{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:10:16Z","timestamp":1756728616542,"version":"3.44.0"},"reference-count":45,"publisher":"Ordem dos Medicos","issue":"9","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Med Port"],"abstract":"<jats:p>Introdu\u00e7\u00e3o: A pandemia de COVID-19, causada pelo coronav\u00edrus da s\u00edndrome respirat\u00f3ria aguda grave 2 (SARS-CoV-2), resultou numa carga significativa de doen\u00e7as e mortalidade. Apesar dos sucessos das vacinas, novas variantes do v\u00edrus persistem, afetando gravemente indiv\u00edduos n\u00e3o vacinados e imunocomprometidos (IIC). Estes grupos de alto risco enfrentam taxas elevadas de mortalidade e hospitaliza\u00e7\u00e3o. A vigil\u00e2ncia e as medidas de sa\u00fade direcionadas permanecem cruciais ap\u00f3s a pandemia. Este estudo teve como objetivo desenvolver um consenso sobre as necessidades n\u00e3o atendidas na preven\u00e7\u00e3o da COVID-19 entre IIC.M\u00e9todos: Realiz\u00e1mos um Delphi envolvendo 45 especialistas, incluindo m\u00e9dicos, gestores de sa\u00fade, decisores pol\u00edticos, especialistas em sa\u00fade p\u00fablica, membros de sociedades m\u00e9dicas e organiza\u00e7\u00f5es de doentes. O consenso foi alcan\u00e7ado em 65% para cada estrat\u00e9gia identificada, utilizando uma escala que varia de \u201cconcordo totalmente\u201d a \u201cdiscordo totalmente\u201d. Foram realizadas tr\u00eas rondas Delphi para abordar quatro quest\u00f5es principais: identificar necessidades n\u00e3o atendidas na preven\u00e7\u00e3o da COVID-19 para IIC; identificar as caracter\u00edsticas que distinguem os IIC como um grupo suscet\u00edvel; determinar os principais resultados da COVID-19 em IIC; e indicar planos de a\u00e7\u00e3o para proteger os IIC. A primeira ronda envolveu a vota\u00e7\u00e3o de indicadores pr\u00e9-identificados. As segunda e terceira rondas envolveram a an\u00e1lise das informa\u00e7\u00f5es recolhidas e a vota\u00e7\u00e3o de cada indicador para alcan\u00e7ar consenso.Resultados: Foi alcan\u00e7ada uma taxa de reten\u00e7\u00e3o de 80%. Dos 89 indicadores v\u00e1lidos analisados, 23 alcan\u00e7aram consenso. Estes inclu\u00edram: oito indicadores que destacaram a import\u00e2ncia de aumentar a conscientiza\u00e7\u00e3o sobre a COVID-19 e os resultados da vacina\u00e7\u00e3o, garantindo seguran\u00e7a e compreens\u00e3o, e desenvolvendo estrat\u00e9gias de vacina\u00e7\u00e3o direcionadas para IIC; cinco indicadores que identificaram grupos suscet\u00edveis dentro dos IIC, como indiv\u00edduos em quimioterapia ou radioterapia, aqueles com imunodefici\u00eancias prim\u00e1rias, recetores de transplantes de \u00f3rg\u00e3os s\u00f3lidos, pacientes com doen\u00e7a renal cr\u00f3nica e recetores de transplantes de medula \u00f3ssea; dois indicadores que mostraram melhorias nos resultados cl\u00ednicos e redu\u00e7\u00e3o das hospitaliza\u00e7\u00f5es; e oito indicadores que recomendaram o desenvolvimento de terapias eficazes, vacinas mais imunog\u00e9nicas e tratamentos para infe\u00e7\u00f5es virais em IIC.Conclus\u00e3o: O estudo enfatizou a import\u00e2ncia de estrat\u00e9gias de vacina\u00e7\u00e3o direcionadas, monitoriza\u00e7\u00e3o e educa\u00e7\u00e3o personalizada para abordar as diversas necessidades dos IIC. Estes resultados fornecem uma base para o desenvolvimento de pol\u00edticas futuras que visem gerir e proteger eficazmente os IIC durante e ap\u00f3s a pandemia de COVID-19.<\/jats:p>","DOI":"10.20344\/amp.9949","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:47:34Z","timestamp":1753890454000},"page":"538-547","source":"Crossref","is-referenced-by-count":0,"title":["Desafios N\u00e3o Atendidos na Preven\u00e7\u00e3o da COVID-19 em Indiv\u00edduos Imunocomprometidos: Uma An\u00e1lise de Consenso em Portugal"],"prefix":"10.20344","volume":"38","author":[{"given":"Ana Soraia","family":"Cunha","sequence":"first","affiliation":[]},{"given":"Beatriz","family":"Raposo","sequence":"additional","affiliation":[]},{"given":"Jo\u00e3o","family":"V. Cordeiro","sequence":"additional","affiliation":[]},{"given":"Maria Jo\u00e3o","family":"Marques","sequence":"additional","affiliation":[]},{"given":"Ana Rita","family":"Pedro","sequence":"additional","affiliation":[]}],"member":"8464","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"10138","unstructured":"World Health Organization. COVID-19 cases. WHO COVID-19 dashboard. [cited 2024 Jul 24]. Available from: https:\/\/data.who.int\/dashboards\/covid19\/cases?n=c."