SARS-CoV-2 seroprevalence and social inequalities in different subgroups of healthcare workers in Rio de Janeiro, Brazil

Correia, Roberta Fernandes; Costa, Ana Carolina Carioca da; Moore, Daniella Campelo Batalha Cox; Gomes, Saint Clair; Oliveira, Maria Paula Carneiro de; Zuma, Maria Célia Chaves; Galvani, Rômulo Gonçalves; Savino, Wilson; Bonomo, Adriana; Vasconcelos, Zilton; Artmann, Elizabeth

doi:10.1016/j.lana.2021.100170

Cited by 16 publications

(33 citation statements)

References 22 publications

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“…We show that over a third of the medical workforce in Maranhão and São Paulo was infected with COVID-19 in the first year of the pandemic, with a substantial loss of labour. This is consistent with the findings from smaller studies from Brazil(20) and other LMICs,(16,18,19) and therefore particularly relevant for those countries with a scarcity of healthcare resources, which will have been hit already particularly hard by the pandemic (35).…”

Section: Discussionsupporting

confidence: 90%

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Demographic and professional risk factors of COVID-19 infections among physicians in low- and middle-income settings; findings from a representative survey in two Brazilian states

Russo

Cassenote

Oliveira

et al. 2022

Preprint

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Introduction. Health workers (HWs) are a key resource for health systems worldwide, and have been affected heavily by the COVID-19 pandemic. Evidence is consolidating on incidence and associated drivers of infections, predominantly in high-income settings. It is however still unclear what the risk factors may be for specific health professions, particularly in low- and middle-income countries (LMICs). Methods. We conducted a cross-sectional survey in a representative sample of 1,183 medical doctors registered with Brazil’s Federal Council of Medicine in one developed (São Paulo) and one disadvantaged state (Maranhão). Between February-June 2021, we administered a telephone questionnaire to collect data on physicians’ demographics, deployment to services, vaccination status, and self-reported COVID-19 infections. We performed descriptive, univariate, and multilevel clustered analysis to explore the association between physicians’ infection rates, and their sociodemographic and employment characteristics. A generalized linear mixed model with a binomial distribution was used to estimate the adjusted odds ratio. Results. We found that 35.8% of physicians in our sample were infected with COVID-19 in the first year of the pandemic. The infection rate in Maranhão (49.2%) [95% CI 45.0-53.4] was almost twice that in São Paulo (24.1%) [95% CI 20.8-27.5]. Being a physician in Maranhão [95% CI 2.08-3.57], younger than 50 years [95% CI 1.41-2.89], and having worked in a COVID-19 ward [95% CI 1.28-2.27], were positively associated with the probability of infections. Conversely, working with diagnostic services [95% CI 0.53-0.96], in administrative functions [95% CI 0.42-0.80], or in teaching and research [95% CI 0.48-0.91] was negatively associated. Conclusions. Based on data from Brazil, COVID-19 infections in LMICs may be more likely in those health systems with lower physician-to-patient ratios, and younger doctors working in COVID-19 wards may be infected more frequently. Such findings may be used to identify policies to mitigate COVID-19 effects on HWs in LMICs.

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Section: Discussionsupporting

confidence: 90%

“…A study assessing COVID-19 infections among health workers in a Rio de Janeiro hospital in Brazil (20) found an overall seroprevalence of 30%. Non-white staff (mostly hospital support workers) with lower income and schooling, as well as users of the mass transportation system, showed the highest infection rates.…”

Section: Introductionmentioning

confidence: 99%

Demographic and professional risk factors of COVID-19 infections among physicians in low- and middle-income settings; findings from a representative survey in two Brazilian states

Russo

Cassenote

Oliveira

et al. 2022

Preprint

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“…Importantly, socially vulnerable people are less likely to be tested for SARS-CoV-2 infection, but more likely to be positive once tested [ 32 ]. Here we present further evidence that, as in the United States and United Kingdom [ 33 ], the socioeconomic and ethnic status are associated with SARS-CoV-2 infection and COVID-19 risk in Brazil [ 34 , 35 ]. The most vulnerable Amazonian children have higher SARS-CoV-2 seropositivity rates and are more likely to have experienced COVID-19-related morbidity by the age of 5 years ( Table 2 ).…”

