Staphylococcus spp. infections concurrent to COVID-19: a literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v11i9.32460

Keywords:

COVID-19; Staphylococcus spp.; SARS-CoV-2; Coinfection; Superinfection; Secondary infection.

Abstract

Species of the genus Staphylococcus are among the main causative agents of nosocomial infections, and is particularly worrisome the increasing multidrug-resistant strains circulating in hospital settings, colonizing and infecting patients and healthcare staff. Secondary infections are an important aggravating factor in COVID-19. The aim of this review manuscript is to analyze through current scientific literature the impact of concomitant infection by species of the genus Staphylococcus among patients with COVID-19. The analysis of the current scientific literature allows us to infer that there is a large heterogeneity regarding the incidence of this co-infection/superinfection/colonization. Heterogeneity was also found regarding antibiotic resistance levels of the isolated Staphylococcus strains and divergent trends regarding the temporal incidence of this bacterial pathogen in infections secondary to COVID-19. These differences probably reflect local patterns, such as resistance profiles and secondary infections prior to the pandemic, as well as the levels of hospital infection control at each healthcare facility. Factors such as length of stay, use of mechanical ventilation, superinfection with hospital-circulating strains of Staphylococcus spp. directly impact secondary infection rates and prognosis in patients with COVID-19. Even considering the heterogeneity of the results, death rates can be considered high in patients presenting concurrent Staphylococcus spp. infection in the severe form of the SARS-CoV-2 disease, with rates that can surpass 90%.

References

Adams, C. E., & Dancer, S. J. (2020). Dynamic Transmission of Staphylococcus aureus in the Intensive Care Unit. International Journal of Environmental Research and Public Health, 17(6), 2109. https://doi.org/10.3390/ijerph17062109

Altintas, M., Kar, M., Aydin Tigli, G., & Cekin, Y. (2022). Methicillin Resistance and Staphylococcus aureus in Nasal Cultures Before and During the Covid-19 Pandemic: A Comparison of the Results. European Journal of Rhinology and Allergy, 5(1), 20–23. https://doi.org/10.5152/ejra.2022.22056

Andrade,G. P. B., Fiorot, P. A. S. P., Amendola T. S., & Norberg, A. N. Shared computer keyboards as pathogenic microorganisms contamination sources. Saudi Journal of Pathology and Microbiology 3(9), 318-322. https://doi.org/10.21276/sjpm.2018.3.9.11

Bassetti, M., Magnasco, L., Vena, A., Portunato, F., & Giacobbe, D. R. (2022). Methicillin-resistant Staphylococcus aureus lung infection in coronavirus disease 2019: How common? Current Opinion in Infectious Diseases, 35(2), 149–162. https://doi.org/10.1097/QCO.0000000000000813

Bennett, J. E., Dolin, R., & Blaser, M. J. (2021). Enfermedades infecciosas: Principios y práctica. https://auth.elsevier.com/ShibAuth/institutionLogin?entityID=https%3A%2F%2Fwww.rediris.es%2Fsir%2Fubidp&appReturnURL=https%3A%2F%2Fwww.clinicalkey.com%2Fstudent%2Fcontent%2Ftoc%2F3-s2.0-C2019004558X

Bhargava, A., Riederer, K., Sharma, M., Fukushima, E. A., Johnson, L., & Saravolatz, L. (2021). High rate of Multidrug-Resistant Organisms (MDROs) among COVID-19 patients presenting with bacteremia upon hospital admission. American Journal of Infection Control, 49(11), 1441–1442. https://doi.org/10.1016/j.ajic.2021.08.010

Bolker, A., Coe, K., Smith, J., Stevenson, K., Wang, S.-H., & Reed, E. (2022). Predictors of respiratory bacterial co-infection in hospitalized COVID-19 patients. Diagnostic Microbiology and Infectious Disease, 102(1), 115558. https://doi.org/10.1016/j.diagmicrobio.2021.115558

Bôtelho, E. X., Melo, R. de O. A., Gusmão, N. B. de, Ximenes, R. M., & Sena, K. X. da F. R. de. (2022). Prevalência e perfil de resistência aos antimicrobianos de Staphylococcus aureus em hospitais do Brasil: Uma revisão integrativa da literatura. Research, Society and Development, 11(6), e2711628744. https://doi.org/10.33448/rsd-v11i6.28744

