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Sehdeh AM, Ebadi A, Saghafi A, Basiri A, Heidaranlu E. Audit of preparedness of selected military hospital in the face of biological threats: action research study. Int J Emerg Med 2024; 17:187. [PMID: 39695995 DOI: 10.1186/s12245-024-00786-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Accepted: 12/07/2024] [Indexed: 12/20/2024] Open
Abstract
INTRODUCTION In today's societies, the threats caused by chemical, biological, radiological and nuclear accidents, whether accidental or intentional, have become a great concern. Acquiring knowledge about how to respond to the management of these incidents and the complications caused by them in order to preserve societies and ensure stability is essential. Due to the fact that hospitals play an important role in dealing with the victims of biological threats, this study was conducted with the aim of auditing the preparedness of selected military Hospital in facing biological threats in 2023-2024. METHODS This applied research was conducted with the participatory action research method in all departments of selected military Hospital during one year from July 2023 to July 2024. The level of biological preparedness of the hospital was investigated using the hospital's preparedness tool in biological events with 147 items in 8 main dimensions and 20 sub-dimensions, and the weak areas of the hospital (9 areas) were identified. Then, in the hospital audit cycle, using the FOCUS-PDCA model, a program to improve work processes and improve the biological preparedness of different departments of the hospital in the face of accidents and disasters was implemented. The level of biological preparedness of the hospital before and after the implementation of the change was compared and analyzed using SPSS. version 22 software. RESULTS The preparedness in the studied hospital in facing biological threats before the change was 196 out of 294 and the hospital's biological preparedness percentage was 66.66%, which was in the average range, and after the change, the preparedness score reached 228 and the hospital's preparedness percentage was 77.55%, which was in the range Well classified. In 9 fields where the level of biological preparedness was moderate and weak, the highest preparedness was created in the field of employees and volunteers with 86.36% and the lowest preparedness was related to the field of corpse management with 50%. CONCLUSION Considering the impact of training in improving the hospital's preparedness program in the face of biological threats, it is suggested that other medical centers include audits in their work plan.
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Affiliation(s)
- Ali Mohammdi Sehdeh
- Trauma Research Center, Nursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Nursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abdollah Saghafi
- Nursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Alireza Basiri
- Health Research Center, Baqiyatullah University of Medical Sciences, Tehran, Iran
| | - Esmail Heidaranlu
- Nursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Guimarães GC, Pereira GS, dos Santos HCNTR, Vianna ECDC, Peixoto TAL, Silva-Junior JS, Gallasch CH. Psychological distress among public and private healthcare professionals during the COVID-19 pandemic. Rev Bras Med Trab 2024; 22:e20241227. [PMID: 39606756 PMCID: PMC11595382 DOI: 10.47626/1679-4435-2024-1227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 02/02/2024] [Indexed: 11/29/2024] Open
Abstract
Introduction Healthcare workers in both the public and private systems were on the front line of the fight against the COVID-19 pandemic. As a consequence, they faced uncertainty, heavy demand, excessive working hours, and the fear of contracting the virus. Objectives To investigate the occurrence of psychological distress among public and private healthcare workers at the start of the COVID-19 pandemic. Methods An observational, quantitative study was conducted from April to June of 2020, enrolling workers who had cared for suspected and confirmed cases of covid-19 in Brazil. Psychological distress was assessed using the Self-Reporting Questionnaire-20. Associations between the outcome and independent variables were analyzed using the chi-square test. Results Majorities of the 400 healthcare workers studied were nursing professionals (69.8%), worked in the Southeast region of Brazil (69.5%), were affiliated to a public healthcare institution (71.8%), and had a mean working week of 45.81 hours. The rate of psychological distress in the sample was 56.8%. There was no statistically significant association between the outcome and the type of organization (public/private). There were associations between psychological distress and professional category and between psychological distress and prior comorbidities. Conclusions There was evidence of impact on mental wellbeing irrespective of care level or setting. Psychological distress was one of the greatest challenges faced by the healthcare workers during the pandemic, irrespective of the type of institution, and was a phenomenon of relevance to occupational health in general during the pandemic.
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Affiliation(s)
| | - Gabrielle Silva Pereira
- School of Nursing, Universidade do Estado do Rio de Janeiro (UERJ),
Rio de Janeiro, RJ, Brazil
| | | | | | | | - João Silvestre Silva-Junior
- Department of Medicine, Centro Universitário São
Camilo, São Paulo, SP, Brazil
- School of Medicine, Universidade de São Paulo, São
Paulo, SP, Brazil
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Baltacioglu M. Mental Symptoms Among Mental Health Workers During the COVID-19 Pandemic. J Nerv Ment Dis 2024; 212:213-218. [PMID: 38113929 DOI: 10.1097/nmd.0000000000001751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
ABSTRACT We aimed to examine the psychological reactions of healthcare professionals working in the field of mental health during the pandemic and their relationship with sleep quality, eating attitudes, and burnout. A cross-sectional survey was conducted over online platforms. A total of 128 mental health workers were included. Beck Depression Inventory, Beck Anxiety Inventory, Maslach Burnout Inventory, Pittsburg Sleep Quality Index, and Eating Attitudes Test were administered. Depression was detected in 38.3%, anxiety in 73.4%, decreased sleep quality in 89.1%, emotional burnout in 64.8%, depersonalization in 85.9%, and decreased personal achievement in 75.8% of the participants. Anxiety scores of participants who did not take an active role in COVID-19 (22.23 ± 5.067) were significantly higher ( p < 0.001) than those who took an active role in COVID-19 (16.5 ± 6.273). Special attention must be paid to the mental health professionals, especially during crisis periods.
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Affiliation(s)
- Mehmet Baltacioglu
- Department of Psychiatry, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
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Talawar P, Tripathy DK, Kaushal A, Dhar M, Vijaybabu A, Tuppad P, Priyanka S, Kumar D, Sharma R, Kumar SS. Efficacy of lignocaine nebulization in patients with COVID-19 respiratory infection: An exploratory randomized double-blinded controlled trial. J Anaesthesiol Clin Pharmacol 2024; 40:271-275. [PMID: 38919418 PMCID: PMC11196040 DOI: 10.4103/joacp.joacp_205_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/02/2022] [Accepted: 10/13/2022] [Indexed: 06/27/2024] Open
Abstract
Background and Aims Coronavirus disease (COVID-19)-related pneumonia is proposed to be an inflammatory process. The treatment currently includes supportive therapy and low-dose steroids. Anti-inflammatory drugs have been proposed to prevent cytokine storms and improve oxygenation in such cases. The study aimed to assess the efficacy of nebulized lignocaine in COVID-19 patients with pneumonia. Material and Methods This was an exploratory randomized double-blinded control trial conducted in COVID-19 patients with respiratory failure requiring oxygen therapy either by face mask or non-invasive mechanical ventilation. Patients included were of the age of more than 18 years of either gender. The patients were randomized to receive either lignocaine or distilled water nebulization. The outcomes assessed were PaO2/FiO2 ratio, hemodynamics, respiratory parameters, and sequential organ failure score (SOFA). Results The two groups were comparable concerning demographic variables. The PaO2/FiO2 were significantly higher in the lignocaine group from day 2 onward. The SPO2 was significantly higher on day 3 in the lignocaine group and thereafter there was no significant difference. Other hemodynamic, respiratory parameters, and SOFA scores showed no difference in both the groups. Conclusion Lignocaine nebulization improved oxygenation in COVID-19 patients and can be used as adjunctive therapy along with other supportive medications.
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Affiliation(s)
- Praveen Talawar
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Debendra Kumar Tripathy
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashutosh Kaushal
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Mridul Dhar
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Adabala Vijaybabu
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Praik Tuppad
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sangadala Priyanka
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepak Kumar
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ruhi Sharma
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sumedha Suresh Kumar
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Brustia R, Bouattour M, Allaire M, Lequoy M, Hollande C, Regnault H, Blaise L, Ganne-Carrié N, Vilgrain V, Larrey E, Lim C, Scatton O, Mouhadi SE, Ozenne V, Paye F, Balladur P, Dohan A, Massault PP, Pol S, Dioguardi Burgio M, Sepulveda A, Cauchy F, Luciani A, Sommacale D, Leroy V, Calderaro J, Roudot-Thoraval F, Nault JC, Amaddeo G. Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area: What's new 12 months later? Ann Hepatol 2023; 28:101141. [PMID: 37468096 DOI: 10.1016/j.aohep.2023.101141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/04/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION AND OBJECTIVES The lockdown policy introduced in 2020 to minimize the spread of the COVID-19 pandemic, significantly affected the management and care of patients affected by hepatocellular carcinoma (HCC). The aim of this follow-up study was to determine the 12 months impact of the COVID-19 pandemic on the cohort of patients affected by HCC during the lockdown, within six French academic referral centers in the metropolitan area of Paris. MATERIALS AND METHODS We performed a 12 months follow-up of the cross-sectional study cohort included in 2020 on the management of patients affected by HCC during the first six weeks of the COVID-19 pandemic (exposed), compared to the same period in 2019 (unexposed). Overall survival were compared between the groups. Predictors of mortality were analysed with Cox regression. RESULTS From the initial cohort, 575 patients were included (n = 263 Exposed_COVID, n = 312 Unexposed_COVID). Overall and disease free survival at 12 months were 59.9 ± 3.2% vs. 74.3 ± 2.5% (p<0.001) and 40.2 ± 3.5% vs. 63.5 ± 3.1% (p<0.001) according to the period of exposure (Exposed_COVID vs. Unexposed_COVID, respectively). Adjusted Cox regression revealed that the period of exposure (Exposed_COVID HR: 1.79, 95%CI (1.36, 2.35) p<0.001) and BCLC stage B, C and D (BCLC B HR: 1.82, 95%CI (1.07, 3.08) p = 0.027 - BCLC C HR: 1.96, 95%CI (1.14, 3.38) p = 0.015 - BCLC D HR: 3.21, 95%CI (1.76, 5.85) p<0.001) were predictors of death. CONCLUSIONS Disruption of routine healthcare services because of the pandemic translated to reduced 1 year overall and disease-free survival among patients affected by HCC, in the metropolitan area of Paris, France.
