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The stars of the Milky Way carry the chemical history of our Galaxy in their atmospheres as they journey through its vast expanse. Like barcodes, we can extract the chemical fingerprints of stars from high-resolution spectroscopy. The fourth data release (DR4) of the Galactic Archaeology with HERMES (GALAH) Survey, based on a decade of observations, provides the chemical abundances of up to 32 elements for 917 588 stars that also have exquisite astrometric data from the Gaia satellite. For the first time, these elements include life-essential nitrogen to complement carbon, and oxygen as well as more measurements of rare-earth elements critical to modern-life electronics, offering unparalleled insights into the chemical composition of the Milky Way. For this release, we use neural networks to simultaneously fit stellar parameters and abundances across the whole wavelength range, leveraging synthetic grids computed with Spectroscopy Made Easy. These grids account for atomic line formation in non-local thermodynamic equilibrium for 14 elements. In a two-iteration process, we first fit stellar labels to all 1 085 520 spectra, then co-add repeated observations and refine these labels using astrometric data from Gaia and 2MASS photometry, improving the accuracy and precision of stellar parameters and abundances. Our validation thoroughly assesses the reliability of spectroscopic measurements and highlights key caveats. GALAH DR4 represents yet another milestone in Galactic archaeology, combining detailed chemical compositions from multiple nucleosynthetic channels with kinematic information and age estimates. The resulting dataset, covering nearly a million stars, opens new avenues for understanding not only the chemical and dynamical history of the Milky Way but also the broader questions of the origin of elements and the evolution of planets, stars, and galaxies.
Here, we present a comprehensive morphological and molecular phylogenetic analysis of Clinostomum sp. (Digenea: Clinostomidae) metacercariae parasitizing two freshwater fish species from Southeast Brazil: Serrasalmus spilopleura (piranha) and Callichthys callichthys (tambuatá). The morphological examination revealed distinct characteristics of metacercariae in each host. Using the cytochrome c oxidase I (COI) gene barcode region, we obtained DNA sequences that allowed for accurate phylogenetic placement. Phylogenetic analyses revealed that Clinostomum sp. HM41 (metacercariae), isolated from S. spilopleura, exhibited 86% similarity to Ithyoclinostomum yamagutii, while Clinostomum sp. HM125 (metacercariae), from C. callichthys, showed 98.7% similarity to Clinostomum sp. Cr_Ha1. The phylogenetic trees constructed through Bayesian Inference and Maximum Likelihood methods indicated high biodiversity within the Clinostomum genus and strong support for distinct lineages. These findings enhance our understanding of the diversity and ecological distribution of Clinostomum species in South American freshwater environments.
Background: The Cognitive Domains and Functional Assessment Questionnaire (CDFAQ) assess cognitive and functional decline based on the DSM-5 criteria for Neurocognitive Disorders. Its accuracy has been assessed and was translated and validated into English. The informant version (CDFAQ-IV) is a 30-item questionnaire that assesses six cognitive domains with 5 items each: Complex Attention (CA), Executive Functions (EF), Learning and
Memory (LM), Language (L), Perceptual-Motor (PM) and Social Cognition. The development of CDFAQ-IV was based on theDSM-5 cognitive domains, but its factor analysis has not been done yet.
Objectives: To perform a Confirmatory Factor Analysis of the CDFAQ-IV to assess the six-factor cognitive domain model.
Methods: Older adults and their informants were invited to participate in this study. The CDFAQ-IV was applied in 292 older adults’ informants. We used the JASP for a Confirmatory Factor Analysis based on Lavaan R Packages. The confirmatory factor analysis was chosen to manual six-factor model. This study was approved by the ethics committee of UFMG.
Results: Concerning model fitness in the confirmatory factor analysis the X2 was significant (p < .001), standardized root mean square residual (SRMR) was .059 (accepted < .08) and the goodness of fit index (GFI) .984 (accepted > .9). However, the root mean square error of approximation (RMSEA) was marginal to the accepted fitness .066 (accepted < .06) and the comparative fit index CFI was .839 under the accepted cutoff (accepted > .9).