Brown, M. M., & Horswill, A. R. (2020). Staphylococcus epidermidis—Skin friend or foe? PLOS Pathogens, 16(11), e1009026. https://doi.org/10.1371/journal.ppat.1009026

Cataño-Correa, J. C., Cardona-Arias, J. A., Porras Mancilla, J. P., & García, M. T. (2021). Bacterial superinfection in adults with COVID-19 hospitalized in two clinics in Medellín-Colombia, 2020. PLOS ONE, 16(7), e0254671. https://doi.org/10.1371/journal.pone.0254671

Centeleghe, I., Norville, P., Hughes, L., & Maillard, J. (2022). Dual species dry surface biofilms; Bacillus species impact on Staphylococcus aureus survival and surface disinfection. Journal of Applied Microbiology, jam.15619. https://doi.org/10.1111/jam.15619

Charante, F. van, Wieme, A., Rigole, P., De Canck, E., Ostyn, L., Grassi, L., Deforce, D., Crabbé, A., Vandamme, P., Joossens, M., Van Nieuwerburgh, F., Depuydt, P., & Coenye, T. (2022). Microbial diversity and antimicrobial susceptibility in endotracheal tube biofilms recovered from mechanically ventilated COVID-19 patients. Biofilm, 4, 100079. https://doi.org/10.1016/j.bioflm.2022.100079

Cheng, L. S., Chau, S. K., Tso, E. Y., Tsang, S. W., Li, I. Y., Wong, B. K., & Fung, K. S. (2020). Bacterial co-infections and antibiotic prescribing practice in adults with COVID-19: Experience from a single hospital cluster. Therapeutic Advances in Infectious Disease, 7, 204993612097809. https://doi.org/10.1177/2049936120978095

Contou, D., Claudinon, A., Pajot, O., Micaëlo, M., Longuet Flandre, P., Dubert, M., Cally, R., Logre, E., Fraissé, M., Mentec, H., & Plantefève, G. (2020). Bacterial and viral co-infections in patients with severe SARS-CoV-2 pneumonia admitted to a French ICU. Annals of Intensive Care, 10(1), 119. https://doi.org/10.1186/s13613-020-00736-x

Coura, J. R. (2013). Dinâmica das Doenças Infecciosas e Parasitárias (2a ed). Rio de Janeiro: Guanabara-Koogan.

Cusumano, J. A., Dupper, A. C., Malik, Y., Gavioli, E. M., Banga, J., Berbel Caban, A., Nadkarni, D., Obla, A., Vasa, C. V., Mazo, D., & Altman, D. R. (2020). Staphylococcus aureus Bacteremia in Patients Infected With COVID-19: A Case Series. Open Forum Infectious Diseases, 7(11), ofaa518. https://doi.org/10.1093/ofid/ofaa518

d’Humières, C., Patrier, J., Lortat-Jacob, B., Tran-dinh, A., Chemali, L., Maataoui, N., Rondinaud, E., Ruppé, E., Burdet, C., Ruckly, S., Montravers, P., Timsit, J.-F., & Armand-Lefevre, L. (2021). Two original observations concerning bacterial infections in COVID-19 patients hospitalized in intensive care units during the first wave of the epidemic in France [Preprint]. Infectious Diseases (except HIV/AIDS). https://doi.org/10.1101/2021.01.22.21250287

Dutra, V. G., Martins, J. S. A., Norberg, A. N., Santa-Helena, A. A., Oliveira, J. T. M., Ribeiro, M. D., & Gouveia, L. O. C. Incidence of Nasal Carriers of Staphylococcus aureus Among Undergraduate Nursing Students in the City of Belford Roxo, Brazil. Saudi Journal of Medical and Pharmaceutical Sciences 4(6), 667-673. http://scholarsmepub.com/wp-content/uploads/2018/07/SJMPS-46-667-673-c.pdf

De Pascale, G., De Maio, F., Carelli, S., De Angelis, G., Cacaci, M., Montini, L., Bello, G., Cutuli, S. L., Pintaudi, G., Tanzarella, E. S., Xhemalaj, R., Grieco, D. L., Tumbarello, M., Sanguinetti, M., Posteraro, B., & Antonelli, M. (2021). Staphylococcus aureus ventilator-associated pneumonia in patients with COVID-19: Clinical features and potential inference with lung dysbiosis. Critical Care, 25(1), 197. https://doi.org/10.1186/s13054-021-03623-4