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Affiliation(s)
- Raffaele Brustia
- Department of Digestive and Hepato-pancreatic-biliary Surgery, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France.
| | - Mohamed Bouattour
- Département d'Oncologie Hépatique, AP-HP, Hôpital Beaujon, F-92110 Clichy, France
| | - Manon Allaire
- Sorbonne Université, Paris, France; Hepatology and Liver transplantation department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Marie Lequoy
- Department of Hepatology, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - Clémence Hollande
- Department of Hepatology, AP-HP, Hôpital Cochin, F-75014 Paris, France
| | - Hélène Regnault
- Department of Hepatology, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France
| | - Lorraine Blaise
- Service d'hépatologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France
| | - Nathalie Ganne-Carrié
- Service d'hépatologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France; Centre de Recherche des Cordeliers, Inserm, Sorbonne Université, Université Paris, INSERM UMR 1138 Functional Genomics of Solid Tumors laboratory, F-75006, Paris, France
| | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France - INSERM U1149 "centre de recherche sur l'inflammation", CRI, Paris France
| | - Edouard Larrey
- Sorbonne Université, Paris, France; Hepatology and Liver transplantation department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Chetana Lim
- Digestive and Liver transplantation department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Olivier Scatton
- Department of Hepatology, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France; Digestive and Liver transplantation department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Sanaa El Mouhadi
- Department of Radiology, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - Violaine Ozenne
- Department of Hepatology, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - François Paye
- Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - Pierre Balladur
- Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - Anthony Dohan
- Department of Radiology, AP-HP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Pierre-Philippe Massault
- Department of Digestive Surgery, AP-HP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Stanislas Pol
- Department of Hepatology, AP-HP, Hôpital Cochin, F-75014 Paris, France
| | - Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France - INSERM U1149 "centre de recherche sur l'inflammation", CRI, Paris France
| | - Ailton Sepulveda
- Digestive and Liver transplantation department, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France
| | - Francois Cauchy
- Digestive and Liver transplantation department, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France
| | - Alain Luciani
- INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France; Department of Radiology, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; Paris Est Créteil University, UPEC, Créteil, France
| | - Daniele Sommacale
- Department of Digestive and Hepato-pancreatic-biliary Surgery, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France; Paris Est Créteil University, UPEC, Créteil, France
| | - Vincent Leroy
- INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France; Department of Hepatology, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; Paris Est Créteil University, UPEC, Créteil, France
| | - Julien Calderaro
- Université Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France; Assistance Publique-Hôpitaux de Paris, Henri Mondor-Albert Chenevier University Hospital, Department of Pathology, Créteil, France; Inserm, U955, Team 18, Créteil, France; European Reference Network (ERN) RARE-LIVER, France
| | | | - Jean-Charles Nault
- Service d'hépatologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France; Centre de Recherche des Cordeliers, Inserm, Sorbonne Université, Université Paris, INSERM UMR 1138 Functional Genomics of Solid Tumors laboratory, F-75006, Paris, France
| | - Giuliana Amaddeo
- INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France; Department of Hepatology, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; Paris Est Créteil University, UPEC, Créteil, France.
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YÜCE Z, ŞİMŞEK N. Psychosocial Support Programs and Telepsychiatry Services Implemented in the World and Türkiye during the Pandemic. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1079919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
In this study, which addresses the psychosocial dimension of the COVID-19 pandemic, it is seen that the pandemic has increased the frequency of anxiety, anxiety, fear, and depression in the society. In this process in the world and in Türkiye, the majority of psychosocial support programs and mental health services are provided on online platforms and the frequency of use of telepsychiatry services has increased. In this study, Google Scholar and Pub Med were scanned and relevant domestic and international studies were examined. The aim of this article was to draw attention to the innovations brought about by the epidemic in the provision of mental health services to people and suggestions were made in order to contribute to the relevant literature.
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Muacevic A, Adler JR. Mental Health Issues Associated With COVID-19 Among the Elderly Population: A Narrative Review. Cureus 2022; 14:e33081. [PMID: 36726914 PMCID: PMC9886379 DOI: 10.7759/cureus.33081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 12/30/2022] Open
Abstract
Since its discovery in December 2019, coronavirus disease 2019 (COVID-19) has been affecting humanity in economic, social, physical, and psychological manner. During COVID-19, the older population needs special consideration since they have a greater risk of developing serious illnesses. We used a narrative review approach to identify the relevant articles. PubMed, Scopus, and Google Scholar databases were searched for the following keywords: (mental health OR mental illness(es) OR anxiety OR depression OR irritability) AND (elderly OR older people OR aged 60 years or more) AND (Covid-19 OR pandemic OR chronic diseases) AND (mitigate OR manage). In the initial search, we found 948 articles related to our search string, and only 33 studies were included in this narrative review. The results demonstrated that the elderly population is more prone to mental health issues associated with COVID-19. This narrative review also reported that loneliness, stress, depression, anxiety, sleep disturbance, and suicidal ideation symptoms are experienced by the elderly during the pandemic. Our results also demonstrate that interventions, such as community activities through social interactions, and the use of digital technologies could improve the quality of life of older people and help in the mitigation and management of the adverse effects of COVID-19.
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Corrêa FI, Souza PHL, Uehara L, Ritti-Dias RM, Oliveira da Silva G, Segheto W, Pacheco-Barrios K, Fregni F, Corrêa JCF. Transcutaneous Auricular Vagus Nerve Stimulation Improves Inflammation but Does Not Interfere with Cardiac Modulation and Clinical Symptoms of Individuals with COVID-19: A Randomized Clinical Trial. Life (Basel) 2022; 12:life12101644. [PMID: 36295080 PMCID: PMC9604701 DOI: 10.3390/life12101644] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/12/2022] [Accepted: 10/15/2022] [Indexed: 11/16/2022] Open
Abstract
Transcranial auricular vagus nerve stimulation (taVNS) has shown effectiveness in reducing inflammation and depression. Thus, this study evaluated its effect on inflammation, cardiac autonomic modulation, and clinical symptoms in individuals affected by COVID-19. Methods: There were 52 randomized participants hospitalized with COVID-19 diagnosis who were to receive active (a-taVNS) or sham taVNS (s-taVNS) for 90 min twice a day for seven consecutive days. Interleukin 6 (IL-6), 10 (IL-10), cortisol, C-reactive protein (CRP), heart rate variability (HRV), and clinical symptoms were assessed before and after seven days of treatment. There were also seven- and fourteen-day follow-ups for clinical symptoms, including anxiety and depression levels, as well as a six-month follow-up for memory and attention levels. Results: There was significant reduction in CRP −23.9%, (95% CI −46.3 to −1.4) and IL-6 −37.7%, (95% CI −57.6 to −17.7) for the a-taVNS group. There were no changes in IL-10, cortisol levels, or in HRV results (p > 0.05) in both groups. There were no changes regarding clinical symptoms, except for a significant decrease in depression level (−2.85, 95% CI −5.44 to −0.27) in the a-taVNS group. Conclusion: taVNS showed effects on CRP, IL-6, and depression levels; however, it did not affect other clinical symptoms.