Conclusions: The six-factor model of the showed a good fit for three parameters, marginal for one and negative for the CFI. These results point to a convergence of the questionnaire and factors the DSM-5 cognitive domains. These are still preliminary results and we aim to increase our sample to further assess the confirmatory factor analysis.
The Atlantic Forest is one of the most threatened biomes globally. Data from monitoring programs are necessary to evaluate the conservation status of species, prioritise conservation actions and to evaluate the effectiveness of these actions. Birds are particularly well represented in citizen-collected datasets that are used worldwide in ecological and conservation studies. Here, we analyse presence-only data from three online citizen science datasets of Atlantic Forest endemic bird species to evaluate whether the representation of these species was correlated with their global threat status, range and estimated abundance. We conclude that even though species are over- and under-represented with regard to their presumed abundance, data collected by citizen scientists can be used to infer species distribution and, to a lesser degree, species abundance. This pattern holds true for species across global threat status.
Information related to the climate, sowing time, harvest, and crop development is essential for defining appropriate strategies for agricultural activities, which helps both producers and responsible bodies. Paraná, the second largest soybean producer in Brazil, has high climatic variability, which greatly influences planting, harvesting, and crop productivity periods. Therefore, the objective of this study was to regionalize the state of Paraná, considering decennial metrics associated with climate variables and the enhanced vegetation index (EVI) during the soybean cycle. Individual and global analyses of these metrics were conducted performed using multivariate techniques. These analyses were carried out in agricultural scenarios with low, medium, and high precipitation, corresponding to harvest years 2011/2012, 2013/2014, and 2015/2016, respectively. The results obtained from the scores of the retained factors and the cluster analysis were the profile of the groups, with Group 1 presenting more favourable climatic and agronomic conditions for the development of soybean crops for the three harvest years. The opposite occurred for Groups 2 (2011/2012 and 2013/2014) and Group 3 (2015/2016). During the soybean reproductive phases (R2 – R5), precipitation values were inadequate, especially for Group 2 (2011/2012 and 2013/2014) with high water deficit, resulting in a drop in soybean productivity. The climatic and agronomic regionalization of Paraná made it possible to identify the regions most suitable for growing soybeans, the effect of climatic conditions on phenological stages, and the variability of soybean productivity in the three harvest years.
Dioctophyme renale, the giant kidney worm, is a nematode related to Trichuris sp and is distributed worldwide. These parasites locate in the kidney of their definitive hosts (mainly belonging to the order Carnivora) and have an indirect life cycle with an annelid as the main intermediate host. Humans are rarely affected, but in those that are, 1 or both kidneys are destroyed. In South America, D. renale is widespread in riparian regions where changing climatic conditions, environmental degradation, and compromised sanitation are increasing the risk of distribution of this parasite, including humans. Here, we provide the descriptions of the genetic diversity of the parasite in the region by analysing 73 adult D. renale samples collected from domestic and wild carnivores. The most common hosts were (Canis lupus familiaris) and maned wolf (Chrysocyon brachyurus Fam. Canidae) among domestic and wild carnivores, respectively. This work shows the descriptions of the genetic diversity of this parasite complementing molecular methods and classical and probabilistic phylogeography. Our results strongly suggest that this parasite has been present on the continent long enough to develop local genetic variants. Also, the phylogenies show transmission between localities and bidirectional transmission between domestic and wild species. We now have new tools to understand the ecological dynamics of this parasite such as molecular markers to study its genetic diversity as well as for identification and reporting in cryptic cases.
