Brief Communication
Hospital-Acquired SARS-CoV-2 infection among patients admitted to a university hospital
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"apellidos" => "de Almeida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0001" ] ] ] 3 => array:4 [ "nombre" => "Eduardo Alexandrino" "apellidos" => "Medeiros" "email" => array:1 [ 0 => "edubalaccih@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0001" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0001" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Universidade Federal de São Paulo, Hospital São Paulo, Infectious Diseases Department, São Paulo, SP, Brazil" "etiqueta" => "a" "identificador" => "aff0001" ] 1 => array:3 [ "entidad" => "Universidade Federal de São Paulo, Department of Medicine Preventive, São Paulo, SP, Brazil" "etiqueta" => "b" "identificador" => "aff0002" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0001" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0001" class="elsevierStylePara elsevierViewall">Transmission of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) occurs primarily through contact with respiratory secretions such as droplets.<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> Aerosol transmission has been reported in situations that favor the dispersion of aerosolized particles.<a class="elsevierStyleCrossRef" href="#bib0002"><span class="elsevierStyleSup">2</span></a> In-hospital transmission of SARS-CoV-2 has been reported at various institutions.<a class="elsevierStyleCrossRefs" href="#bib0003"><span class="elsevierStyleSup">3-7</span></a> In a prospective study of 1,353 health care workers in Singapore, Ran et al.<a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a> found that 86 (6.4%) were infected with SARS-CoV-2, suggesting that the infections were hospital-acquired.</p><p id="para0002" class="elsevierStylePara elsevierViewall">The objective of this study was to evaluate the impact of nosocomial transmission of SARS-CoV-2 among inpatients in Brazil. We evaluated patients hospitalized at a tertiary care teaching hospital—the Hospital São Paulo, operated by the Federal University of São Paulo, in the city of São Paulo, Brazil—between March 1 and May 31 of 2020.</p><p id="para0003" class="elsevierStylePara elsevierViewall">To define cases of nosocomial transmission of SARS-CoV-2, we applied the criteria established by the Brazilian National Health Oversight Agency<a class="elsevierStyleCrossRef" href="#bib0008"><span class="elsevierStyleSup">8</span></a>: having been hospitalized with a diagnosis unrelated to infection with the target pathogen - SARS-CoV-2 - and having presented signs and symptoms or radiological findings consistent with the target disease—coronavirus disease 2019 (COVID-19) - or having tested positive for infection with the target pathogen - SARS-CoV-2 (by reverse-transcriptase polymerase chain reaction)—after day 14 of hospitalization or between days seven and 14 of hospitalization in case of close contact with an infected individual (health care worker, companion, or visitor) for more than 24 hours. Patients who were readmitted with signs and symptoms of COVID-19 within the first seven days after discharge were also evaluated.</p><p id="para0004" class="elsevierStylePara elsevierViewall">This study was approved by the Research Ethics Committee of the Hospital São Paulo (Reference nos. 4,264,650 and 37048020.3.0000.5505). Because of the retrospective nature of the study, the requirement for written informed consent was waived.</p><p id="para0005" class="elsevierStylePara elsevierViewall">During the study period, positivity for SARS-CoV-2 was identified, by reverse-transcriptase polymerase chain reaction, in respiratory secretions collected from 455 inpatients. Of those, 42 (9.3%) were considered cases of nosocomial transmission.</p><p id="para0006" class="elsevierStylePara elsevierViewall">Among the 42 patients identified as cases of nosocomial SARS-CoV-2 infection, the mean age was 59 years (range, 23–86 years), 24 (57.1%) male and 22 (52.3%) self-reported their skin color as White.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a> The main diagnoses that prompted admission were diseases of the circulatory system in 12 (28.5%), infectious and parasitic diseases in 10 (23.8%), and injury, poisoning, and certain other consequences of external causes in 7 (16.6%). The most affected hospital wards were the emergency/internal medicine ward, with 18 cases (42.8%), the semi-intensive care unit, with 8 (19.0%), and the cardiac intensive care unit, with 5 (11.9%).</p><p id="para0007" class="elsevierStylePara elsevierViewall">Out of the 42 patients evaluated, the main comorbidities were diabetes, in 17 (40.4%), chronic kidney disease, in 10 (23.8%), and heart failure, in 8 (19%). We also calculated the Charlson comorbidity index, which was found to be 0 in 3 (7.0%) cases, 1–2 in 9 (21.4%), 3–4 in 13 (31.0%), and > 4 in 17 (40.4%).</p><p id="para0008" class="elsevierStylePara elsevierViewall">In 69.0% (29/42) of the cases, SARS-CoV-2 infection was identified after day 14 of hospitalization, whereas in 13 (31.0%) it was identified between days 7 and 14. Of those, 69.2% (9/13) were tested because they had been in close contact with SARS-CoV-2-infected patients and 4 (30.7%) were tested after isolated outbreaks among the staff of the wards.</p><p id="para0009" class="elsevierStylePara elsevierViewall">During the study period, 85.7% (36/42) of the patients with nosocomial infection were diagnosed with COVID-19 during their hospital stay. The mean time from admission to the onset of COVID-19 symptoms was 19.5 (8-129) days. Six patients (14.3%) were discharged and readmitted with symptoms of COVID-19 within seven days after discharge (mean, 3.8 days). Among those patients, the mean hospital stay during the first hospitalization was 21.6 (8–39) days and the mean time from discharge to symptom onset was 1.8 (1–3) days. In the 42 patients with confirmed nosocomial infection, the symptoms reported were dyspnea, in 20 cases (47.6%); cough, in 16 (38.0%); fever, in 15 (35.7%); diarrhea, in 10 (23.8%); nausea, in 6 (14.2%); vomiting, in 3 (7.1%); coryza, in 2 (4.7%); myalgia, in 1 (2.3%); and sore throat, in 1 (2.3%). Seven patients (16.6%) were asymptomatic. Supplemental oxygen was required in 25 (59.5%) cases. Twenty-six (62.0%) patients were treated in the intensive care unit, and mechanical ventilation was required in 15 (57.6%) of those patients. The mean stay at the intensive care unit was 14 (1–69) days and the mean time on mechanical ventilation was 9.5 (3-28) days. In 5 (15.1%) cases, the first symptom was acute respiratory failure, and the affected patients were promptly intubated. Twenty-three (54.7%) patients died. The mean time from the diagnosis of COVID-19 to death was 22 (1–88) days. Of the 23 patients who died, 9 (39%) had a Charlson comorbidity index > 4.