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Affiliation(s)
- Fernanda Ishida Corrêa
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
- Correspondence: ; Tel.: +55-11-973440380
| | - Paulo Henrique Leite Souza
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Laura Uehara
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Raphael Mendes Ritti-Dias
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Gustavo Oliveira da Silva
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Wellington Segheto
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Unidad de Investigación para la Generación y Síntesede Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15024, Peru
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - João Carlos Ferrari Corrêa
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
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Miao X, Wang W, Chen Y, Huang X, Wang R. Psychological stress and influencing factors of hospital workers in different periods under the public health background of infectious disease outbreak: A cross-sectional study. Health Sci Rep 2022; 5:e834. [PMID: 36177398 PMCID: PMC9476554 DOI: 10.1002/hsr2.834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/07/2022] Open
Abstract
Background and Aims It is well known that public health emergencies can affect the mental health of medical personnel, and many studies have focused on cross-sectional studies with short-term benefits. The present study aimed to investigate the long-term influence of infectious disease outbreak about the mental health of hospital staff. Methods The demographic characteristics and mental health status of staff in Fuzhou, China, were analyzed by using the Generalized Anxiety Disorder (GAD-7) Scale and Depression Screening Scale (9-item Patient Health Questionnaire [PHQ-9]) in February and December 2020. Results There were no significant differences in anxiety levels during different time periods (p > 0.05), but there were significant differences among anxiety level and total score of GAD-7 scale (p < 0.001). There were significant differences among the number of people with depression, depression level, and total score on the PHQ-9 scale (p < 0.001). As the pandemic progressed, total scores of anxiety in medical staff with different titles decreased (p < 0.05), but depression scores in professionals with intermediate and senior titles increased significantly (p < 0.05). changes in anxiety and depression scores during different time periods also changed according to hospital worker specialty. Total scores of anxiety in doctors, nurses, medical technicians, and other staff members all decreased (p < 0.05), while total scores of depression in doctors, nurses, and other staff members significantly increased (p < 0.05). There were no significant differences in total depression score among medical technicians (p > 0.05). Conclusions Since the outbreak of an infectious disease public health emergency, the anxiety of hospital staff has decreased over time, but the depression has increased. The management and psychological support personnel in medical institutions should continue to pay attention to the mental health of medical staff, and it is necessary to take different intervention measures in different periods when implementing the psychological crisis prevention mechanism.
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Affiliation(s)
- Xing Miao
- Department of Cardiology Fujian Provincial Hospital Fuzhou China
- Department of Cardiology Shengli Clinical Medical College of Fujian Medical University Fuzhou China
| | - Wei Wang
- Department of Psychiatry Fuzhou Neuropsychiatric Hospital Affiliated to Fujian Medical University Fuzhou China
| | - Yongli Chen
- Department of Cardiology Shengli Clinical Medical College of Fujian Medical University Fuzhou China
| | - Xiufang Huang
- Department of Cardiology Fujian Provincial Hospital Fuzhou China
| | - Rehua Wang
- Department of Cardiology Fujian Provincial Hospital Fuzhou China
- Department of Cardiology Shengli Clinical Medical College of Fujian Medical University Fuzhou China
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Lucidi S, Iannattone S, Mallardo F, Spoto A, Lorio R. Psychological Distress in Healthcare Workers During the Covid-19 Pandemic: Development and Validation of the Italian Version of the Healthcare Workers Emergency Distress Questionnaire (HEDQ). CLINICAL NEUROPSYCHIATRY 2022; 19:206-219. [PMID: 36101647 PMCID: PMC9442851 DOI: 10.36131/cnfioritieditore20220403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective The COVID-19 pandemic has presented unprecedented challenges for health systems as it has proven to be an extraordinary emergency. Exposure to such chronic stress can have detrimental effects on the psychophysical well-being of healthcare workers, with possible manifestation of stress-related symptoms. The present study aimed to develop and validate the Healthcare Workers Emergency Distress Questionnaire (HEDQ), a self-report screening questionnaire with the purpose of identifying the healthcare workers at risk for psychological and moral distress, and PTSD-related symptoms during emergencies. Method The HEDQ was administered to 250 healthcare workers of the AULSS 3 Serenissima and 47 citizens from the general population in Venice (Italy) during the health emergency period (from April to June 2020). In the second administration (from August to September 2020), data were collected from 101 of the 250 healthcare workers who had participated in the first administration. To test for the convergent validity, the Depression Anxiety Stress Scale (DASS-21) was also administered. Results Exploratory and hierarchical confirmatory factor analyses validated the 21-item structure of the questionnaire. Internal consistency, and factorial and convergent validity were good. Moreover, the HEDQ discriminated between those who worked in COVID-19 hospital units and those who did not (including the general population), showing good known-group validity. The two-month temporal stability of the questionnaire was excellent. The HEDQ scale scores significantly decreased from the first to the second administration, thus supporting that the tool is a measure of acute stress in healthcare workers. Conclusions Our results provide support for the use of the HEDQ as a brief, multidimensional measure of emergency-related stress reactions in healthcare workers. Consequently, the HEDQ can be considered a useful instrument supporting clinical activity to identify those who may be more easily affected by stress reactions in the event of atypically high levels of risk exposure during crises.
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Affiliation(s)
- Sara Lucidi
- Clinical and Health Psychology Unit, Azienda ULSS3 Serenissima, Venice, Italy; sara. (S.L.); (F.M.); rita.lorio@ aulss3.veneto.it (R.L.)
| | - Sara Iannattone
- Department of General Psychology, University of Padova, Via Venezia, 8, 35131, Padova (PD), Italy; (S.I.); (A.S.)
| | - Fabio Mallardo
- Clinical and Health Psychology Unit, Azienda ULSS3 Serenissima, Venice, Italy; sara. (S.L.); (F.M.); rita.lorio@ aulss3.veneto.it (R.L.)
| | - Andrea Spoto
- Department of General Psychology, University of Padova, Via Venezia, 8, 35131, Padova (PD), Italy; (S.I.); (A.S.)
| | - Rita Lorio
- Clinical and Health Psychology Unit, Azienda ULSS3 Serenissima, Venice, Italy; sara. (S.L.); (F.M.); rita.lorio@ aulss3.veneto.it (R.L.)
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Melnychuk E, Sallade TD, Kraus CK. Hospitals as disaster victims: Lessons not learned? J Am Coll Emerg Physicians Open 2022; 3:e12632. [PMID: 35036993 PMCID: PMC8749465 DOI: 10.1002/emp2.12632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 11/07/2021] [Accepted: 11/17/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Hospitals are a key component to disaster response but are susceptible to the effects of disasters as well, including infrastructure damage that disrupts patient care. These events offer an opportunity for evaluation and improvement of preparedness and response efforts when hospitals are affected directly by a disaster. The objective of this structured review was to evaluate the existing literature on hospitals as disaster victims. METHODS A structured and scoping review of peer-reviewed literature, gray literature, and news reports related to hospitals as disaster victims was completed to identify and analyze themes and lessons observed from disasters in which hospitals are victims, to aid in future emergency operations planning and disaster response. RESULTS The literature search and secondary search of referenes identified 366 records in English. A variety of common barriers to successful disaster response include loss of power, water, heating and ventilation, communications, health information technology, staffing, supplies, safety and security, and structural and non-structural damage. CONCLUSIONS There are common weaknesses in disaster preparedness that we can learn from and account for in future planning with the aim of improving resilience in the face of future disasters.
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Affiliation(s)
- Eric Melnychuk
- Department of Emergency MedicineGeisinger Medical CenterDanvillePAUSA
- Department of Critical Care MedicineGeisinger Medical CenterDanvillePAUSA
| | - Thomas D. Sallade
- Department of Emergency MedicineGeisinger Medical CenterDanvillePAUSA
| | - Chadd K. Kraus
- Department of Emergency MedicineGeisinger Medical CenterDanvillePAUSA
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Risk Factors for Severity and Mortality in Adult Patients Confirmed with COVID-19 in Sierra Leone: A Retrospective Study. INFECTIOUS DISEASES & IMMUNITY 2022. [PMID: 37521952 PMCID: PMC9112504 DOI: 10.1097/id9.0000000000000037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background: The coronavirus disease 2019 (COVID-19) is a highly infectious respiratory disease. There is no recommended antiviral treatment approved for COVID-19 in Sierra Leone, and supportive care and protection of vital organ function are performed for the patients. This study summarized the clinical characteristics, drug treatments, and risk factors for the severity and prognosis of COVID-19 in Sierra Leone to provide evidence for the treatment of COVID-19. Methods: Data of 180 adult COVID-19 patients from the 34th Military Hospital in Freetown Sierra Leone between March 31, 2020 and August 11, 2020 were retrospectively collected. Patients with severe and critically ill are classified in the severe group, while patients that presented asymptomatic, mild, and moderate disease were grouped in the non-severe group. The clinical and laboratory information was retrospectively collected to assess the risk factors and treatment strategies for severe COVID-19. Demographic information, travel history, clinical symptoms and signs, laboratory detection results, chest examination findings, therapeutics, and clinical outcomes were collected from each case file. Multivariate logistic analysis was adopted to identify the risk factors for deaths. Additionally, the clinical efficacy of dexamethasone treatment was investigated. Results: Seventy-six (42.22%) cases were confirmed with severe COVID-19, while 104 patients (57.78%) were divided into the non-severe group. Fever (56.67%, 102/180) and cough (50.00%, 90/180) were the common symptoms of COVID-19. The death rate was 18.89% (34/180), and severe pneumonia (44.12%, 15/34) and septic shock (23.53%, 8/34) represented the leading reasons for deaths. The older age population, a combination of hypertension and diabetes, the presence of pneumonia, and high levels of inflammatory markers were significantly associated with severity of COVID-19 development (P < 0.05 for all). Altered level of consciousness [odds ratio (OR) = 56.574, 95% confidence interval (CI) 5.645–566.940, P = 0.001], high levels of neutrophils (OR = 1.341, 95%CI 1.109–1.621, P = 0.002) and C-reactive protein (CRP) (OR = 1.014, 95%CI 1.003–1.025, P = 0.016) might be indicators for COVID-19 deaths. Dexamethasone treatment could reduce mortality [30.36% (17/56) vs. 50.00% (10/20)] among severe COVID-19 cases, but the results were not statistically significant (P > 0.05). Conclusions: The development and prognosis of COVID-19 may be significantly correlated with consciousness status, and the levels of neutrophils and CRP.
