs = 0.843 (p < 0.001)] and ACS [girls: rs = 0.433 (p < 0.001); boys: rs = 0.554 (p < 0.001)]; while a negative correlation was found between HDI and TV viewing [girls: rs = -0.330 (p < 0.001); boys: rs = -0.348 (p < 0.001)]. Conclusions: Brazilian adolescents from states with higher HDI were more active and spent more time watching TV than their counterparts from states with lower HDI.

COVID-19 dramatically impacted social vulnerable regions at the periphery of large Brazilian cities. Besides, low testing capacity resulted in the lack of proper control measures due inconsistent information on the disease behave. Objectives: to estimate seroprevalence of SARS-CoV-2 antibodies among Baixada Santista Metropolitan Region (RMBS) population and the impacts of social vulnerability and public policies implemented within an iniquity environment. Methods: a quantitative, cross-sectional study, through a serial serological survey and the application of a questionnaire in stratified population sampling and home drew, in nine municipalities of RMBS. Conclusions: Seroprevalence was 1.4% in the first and 2.2% in the second phase, allowing estimating 15 infected people for each case notified in the first phase, and 10 in the following. Lethality was recalculated to 0.40% and 0.48% in each phase, approaching the international rates. Social vulnerable people were the most affected by the pandemic. Informal work, low income, self-reported skin color as black or brown and ambivalent information regarding prevention should be considered as risk factors. Our results reinforce the relevance of social isolation and the adoption of protective economic and social measures especially for social vulnerable populations

A COVID-19 chegou rapidamente na periferia das grandes cidades brasileiras, socialmente mais vulnerável. A baixa capacidade de testagem resulta na adoção de medidas sem informações consistentes sobre o comportamento da doença e interfere na adoção de ações de controle. Objetivos: estimar a prevalência de infecção por SARS-CoV-2 na população da Região Metropolitana da Baixada Santista (RMBS) e analisar impactos da vulnerabilidade social e de políticas públicas implementadas em contextos de desigualdades. Métodos: estudo de caráter quantitativo, transversal, através de inquérito sorológico seriado e aplicação de questionário em amostragem populacional estratificada e coleta domiciliar, nos nove municípios da RMBS. Conclusões: A soroprevalência medida foi de 1,4% na primeira fase e de 2,2 % na segunda permitindo estimar 15 pessoas infectadas para cada caso notificado na primeira fase, e 10 na seguinte. A letalidade foi recalculada para 0,40% e 0,48 % em cada fase, aproximando-se da casuística internacional. Pessoas mais vulneráveis são as mais atingidas pela pandemia, devendo ser consideradas: a informalidade no trabalho, baixa renda, cor da pele auto referida como preta ou parda e informações ambivalentes quanto à prevenção. Os resultados reforçam a importância do isolamento social e de adoção de medidas econômicas e sociais protetivas destinadas às populações vulneráveis.

RESUMO A Covid-19 chegou rapidamente à periferia das grandes cidades brasileiras, a qual é socialmente mais vulnerável. A baixa capacidade de testagem resulta na adoção de medidas sem informações consistentes sobre o comportamento da doença e interfere na adoção de ações de controle. Objetivou-se estimar a prevalência de infecção por SARS-CoV-2 na população da Região Metropolitana da Baixada Santista (RMBS) e analisar impactos da vulnerabilidade social e de políticas públicas implementadas em contextos de desigualdades. Estudo de caráter quantitativo, transversal, mediante inquérito sorológico seriado e aplicação de questionário em amostragem populacional estratificada e coleta domiciliar, nos nove municípios da RMBS. Conclui-se que a soroprevalência medida foi de 1,4% na primeira fase, e de 2,2% na segunda; permitindo estimar 15 pessoas infectadas para cada caso notificado na primeira fase, e 10 na seguinte. A letalidade foi recalculada para 0,40% e 0,48% em cada fase, aproximando-se da casuística internacional. Pessoas mais vulneráveis são as mais atingidas pela pandemia, devendo ser consideradas: informalidade no trabalho, baixa renda, cor da pele autorreferida como preta ou parda e informações ambivalentes quanto à prevenção. Os resultados reforçam a importância do isolamento social e da adoção de medidas econômicas e sociais protetivas destinadas às populações vulneráveis.

ABSTRACT Covid-19 dramatically impacted socially vulnerable regions at the outskirts of large Brazilian cities. Besides, low testing capacity resulted in the lack of proper control measures due to inconsistent information on the disease’s behavior. This study aimed to estimate prevalence of SARS-CoV-2 antibodies among the Baixada Santista Metropolitan Region (RMBS) population and the impacts of social vulnerability and public policies implemented within an environment of inequality. A quantitative, cross-sectional study, through a serial serological survey and the application of a questionnaire in stratified population sampling and home drew, in nine municipalities of RMBS. Seroprevalence was 1.4% in the first and 2.2% in the second phase, allowing to estimate 15 infected people for each case notified in the first phase, and 10 in the following. Lethality was recalculated to 0.40% and 0.48% in each phase, approaching the international rates. Socially vulnerable people were the most affected by the pandemic. Informal work, low income, self-reported skin color as black or brown, and ambivalent information regarding prevention should be considered as risk factors. Our results reinforce the relevance of social isolation and the adoption of protective economic and social measures, especially for socially vulnerable populations.