The occurrence of dyslipidaemia, which is an established risk factor for cardiovascular diseases, has been attributed to multiple factors including genetic and environmental factors. We used a genetic risk score (GRS) to assess the interactions between genetic variants and dietary factors on lipid-related traits in a cross-sectional study of 190 Brazilians (mean age: 21 ± 2 years). Dietary intake was assessed by a trained nutritionist using three 24-h dietary recalls. The high GRS was significantly associated with increased concentration of TAG (beta = 0·10 mg/dl, 95 % CI 0·05–0·16; P < 0·001), LDL-cholesterol (beta = 0·07 mg/dl, 95 % CI 0·04, 0·11; P < 0·0001), total cholesterol (beta = 0·05 mg/dl, 95 % CI: 0·03, 0·07; P < 0·0001) and the ratio of TAG to HDL-cholesterol (beta = 0·09 mg/dl, 95 % CI: 0·03, 0·15; P = 0·002). Significant interactions were found between the high GRS and total fat intake on TAG:HDL-cholesterol ratio (Pinteraction = 0·03) and between the high GRS and SFA intake on TAG:HDL-cholesterol ratio (Pinteraction = 0·03). A high intake of total fat (>31·5 % of energy) and SFA (>8·6 % of energy) was associated with higher TAG:HDL-cholesterol ratio in individuals with the high GRS (beta = 0·14, 95 % CI: 0·06, 0·23; P < 0·001 for total fat intake; beta = 0·13, 95 % CI: 0·05, 0·22; P = 0·003 for SFA intake). Our study provides evidence that the genetic risk of high TAG:HDL-cholesterol ratio might be modulated by dietary fat intake in Brazilians, and these individuals might benefit from limiting their intake of total fat and SFA.
Eating disorders are characterized by a persistent disturbance in eating and/or eating-related behavior, resulting in altered food consumption or absorption, which can significantly compromise physical health as well as psychosocial functioning. These disorders are closely linked with stressful experiences which university students configure a group prone to development.
Objectives
The objective is to evaluate the impact of eating disorders on young people when entering and staying at university.
Methods
This is an observational, quantitative, analytical and cross-sectional study, in which 1300 (one thousand and three hundred) medical students were invited, of both sexes and over 18 years of age from the 1st (first) to the 12th (twelfth) year. period of the Medicine course at the University of Oeste Paulista (UNOESTE) with 91 students joining. A structured interview was applied via online, aiming at collecting sociodemographic and occupational data in conjunction with the application of the Periodic Eating Compulsion Scale - ECAP, assessing the existence and degree of eating disorders in medical students.
Results
Mean age 22.7 ± 3.9 years, predominantly female (76.9%) and white ethnicity (86.8%). Most live alone or with a parent (82.5%). With regard to eating habits, 81 (89.0%) said they did not follow a nutrition professional’s diet, and 84 (92.3%) have at least 3 meals a day. Lunch is eaten by 100% of the participants, while supper is the least consumed meal (17.6%). A total of 24 (26.4%) participants said they had little time to eat, and almost half (46.2%) did not prepare their own meals, with 12.5% choosing to eat salted or not. eating a certain meal. The ECAP binge eating score had a median of 9 (11.5) points, with a minimum score equal to 1 and a maximum equal to 41. Sixty-eight (74.7%) of the participants were classified as having no binge eating, with moderate binge eating 15 (16.5%), and severe, 8 (8.8%).
Conclusions
There is a need for changes in lifestyle aspects in order to present healthier meals in appropriate amounts, in addition to an adequate therapeutic approach to these disorders. Research funding agency We also declare that we received financial support from the Institutional Program for Scientific Initiation Scholarships (PROBIC).
A 56-year-old patient diagnosed with bipolar affective disorder type II, who remains stable, with no manifest episodes, thanks to aripiprazole 60mg daily.
Objectives
The aim is to carry out a brief review of the use of the drug as the only stabiliser in bipolar affective disorder.
Methods
A 56-year-old patient, who has been suffering from episodes of hypomania since the age of 40, with episodes of depression. After poor tolerance to the use of the usual stabilisers, and the impossibility of using antidepressants due to hypomanic swings, it was decided to start treatment with aripiprazole orally, up to a maximum of 60mg daily. Despite the fact that the patient, with this treatment, had no side effects and remained more stable psychopathologically, the patient did not comply adequately with the correct dosage, due to his rotating work shifts. This fact explained that although he acknowledged an improvement, he continued with episodes of depressive symptoms lasting several days followed by episodes of hypomanic characteristics.