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Satapathy S. Mental Risk Faced During Lockdown in COVID-19. JOURNAL OF INFORMATION TECHNOLOGY RESEARCH 2022. [DOI: 10.4018/jitr.299377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Indian Govt has taken broad step and declared lock down to reduce the community-transmission of the novel “Coronavirus”.Many people tried to utilize this period by doing online work and household work simulateneouly. Many small scale industries,shops ,agencies,school colleges shut their door following Govt rules and regulations to avoid spreading of virus.People working or engaged in these activities or duties became unemployed .As man is a social animal and feels safe and secured in society due to increase in distance from society from office space and due to financial crises , day by day negative thought impacts their mind and they are mental in stability or pressure . In this study, an attempt was made to prioritize the cause of mental pressure faced by common people. Such that precautionary measures can be taken for the public-health such that appropriate steps can be taken to protect their health from the transmission of this virus. By using the “Grey-technique for order of preference by similarity to ideal solution (Grey-TOPSIS)”method .
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Ranzani Rigotti A, Mara Zamarioli C, do Prado PR, Helena Pereira F, Gimenes FRE. Resiliência de Sistemas de Assistência à Saúde no enfrentamento da COVID-19: relato de experiência. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2021-0210pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: relatar a experiência profissional de um enfermeiro gestor frente aos desafios da reestruturação de um serviço hospitalar diante da pandemia da COVID-19. Método: relato de experiência, baseado na perspectiva da resiliência do sistema em um hospital público. Resultados: os desafios enfrentados foram: reorganização do fluxo de serviço interno para atender os casos suspeitos de COVID-19; instituição de mudanças e adaptações estruturais, desde a entrada na urgência e emergência, até nas enfermarias e unidade de terapia intensiva; aquisição de equipamentos e insumos para o atendimento dos pacientes com foco na qualidade e funcionalidade destes; treinamento das equipes, com a reestruturação dos processos de trabalho; dimensionamento de pessoal, considerando o tempo de exposição ao vírus; qualificação profissional, absenteísmo, estresse, adoecimento físico e psicológico da equipe, com vistas à uma assistência segura e de qualidade; liderança da equipe de Enfermagem para lidar com os conflitos gerados pelo estresse e adoecimento dos profissionais. Conclusão: a resiliência do serviço de saúde é fundamental para a reestruturação hospitalar na pandemia da COVID-19, no entanto, devem-se considerar o cuidado dos pacientes e a saúde física e mental dos profissionais de saúde.
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Ranzani Rigotti A, Mara Zamarioli C, do Prado PR, Helena Pereira F, Gimenes FRE. Resilience of Healthcare Systems in the face of COVID-19: an experience report. Rev Esc Enferm USP 2022; 56:e20210210. [PMID: 35635792 PMCID: PMC10081586 DOI: 10.1590/1980-220x-reeusp-2021-0210en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 03/24/2022] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to report the professional experience of a nurse manager facing the challenges of restructuring a hospital service in the face of the COVID-19 pandemic. Method: this is an experience report, based on the perspective of system resilience in a public hospital. Results: the challenges faced were: internal service flow reorganization to assist suspected cases of COVID-19; institution of structural changes and adaptations, from entry into the emergency room to the wards and intensive care unit; equipment and supply acquisition for patient care with a focus on their quality and functionality; staff training, with the restructuring of work processes; staff sizing, considering the time of exposure to the virus; staff’s professional qualification, absenteeism, stress, physical and psychological illness, with a view to safe and quality care; nursing staff leadership to deal with conflicts generated by professionals’ stress and illness. Conclusion: healthcare service resilience is critical for hospital restructuring in the COVID-19 pandemic; however, patient care and healthcare professionals’ physical and mental health must be considered.
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Suresh P, Gupta S, Anmol, Sharma U. Insight into coronaviruses and natural products-based approach for COVID-19 treatment. BIOACTIVE NATURAL PRODUCTS 2022. [PMCID: PMC9294970 DOI: 10.1016/b978-0-323-91099-6.00005-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
There is a deep-rooted belief in mankind that for every illness, somewhere in the world, there exists a botanical-based healing agent in nature in the form of a natural product. Natural products are better equipped to become successful drugs because of their million years of coevolution in a biological milieu. Generally, most herbal formulations and natural products obtained from traditionally used medicinal plants are nontoxic and have rarely shown any adverse side effects on humans. Plants synthesize secondary metabolites primarily for their defense against microbes and herbivores, and because of this, these metabolites have good specificity and potency against harmful pathogens. Nowadays, mankind is facing the contagion effect of SARS-CoV-2 that has caused the ongoing pandemic of COVID-19, which has no specific and effective treatment. Hence this is the time to explore nature for effective, safe, and affordable remedies against this disease. This chapter includes an overview of coronaviruses, their therapeutic targets, and the progress made in identifying lead natural products against the coronaviruses. Additionally, molecular docking and pharmacokinetics analysis of anticoronaviral natural products have been performed to narrow down the possible lead molecules.
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Andersen EM, Kelly TL, Sharp A, Keller-Ross ML, Brunsvold ME. Active Rehabilitation in a Patient During and After Venovenous Extracorporeal Membrane Oxygenation With a Diagnosis of COVID-19: A Case Report. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2022; 13:8-15. [PMID: 34925957 PMCID: PMC8670079 DOI: 10.1097/jat.0000000000000164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 01/21/2021] [Indexed: 01/16/2023]
Abstract
PURPOSE The coronavirus disease-2019 (COVID-19) pandemic has resulted in an influx of critically ill patients requiring mechanical ventilation, some receiving venovenous (VV) extracorporeal membrane oxygenation (ECMO). The benefits of early mobility while undergoing ECMO have been previously documented. However, the COVID-19 pandemic has presented physical therapists with novel challenges, balancing the risk of a widespread shortage of personal protective equipment (PPE) with the benefits of early mobility for patients on ECMO. The purpose of this case study is to report the successful rehabilitation of a critically ill patient with COVID-19 undergoing VV ECMO. METHODS This is a case description of a 38-year-old man who presented to the hospital with COVID-19 and subsequent intubation and cannulation for VV ECMO. Physical therapy was initiated while the patient remained critically ill on VV ECMO. Focused coordination and education were employed to limit PPE usage by limiting the number of essential staff/therapists that entered the room as well as changing the frequency of therapy sessions dependent on how the patient was progressing functionally. RESULTS On VV ECMO day 11, he was able to sit up and perform a sit-to-stand. ECMO decannulation occurred on hospital day 14 with extubation on hospital day 18. The patient progressed functionally while quarantined in the room until he was discharged home with supplemental oxygen after spending 29 days in the hospital. CONCLUSION This case study demonstrates the clinical decision-making used to provide physical therapy services for a critically ill patient with COVID-19. High-level team coordination resulted in limiting the use of PPE as well as reducing staff exposure frequency during rehabilitation. Despite his severe critical illness, the patient was successfully discharged home within 30 days.
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Affiliation(s)
- Eric M Andersen
- M Health Fairview, Minneapolis, MN 55455 (USA).
- M Health Fairview, Minneapolis, Minnesota
- Department of Rehabilitation Medicine, Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis
- Department of Rehabilitation Medicine, Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis
- Department of Surgery, Division of Acute Care Surgery, Medical School, University of Minnesota, Minneapolis
| | - Tara L Kelly
- M Health Fairview, Minneapolis, MN 55455 (USA).
- M Health Fairview, Minneapolis, Minnesota
- Department of Rehabilitation Medicine, Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis
- Department of Rehabilitation Medicine, Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis
- Department of Surgery, Division of Acute Care Surgery, Medical School, University of Minnesota, Minneapolis
| | - Amanda Sharp
- M Health Fairview, Minneapolis, MN 55455 (USA).
- M Health Fairview, Minneapolis, Minnesota
- Department of Rehabilitation Medicine, Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis
- Department of Rehabilitation Medicine, Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis
- Department of Surgery, Division of Acute Care Surgery, Medical School, University of Minnesota, Minneapolis
| | - Manda L Keller-Ross
- M Health Fairview, Minneapolis, MN 55455 (USA).