Dias, M. L. S., Molinaro, C. G. S., Aragão, L. C. M., de Lima, E. M., & Correal, J. C. D. (2022). Análise comparativa da resistência bacteriana de microrganismos causadores de bacteremia em pacientes críticos nos períodos pré-pandemia e COVID-19 em um hospital terciário privado de Rio de Janeiro. The Brazilian Journal of Infectious Diseases, 26, 102227. https://doi.org/10.1016/j.bjid.2021.102227

Docherty, A. B., Harrison, E. M., Green, C. A., Hardwick, H. E., Pius, R., Norman, L., Holden, K. A., Read, J. M., Dondelinger, F., Carson, G., Merson, L., Lee, J., Plotkin, D., Sigfrid, L., Halpin, S., Jackson, C., Gamble, C., Horby, P. W., Nguyen-Van-Tam, J. S., … Semple, M. G. (2020). Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: Prospective observational cohort study. BMJ, m1985. https://doi.org/10.1136/bmj.m1985

Elabbadi, A., Turpin, M., Gerotziafas, G. T., Teulier, M., Voiriot, G., & Fartoukh, M. (2021). Bacterial coinfection in critically ill COVID-19 patients with severe pneumonia. Infection, 49(3), 559–562. https://doi.org/10.1007/s15010-020-01553-x

Fitzgerald, J. R. (2014). Evolution of Staphylococcus aureus during human colonization and infection. Infection, Genetics and Evolution, 21, 542–547. https://doi.org/10.1016/j.meegid.2013.04.020

Gerver, S. M., Guy, R., Wilson, K., Thelwall, S., Nsonwu, O., Rooney, G., Brown, C. S., Muller-Pebody, B., Hope, R., & Hall, V. (2021). National surveillance of bacterial and fungal coinfection and secondary infection in COVID-19 patients in England: Lessons from the first wave. Clinical Microbiology and Infection, 27(11), 1658–1665. https://doi.org/10.1016/j.cmi.2021.05.040

Giacobbe, D. R., Battaglini, D., Enrile, E. M., Dentone, C., Vena, A., Robba, C., Ball, L., Bartoletti, M., Coloretti, I., Di Bella, S., Di Biagio, A., Brunetti, I., Mikulska, M., Carannante, N., De Maria, A., Magnasco, L., Maraolo, A. E., Mirabella, M., Montrucchio, G., … Bassetti, M. (2021). Incidence and Prognosis of Ventilator-Associated Pneumonia in Critically Ill Patients with COVID-19: A Multicenter Study. Journal of Clinical Medicine, 10(4), 555. https://doi.org/10.3390/jcm10040555

González-García, S., Hamdan-Partida, A., Bustos-Hamdan, A., & Bustos-Martínez, J. (2021). Factors of Nasopharynx that Favor the Colonization and Persistence of Staphylococcus aureus. Em X. Zhou & Z. Zhang (Orgs.), Pharynx—Diagnosis and Treatment. IntechOpen. https://doi.org/10.5772/intechopen.95843

Grasselli, G., Scaravilli, V., Mangioni, D., Scudeller, L., Alagna, L., Bartoletti, M., Bellani, G., Biagioni, E., Bonfanti, P., Bottino, N., Coloretti, I., Cutuli, S. L., De Pascale, G., Ferlicca, D., Fior, G., Forastieri, A., Franzetti, M., Greco, M., Guzzardella, A., … Bandera, A. (2021). Hospital-Acquired Infections in Critically Ill Patients With COVID-19. Chest, 160(2), 454–465. https://doi.org/10.1016/j.chest.2021.04.002

Horn, C. M., & Kielian, T. (2021). Crosstalk Between Staphylococcus aureus and Innate Immunity: Focus on Immunometabolism. Frontiers in Immunology, 11, 621750. https://doi.org/10.3389/fimmu.2020.621750

Jang, I.-T., Yang, M., Kim, H.-J., & Park, J.-K. (2020). Novel Cytoplasmic Bacteriocin Compounds Derived from Staphylococcus epidermidis Selectively Kill Staphylococcus aureus, Including Methicillin-Resistant Staphylococcus aureus (MRSA). Pathogens, 9(2), 87. https://doi.org/10.3390/pathogens9020087