Results
For this reason, it was decided to change treatment to aripiprazole long-acting injectable, in order to ensure linear blood levels of the drug. Initially, it was decided to prescribe 400mg every 28 days. However, after the first administration, 20 days later, the patient began to show dysphoric mood, with marked emotional lability, living in an egodystonic manner. For this reason, the dose was increased to 600mg on a monthly basis. Since then, after a year and a half with the same treatment, the patient has been stable and in line. There has been no further decompensation of the underlying psychopathology and no side effects.
Conclusions
Aripiprazole in TAB is superior to placebo in type I patients, mainly affecting manic and mixed episodes, but not so much in depressive episodes. It has also been observed that it not only acts in the acute phases, but also has a stabilising function, preventing manic episodes.
One study showed that up to 65% of patients on oral aripiprazole in whom it was replaced by AOM remained clinically stable. In the same study, approximately 50% of those who completed 52 weeks of follow-up were able to maintain clinical stability.
Dementia is a syndrome of high prevalence and health impact. The Montreal Cognitive Assessment (MoCA) questionnaire is a screening tool whose use has increased in recent years, especially in cases of mild cognitive impairment. Some studies suggest that its ability to detect cognitive impairment, especially in early or mild stages, seems to be greater than gold-standard instruments (Ciesielska et al., 2016).
Objectives
We have performed a meta-analysis of reliability generalization to see if different adaptations and use in different contexts show consistent results.
Methods
We performed a literature search in PyscINFO and Medline with the terms “Cognitive impairment” AND “internal consistency” AND “Cronbach”, using the following inclusion criteria:
1. Be a study in which the MoCA scale was applied to a population sample.
2. Studies published in the last 10 years.
3. Studies that provide the reliability coefficient or sufficient data to calculate them.
4. Be written in English or Spanish.
We have limited our study to the last 10 years and the English language has given us a total of 19 results in Medline and 132 results in PsycINFO. Subsequently, we completed this search by snowball sampling.
A random effects model was assumed for the statistical calculations and the transformation of our values using the Hakstian and Whalen (1976) proposal. Statistical analysis was performed with the MAJOR package of the Janovi program, based on the R environment.
Results
We obtained a mean reliability for the transformed test scores of 0.42 (95% CI: 0.38 - 0.45), as well as high heterogeneity measured by Cochran’s Q statistic and the I2 index, which is attributed after analysis of moderating variables to the geographical adaptation of the questionnaire and the type of patient on whom it is applied. Our Funnel Plot graph indicates that we do not appear to have committed a publication bias.
Conclusions
Our meta-analysis shows high heterogeneity, mainly explained by the population of origin, both geographically (continent) and clinically (presence of primary cognitive impairment or not), with special incidence in those with impairment secondary to other pathologies, mainly neurological. However, we should consider the high probability that we have not included important variables in our analysis that could increase the explanatory power of our model.
Sucrose yield in sugarcane is a complex process regulated by both environmental and endogenous factors. However, the metabolic balance driving vegetative growth and sucrose accumulation remains poorly understood. Herein, we carried out a comprehensive assessment of carbohydrate dynamics throughout the crop cycle in two sugarcane varieties varying in biomass production, evaluating the carbon metabolism in both leaves and stalks. Our data revealed that the decline in photosynthetic rates during sugarcane maturation is associated not only to accumulation of sugars in leaves but also due to stomatal and non-stomatal limitations. We found that metabolic processes in leaves and stalks were intrinsically linked. While IACSP94-2094 had higher stalk sucrose concentration than IACSP95-5000, this latter produced more biomass. Compared to IACSP95-5000, IACSP94-2094 showed higher sucrose phosphate synthase (SPS) activity in leaves and stalks, along with lower soluble acid invertase (SAI) activity in leaves during the maximum growth stage. Interestingly, IACSP94-2094 also exhibited higher stalk SPS activity and lower stalk SAI activity than IACSP95-5000 during maturation. High biomass production by IACSP95-5000 was associated with higher sucrose synthase (SuSy) and SAI activity in leaves and higher SuSy and soluble neutral invertase (SNI) activity in stalks when compared to IACSP94-2094 during the maximum growth. Despite the contrasting strategies, both varieties displayed similar total sucrose yield, a balance between sucrose concentration and biomass production. This phenomenon implies the presence of a compensatory mechanism in sugarcane, with high biomass production compensating low sucrose accumulation and vice versa.