- M Health Fairview, Minneapolis, Minnesota
- Department of Rehabilitation Medicine, Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis
- Department of Rehabilitation Medicine, Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis
- Department of Surgery, Division of Acute Care Surgery, Medical School, University of Minnesota, Minneapolis
| | - Melissa E Brunsvold
- M Health Fairview, Minneapolis, MN 55455 (USA).
- M Health Fairview, Minneapolis, Minnesota
- Department of Rehabilitation Medicine, Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis
- Department of Rehabilitation Medicine, Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis
- Department of Surgery, Division of Acute Care Surgery, Medical School, University of Minnesota, Minneapolis
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Bellgardt M, Özcelik D, Breuer-Kaiser AFC, Steinfort C, Breuer TGK, Weber TP, Herzog-Niescery J. Extracorporeal membrane oxygenation and inhaled sedation in coronavirus disease 2019-related acute respiratory distress syndrome. World J Crit Care Med 2021; 10:323-333. [PMID: 34888158 PMCID: PMC8613718 DOI: 10.5492/wjccm.v10.i6.323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/24/2021] [Accepted: 08/23/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) related acute respiratory distress syndrome (ARDS) is a severe complication of infection with severe acute respiratory syndrome coronavirus 2, and the primary cause of death in the current pandemic. Critically ill patients often undergo extracorporeal membrane oxygenation (ECMO) therapy as the last resort over an extended period. ECMO therapy requires sedation of the patient, which is usually achieved by intravenous administration of sedatives. The shortage of intravenous sedative drugs due to the ongoing pandemic, and attempts to improve treatment outcome for COVID-19 patients, drove the application of inhaled sedation as a promising alternative for sedation during ECMO therapy. Administration of volatile anesthetics requires an appropriate delivery. Commercially available ones are the anesthetic gas reflection systems AnaConDa® and MIRUSTM, and each should be combined with a gas scavenging system. In this review, we describe respiratory management in COVID-19 patients and the procedures for inhaled sedation during ECMO therapy of COVID-19 related ARDS. We focus particularly on the technical details of administration of volatile anesthetics. Furthermore, we describe the advantages of inhaled sedation and volatile anesthetics, and we discuss the limitations as well as the requirements for safe application in the clinical setting.
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Affiliation(s)
- Martin Bellgardt
- Anesthesia and Intensive Care Medicine, St. Josef-Hospital, University Hospital of Ruhr-University of Bochum, Bochum 44791, Germany
| | - Dennis Özcelik
- Chemistry | Biology | Pharmacy Information Center, ETH Zürich, Zürich 8093, Switzerland
| | | | - Claudia Steinfort
- General and Visceral Surgery, St. Josef-Hospital, University Hospital of Ruhr-University of Bochum, Bochum 44791, Germany
| | - Thomas Georg Karl Breuer
- Internal Medicine/Intensive Care, St. Josef-Hospital, University Hospital of Ruhr-University of Bochum, Bochum 44791, Germany
| | - Thomas Peter Weber
- Anesthesia and Intensive Care Medicine, St. Josef-Hospital, University Hospital of Ruhr-University of Bochum, Bochum 44791, Germany
| | - Jennifer Herzog-Niescery
- Anesthesia and Intensive Care Medicine, St. Josef-Hospital, University Hospital of Ruhr-University of Bochum, Bochum 44791, Germany
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19
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Silva-Junior JS, da Cunha AA, Lourenção DCDA, da Silva SM, da Silva RFA, Faria MGDA, Mininel VA, Almeida MCDS, Baptista PCP, Gallasch CH. Occupational psychosocial stressors and mental distress among healthcare workers during COVID-19 pandemic. EINSTEIN-SAO PAULO 2021; 19:eAO6281. [PMID: 34755826 PMCID: PMC8555877 DOI: 10.31744/einstein_journal/2021ao6281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/14/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To analyze the factors associated with mental distress among health workers who cared for patients with a suspected or confirmed diagnosis of coronavirus disease 2019 (COVID-19). METHODS A cross-sectional analytical study of national scope, carried out between in the second quarter of 2020. A total of 437 health professionals, who filled out an electronic form about sociodemographic data, occupational aspects, psychosocial characteristics of work and mental distress. Multiple logistic regression was performed to analyze the covariables associated with mental distress. RESULTS There was a predominance of workers on the nursing team (65.0%), female (71.0%), from Southeastern region of the country (68.6%) and with no morbidities (36.2%). The prevalence of mental distress was 61.6%. Job strain was reported by 24% of participants, and the perception of low support from coworkers was described by 52.9%. The final multiple regression model showed that mental distress was associated with females (odds ratio - OR: 1.93; 95%CI: 1.22-3.07), age up to 40 years (OR: 1.64; 95%CI: 1.07-2.52), weekly working hours equal or over 60 hours (OR: 1.87; 95%CI: 1.15-3.11), job strain (OR: 2.45; 95%CI: 1.41-4.40) and low support from co-workers (OR: 3.47; 95%CI: 2.26-5.38). CONCLUSION Six out of ten participants presented mental distress, which was associated to both individual characteristics and factors related to the work carried out during the pandemic. There is an urgent need to map services that have such characteristics, to outline actions to promote mental health and prevent emotional distress at different levels of health care.
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Affiliation(s)
| | - Arthur Arantes da Cunha
- Universidade Federal do AmapáMacapáAPBrazilUniversidade Federal do Amapá, Macapá, AP, Brazil.
| | | | - Silmar Maria da Silva
- Universidade Federal de Minas GeraisBelo HorizonteMGBrazilUniversidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Renata Flavia Abreu da Silva
- Universidade Federal do Estado do Rio de JaneiroRio de JaneiroRJBrazilUniversidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Magda Guimarães de Araujo Faria
- Universidade do Estado do Rio de JaneiroRio de JaneiroRJBrazilUniversidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Vivian Aline Mininel
- Universidade Federal de São CarlosSão CarlosSPBrazilUniversidade Federal de São Carlos, São Carlos, SP, Brazil.
| | | | | | - Cristiane Helena Gallasch
- Universidade do Estado do Rio de JaneiroRio de JaneiroRJBrazilUniversidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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Holthof N, Luedi MM. Considerations for acute care staffing during a pandemic. Best Pract Res Clin Anaesthesiol 2021; 35:389-404. [PMID: 34511227 PMCID: PMC7726522 DOI: 10.1016/j.bpa.2020.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 12/15/2022]
Abstract
The increase in interconnectedness of the global population has enabled a highly transmissible virus to spread rapidly around the globe in 2020. The COVID-19 (Coronavirus Disease 2019) pandemic has led to physical, social, and economic repercussions of previously unseen proportions. Although recommendations for pandemic preparedness have been published in response to previous viral disease outbreaks, these guidelines are primarily based on expert opinion and few of them focus on acute care staffing issues. In this review, we discuss how working in acute care medicine during a pandemic can affect the physical and mental health of medical and nursing staff. We provide ideas for limiting staff shortages and creating surge capacity in acute care settings, and strategies for sustainability that can help hospitals maintain adequate staffing throughout their pandemic response.
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Affiliation(s)
- Niels Holthof
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Markus M Luedi
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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21
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Rocha RPDS, Oliveira JLCD, Carvalho ARDS, Matos BABE, Mufato LF, Ribeiro AC, Silva GKTD. Características de profissionais de saúde acometidos por Covid-19: revisão integrativa da literatura. SAÚDE EM DEBATE 2021. [DOI: 10.1590/0103-1104202113023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
RESUMO O objetivo do estudo consistiu em identificar as características de profissionais de saúde acometidos por Covid-19. Trata-se de uma revisão integrativa da literatura guiada por seis etapas e que pesquisou cinco fontes de dados. Após o estabelecimento do fluxo de seleção do material levantado (N=5.522), determinou-se a amostra de artigos analisada (n=30). Desta, foram sintetizadas informações a respeito das características dos trabalhadores e relativas ao acometimento por Covid-19. Entre os estudos selecionados, foram compilados dados de 10.760 trabalhadores de saúde, predominantemente da equipe de enfermagem (27,3%) e médicos (13,2%). A maior parte (n=20; 66,6%) dos estudos atestou que os profissionais de saúde foram contaminados no ambiente de trabalho, principalmente hospitalar. A testagem por RT-PCR foi o principal método diagnóstico. Alguns estudos (n=16; 53,3%) relataram comorbidades prévias entre os trabalhadores. Os principais sintomas da Covid-19 nos profissionais de saúde acometidos foram: febre, tosse, fadiga e mialgia. Constataram-se características que remontam em perfil concentrado de enfermeiras e médicos contaminados no hospital. Essa realidade foi focalizada entre pesquisas transversais chinesas, italianas e estadunidenses.