Jeon, K., Jeong, S., Lee, N., Park, M.-J., Song, W., Kim, H.-S., Kim, H. S., & Kim, J.-S. (2022). Impact of COVID-19 on Antimicrobial Consumption and Spread of Multidrug-Resistance in Bacterial Infections. Antibiotics, 11(4), 535. https://doi.org/10.3390/antibiotics11040535

Karataş, M., Duman, M. Y., Tünger, A., Çilli, F., Aydemir, Ş., & Ozenci, V. (2021). Secondary Bacterial Infections and Antimicrobial Resistance in COVID-19: Comparative Evaluation of Pre-Pandemic and Pandemic-Era, A Retrospective Single Center Study [Preprint]. In Review. https://doi.org/10.21203/rs.3.rs-157931/v1

Karimzadeh, R., & Ghassab, R. K. (2022). Identification of nuc nuclease and sea enterotoxin genes in Staphylococcus aureus isolates from nasal mucosa of burn hospital staff: A cross-sectional study. New Microbes and New Infections, 47, 100992. https://doi.org/10.1016/j.nmni.2022.100992

Kellerman, R. D., Rakel, D., & Conn, H. F. (2022). Conn’s current therapy 2022. https://www.vlebooks.com/vleweb/product/openreader?id=none&isbn=9780323833790

Kewan, T., Chawla, S., Saleem, T., Afzal, S., Saand, A., & Alqaisi, S. (2020). Superinfections in patients infected with COVID-19: a single-center experience. Chest, 158(4), A350. https://doi.org/10.1016/j.chest.2020.08.347

Kloepfer, K. M., Singh, A., & Ramakrishnan, V. (2022). Allergic Rhinitis and Chronic Rhinosinusitis. Em Y. J. Huang & S. Garantziotis (Orgs.), The Microbiome in Respiratory Disease (p. 61–84). Springer International Publishing. https://doi.org/10.1007/978-3-030-87104-8_4

López-Jácome, L. E., Fernández-Rodríguez, D., Franco-Cendejas, R., Camacho-Ortiz, A., Morfin-Otero, M. D. R., Rodríguez-Noriega, E., Ponce-de-León, A., Ortiz-Brizuela, E., Rojas-Larios, F., Velázquez-Acosta, M. D. C., Mena-Ramírez, J. P., Rodríguez-Zulueta, P., Bolado-Martínez, E., Quintanilla-Cazares, L. J., Avilés-Benítez, L. K., Consuelo-Munoz, S., Choy-Chang, E. V., Feliciano-Guzmán, J. M., Couoh-May, C. A., … Garza-González, E. (2022). Increment Antimicrobial Resistance During the COVID-19 Pandemic: Results from the Invifar Network. Microbial Drug Resistance (Larchmont, N.Y.), 28(3), 338–345. https://doi.org/10.1089/mdr.2021.0231

Miller, M., Cook, H. A., Furuya, E. Y., Bhat, M., Lee, M.-H., Vavagiakis, P., Visintainer, P., Vasquez, G., Larson, E., & Lowy, F. D. (2009). Staphylococcus aureus in the Community: Colonization Versus Infection. PLoS ONE, 4(8), e6708. https://doi.org/10.1371/journal.pone.0006708

Norberg, P. R. B. M., Villalba, M. L. M., Ortellado, L. D., Coronel, M., Ribeiro, P. C., & Norberg, A. N. (2018). Nasal carriage of Staphylococcus aureus among indigenous people of Toba Qom ethnic, Benjamín Aceval, Paraguay. International Journal Of Community Medicine And Public Health, 5(7), 2720. https://doi.org/10.18203/2394-6040.ijcmph20182605

Norberg, A. N., Norberg, P. R. B. M., Guerra-Sanches, F., Ribeiro, P. C., Sant'Anna, N. F., Ferreira-Filho, R. M., & Faial, L. C. M. Paraepidemics: the role of microbial co-infections and superinfections on the COVID-19. World Journal of Pharmacy and Pharmaceutical Sciences 10(8), 140-153. https://doi.org/10.20959/wjpps20218-19635