Polydrug use studies mention demographic and socioeconomic factors that may influence this problem. One of them is the existence of psychiatric comorbidity; Rentrop’s study (Rentrop et al., 2014) finds in a sample of 50 patients that all patients had at least one axis I disorder, 90% at least one axis II disorder, which may compromise the outcome of detoxification and dehabituation treatments (Rentrop et al., 2014). Another study found that 44.9% of patients admitted to a psychiatric unit are polydrug users (Karam et al., 2002).
Objectives
To study the possible association of polydrug use with psychiatric comorbidity in patients admitted to a general hospital and presenting drug use.
Methods
We made a descriptive retrospective study through the use of electronic medical records. The drug use history was obtained for all patients admitted to the inpatient service of a general hospital during a 3-year period.
Results
More cases of poly-consumption together with psychiatric comorbidity are found than expected in the χ² Test, with significant results (χ² = 27.2; p<0.001). The mean age of the patient with poly-consumption and psychiatric comorbidity is 34.9 years.
Psychiatric comorbidity
Polydrug use
No
Yes
Total
No
Observed
296
0
296
Expected
284
11.64
296
Yes
Observed
217
21
238
Expected
229
9.36
238
Total
Observed
513
21
534
513
21
534
Conclusions
Psychiatric comorbidity in patients with polydrug use may be overlooked (Kruckow et al. 2016). Identifying patients with dual diagnosis is important given that these patients suffer decreased treatment compliance and life expectancy compared with single-diagnosis patients (Kruckow et al., 2016).
References
Rentrop, M., Zilker, T., Lederle, A., Birkhofer, A., & Hörz, S. (2014). Psychiatric comorbidity and personality structure in patients with polyvalent addiction. Psychopathology, 47(2), 133–140. https://doi.org/10.1159/000351784
Kruckow, L., Linnet, K., & Banner, J. (2016). Psychiatric disorders are overlooked in patients with drug abuse. Danish medical journal, 63(3), A5207.
Four cases are presented who debut with depressive episodes and after close follow-up, are diagnosed and treated for Alzheimer’s disease
Objectives
The aim of this case series is to give a brief review of the depressive prodrome of dementia.
Methods
Four women, aged 67-77 years, treated on an outpatient basis, consulted for depressive symptoms. In addition to affective symptoms such as apathy, lack of interest, sadness, increased emotional lability and anhedonia, all three reported cognitive impairment. In their follow-up after two years, they became progressively more dependent on their partners, with more memory lapses, forgetfulness and progressive loss of higher cognitive functions. With the progression of cognitive impairment, anxious symptoms have become increasingly present.
Results
The mean age of the patients is 70 years. Two of them had an insidious onset of depressive symptoms, while the other two had a psychotic onset of depression. None of the patients had no previous history of depression. All four were started on antidepressant treatment with little response. Following the diagnosis of cognitive impairment, treatment was started with rivastigmine, with an adequate response.
Conclusions
Dementia and depression are very common in the elderly. It appears that up to 40% of patients with dementia have depressive symptoms. It appears that depression in old age may actually be a prodromal symptom of dementia.
We present the case of a 41-year-old male patient with multiple psychiatric diagnoses, he was diagnosed with agenesis of the corpus callosum, which explains his clinical presentation.
Objectives
The objective is to carry out a brief review of the symptoms associated with the agenesis of the corpus callosum.
Methods
The patient has been diagnosed with ADHD, cyclothymia, depressive anxiety disorder and social phobia. He has been treated with a multitude of drugs such as antidepressants, anxiolytics, stimulants and even low-dose antipsychotics. Despite the pharmacological treatments received, as well as the therapies, the patient’s functionality has progressively worsened, to the point of restricting going out of the home or maintaining a stable job.