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22
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Al Majali SA, Alghazo EM. Mental health of individuals who are deaf during COVID-19: Depression, anxiety, aggression, and fear. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:2134-2143. [PMID: 33635582 PMCID: PMC8013852 DOI: 10.1002/jcop.22539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 06/04/2023]
Abstract
This study aims to assess depression and anxiety levels among individuals, who are deaf during the lockdown throughout the first wave of the pandemic United Arab Emirates. The sample of the study consisted of 36 (n = 36) individuals aged 20.3 ± 1.2 years, who were deaf from birth. The respondents were divided into two groups; (1) those who were living with their parents (n = 20), (2) those who were independently living on their own (n = 16). Results of the study indicated that from May to October, there was decrease in the number of normal mental health cases among those living with parents (p ≤ 0.05). The results of the study show that in the time of the pandemic, deaf people constitute a vulnerable portion of the population. The correlation between living alone and stress levels was 0.78. The correlation between living with parents and stress levels was -0.85.
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Chen Q, Gao Y, Wang CS, Kang K, Yu H, Zhao MY, Yu KJ. Exploration of transmission chain and prevention of the recurrence of coronavirus disease 2019 in Heilongjiang Province due to in-hospital transmission. World J Clin Cases 2021; 9:5420-5426. [PMID: 34307595 PMCID: PMC8281417 DOI: 10.12998/wjcc.v9.i20.5420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/25/2021] [Accepted: 05/26/2021] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) epidemic is a major public health emergency characterized by fast spread, a wide range of infections, and enormous control difficulty. Since the end of December 2019, Wuhan has become the first core infection area of China's COVID-19 outbreak. Since March 2020, the domestic worst-hit areas have moved to the Heilongjiang Province due to the increased number of imported COVID-19 cases. Herein, we reported the major COVID-19 outbreak, which caused a rebound of the epidemic in Harbin, China. After the rebound, different levels of causes for the recurrence of COVID-19, including city-level, hospital-level, and medical staff-level cause, were investigated. Meanwhile, corresponding countermeasures to prevent the recurrence of the epidemic were also carried out on the city level, hospital level, and medical staff level, which eventually showed the effect of infection control function in a pandemic. In this study, we described the complete transmission chain, analyzed the causes of the outbreak, and proposed corresponding countermeasures from our practical clinical experience, which can be used as a valuable reference for COVID-19 control.
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Affiliation(s)
- Qi Chen
- Department of Critical Care Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang Province, China
| | - Yang Gao
- Department of Critical Care Medicine, The sixth Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin 150028, Heilongjiang Province, China
| | - Chang-Song Wang
- Department of Critical Care Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang Province, China
| | - Kai Kang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Hong Yu
- Department of Critical Care Medicine, The Second Hospital of Harbin, Harbin 150056, Heilongjiang Province, China
| | - Ming-Yan Zhao
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Kai-Jiang Yu
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin 150001, Heilongjiang Province, China
- Institute of Critical Care Medicine, The Sino Russian Medical Research Center of Harbin Medical University, Harbin 150081, Heilongjiang Province, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, Harbin 150001, Heilongjiang Province, China
- The Cell Transplantation Key Laboratory of National Health Commission, Harbin 150001, Heilongjiang Province, China
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Lerthattasilp T, Kosulwit L, Phanasathit M, Nuallaong W, Tapanadechopone P, Thanetnit C, Charernboon T. Effect of an online psychological support group on patients with COVID-19 in a Thai field hospital: a real world study. JOURNAL OF HEALTH RESEARCH 2021. [DOI: 10.1108/jhr-01-2021-0044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
The purpose of this study is to evaluate the effectiveness of an online psychological support group on patients with coronavirus disease 2019 (COVID-19) in a Thai field hospital.
Design/methodology/approach
A prospective controlled trial was conducted at a Thai field hospital and included patients with confirmed COVID-19 who were over the age of 18 and able to use an online communication application. Patients were free to decide whether to participate in the online group. The group provided a space for participants to communicate with each other and a mental health service team. The everyday activities were designed to enable group support via texting or livestreaming through the LINE application. Psychoeducation via video clips or articles regarding stress management were provided. Outcomes were measured by an online self-reported questionnaire based on the twenty-one-item Depression, Anxiety and Stress Scale (DASS-21) on the first and fourteenth day of admission to the field hospital.
Findings
Forty-six patients participated in this study. Forty participants completed the secondary assessment, with 21 in the intervention group and 19 in the control group. From multilevel mixed-effects regression analysis, adjusted for gender, age and education, participation in the intervention group significantly decreased total DASS scores and anxiety subdomain scores compared to those in the control group (p = 0.038 and 0.008).
Originality/value
The online psychological support group offered benefits for patients with COVID-19 who were isolated in the field hospital. It could be an effective alternative measure to distribute psychological care during a pandemic situation. However, a small sample size was a limitation of this study.
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Rao H, Mancini D, Tong A, Khan H, Santacruz Gutierrez B, Mundo W, Collings A, Cervantes L. Frontline interdisciplinary clinician perspectives on caring for patients with COVID-19: a qualitative study. BMJ Open 2021; 11:e048712. [PMID: 33947739 PMCID: PMC8098296 DOI: 10.1136/bmjopen-2021-048712] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To describe the drivers of distress and motivations faced by interdisciplinary clinicians who were on the frontline caring for patients with COVID-19. DESIGN 50 semistructured interviews. Transcripts were analysed using qualitative thematic analysis. SETTING A safety-net hospital in Denver, Colorado. PARTICIPANTS Interdisciplinary frontline clinicians including physicians, advance practice providers, nurses, respiratory therapists and paramedics providing inpatient hospital care to patients hospitalised for COVID-19. RESULTS Fifty clinicians (32 women and 18 men) participated. Five themes with respective subthemes (in parentheses) were identified: depersonalisation and barriers to care (impeding rapport and compassion, focusing on infection risk at the expense of high-quality care, grief from witnessing patients suffer in isolation), powerless in uncertainty (inescapable awareness of personal risk, therapeutic doubt in a void of evidence, confronting ethical dilemmas, struggling with dynamic and unfamiliar challenges), overwhelmed and exhausted (burden of personal protective equipment (PPE), information overload and confusion, overstretched by additional responsibilities at work, compounded by personal life stressors, feeling vulnerable and dispensable, compassion fatigue, distress from the disproportionate impact on socially oppressed communities), bolstering morale and confidence (motivated by community and family support, equipped with data), and driven by moral duty (responsibility to patient care and community, collegial solidarity and collaboration, contributing to the greater good). CONCLUSION Frontline clinicians reported distress due to the challenges of PPE, uncertainty and powerlessness, new responsibilities at work and home, losing control of their schedules, grief from witnessing patients suffer in isolation and witnessing healthcare disparities exacerbated by this pandemic. Clinicians feel supported by their colleagues, families, and community and were driven by a sense of moral duty. Healthcare system should adopt strategies to minimise distress faced by interdisciplinary clinicians on the frontline of COVID-19.
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Affiliation(s)
- Hassan Rao
- Division of Hospital Medicine, Denver Health, Denver, Colorado, USA
| | - Diana Mancini
- Division of Hospital Medicine, Denver Health, Denver, Colorado, USA
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Humaira Khan
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - William Mundo
- University of Colorado, Anschutz Medical Campus, Denver, Colorado, USA
| | | | - Lilia Cervantes
- Division of Hospital Medicine, Denver Health, Denver, Colorado, USA
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Golamari R, Kapoor N, Devaraj T, Sahu N, Kramer C, Jain R. Experimental therapies under investigation for COVID-19. J Community Hosp Intern Med Perspect 2021; 11:187-193. [PMID: 33889318 PMCID: PMC8043541 DOI: 10.1080/20009666.2021.1874093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/06/2021] [Indexed: 12/18/2022] Open
Abstract
Coronavirus Disease 2019, caused by the virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), is a pandemic first discovered in Wuhan, China which has claimed over 1.7 million lives to date across the globe as of 24 December 2020. As the virus spreads across the world affecting millions of patients, there has been a massive movement to discover readily available and effective treatment options including vaccines. One of the limiting factors in treating the disease is its varied presentation and effect in patients, ranging from asymptomatic patients to those left in intensive care units, intubated and fighting for their lives. There are numerous clinical trials and small-scale studies underway to investigate potential treatment options. However, very few studies and drugs demonstrated efficacy while many more are under investigation, leaving care teams dependent on supportive care coupled with experimental treatment options. In this review, we summarize the various treatment options explored to treat COVID-19, discussing possible the mechanisms of fighting the virus.