Odorizi, V. A., Rocha, J, M, N,. Oliveira, G. G., Araujo, R. K. S., & Norberg, A. N. (2018). Asymptomatic Nasal Carriers of Staphylococcus aureus Among Indigenous People of Xerente Ethnic, Tocantinia City, Province of Tocantins, Brazil. International Journal of Scientific Research in Science and Technology, 4(2), 1536-1541. https://ijsrst.com/IJSRST1841355

Ortega-Peña, S., Rodríguez-Martínez, S., Cancino-Diaz, M. E., & Cancino-Diaz, J. C. (2022). Staphylococcus epidermidis Controls Opportunistic Pathogens in the Nose, Could It Help to Regulate SARS-CoV-2 (COVID-19) Infection? Life, 12(3), 341. https://doi.org/10.3390/life12030341

Pemán, J., Ruiz-Gaitán, A., García-Vidal, C., Salavert, M., Ramírez, P., Puchades, F., García-Hita, M., Alastruey-Izquierdo, A., & Quindós, G. (2020). Fungal co-infection in COVID-19 patients: Should we be concerned? Revista Iberoamericana De Micologia, 37(2), 41–46. https://doi.org/10.1016/j.riam.2020.07.001

Polly, M., de Almeida, B. L., Lennon, R. P., Cortês, M. F., Costa, S. F., & Guimarães, T. (2022). Impact of the COVID-19 pandemic on the incidence of multidrug-resistant bacterial infections in an acute care hospital in Brazil. American Journal of Infection Control, 50(1), 32–38. https://doi.org/10.1016/j.ajic.2021.09.018

Proctor, R. A. (2021). Have We Outlived the Concept of Commensalism for Staphylococcus aureus ? Clinical Infectious Diseases, 73(1), e267–e269. https://doi.org/10.1093/cid/ciaa1431

Punjabi, C. D., Madaline, T., Gendlina, I., Chen, V., Nori, P., & Pirofski, L. (2021). Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in respiratory cultures and diagnostic performance of the MRSA nasal polymerase chain reaction (PCR) in patients hospitalized with coronavirus disease 2019 (COVID-19) pneumonia. Infection Control & Hospital Epidemiology, 42(9), 1156–1158. https://doi.org/10.1017/ice.2020.440

Ramadan, H. K.-A., Mahmoud, M. A., Aburahma, M. Z., Elkhawaga, A. A., El-Mokhtar, M. A., Sayed, I. M., Hosni, A., Hassany, S. M., & Medhat, M. A. (2020). Predictors of Severity and Co-Infection Resistance Profile in COVID-19 Patients: First Report from Upper Egypt. Infection and Drug Resistance, Volume 13, 3409–3422. https://doi.org/10.2147/IDR.S272605

Raychaudhuri, D., Sarkar, M., Roy, A., Roy, D., Datta, K., Sengupta, T., Hazra, A., & Mondal, R. (2021). COVID-19 and Co-infection in Children: The Indian Perspectives. Journal of Tropical Pediatrics, 67(4), fmab073. https://doi.org/10.1093/tropej/fmab073

Rezaei, N. (2022). Encyclopedia of infection and immunity. https://www.sciencedirect.com/science/referenceworks/9780323903035

Risa, E., Roach, D., Budak, J. Z., Hebert, C., Chan, J. D., Mani, N. S., Bryson-Cahn, C., Town, J., & Johnson, N. J. (2021). Characterization of Secondary Bacterial Infections and Antibiotic Use in Mechanically Ventilated Patients With COVID-19 Induced Acute Respiratory Distress Syndrome. Journal of Intensive Care Medicine, 36(10), 1167–1175. https://doi.org/10.1177/08850666211021745

Sakr, A., Brégeon, F., Mège, J. L., Rolain, J. M., & Blin, O. (2018). Staphylococcus aureus Nasal Colonization: An Update on Mechanisms, Epidemiology, Risk Factors, and Subsequent Infections. Frontiers in Microbiology 8(9),2419. https://doi.org/10.3389/fmicb.2018.02419

Senok, A., Alfaresi, M., Khansaheb, H., Nassar, R., Hachim, M., Al Suwaidi, H., Almansoori, M., Alqaydi, F., Afaneh, Z., Mohamed, A., Qureshi, S., Ali, A., Alkhajeh, A., & Alsheikh-Ali, A. (2021). Coinfections in Patients Hospitalized with COVID-19: A Descriptive Study from the United Arab Emirates. Infection and Drug Resistance, Volume 14, 2289–2296. https://doi.org/10.2147/IDR.S314029