Biographical data were collected, including psychomotor retardation and inappropriate laughter. He showed mannerisms such as fluttering and low frustration tolerance. He was slow to respond to his name and showed little affective resonance with his sister and parents. Restrictive interests, especially with English culture, for which he later studied English philology. On the other hand, his mother explains that he had no symbolic play and that, from early childhood, he had difficulties in relationships with peers.
Due to the aforementioned clinical manifestations, the functional worsening and the examination carried out in the consultation room, it was decided to extend the study with a brain MRI, where an agenesis of the corpus callosum was observed.
Results
Agenesis of the corpus callosum is a malformation of the central nervous system, which affects one in every 4000 births. It can be partial or complete, and occurs between the 7th-20th week of gestation.
Agenesis of the corpus callosum presents with a triad of symptoms:
- Reduced interhemispheric communication of sensory-motor information.
- Increased information processing time
- Difficulty in abstract thinking.
This triad causes difficulties not only cognitively, but also socially. There is difficulty in integrating and learning new verbal and visual information. Tendency to literalism, with difficulty in understanding double meanings. They also have difficulty understanding non-verbal language and reading emotions, which makes interaction with peers difficult. All these symptoms can sometimes be confused with symptoms compatible with Autism Spectrum Disorder.
Conclusions
After the diagnosis and after focusing the patient’s treatment on the most limiting symptoms of his daily life, an integrated approach was initiated, not only at a pharmacological level, with the use of antidepressants and anxiolytics, but also from a psychotherapeutic point of view, working on those areas in which the patient is most dysfunctional. He was accompanied in the disability application process, as well as helped in the search for associations for adults with ASD, finding there the answer to his symptoms and difficulties.
Preeclampsia (PE) affects up to five times more women with pre-existing diabetes mellitus (PDM) than women without it. The present study aimed to identify the effect of the DASH diet on PE incidence (primary outcome) and blood pressure, glycated haemoglobin (GH), serum lipids, glutathione peroxidase (GP), C-reactive protein (CRP – secondary outcomes) in pregnant with PDM. This randomised, controlled, single-blind trial studied sixty-eight pregnant women with PDM throughout prenatal care until delivery (18 weeks) at a public maternity hospital, Brazil. The standard diet group (SDG) received a diet containing 45–65 % carbohydrates, 15–20 % protein and 25–30 % lipids. The DASH diet group (DDG) received the adapted DASH diet with a similar macronutrient distribution, but with a higher concentration of fibres, unsaturated fats, calcium, magnesium and potassium as well as lower saturated fat. Student's t, Mann–Whitney U and the Chi-square tests were used to compare outcomes. PE incidence was 22⋅9 % in the SDG and 12⋅1 % in the DDG (P = 0⋅25). GP levels significantly increased in the DDG (intra-group analysis; mean difference = 1588 [CI 181, 2994], P = 0⋅03) and tended to be different from the variation in the SDG (mean difference = −29⋅5 [CI −1305; 1⋅365]; v. DDG: 1588 [CI 181; 2994], P = 0⋅09). GH levels decreased significantly and similarly between groups (SDG: −0⋅61 [CI −0⋅26, −0⋅96], P = 0⋅00) v. DDG: −1⋅1 [CI −0⋅57, −1⋅62], P = 0⋅00). There was no evidence of a difference in PE incidence at the end of the intervention between the two diets. The DASH diet seems to favour PE-related biochemical markers.
