Resumo O objetivo deste estudo é identificar a prevalência de ansiedade em profissionais de saúde durante a pandemia da COVID-19. Trata-se de revisão sistemática de estudos publicados em qualquer idioma em 2020. Foi realizada busca nas bases de dados Embase, LILACS e PubMed utilizando os descritores anxiety, COVID-19, health workers, e sinônimos. A estimativa da prevalência geral de ansiedade com intervalo de confiança de 95% foi calculada utilizando o modelo de efeitos aleatórios. Dos 861 registros identificados, 36 artigos foram incluídos na revisão sistemática e 35 na metanálise. A prevalência geral de ansiedade foi de 35% (IC95%: 29-40). Foi identificado maior risco de ansiedade nas mulheres em relação aos homens (Odds Ratio: 1.64 [IC95%: 1,47-1,84]), e nos enfermeiros, na comparação com médicos (Odds Ratio: 1.19 [IC95%: 1,07-1,33]). Atuar na linha de frente no combate a COVID-19, estar infectado com coronavírus e apresentar doenças crônicas também foram fatores associados com maior risco de ansiedade. Observa-se alta prevalência de ansiedade entre profissionais de saúde, com maior risco entre mulheres e enfermeiros. Há necessidade de medidas que visem sua prevenção, bem como o fornecimento de tratamento precoce e adequado aos com ansiedade moderada e grave.

Abstract This study sets out to identify the prevalence of anxiety among health professionals during the COVID-19 pandemic. It involves a systematic review and meta-analysis of studies published in any language in 2020. A search was conducted in the Embase, LILACS and PubMed databases using the keywords anxiety, COVID-19, health workers, and synonyms. The estimated overall prevalence of anxiety with a 95% confidence interval was calculated using the random effects model. Of the 861 records identified, 36 articles were included in the systematic review and 35 in the meta-analysis. The overall prevalence of anxiety was 35% (95%CI: 29-40). A higher risk of anxiety was identified among women compared to men (Odds Ratio: 1.64 [95%CI: 1.47-1.84]), and in nurses, in comparison with physicians (Odds Ratio: 1.19 [95%CI: 1.07-1.33]). Being on the front line of COVID-19, being infected with coronavirus and having chronic diseases were also factors associated with a higher risk of anxiety. A high prevalence of anxiety among health professionals was observed, with higher risk among women and nurses. There is a pressing need for measures aimed at prevention of anxiety and providing early and appropriate treatment for those suffering from moderate and severe anxiety.

Resumo O objetivo deste estudo é identificar a prevalência de ansiedade em profissionais de saúde durante a pandemia da COVID-19. Trata-se de revisão sistemática de estudos publicados em qualquer idioma em 2020. Foi realizada busca nas bases de dados Embase, LILACS e PubMed utilizando os descritores anxiety, COVID-19, health workers, e sinônimos. A estimativa da prevalência geral de ansiedade com intervalo de confiança de 95% foi calculada utilizando o modelo de efeitos aleatórios. Dos 861 registros identificados, 36 artigos foram incluídos na revisão sistemática e 35 na metanálise. A prevalência geral de ansiedade foi de 35% (IC95%: 29-40). Foi identificado maior risco de ansiedade nas mulheres em relação aos homens (Odds Ratio: 1.64 [IC95%: 1,47-1,84]), e nos enfermeiros, na comparação com médicos (Odds Ratio: 1.19 [IC95%: 1,07-1,33]). Atuar na linha de frente no combate a COVID-19, estar infectado com coronavírus e apresentar doenças crônicas também foram fatores associados com maior risco de ansiedade. Observa-se alta prevalência de ansiedade entre profissionais de saúde, com maior risco entre mulheres e enfermeiros. Há necessidade de medidas que visem sua prevenção, bem como o fornecimento de tratamento precoce e adequado aos com ansiedade moderada e grave.