</p><p id="para0010" class="elsevierStylePara elsevierViewall">Despite preventive measures, nosocomial infections affect health care workers disproportionately. We identified nosocomial transmission of SARS-CoV-2 in 42 (9.3%) of the 455 inpatients diagnosed with COVID-19 during the study period. Other studies have reported similar rates.<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#bib0007"><span class="elsevierStyleSup">7</span></a> In Brazil, until May 31, 2020, 514,992 cases had been confirmed (2,437 cases per 1,000,000 inhabitants), 29,341 (5.7%) deaths, 206,555 (40%) cases recovered, according to official data released by the Ministry of Health. In the same period in São Paulo, 109,698 cases and 7,615 deaths were reported.<a class="elsevierStyleCrossRef" href="#bib0009"><span class="elsevierStyleSup">9</span></a></p><p id="para0011" class="elsevierStylePara elsevierViewall">We chose to define nosocomial transmission on the basis of the criteria established by the Brazilian National Health Oversight Agency,<a class="elsevierStyleCrossRef" href="#bib0008"><span class="elsevierStyleSup">8</span></a> which defines cases as those occurring after day 14 of hospitalization or after day 7 if the individual has been in close contact with a confirmed case. Nishiura et al.<a class="elsevierStyleCrossRef" href="#bib0011"><span class="elsevierStyleSup">11</span></a> found the mean incubation time in cases of nosocomial transmission to be 6.4 days. In other studies, cases of nosocomial SARS-CoV-2 transmission have been defined as those that occur after day 5 of hospitalization in patients hospitalized with a diagnosis unrelated to COVID-19,<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a> which could result in the inclusion of cases of community transmission, given the ≤ 14 day incubation period of COVID-19. In our sample, the reasons for hospitalization and the comorbidities reported at admission were similar to those reported in other studies,<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> indicating that chronic diseases are potential aggravating factors for SARS-CoV-2 infection.</p><p id="para0012" class="elsevierStylePara elsevierViewall">Few studies have investigated the possibility that the hospital ward were a patient is could be a risk factor. In all of the wards identified in the present study, there was considerable foot traffic, which made it difficult for us to identify sources of transmission.</p><p id="para0013" class="elsevierStylePara elsevierViewall">In our sample, the most common symptom of COVID-19 was dyspnea, followed by cough and fever. Other studies have found the predominant symptoms to be fever, sore throat, nausea, and diarrhea.<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#bib0007"><span class="elsevierStyleSup">7</span></a> Our finding of asymptomatic cases supports evidence that < 50% of individuals infected with COVID-19 in the hospital environment are asymptomatic.<a class="elsevierStyleCrossRef" href="#bib0011"><span class="elsevierStyleSup">11</span></a> However, it should be borne in mind that asymptomatic individuals are a major source of silent transmission. Therefore, the COVID-19 contact tracing process should include the contacts of asymptomatic individuals.</p><p id="para0014" class="elsevierStylePara elsevierViewall">It is well known that comorbidities are risk factors for the severe form of COVID-19.<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> In the present study, comorbidity rates (i.e., Charlson comorbidity indices) were highest among those who died.</p><p id="para0015" class="elsevierStylePara elsevierViewall">Nosocomial SARS-CoV-2 transmission can be prevented through early identification of cases, diagnostic confirmation (by reverse-transcriptase polymerase chain reaction and imaging analysis), and better communication among hospital sectors, as well as precautions and isolation measures. It should be underscored the need for the hospital infection control team to establish daily communication sessions and provide continuing education on the use of personal protective equipment to prevent SARS-CoV-2 outbreaks. (<a class="elsevierStyleCrossRef" href="#tbl0001">Table 1</a>)</p><elsevierMultimedia ident="tbl0001"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-06-16" "fechaAceptado" => "2021-10-03" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1456847" "palabras" => array:4 [ 0 => "SARS-CoV-r2" 1 => "Cross infection" 2 => "Infection prevention and control" 3 => "Health care-associated infection" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><p id="spara005a" class="elsevierStyleSimplePara elsevierViewall">The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a public health emergency, as it is a highly contagious disease, health services had to adapt to the high demand for hospitalizations in order to contain hospital outbreaks. We aimed to identify the impact of nosocomial transmission of severe acute respiratory coronavirus virus 2 among inpatients at a university hospital in São Paulo, Brazil. Among 455 inpatients diagnosed with coronavirus disease 2019 in March–May, 2020, nosocomial infection was implicated in 42 (9.2%), of whom 23 (54.7%) died. becoming routine, especially when community transmission occur with high levels of incidence. It was possible to observe with this study that the nosocomial transmission by SARS-CoV-2 was present even with these measures instituted, and some of the damages caused by these infections are intangible.</p></span>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0001" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0001" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><a name="en0001"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0002"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">n (%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><a name="en0003"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">Sex \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0004"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0005"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Male \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0006"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">24 (57.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0007"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Female \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0008"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">18 (42.