Section: Discussionmentioning

confidence: 58%

SARS-CoV-2 seropositivity and COVID-19 among 5 years-old Amazonian children and their association with poverty and food insecurity

et al. 2022

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Background The epidemiology of childhood SARS-CoV-2 infection and COVID-19-related illness remains little studied in high-transmission tropical settings, partly due to the less severe clinical manifestations typically developed by children and the limited availability of diagnostic tests. To address this knowledge gap, we investigate the prevalence and predictors of SARS-CoV-2 infection (either symptomatic or not) and disease in 5 years-old Amazonian children. Methodology/Principal findings We retrospectively estimated SARS-CoV-2 attack rates and the proportion of infections leading to COVID-19-related illness among 660 participants in a population-based birth cohort study in the Juruá Valley, Amazonian Brazil. Children were physically examined, tested for SARS-CoV-2 IgG and IgM antibodies, and had a comprehensive health questionnaire administered during a follow-up visit at the age of 5 years carried out in January or June-July 2021. We found serological evidence of past SARS-CoV-2 infection in 297 (45.0%; 95% confidence interval [CI], 41.2–48.9%) of 660 cohort participants, but only 15 (5.1%; 95% CI, 2.9–8.2%) seropositive children had a prior medical diagnosis of COVID-19 reported by their mothers or guardians. The period prevalence of clinically apparent COVID-19, defined as the presence of specific antibodies plus one or more clinical symptoms suggestive of COVID-19 (cough, shortness of breath, and loss of taste or smell) reported by their mothers or guardians since the pandemic onset, was estimated at 7.3% (95% CI, 5.4–9.5%). Importantly, children from the poorest households and those with less educated mothers were significantly more likely to be seropositive, after controlling for potential confounders by mixed-effects multiple Poisson regression analysis. Likewise, the period prevalence of COVID-19 was 1.8-fold (95%, CI 1.2–2.6-fold) higher among cohort participants exposed to food insecurity and 3.0-fold (95% CI, 2.8–3.5-fold) higher among those born to non-White mothers. Finally, children exposed to household and family contacts who had COVID-19 were at an increased risk of being SARS-CoV-2 seropositive and–even more markedly–of having had clinically apparent COVID-19 by the age of 5 years. Conclusions/Significance Childhood SARS-CoV-2 infection and COVID-19-associated illness are substantially underdiagnosed and underreported in the Amazon. Children in the most socioeconomically vulnerable households are disproportionately affected by SARS-CoV-2 infection and disease.

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“…A eclosão da pandemia de COVID-19, contudo, trouxe novos desafios para os sistemas de saúde e seus profissionais. No enfrentamento à doença, os trabalhadores da saúde se tornaram um grupo vulnerável pelo alto grau de exposição à COVID-19 em serviço (16,17).…”

Section: Introductionunclassified

Burnout e a segurança do paciente na Atenção Primária à Saúde: aspectos jurídico-sanitários em tempos de pandemia de COVID-19

Costa¹,

Carvalho

Coelho

et al. 2022

Cad. Ibero Am. Direito Sanit.

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Objetivo: discutir os desafios para a construção de uma política pública de segurança do paciente na Atenção Primária à Saúde (APS) brasileira frente ao crescimento da síndrome de burnout entre seus profissionais. Metodologia: pesquisa bibliográfica e documental sobre a segurança do paciente e o burnout entre trabalhadores da APS utilizando o referencial dos direitos humanos e a matriz teórica de Maslach e Jackson. Resultados: o burnout possui implicações sanitárias severas nos profissionais da APS e repercute sobre o processo de trabalho das equipes, gerando prejuízos nas ações e estratégias de segurança do paciente. As políticas de segurança do paciente e de saúde do trabalhador no Brasil são dialógicas e complementares, mas mostram-se insuficientes para impactar o cenário do burnout na APS frente à estagnação e retrocessos vivenciados recentemente nesse nível de atenção. Considerações finais: a resposta institucional para a abordagem da síndrome de burnout na APS tem sido insatisfatória. Para além do arcabouço das políticas preexistentes, mostra-se urgente a realização de mudanças no financiamento da APS e no aporte de equipes multiprofissionais para a melhoria das condições de trabalho que, em última instância, refletem na segurança do paciente na rede primária.

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SARS-CoV-2 seroprevalence and social inequalities in different subgroups of healthcare workers in Rio de Janeiro, Brazil

Cited by 16 publications

References 22 publications

Demographic and professional risk factors of COVID-19 infections among physicians in low- and middle-income settings; findings from a representative survey in two Brazilian states

Demographic and professional risk factors of COVID-19 infections among physicians in low- and middle-income settings; findings from a representative survey in two Brazilian states

SARS-CoV-2 seropositivity and COVID-19 among 5 years-old Amazonian children and their association with poverty and food insecurity

Burnout e a segurança do paciente na Atenção Primária à Saúde: aspectos jurídico-sanitários em tempos de pandemia de COVID-19

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