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Affiliation(s)
- Reshma Golamari
- Assistant Professor of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Neeru Kapoor
- Microbiologist, Maulana Azad Medical College, New Delhi, India
| | - Tanuja Devaraj
- Assistant Professor of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Nitasa Sahu
- Assistant Professor of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | | | - Rohit Jain
- Assistant Professor of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
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Ng TSB, Leblanc K, Yeung DF, Tsang TSM. Medication use during COVID-19: Review of recent evidence. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2021; 67:171-179. [PMID: 33727376 PMCID: PMC7963004 DOI: 10.46747/cfp.6703171] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To keep health care providers, in response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, informed about the medications that have been proposed to treat the disease and the evidence supporting their use. QUALITY OF EVIDENCE A narrative review of medications most widely used to treat COVID-19 was conducted, outlining the best available evidence for each pharmacologic treatment to date. Searches were performed in PubMed, EMBASE, and MEDLINE using key words COVID-19 and treatment, as well as related terms. Relevant research studies conducted in human populations and cases specific to patients with COVID-19 were included, as were relevant hand-searched papers and reviews. Only articles in English and Chinese were included. MAIN MESSAGE While current management of patients with COVID-19 largely involves supportive care, without a widely available vaccine, practitioners have also resorted to repurposing medications used for other indications. This has caused considerable controversy, as many of these treatments have limited clinical evidence supporting their use and therefore pose implications for patient safety, drug access, and public health. For instance, medications such as hydroxychloroquine and chloroquine, lopinavir-ritonavir, nonsteroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers gained widespread media attention owing to hype, misinformation, or misinterpretation of research evidence. CONCLUSION Given the severity of the pandemic and the potential broad effects of implementing safe and effective treatment, this article provides a narrative review of the current evidence behind the most widely used medications to treat COVID-19 in order to enable health care practitioners to make informed decisions in the care of patients with this life-threatening disease.
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Affiliation(s)
- T S Brandon Ng
- Medical student in the Faculty of Medicine at the University of British Columbia in Vancouver
| | - Kori Leblanc
- Assistant Professor in the Leslie Dan Faculty of Pharmacy at the University of Toronto in Ontario
| | - Darwin F Yeung
- Clinical Assistant Professor in the Faculty of Medicine at the University of British Columbia
| | - Teresa S M Tsang
- Director of Echocardiography at Vancouver General Hospital and the UBC Hospital, and Professor of Medicine in the Division of Cardiology and Associate Head of Research for the Department of Medicine at the University of British Columbia.
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Ng TSB, Leblanc K, Yeung DF, Tsang TSM. Médicaments utilisés durant la COVID-19. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2021; 67:e69-e78. [PMID: 33727386 PMCID: PMC7963008 DOI: 10.46747/cfp.6703e69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Objectif En réponse à la pandémie actuelle de maladie à coronavirus 2019 (COVID-19), garder les médecins au fait des médicaments qui ont été proposés pour combattre la maladie, et des données probantes à l’appui de leur utilisation. Sources d’information Une revue narrative des médicaments les plus fréquemment utilisés pour combattre la COVID-19 a été réalisée, afin de souligner les meilleures données probantes disponibles concernant chaque traitement pharmacologique jusqu’ici. Des recherches ont été effectuées sur PubMed, EMBASE et MEDLINE à l’aide des mots-clés anglais COVID-19 et treatment , ainsi que d’autres mots-clés connexes. Ont été inclus les études pertinentes menées auprès de populations humaines et des cas de patients atteints de la COVID-19, ainsi que les articles et revues relevés à la main. Seuls les articles rédigés en anglais et en chinois ont été retenus. Message principal Alors que la prise en charge actuelle des patients atteints de la COVID-19 consiste principalement en soins de soutien, sans accès aux vaccins, les praticiens se sont tournés vers des médicaments utilisés dans d’autres indications. Cela a causé une grande controverse, puisque des données cliniques limitées étayaient l’utilisation de beaucoup de ces traitements, et cela pouvait se répercuter sur la sécurité du patient, l’accès aux médicaments et la santé publique. Par exemple, les médicaments tels que l’hydroxychloroquine et la chloroquine, le lopinavir-ritonavir, les anti-inflammatoires non stéroïdiens, les inhibiteurs de l’enzyme de conversion de l’angiotensine et les antagonistes des récepteurs de l’angiotensine ont capté l’attention des médias en raison de la médiatisation, de la mésinformation ou de la mauvaise interprétation des données de recherche. Conclusion Vu la gravité de la pandémie et les vastes effets éventuels de l’adoption de traitements sûrs et efficaces, cet article se veut être une revue narrative des données probantes actuelles étayant les médicaments les plus utilisés pour le traitement de la COVID-19 afin de permettre aux professionnels de la santé de prendre des décisions éclairées en matière de soins pour les patients qui sont atteints de cette maladie potentiellement mortelle.
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Affiliation(s)
- T S Brandon Ng
- Étudiant en médecine à la faculté de médecine de l'Université de la Colombie-Britannique à Vancouver
| | - Kori Leblanc
- Professeure adjointe à la faculté de pharmacie Leslie Dan de l'Université de Toronto en Ontario
| | - Darwin F Yeung
- Professeur clinique adjoint à la faculté de médecine de l'Université de la Colombie-Britannique
| | - Teresa S M Tsang
- Directrice de l'échocardiographie à l'Hôpital Vancouver General Hospital et UBC Hospital, et elle est professeure de médecine à la division de cardiologie et directrice associée de recherche au département de médecine de l'Université de la Colombie-Britannique.
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Aminizadeh M, Saberinia A, Salahi S, Sarhadi M, Jangipour Afshar P, Sheikhbardsiri H. Quality of working life and organizational commitment of Iranian pre-hospital paramedic employees during the 2019 novel coronavirus outbreak. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2021. [DOI: 10.1080/20479700.2020.1836734] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Mohsen Aminizadeh
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Amin Saberinia
- Department of Emergency Medicine, Shahid-Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Salahi
- Department of Nursing, Yasooj Branch, Islamic Azad University, Yasooj, Iran
| | - Mahdeyeh Sarhadi
- Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Parya Jangipour Afshar
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hojjat Sheikhbardsiri
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Alhashash M, Elsebaiy W, Farag M, Shousha M. Emergency surgical management of cervical spine fracture-dislocation with acute paraplegia in COVID-19 (Coronavirus disease 2019)-suspected patient: first experience from a German spine centre. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:468-474. [PMID: 33095369 PMCID: PMC7581954 DOI: 10.1007/s00586-020-06625-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/15/2020] [Accepted: 10/03/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE We present an organized hospital plan for the management of Coronavirus disease (COVID-19) patients requiring emergency surgical interventions. To introduce a multidisciplinary approach for the management of COVID-19-infected patients and to report the first operated patient in the Corona unit. METHODS A detailed presentation of the hospital plan for a separate Corona unit with its intensive care unit and operating rooms. Description of the management of the first spine surgery case treated in this unit. RESULTS The Corona unit showed a practical approach for the management of an emergency cervical spine fracture-dislocation with acute paralysis. The patient is 92-year-old female. The mechanism of injury was a simple fall during the stay in the internal medicine department where the patient was treated in the referring hospital. The patient had no other injuries and was awake and oriented. The patient did not have the clinical symptom of COVID-19, and the test result of COVID-19 done in the referring hospital was not available on admission in our emergency room. Education of the medical staff and organization of the operating theatre facilitated the management of the patient without an increased risk of spreading the infection. CONCLUSIONS The current COVID-19 pandemic requires an extra-ordinary organization of the medical and surgical care of the patients. It is possible to manage an infected or a potentially infected patient surgically, but a multidisciplinary plan is necessary to protect other patients and the medical staff.
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Affiliation(s)
- Mohamed Alhashash
- Department of Spine Surgery, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437, Bad Berka, Germany.
- Department of Orthopedic Surgery, Alexandria University, Alexandria, Egypt.
| | - Walaa Elsebaiy
- Department of Anesthesia and Intensive Care, Alexandria University, Alexandria, Egypt
| | - Mohamed Farag
- Department of Spine Surgery, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437, Bad Berka, Germany
| | - Mootaz Shousha
- Department of Spine Surgery, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437, Bad Berka, Germany
- Department of Orthopedic Surgery, Alexandria University, Alexandria, Egypt
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Ubaldo OGV, Palo JEM, Cinco JEL. COVID-19: A Single-Center ICU Experience of the First Wave in the Philippines. Crit Care Res Pract 2021; 2021:7510306. [PMID: 33604085 PMCID: PMC7870312 DOI: 10.1155/2021/7510306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 01/18/2021] [Indexed: 12/20/2022] Open
Abstract
On January 30, 2020, the WHO declared the novel coronavirus of 2019 a pandemic, causing millions of cases and thousands of deaths worldwide, exposing the vulnerabilities of healthcare systems around the world with each country having its own experience. These ranged from patient clinical profiles to management recommendations and to government interventions. There is a paucity of published data regarding Philippine experience. This study is a retrospective, descriptive study of ninety-one COVID-19 probable patients admitted in the COVID ICU of The Medical City from March 16 to May 7, 2020. We described clinical and demographic characteristics amongst COVID-19-confirmed and -negative patients. Therapeutic interventions including COVID-19 investigational drug use and other organ failure strategies were noted and tested for association with ICU survivors and nonsurvivors. We observed that there was no therapeutic intervention that was associated with improved outcomes, with some interventions showing trends favoring the ICU nonsurvivor group. These interventions include, but are not limited to, the use of hydroxychloroquine and tocilizumab, and prone positioning. We also observed that a higher SAPS-3 score was associated with the COVID-19 positive group and the ICU nonsurvivor group. On PubMed search, there seems to be no Philippine-specific literature regarding COVID-19 ICU experience. Further investigations to include more variables are recommended.