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0009"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0010"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0011"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>20–59 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0012"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">17 (40.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0013"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>60–79 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0014"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">23 (54.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0015"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>> 80 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0016"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">2 (6.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0017"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">Skin color \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0018"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0019"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>White \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0020"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">22 (52.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0021"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Brown \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0022"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">14 (33.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0023"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Black \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0024"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">6 (14.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0025"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">Initial reason for hospitalization \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0026"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0027"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Diseases of the circulatory system \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0028"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">12 (28.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0029"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Infectious or parasitic diseases \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0030"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">10 (23.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0031"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Injury, poisoning, or other external causes \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0032"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">7 (16.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0033"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Neoplasms \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0034"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">4 (9.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0035"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Respiratory system diseases \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0036"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">3 (7.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0037"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Diseases of the digestive system \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0038"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">2 (4.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0039"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Diseases of the genitourinary system \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0040"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">2 (4.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0041"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Diseases of the skin or subcutaneous tissue \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0042"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">1 (2.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0043"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Endocrine, nutritional, or metabolic diseases \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0044"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">1 (2.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0045"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">Hospital sectors \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0046"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0047"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Emergency/internal medicine \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0048"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">18 (42.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0049"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Semi-intensive care unit \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0050"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">8 (19.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0051"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiology ward \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0052"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">5 (11.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0053"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Orthopedics ward \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0054"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">4 (9.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0055"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Neurology ward \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0056"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">2 (6.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0057"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Internal medicine ward \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0058"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">2 (6.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0059"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Internal medicine intensive care unit \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0060"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">2 (6.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0061"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiology intensive care unit \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0062"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">1 (3.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0063"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">Comorbidities \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0064"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0065"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0066"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">17 (40.