SUMMARY The first confirmed case of coronavirus disease 2019 (COVID-19) in Brasil was reported on February 25th, 2020, and by April 3rd, 8076 were confirmed in the country. As COVID-19 disease incidence escalates in Brasil, management of cancer patients requires immediate action and oncology clinics are urged to establish a contingency plan. We have installed a COVID-19 Management Committee to elaborate and implement best practices to assist cancer outpatients as well as to provide a safe environment for clinical staff and other employees at the outpatient clinics. The challenges of cancer treatment in the midst of COVID-19 global pandemic highlight the importance of a rapid response by institutions, where organizational structure, strategic planning, agility in guidelines implementation and alternative ways to protect and support clinical staff, employees and patients may be the key to mitigate pandemic effects.

Background: SARS-CoV-2 infected individuals ≥60 years old have the highest hospitalization rates and represent >80% fatalities. Within this population, those in long-term facilities represent >50% of the total COVID-19 related deaths per country. Among those without symptoms, the rate of pre-symptomatic illness is unclear, and potential predictors of progression for symptom development are unknown. Our objective was to delineate the natural evolution of asymptomatic SARS-CoV-2 infection in elders and identify determinants of progression. Methods: We established a medical surveillance team monitoring 63 geriatric institutions. When an index COVID-19 case emerged, we tested all other eligible asymptomatic elders ≥75 or >60 years old with at least 1 comorbidity. SARS-CoV-2 infected elders were followed for 28 days. Disease was diagnosed when any COVID-19 manifestation occurred. SARS-CoV-2 load at enrollment, shedding on day 15, and antibody responses were also studied. Results: After 28 days of follow-up, 74/113(65%) SARS-CoV-2-infected elders remained asymptomatic. 21/39(54%) pre-symptomatic patients developed hypoxemia and ten pre-symptomatic patients died(median day 13.5,IQR 12). Dementia was the only clinical risk factor associated with disease(OR 2.41(95%CI=1.08, 5.39). In a multivariable logistic regression model, dementia remained as a risk factor for COVID-19 severe disease. Furthermore, dementia status showed a statistically significant different trend when assessing the cumulative probability of developing COVID-19 symptoms(log-rank p=0.027). On day 15, SARS-CoV-2 was detectable in 30% of the asymptomatic group while in 61% of the pre-symptomatic(p=0.012). No differences were observed among groups in RT-PCR mean cycle threshold at enrollment(p=0.391) and in the rates of antibody seropositivity(IgM and IgG against SARS-CoV-2 nucleocapsid protein). Conclusions: In summary, 2/3 of our cohort of SARS-CoV-2 infected elders from vulnerable communities in Argentina remained asymptomatic after 28 days of follow-up with high mortality among those developing symptoms. Dementia and persistent SARS-CoV-2 shedding were associated with progression from asymptomatic to symptomatic infection.

O ambiente de trabalho de um supermercado envolve atividades que trazem elevados riscos ergonômicos decorrentes de postura incorreta, trabalho físico pesado, equipamentos inadequados e trabalho repetitivo, interferindo diretamente na queda de seu rendimento, levando ao comprometimento da integridade física e da saúde dos funcionários, como consequência traz ao trabalhador traumas físicos e psicológicos, como a depressão, e invalidez. Desta forma, este estudo caracteriza-se como observacional, de perfil populacional e neste primeiro momento, traz os pré-resultados da pesquisa intitulada “Caracterização da força de preensão manual dos trabalhadores em rede de supermercados”, analisando o perfil sociodemográfico e sintomas osteomusculares de cerca de 72 trabalhadores da rede de supermercados Dino’s da cidade de Tupanciretã/RS. A partir dos resultados obtidos, conclui-se que cerca de 52,1% dos funcionários expuseram sentir algum tipo de sintoma ou desconforto, com predomínio à região lombar (9,7%/n=7), ombros e braços (ambas com 5,6%/n=4), antebraço, joelho e tornozelo (2,8%/n=2 cada), e com maior incidência entre operadores de caixa. Por fim, entende-se que esta pesquisa beneficia trabalhadores e empresários, pois os resultados encontrados podem levar a um direcionamento preventivo na saúde do trabalhador, dando atenção à saúde, integridade física, segurança e melhorias no ambiente de trabalho.

