Highlights
RT-PCR followed by CT shows high sensitivity for detecting COVID-19.
Immunological tests should use a combination of IgG and IgM.
The genes E and RdRp present high analytical sensitivity to detect the virus.
Assays for molecular diagnosis should employ 2-target systems.
Studies of diagnostic tests for COVID-19 are of moderate methodological quality.
We investigated the predictors of delay in the diagnosis and mortality of patients with COVID-19 in Rio de Janeiro, Brazil. A cohort of 3,656 patients were evaluated (Feb-Apr 2020) and patients’ sociodemographic characteristics, and social development index (SDI) were used as determinant factors of diagnosis delays and mortality. Kaplan-Meier survival analyses, time-dependent Cox regression models, and multivariate logistic regression analyses were conducted. The median time from symptoms onset to diagnosis was eight days (interquartile range [IQR] 7.23-8.99 days). Half of the patients recovered during the evaluated period, and 8.3% died. Mortality rates were higher in men. Delays in diagnosis were associated with male gender (p = 0.015) and patients living in low SDI areas (p < 0.001). The age groups statistically associated with death were: 70-79 years, 80-89 years, and 90-99 years. Delays to diagnosis greater than eight days were also risk factors for death. Delays in diagnosis and risk factors for death from COVID-19 were associated with male gender, age under 60 years, and patients living in regions with lower SDI. Delays superior to eight days to diagnosis increased mortality rates.
Background & aims: COVID-19 is an emergency public health problem of global importance. This study aimed to investigate the effect of foods and nutrients as complementary approaches on the recovery from COVID-19 in 170 countries, especially considering the complexity of the disease and the current scarcity of active treatments. Methods: A retrospective study was performed using the Kaggle database, which links the consumption of various foods with recovery from COVID-19 in 170 countries, using multivariate analysis based on a generalized linear model. Results: The results showed that certain foods had a positive effect on recovery from COVID-19: eggs, fish and seafood, fruits, meat, milk, starchy roots, stimulants, vegetable products, nuts, vegetable oil and vegetables. In general, consumption of higher levels of proteins and lipids had a positive effect on COVID-19 recovery, whereas high consumption of alcoholic beverages had a negative effect. In developed countries, where hunger had been eradicated, the effect of food on recovery from COVID-19 had a greater magnitude than in countries with a higher global hunger index (GHI), where there was almost no identifiable effect. Conclusion: Several foods had a positive effect on COVID-19 recovery in developed countries, especially food groups with a higher content of lipids, proteins, antioxidants and micronutrients (e.g., selenium and zinc). In countries with extreme poverty (high GHI), foods presented little effect on recovery from COVID-19.
Introduction:Rabies is an acute zoonotic disease, caused by a rhabdovirus that can affect all mammals, and is commonly transmitted by the bite of a rabid animal. The definitive diagnosis is laboratorial, by the Fluorescent Antibody Test (FAT) as a quick test and Mouse Inoculation Test (MIT) as a confirmatory test (gold standard). Studies conducted over the past three decades indicate that MIT and Virus Isolation in Cell Culture (VICC) can provide the same effectiveness, the latter being considered superior in bioethics and animal welfare. The aim of this study was to compare VICC with MIT, in terms of accuracy, biosafety and occupational health, supply and equipment costs, bioethics and animal welfare, in a Brazilian public health lab. Methods: We utilized 400 samples of animal neurological tissue to compare the performance of VICC against MIT. The variables analyzed were accuracy, biosafety and occupational health, time spent in performing the tests, supply and equipment costs, bioethics and animal welfare evaluation. Results: Both VICC and MIT had almost the same accuracy (99.8%), although VICC presented fewer risks regarding biosafety and mental health of the technicians, and reduced time between inoculation and obtaining the results (approximately 22 days less). In addition, VICC presented lower supply costs (86.5% less), equipment costs (32.6% less), and the advantage of not using animals. Conclusions: These results confirm that VICC can replace MIT, offering the same accuracy and better features regarding cost, results, biosafety and occupational health, and bioethics and animal welfare.
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