},{"key":"10139","doi-asserted-by":"publisher","DOI":"10.1177\/10732748221106266"},{"key":"10140","doi-asserted-by":"publisher","DOI":"10.1080\/14760584.2023.2191716"},{"key":"10141","doi-asserted-by":"publisher","DOI":"10.1111\/all.14657"},{"key":"10142","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2021.03.876"},{"key":"10143","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003917"},{"key":"10144","doi-asserted-by":"publisher","DOI":"10.1007\/s40472-022-00385-y"},{"key":"10145","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.02.030"},{"key":"10146","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7127a3"},{"key":"10147","unstructured":"Portugal. Directorate-General of Health. Number of new cases and deaths per day, last updated on July 24. [cited 2024 Jul 24]. Available from: https:\/\/covid19.min-saude.pt\/numero-de-novos-casos-e-obitos-por-dia\/."},{"key":"10148","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.p1041"},{"key":"10149","unstructured":"Centers for Disease Control and Prevention. Underlying medical conditions associated with higher risk for severe COVID-19: information for healthcare professionals. 2024. [cited 2024 May 03]. Available from: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/clinical-care\/underlyingconditions.html."},{"key":"10150","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines9111299"},{"key":"10151","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.27487"},{"key":"10152","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2021.7024"},{"key":"10153","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.848582"},{"key":"10154","doi-asserted-by":"publisher","DOI":"10.5662\/wjm.v11.i4.116"},{"key":"10155","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-016-0257-x"},{"key":"10156","unstructured":"Delbecq A, Van de Ven A, Gustafson D. Group techniques for program planning: a guide to nominal group and Delphi processes. Group Organ Stud. 1976;1."},{"key":"10157","doi-asserted-by":"publisher","DOI":"10.1136\/ebnurs-2020-103303"},{"key":"10158","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"10159","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2000.t01-1-01567.x"},{"key":"10160","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.101965"},{"key":"10161","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1397040"},{"key":"10162","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad181"},{"key":"10163","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad150"},{"key":"10164","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2021.108021"},{"key":"10165","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad181"},{"key":"10166","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13722"},{"key":"10167","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.09.036"},{"key":"10168","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-068632"},{"key":"10169","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1147871"},{"key":"10170","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa863"},{"key":"10171","doi-asserted-by":"publisher","DOI":"10.1002\/iid3.1259"},{"key":"10172","unstructured":"National Institutes of Health. Immunocompromised. COVID-19 treatment guidelines. 2024. [cited 2024 Jul 03]. Available from: https:\/\/www.covid19treatmentguidelines.nih.gov\/special-populations\/immunocompromised\/."},{"key":"10173","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2023.100747"},{"key":"10174","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.09.038"},{"key":"10175","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1146704"},{"key":"10176","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2022.01.006"},{"key":"10177","doi-asserted-by":"publisher","DOI":"10.1186\/s12981-021-00427-y"},{"key":"10178","doi-asserted-by":"publisher","DOI":"10.2139\/ssrn.4317875"},{"key":"10179","doi-asserted-by":"publisher","DOI":"10.1016\/j.techfore.2004.03.004"},{"key":"10180","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1004086"},{"key":"10181","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1324330"},{"key":"10182","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2019.09.002"}],"container-title":["Acta M\u00e9dica Portuguesa"],"original-title":[],"link":[{"URL":"https:\/\/actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/download\/9949\/15717","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/download\/9949\/15718","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T11:42:11Z","timestamp":1756726931000},"score":1,"resource":{"primary":{"URL":"https:\/\/actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/view\/9949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,30]]},"references-count":45,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,1]]}},"URL":"https:\/\/doi.org\/10.20344\/amp.9949","relation":{},"ISSN":["1646-0758","0870-399X"],"issn-type":[{"type":"electronic","value":"1646-0758"},{"type":"print","value":"0870-399X"}],"subject":[],"published":{"date-parts":[[2025,7,30]]}}}