Abstract This study sets out to identify the prevalence of anxiety among health professionals during the COVID-19 pandemic. It involves a systematic review and meta-analysis of studies published in any language in 2020. A search was conducted in the Embase, LILACS and PubMed databases using the keywords anxiety, COVID-19, health workers, and synonyms. The estimated overall prevalence of anxiety with a 95% confidence interval was calculated using the random effects model. Of the 861 records identified, 36 articles were included in the systematic review and 35 in the meta-analysis. The overall prevalence of anxiety was 35% (95%CI: 29-40). A higher risk of anxiety was identified among women compared to men (Odds Ratio: 1.64 [95%CI: 1.47-1.84]), and in nurses, in comparison with physicians (Odds Ratio: 1.19 [95%CI: 1.07-1.33]). Being on the front line of COVID-19, being infected with coronavirus and having chronic diseases were also factors associated with a higher risk of anxiety. A high prevalence of anxiety among health professionals was observed, with higher risk among women and nurses. There is a pressing need for measures aimed at prevention of anxiety and providing early and appropriate treatment for those suffering from moderate and severe anxiety.

Recently, many studies have evaluated HPV vaccine safety and adverse effects. Two vaccine shave been recently evaluated in randomized controlled trials: the bivalent vaccine for HPV 16 and 18 (Cervarix, GlaxoSmithKline Biologicals, Rixensart, Belgium) and the quadrivalent vaccine for HPV 6, 11, 16, and 18 (Gardasil, Merck and Co., Inc., Whitehouse Station, NJ). We have performed a systematic review of all randomized controlled trials in which HPV vaccines were compared with placebo regarding safety, tolerability and adverse effects. Studies were searched up to March 2013 in the databases: Pubmed, Embase, Scielo and Cancerlit. Odds Ratios (OR) of most incident adverse effects were obtained. Twelve reports, involving 29,540 subjects, were included. In the HPV 16/18 group, the most frequently reported events related to the vaccine were pain (OR 3.29; 95% CI: 3.00–3.60), swelling (OR 3.14; 95% CI: 2.79–3.53) and redness (OR 2.41; 95% CI: 2.17–2.68). For the HPV 6/11/16/18 group the events were pain (OR 2.88; 95% CI: 2.42–3.43) and swelling (OR 2.65; 95% CI: 2.0–3.44). Concerning the HPV 16/18 vaccine, pain was the most common outcome detected. These effects can be due to a possible VLP-related inflammation process. Fatigue was the most relevant general effect observed followed by fever, gastrointestinal symptoms, and headache. In the HPV 6/11/16/18 group, only general symptoms, pain and swelling were observed. Pain and swelling were the most frequent. Comparing HPV 16/18 to HPV 6/11/16/18 vaccines, the former presented more adverse effects, perhaps because there are many more trials evaluating the bivalent vaccine. Other studies are needed to clarify this issue.

O Sistema Único de Saúde (SUS) brasileiro garante o acesso universal e integral aos serviços de saúde. Entretanto, na prática, o SUS não tem permitido que os cidadãos desfrutem de uma assistência com equidade, reforçando a dificuldade de se atingir a justiça social em uma sociedade tão desigual e injusta como a brasileira. A ética propõe a equidade como base para resolver as distorções na distribuição da saúde, possibilitando o acesso universal. Este artigo tem como objetivo precípuo discutir como a bioética pode auxiliar para que haja maior equidade na assistência médica em nosso país.

Brazilian's Unified Health System (SUS) ensures universal access to comprehensive health services. However,in practice SUS has not allowed citizens to enjoy a health care with equity, increasing the difficulty of achieving social justice in a society as unequal and unfair as the Brazilian. Ethics proposes equity as a basis for resolving the distortions in the distribution of health, enabling universal access. This article aims to discuss how bioethics can help for greater equity in health care in our country.

El Sistema Único de Salud (SUS) de Brasil garantiza el acceso universal e integral a servicios de salud. Sin embargo, en la práctica, el SUS no ha permitido a los ciudadanos a disfrutar de una asistencia con equidad, lo que aumenta la dificultad de lograr la justicia social en una sociedad tan desigual e injusta como la brasileña. La ética propone la equidad como base para resolver las distorsiones en la distribución de la salud, permitiendo el acceso universal. Este artículo tiene como principal objetivo discutir cómo la bioética puede ayudar a lograr una mayor equidad en la atención médica en Brasil.