Sharifipour, E., Shams, S., Esmkhani, M., Khodadadi, J., Fotouhi-Ardakani, R., Koohpaei, A., Doosti, Z., & EJ Golzari, S. (2020). Evaluation of bacterial co-infections of the respiratory tract in COVID-19 patients admitted to ICU. BMC Infectious Diseases, 20(1), 646. https://doi.org/10.1186/s12879-020-05374-z

Sharov, K. S. (2020). SARS-CoV-2-related pneumonia cases in pneumonia picture in Russia in March-May 2020: Secondary bacterial pneumonia and viral co-infections. Journal of Global Health, 10(2), 020504. https://doi.org/10.7189/jogh.10.-020504

Silva, D. L., Lima, C. M., Magalhães, V. C. R., Baltazar, L. M., Peres, N. T. A., Caligiorne, R. B., Moura, A. S., Fereguetti, T., Martins, J. C., Rabelo, L. F., Abrahão, J. S., Lyon, A. C., Johann, S., & Santos, D. A. (2021). Fungal and bacterial coinfections increase mortality of severely ill COVID-19 patients. Journal of Hospital Infection, 113, 145–154. https://doi.org/10.1016/j.jhin.2021.04.001

Sullivan, S. B., Kamath, S., McConville, T. H., Gray, B. T., Lowy, F. D., Gordon, P. G., & Uhlemann, A.-C. (2016). Staphylococcus epidermidis Protection Against Staphylococcus aureus Colonization in People Living With Human Immunodeficiency Virus in an Inner-City Outpatient Population: A Cross-Sectional Study. Open Forum Infectious Diseases, 3(4), ofw234. https://doi.org/10.1093/ofid/ofw234

Tang, H., Zhao, Z., Zhang, X., Pan, L., Wu, Q., Wang, M., Zhang, Y., & Li, F. (2021). Analysis of pathogens and risk factors of secondary pulmonary infection in patients with COVID-19. Microbial Pathogenesis, 156, 104903. https://doi.org/10.1016/j.micpath.2021.104903

Unger, S. A., & Bogaert, D. (2017). The respiratory microbiome and respiratory infections. Journal of Infection, 74, S84–S88. https://doi.org/10.1016/S0163-4453(17)30196-2

Veronesi, R., Focaccia, R. (2015) Tratado de Infectologia (5a ed.). São Paulo: Atheneu.

Viana, S. L. N., Norberg, A. N., Barradas, N. A., Oliveira, J. T. M., Santa-Helena, A. A., Matos, M. L. F. M., & Matos, A. L. (2019). Bacterial contamination of the stretchers's surfaces of a physiotherapy undergraduate school clinic. World Journal of Pharmacy and Pharmaceutical Sciences 8(6), 1071-1079. https://doi.org/10.20959/wjpps20196-13963

Viancelli, A., Fornari, B. F., Fonseca, T. G., Mass, A. P., Ramos, F. M., & Michelon, W. (2022). Contamination by pathogenic multidrug resistant bacteria on interior surfaces of ambulances. Research, Society and Development, 11(2), e48111225925. https://doi.org/10.33448/rsd-v11i2.25925

Yang, S., Hua, M., Liu, X., Du, C., Pu, L., Xiang, P., Wang, L., & Liu, J. (2021). Bacterial and fungal co-infections among COVID-19 patients in intensive care unit. Microbes and Infection, 23(4–5), 104806. https://doi.org/10.1016/j.micinf.2021.104806

Published

19/07/2022

How to Cite

NORBERG, A. N. .; NORBERG, P. R. B. M. .; MANHÃES, F. C. .; MANGIAVACCHI, B. M. .; FAIAL, L. C. M. .; FERREIRA FILHO, R. M. .; RIBEIRO, P. C. .; MATOS, A. A. L. de .; MARTINS, L. M. .; SANT’ANNA, N. F. de . Staphylococcus spp. infections concurrent to COVID-19: a literature review. Research, Society and Development, [S. l.], v. 11, n. 9, p. e58611932460, 2022. DOI: 10.33448/rsd-v11i9.32460. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/32460. Acesso em: 5 nov. 2024.

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Health Sciences