We present the results of direct numerical simulations of a NACA 0012 airfoil, with Mach number 0.3 and angle of attack of $3^\circ$, examining the dynamics of the flow with increasing Reynolds numbers. Two-dimensional simulation results are obtained with chord-based Reynolds numbers in the range $3.2 \times 10^3 \leq Re \leq 2.70 \times 10^4$, where each simulation uses the last time step of the previous one as a starting point, to capture the evolution of dynamics as a function of $Re$. The development of the pressure fluctuations with time shows a transition from periodic to quasi-periodic attractor for $2.38 \times 10^4 \leq Re \leq 2.42 \times 10^4$, leading to the emergence of secondary tones in the wall and acoustic field pressure spectra, different from peaks related to the fundamental frequency $f_1$ and the respective harmonics; a second, incommensurate frequency $f_2$ appears, leading to several secondary tones with frequency $af_1 + bf_2$, with $a$ and $b$ integers. Further increase of the Reynolds number leads to the emergence of a tertiary frequency, $f_3$, indicating a route to chaos of the Ruelle–Takens–Newhouse type. Such a mechanism is related to the ladder-type characteristic structure of the tones, indicating that dynamic systems theory is an important tool for understanding airfoil tonal noise.
To compare the long-term vaccine effectiveness between those receiving viral vector [Oxford-AstraZeneca (ChAdOx1)] or inactivated viral (CoronaVac) primary series (2 doses) and those who received an mRNA booster (Pfizer/BioNTech) (the third dose) among healthcare workers (HCWs).
Methods:
We conducted a retrospective cohort study among HCWs (aged ≥18 years) in Brazil from January 2021 to July 2022. To assess the variation in the effectiveness of booster dose over time, we estimated the effectiveness rate by taking the log risk ratio as a function of time.
Results:
Of 14,532 HCWs, coronavirus disease 2019 (COVID-19) was confirmed in 56.3% of HCWs receiving 2 doses of CoronaVac vaccine versus 23.2% of HCWs receiving 2 doses of CoronaVac vaccine with mRNA booster (P < .001), and 37.1% of HCWs receiving 2 doses of ChAdOx1 vaccine versus 22.7% among HCWs receiving 2 doses of ChAdOx1 vaccine with mRNA booster (P < .001). The highest vaccine effectiveness with mRNA booster was observed 30 days after vaccination: 91% for the CoronaVac vaccine group and 97% for the ChAdOx1 vaccine group. Vacine effectiveness declined to 55% and 67%, respectively, at 180 days. Of 430 samples screened for mutations, 49.5% were SARS-CoV-2 delta variants and 34.2% were SARS-CoV-2 omicron variants.
Conclusions:
Heterologous COVID-19 vaccines were effective for up to 180 days in preventing COVID-19 in the SARS-CoV-2 delta and omicron variant eras, which suggests the need for a second booster.
To determine risk factors for the development of long coronavirus disease 2019 (COVID-19) in healthcare personnel (HCP).
Methods:
We conducted a case–control study among HCP who had confirmed symptomatic COVID-19 working in a Brazilian healthcare system between March 1, 2020, and July 15, 2022. Cases were defined as those having long COVID according to the Centers for Disease Control and Prevention definition. Controls were defined as HCP who had documented COVID-19 but did not develop long COVID. Multiple logistic regression was used to assess the association between exposure variables and long COVID during 180 days of follow-up.
Results:
Of 7,051 HCP diagnosed with COVID-19, 1,933 (27.4%) who developed long COVID were compared to 5,118 (72.6%) who did not. The majority of those with long COVID (51.8%) had 3 or more symptoms. Factors associated with the development of long COVID were female sex (OR, 1.21; 95% CI, 1.05–1.39), age (OR, 1.01; 95% CI, 1.00–1.02), and 2 or more SARS-CoV-2 infections (OR, 1.27; 95% CI, 1.07–1.50). Those infected with the SARS-CoV-2 δ (delta) variant (OR, 0.30; 95% CI, 0.17–0.50) or the SARS-CoV-2 o (omicron) variant (OR, 0.49; 95% CI, 0.30–0.78), and those receiving 4 COVID-19 vaccine doses prior to infection (OR, 0.05; 95% CI, 0.01–0.19) were significantly less likely to develop long COVID.
Conclusions:
Long COVID can be prevalent among HCP. Acquiring >1 SARS-CoV-2 infection was a major risk factor for long COVID, while maintenance of immunity via vaccination was highly protective.