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0067"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Chronic kidney disease \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0068"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">10 (23.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0069"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Heart failure \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0070"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">8 (19.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0071"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Neoplasms \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0072"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">7 (21.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0073"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Liver disease \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0074"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">7 (16.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0075"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Chronic lung disease \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0076"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">5 (11.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0077"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Acquired immunodeficiency syndrome \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0078"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">2 (6.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0079"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Acute myocardial infarction \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0080"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">1 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0081"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Cerebrovascular disease \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0082"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">1 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0083"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">Charlson comorbidity index \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0084"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0085"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>0 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0086"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">3 (7.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0087"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>1–2 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0088"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">9 (21.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0089"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>3–4 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0090"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">13 (31.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0091"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>> 4 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0092"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">17 (40.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0093"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">Signs and symptoms \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0094"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0095"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Dyspnea \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0096"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">20 (47.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0097"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Cough \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0098"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">16 (38.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0099"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Fever \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0100"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">15 (35.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0101"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Diarrhea \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0102"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">10 (23.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0103"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Nausea \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0104"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">6 (14.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0105"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Vomiting \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0106"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">3 (7.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0107"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Coryza \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0108"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">2 (4.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0109"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Myalgia \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0110"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">1 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0111"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">Sore throat \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0112"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">1 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0113"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">Outcome \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0114"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0115"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Death \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0116"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">23 (54.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0117"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><span class="elsevierStyleHsp" style=""></span>Discharge \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0118"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">19 (45.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2782177.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Characteristics of Inpatients Infected Nosocomially with Severe Acute Respiratory Coronavirus Virus 2 (n = 42).