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The need for fast-track, high-quality and low-cost studies about the role of the BCG vaccine in the fight against COVID-19.

2025-09-09T18:07:43Z

Título: The need for fast-track, high-quality and low-cost studies about the role of the BCG vaccine in the fight against COVID-19. Autor(es): Pereira, Marcos; Paixão, Enny; Trajman, Anete; Souza, Ramon Andrade de; Natividade, Marcio Santos da; Pescarini, Julia M.; Pereira, Susan Martins; Barreto, Florisneide Rodrigues; Ximenes, Ricardo; Dalcomo, Margareth; Ichihara, Maria Yury; Nunes, Ceuci; Barral-Netto, Manoel; Barreto, Maurício Lima Abstract: Bacillus Calmette-Guérin (BCG) vaccination is routine and near-universal in many low- and middle-income countries (LMIC). It has been suggested that BCG can have a protective effect on COVID-19 morbidity and mortality. This commentary discusses the limitations of the evidence around BCG and COVID-19. We argue that higher-quality evidence is necessary to understand the protective effect of the BCG vaccine from existing, secondary data, while we await results from clinical trials currently conducted in different settings. Tipo: Artigo de Periódico

Previous BCG vaccination is associated with less severe clinical progression of COVID-19.

2025-09-09T18:07:23Z

Título: Previous BCG vaccination is associated with less severe clinical progression of COVID-19. Autor(es): Pereira, Susan Martins; Barreto, Florisneide Rodrigues; Souza, Ramon Andrade de; Santos, Carlos Antonio de Souza Teles; Pereira, Marcos; Paixão, Enny Santos da; Lima, Carla Cristina Oliveira de Jesus; Natividade, Marcio Santos da; Lindoso, Ana Angélica Bulcão Portela; Fernandes, Eder Gatti; Campelo Junior, Evonio Barros; Pescarini, Julia Moreira; Andrade, Kaio Vinicius Freitas de; Souza, Fernanda Mattos de; Britto, Elisangela Alves de; Nunes, Ceuci; Ichihara, Maria Yuri; Dalcolmo, Margareth; Trajman, Anete; Barral‑Netto, Manoel; Abubakar, Ibrahim; Barreto, Mauricio Lima; Ximenes, Ricardo Arraes de Alencar; Rodrigues, Laura Cunha Abstract: Background BCG vaccination, originally used to prevent tuberculosis, is known to “train” the immune system to improve defence against viral respiratory infections. We investigated whether a previous BCG vaccination is associated with less severe clinical progression of COVID-19. Methods A case-control study comparing the proportion with a BCG vaccine scar (indicating previous vaccination) in cases and controls presenting with COVID-19 to health units in Brazil. Cases were subjects with severe COVID-19 (O2 saturation < 90%, severe respiratory efort, severe pneumonia, severe acute respiratory syndrome, sepsis, and septic shock). Controls had COVID-19 not meeting the defnition of “severe” above. Unconditional regression was used to estimate vaccine protection against clinical progression to severe disease, with strict control for age, comorbidity, sex, educational level, race/colour, and municipality. Internal matching and conditional regression were used for sensitivity analysis. Results BCG was associated with high protection against COVID-19 clinical progression, over 87% (95% CI 74–93%) in subjects aged 60 or less and 35% (95% CI −44–71%) in older subjects. Conclusions This protection may be relevant for public health in settings where COVID-19 vaccine coverage is still low and may have implications for research to identify vaccine candidates for COVID-19 that are broadly protective against mortality from future variants. Further research into the immunomodulatory efects of BCG may inform COVID-19 therapeutic research. Tipo: Artigo de Periódico

Time to treatment and severity of snake envenoming in Brazil

2022-10-22T21:32:58Z

Título: Time to treatment and severity of snake envenoming in Brazil Autor(es): Mise, Yukari Figueroa; Lira-da-Silva, Rejâne Maria; Carvalho, Fernando Martins Abstract: Objective. To analyze the relationship between time to treatment and severity of snakebite envenomation in Brazil. Methods. This case-series retrospective study analyzed 144 251 snakebite cases in Brazil between 2007 and 2015, as reported to the Brazilian Notifiable Diseases Information System. The main dependent variable was snakebite envenomation severity (mild/moderate/severe). The main predictor was time to treatment (early (< 6 hours) vs. delayed (ë 6 hours)). Covariables were snake type(Bothrops/Crotalus/Micrurus/Lachesis), patient’s age and sex, bite site, and treatment at a specialized care center (center/noncenter). Polytomous logistic regression techniques were used to control the covariates and assess confounding and effect modification. Results. The time to treatment variable was strongly associated with the severity of snakebite envenomation. Snake type and treatment at specialized care center modified the main association effect. The association between delayed time to treatment and envenomation severity was consistently stronger among patients treated at specialized care centers than among those who were not treated at such centers. Odds ratios tended to increase significantly from moderate to severe envenomation for cases within the subgroups “Center + Bothrops” (1.37 to 2.05),“No center + Bothrops” (1.25 to 1.47), “Center + Crotalus” (1.35 to 3.03), “No center + Crotalus” (0.97 to 2.72), and “Center + Lachesis” (1.22 to 1.89). Discussion. This study confirmed the classical hypothesis that the time between snakebite and initiation of medical care is associated with severity of snakebite envenomation. It is therefore necessary to provide snakebite victims early access to specialized medical care, particularly to antivenom therapy. Tipo: Artigo de Periódico

Por uma atenção diferenciada e menos desigual: o caso do Distrito Sanitário Especial Indígena da Bahia

2022-10-24T18:39:58Z

Título: Por uma atenção diferenciada e menos desigual: o caso do Distrito Sanitário Especial Indígena da Bahia Autor(es): Mota, Sara Emanuela de Carvalho; Nunes, Mônica Abstract: Nesse estudo buscou-se conhecer os significados do princípio da “atenção diferenciada” por meio da análise dos enunciados e da observação das práticas de gestores do Subsistema de Atenção à Saúde dos Povos Indígenas na Bahia, a fim de revelar as bases sociais, políticas e culturais que os sustentam e analisar como contribuem, ou não, para a sua operacionalização. Parte-se do pressuposto de que a prestação de ações de atenção à saúde efetivamente diferenciadas, que considerem as especificidades socioculturais dos povos indígenas e sua medicina tradicional, pode contribuir para maior resolutividade do cuidado à saúde desses povos e mitigação de algumas implicações de determinantes sociais sobre os modos de viver, adoecer e morrer na população indígena. Optou-se pela realização de um estudo qualitativo, de abordagem etnográfica, com aplicação das técnicas de observação participante e de entrevistas semiestruturadas entre gestores do Subsistema na Bahia. A coleta de informações ocorreu entre setembro de 2014 e março de 2017. As narrativas revelaram frequentemente um tom retórico da ideia de “atenção diferenciada” como uma iniciativa de respeito às especificidades culturais indígenas, as quais foram mais insistentemente utilizadas como justificativa para a não realização de práticas diferenciadas de cuidado (por exemplo, protocolos específicos). A presença de indígenas na gestão contribuiu para a produção de práticas mais contextualizadas e orientadas para os problemas vivenciados pelas comunidades, mas o esforço de legitimação nesse espaço social ratifica a hegemonia “branca” na pauta principal de discussões. Tipo: Artigo de Periódico