Background: SARS-CoV-2 infected individuals ≥60 years old have the highest hospitalization rates and represent >80% fatalities. Within this population, those in long-term facilities represent >50% of the total COVID-19 related deaths per country. Among those without symptoms, the rate of pre-symptomatic illness is unclear, and potential predictors of progression for symptom development are unknown. Our objective was to delineate the natural evolution of asymptomatic SARS-CoV-2 infection in elders and identify determinants of progression. Methods: We established a medical surveillance team monitoring 63 geriatric institutions in Buenos Aires, Argentina during June-July 2020. When an index COVID-19 case emerged, we tested all other eligible asymptomatic elders ≥75 or >60 years old with at least 1 comorbidity. SARS-CoV-2 infected elders were followed for 28 days. Disease was diagnosed when any COVID-19 manifestation occurred. SARS-CoV-2 load at enrollment, shedding on day 15, and antibody responses were also studied. Results: After 28 days of follow-up, 74/113(65%) SARS-CoV-2-infected elders remained asymptomatic. 54% of pre-symptomatic patients developed hypoxemia and ten pre-symptomatic patients died. Dementia was the only clinical risk factor associated with disease(OR 2.41(95%CI=1.08, 5.39). In a multivariable logistic regression model, dementia remained as risk factor for COVID-19 severe disease. Furthermore, dementia status showed a statistically significant different trend when assessing the cumulative probability of developing COVID-19 symptoms(log-rank p=0.027). On day 15, SARS-CoV-2 was detectable in 30% of the asymptomatic group while in 61% of the pre-symptomatic(p=0.012). No differences were observed among groups in RT-PCR mean cycle threshold at enrollment(p=0.391) and in the rates of antibody seropositivity(IgM and IgG against SARS-CoV-2). Conclusions: In summary, 2/3 of our cohort of SARS-CoV-2 infected elders from vulnerable communities in Argentina remained asymptomatic after 28 days of follow-up with high mortality among those developing symptoms. Dementia and persistent SARS-CoV-2 shedding were associated with progression from asymptomatic to symptomatic infection.

Objetivo: El objetivo del estudio fue identificar el perfil de las personas que buscaron atención en un Servicio de Atención Especializada (SAE) en ETS/SIDA para orientación, prevención y profilaxis del VIH después de la exposición sexual.Método: Estudio cuantitativo, descriptivo, basado en datos secundarios de 312 informes de diciembre de 2010 a diciembre de 2014 en un SAE de Porto Alegre/Brasil. Los datos seleccionados fueron: edad; sexo; rutas de exposición; casos positivos/negativos en la primera prueba; regreso para seguimiento de antirretrovirales utilizados em las profilaxis.Resultado: Predominó el género masculino (73.7%), el grupo de edad con mayor incidencia fue entre 20 y 39 años (75.1%). La ruta más elegida para la práctica sexual fue la vaginal 52.6%. En el 63.3% de los casos, los pacientes desconocían la serología de sus parejas y el 35.7% sabían que su pareja era VIH, pero no usaban condones. A pesar de exponerse a parejas con serología del VIH desconocida o conocida, el 61,6% no regresó a SAE. Los dos antirretrovirales más recetados fueron los recomendados por el Ministerio de Salud en ese momento.Conclusión: Se sugiere implementar medidas y campañas que ayuden en la prevención del SIDA y, además, refuercen la importancia de llevar a cabo todas las etapas del monitoreo después de la exposición sexual. Objective: The aim of the study was to identify the profile of the individuals searching for care in a Specialized Care Service (SCS) in HIV/AIDS for guidance, prevention and prophylaxis for HIV after sexual exposure.Methods: Quantitative, descriptive study, based on secondary data from 312 service reports from December 2010 to December 2014 in an SCS in Porto Alegre/Brazil. The selected data were: age; sex; exposure routes; positive / negative cases in the first test; return for follow-up and antiretrovirals used in prophylaxis.Results: Male gender predominated (73.7%), the age group with the highest incidence was between 20 and 39 years old (75.1%). The most chosen route for sexual practice was the vaginal one with 52.6%. In 63.3% of cases, patients were unaware of their partners’ serology and 35.7% knew their partner had the HIV virus, but did not use a condom. Even if exposed to partners with unknown or known HIV serology, 61.6% did not return to SCS. The two most prescribed antiretrovirals were those recommended by the Ministry of Health at the time.Conclusion: It is suggested to implement measures and campaigns to assist in the prevention of AIDS and, also, reinforce the importance of carrying out all stages of monitoring after sexual exposure. Objetivo: O objetivo do estudo foi identificar o perfil dos indivíduos que procuraram por atendimento em um Serviço de Atenção Especializada (SAE) em DST/AIDS para orientação, prevenção e profilaxia para HIV após exposição sexual.Método: Estudo quantitativo, descritivo, baseado em dados secundários de 312 boletins de atendimento do período de dezembro de 2010 a dezembro de 2014 em um SAE de Porto Alegre/Brasil. Os dados selecionados foram: faixa etária dos indivíduos; sexo; vias de exposição; casos positivos/negativos na primeira testagem; retorno para acompanhamento e antirretrovirais utilizados nas profilaxias. Resultados: Predominou o sexo masculino (73,7%), a faixa etária de maior incidência foi entre 20 a 39 anos (75,1%). A via de maior escolha para prática sexual foi a vaginal 52,6%. Em 63,3% dos casos os pacientes desconheciam a sorologia dos parceiros e 35,7% sabiam que seu parceiro era HIV, porém não fizeram o uso do preservativo. Mesmo se expondo com parceiros de sorologia desconhecida ou sabidamente HIV, 61,6% não retornaram ao SAE. Os dois antirretrovirais mais prescritos foram os recomendados pelo Ministério da Saúde na época.Conclusões: Sugere-se a implementação de medidas e campanhas que auxiliem na prevenção da AIDS e, também, reforcem a importância na realização de todas as etapas do acompanhamento após a exposição sexual.