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec1" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0001" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "WHO Recommended Surveillance Standards WHO/CDS/CSR/ISR/99.2. <a target="_blank" href="https://www.who.int/publications/i/item/laboratory-testing-for-2019-novel-coronavirus-in-suspected-human-cases-20200117">https://www.who.int/publications/i/item/laboratory-testing-for-2019-novel-coronavirus-in-suspected-human-cases-20200117</a>. Accessed June 7, 2020." ] ] ] 1 => array:3 [ "identificador" => "bib0002" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "NV Doremalen" 1 => "T Bushmaker" 2 => "DH Morris" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMc2004973" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2020" "volumen" => "382" "paginaInicial" => "1564" "paginaFinal" => "1567" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32182409" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0003" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Q. Li" 1 => "X. Guan" 2 => "P. Wu" 3 => "X. Wang" 4 => "L. Zhou" 5 => "Y. Tong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa2001316" "Revista" => array:4 [ "tituloSerie" => "N Engl J Med" "fecha" => "2020 Jan 29" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32222134" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0959804916330684" "estado" => "S300" "issn" => "09598049" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0004" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D. Wang" 1 => "B. Hu" 2 => "C. Hu" 3 => "F. Zhu" 4 => "X. Liu" 5 => "J. Zhang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2020.1585" "Revista" => array:3 [ "tituloSerie" => "JAMA" "fecha" => "2020 Feb 7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34606578" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0005" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reducing nosocomial transmission of COVID-19: implementation of a COVID-19 triage system" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Rachel M Wake" 1 => "Matthew Mrgan" 2 => "Jenny Choi" 3 => "Simon Winn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7861/clinmed.2020-0411" "Revista" => array:4 [ "tituloSerie" => "Clinical Medicine" "fecha" => "2020" "paginaInicial" => "1" "paginaFinal" => "5" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0006" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors of healthcare workers with corona virus disease 2019: a retrospective cohort study in a designated hospital of Wuhan in China" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L Ran" 1 => "X Chen" 2 => "Y Wang" 3 => "W Wu" 4 => "L Zhang" 5 => "X. Tan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/cid/ciaa287" "Revista" => array:3 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "2020" "volumen" => "287" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0007" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "BE Young" 1 => "SWX Ong" 2 => "S Kalimuddin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2020.3204" "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2020" "volumen" => "323" "paginaInicial" => "1488" "paginaFinal" => "1494" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32125362" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0008" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Technical Note 07, of August 5, 2020. Guidelines for the Prevention and Epidemiological Surveillance of SARS-CoV-2 Infections (COVID-19) Within Health Services" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "BRAZIL" "etal" => false ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Libro" => array:2 [ "edicion" => "01. ed." "fecha" => "08 May 2020" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "https://www20.anvisa.gov.br/segurancadopaciente/index.php/alertas/item/nota-tecnica-gvims-ggtes-anvisa-n-07-2021" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0009" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ministry of Health (BR). Health Surveillance Department. Coronavirus disease COVID-19: epidemiological week 52 (12/27/2020 to 01/02/2021) . Bol Epidemiol Spec . 2021 Feb ; 28 . Available at: <a target="_blank" href="https://www.gov.br/saude/pt-br/media/pdf/2021/marco/05/boletim_epidemiologico_covid_18_final2.pdf">https://www.gov.br/saude/pt-br/media/pdf/2021/marco/05/boletim_epidemiologico_covid_18_final2.pdf</a>. Accessed Feb 24, 2021." ] ] ] 9 => array:3 [ "identificador" => "bib0010" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Petruccelli JL. Ethnic-racial characteristics of the population: classification and identities. Classification and Identities. 2013. Brazilian Institute of Geography and Statistics (IBGE). Available at: <a target="_blank" href="https://biblioteca.ibge.gov.br/visualizacao/livros/liv63405.pdf">https://biblioteca.ibge.gov.br/visualizacao/livros/liv63405.pdf</a>. Accessed on: September 11 2021." ] ] ] 10 => array:3 [ "identificador" => "bib0011" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H Nishiura" 1 => "T. Kobayashi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijid.2020.03.020" "Revista" => array:7 [ "tituloSerie" => "Int J Infect Dis" "fecha" => "2020" "volumen" => "94" "paginaInicial" => "154" "paginaFinal" => "155" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32179137" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0092867420310138" "estado" => "S300" "issn" => "00928674" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/14138670/0000002500000006/v1_202112201713/S1413867021001069/v1_202112201713/en/main.assets" "Apartado" => array:4 [ "identificador" => "19369" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Brief Communications" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/14138670/0000002500000006/v1_202112201713/S1413867021001069/v1_202112201713/en/main.pdf?idApp=UINPBA00003Y&text.app=https://bjid.org.br/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1413867021001069?idApp=UINPBA00003Y" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 16 | 10 | 26 |
| 2024 September | 37 | 23 | 60 |
| 2024 August | 62 | 23 | 85 |
| 2024 July | 65 | 32 | 97 |
| 2024 June | 52 | 27 | 79 |
| 2024 May | 43 | 24 | 67 |
| 2024 April | 59 | 32 | 91 |
| 2024 March | 53 | 33 | 86 |
| 2024 February | 42 | 29 | 71 |
| 2024 January | 44 | 27 | 71 |
| 2023 December | 63 | 37 | 100 |
| 2023 November | 65 | 47 | 112 |
| 2023 October | 47 | 33 | 80 |
| 2023 September | 54 | 55 | 109 |
| 2023 August | 33 | 25 | 58 |
| 2023 July | 45 | 28 | 73 |
| 2023 June | 40 | 19 | 59 |
| 2023 May | 57 | 22 | 79 |
| 2023 April | 44 | 18 | 62 |
| 2023 March | 69 | 33 | 102 |
| 2023 February | 58 | 46 | 104 |
| 2023 January | 42 | 25 | 67 |
| 2022 December | 73 | 37 | 110 |
| 2022 November | 76 | 42 | 118 |
| 2022 October | 75 | 36 | 111 |
| 2022 September | 57 | 49 | 106 |
| 2022 August | 84 | 34 | 118 |
| 2022 July | 98 | 50 | 148 |
| 2022 June | 86 | 46 | 132 |
| 2022 May | 79 | 25 | 104 |
| 2022 April | 84 | 54 | 138 |
| 2022 March | 100 | 55 | 155 |
| 2022 February | 96 | 52 | 148 |
| 2022 January | 120 | 81 | 201 |
| 2021 December | 106 | 78 | 184 |
| 2021 November | 77 | 41 | 118 |
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