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Affiliation(s)
- Onion Gerald V. Ubaldo
- Acute and Critical Care Institute, The Medical City–Ortigas, Pasig City 1605, Philippines
| | - Jose Emmanuel M. Palo
- Acute and Critical Care Institute, The Medical City–Ortigas, Pasig City 1605, Philippines
| | - Jude Erric L. Cinco
- Acute and Critical Care Institute, The Medical City–Ortigas, Pasig City 1605, Philippines
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Ni J, Wang F, Liu Y, Wu M, Jiang Y, Zhou Y, Sha D. Psychological Impact of the COVID-19 Pandemic on Chinese Health Care Workers: Cross-Sectional Survey Study. JMIR Ment Health 2021; 8:e23125. [PMID: 33341754 PMCID: PMC7819543 DOI: 10.2196/23125] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 11/09/2020] [Accepted: 12/14/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The outbreak of COVID-19 has dominated headlines worldwide. The number of infections has continued to rise and had reached 30,000 worldwide at the time this paper was written. Because of the high risk of nosocomial transmission, medical health care workers may be experiencing substantial psychological stress. This descriptive study aimed to identify psychosocial effects on hospital staff associated with working in a hospital environment during the COVID-19 outbreak. OBJECTIVE Our survey participants included 57 frontline clinicians working at Wuhan First Hospital and 157 medical students working at Jiangsu Provincial People's Hospital during the COVID-19 outbreak. The questionnaire we adopted included questions regarding the participants' personal well-being, sociodemographic characteristics, and psychological status. METHODS 57 frontline clinicians working in Wuhan First Hospital and 157 medical training students working in Jiangsu Provincial Peoples Hospital during this outbreak participated in our survey. The questionnaire we adopted included questions regarding the participants' personal well-being, sociodemographic characteristics and the psychological status. RESULTS The COVID-19 outbreak had psychological impacts both on formal workers and medical students. The psychological effects included sleep disorders, anxiety, and depression. There was no significant difference between the group of formal workers and medical students (P=.85), and more than 50% (30/54, 56%, vs. 83/157, 52.9%) of the respondents reported pandemic-related mental disorders. CONCLUSIONS Our study indicates that the high risk of SARS-CoV-2 exposure caused substantial psychological stress among health care workers. This finding emphasizes the need to promote psychological crisis intervention for medical personnel during this epidemic.
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Affiliation(s)
- Jie Ni
- General Medical Department, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Fang Wang
- Department of Emergency, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yihai Liu
- Department of Cardiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China
| | - Mingyue Wu
- Department of Cardiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China
| | - Yan Jiang
- Department of Education, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yujie Zhou
- Department of Education, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Dujuan Sha
- General Medical Department, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
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Promising phytochemicals of traditional Indian herbal steam inhalation therapy to combat COVID-19 - An in silico study. Food Chem Toxicol 2021; 148:111966. [PMID: 33412235 PMCID: PMC7780060 DOI: 10.1016/j.fct.2020.111966] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/09/2020] [Accepted: 12/27/2020] [Indexed: 12/12/2022]
Abstract
Background COVID-19, the presently prevailing global public health emergency has culminated in international instability in economy. This unprecedented pandemic outbreak pressingly necessitated the trans-disciplinary approach in developing novel/new anti-COVID-19 drugs especially, small molecule inhibitors targeting the seminal proteins of viral etiological agent, SARS-CoV-2. Methods Based on the traditional medicinal knowledge, we made an attempt through molecular docking analysis to explore the phytochemical constituents of three most commonly used Indian herbs in ‘steam inhalation therapy’ against well recognized viral receptor proteins. Results A total of 57 phytochemicals were scrutinized virtually against four structural protein targets of SARS-CoV-2 viz. 3CLpro, ACE-2, spike glycoprotein and RdRp. Providentially, two bioactives from each of the three plants i.e. apigenin-o-7-glucuronide and ellagic acid from Eucalyptus globulus; eudesmol and viridiflorene from Vitex negundo and; vasicolinone and anisotine from Justicia adhatoda were identified to be the best hit lead molecules based on interaction energies, conventional hydrogen bonding numbers and other non-covalent interactions. On comparison with the known SARS-CoV-2 protease inhibitor –lopinavir and RdRp inhibitor –remdesivir, apigenin-o-7-glucuronide was found to be a phenomenal inhibitor of both protease and polymerase, as it strongly interacts with their active sites and exhibited remarkably high binding affinity. Furthermore, in silico drug-likeness and ADMET prediction analyses clearly evidenced the usability of the identified bioactives to develop as drug against COVID-19. Conclusion Overall, the data of the present study exemplifies that the phytochemicals from selected traditional herbs having significance in steam inhalation therapy would be promising in combating COVID-19.
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Management of acute coronary syndrome in patients with suspected or confirmed coronavirus disease 2019: Consensus from Taiwan Society of Cardiology. J Formos Med Assoc 2021; 120:78-82. [PMID: 32682701 PMCID: PMC7357505 DOI: 10.1016/j.jfma.2020.07.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/27/2020] [Accepted: 07/10/2020] [Indexed: 12/28/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Infection with SARS-CoV may cause coronary plaque instability and lead to acute coronary syndrome (ACS). Management of ACS in patients with COVID-19 needs more consideration of the balance between clinical benefit and transmission risk of virus. This review provides recommendations of management strategies for ACS in patients with suspected or confirmed COVID-19 in Taiwan.
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Cecchini JA, Carriedo A, Fernández-Río J, Méndez-Giménez A, González C, Sánchez-Martínez B, Rodríguez-González P. A longitudinal study on depressive symptoms and physical activity during the Spanish lockdown. Int J Clin Health Psychol 2021; 21:100200. [PMID: 33363583 PMCID: PMC7753030 DOI: 10.1016/j.ijchp.2020.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/01/2020] [Indexed: 12/17/2022] Open
Abstract
Background/Objective: The aim was to evaluate the evolution of depressive symptoms and to explore the influence of physical activity (PA) practice during the home confinement due to the COVID-19 outbreak in Spain. Method: Information was collected from 595 confined participants who reported personal and contextual information, depressive symptoms and PA levels at four time points. Results: The changes in depressive symptoms were analyzed using a linear mixed model with cubic splines. Results showed a significant increase, with a significant rise between T1 and T2 (OR = 2.38, 95% CI = 1.83-3.10). It continued growing until T4 (OR = 2.93, 95% CI = 1.97-4.38). A negative relationship was observed between the increase in depressive symptoms and moderate-to-vigorous physical activity (MVPA) levels, with a significant slope up to 4 hours of MVPA per week (OR = 0.51, 95% CI = 0.29-0.90) that tended to increase until 16 hours per week of MVPA (OR = 0.41, 95% CI = 0.20-0.87). Conclusions: Results from a partition model showed that moderate intensity of PA could be enough to prevent an increase of depressive symptoms during home isolation.
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Affiliation(s)
- José Antonio Cecchini
- Facultad de Formación del Profesorado y Educación, Universidad de Oviedo, Spain, Spain
| | - Alejandro Carriedo
- Facultad de Formación del Profesorado y Educación, Universidad de Oviedo, Spain, Spain
| | - Javier Fernández-Río
- Facultad de Formación del Profesorado y Educación, Universidad de Oviedo, Spain, Spain
| | | | - Carmen González
- Facultad de Formación del Profesorado y Educación, Universidad de Oviedo, Spain, Spain
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Ha JF. COVID-19 in Children: A Narrative Review. Curr Pediatr Rev 2021; 17:212-219. [PMID: 34042036 DOI: 10.2174/1573396317666210526155313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/31/2020] [Accepted: 03/06/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic is caused by the third known zoonotic coronavirus. It is a disease that does not spare any age group. The scientific community has been inundated with information since January. This review aims to summarise pertinent information related to COVID-19 in children. METHODS A literature search was conducted in 2020 on the PubMed, MEDLINE, and Embase databases, with the keyword "COVID 19" and "children". A bibliographic search of articles included was also undertaken. The abstracts were scanned to assess their appropriateness to be included in this narrative review. This was updated on the 11th April, 2020. RESULTS The aetiology, transmission, incubation, pathophysiology, clinical features and complications, and management are discussed. CONCLUSION Our understanding of COVID-19 is evolving as more reports are published. The growth of SARS-CoV2 is limited in children and they are often asymptomatic. The disease course is also milder. Continued research to understand its effect on children is important to help us manage the disease in these vulnerable populations in a timely fashion.
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Affiliation(s)
- Jennifer F Ha
- Department of Paediatrics Otolaryngology-Head & Neck Surgery, Perth Children's Hospital, 15 Hospital Avenue, Nedlands 6009, Western Australia, Australia
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Yao RQ, Ren C, Ren D, Li JX, Li Y, Liu XY, Huang L, Liu Y, Peng M, Feng YW, Yao YM. Development of septic shock and prognostic assessment in critically ill patients with coronavirus disease outside Wuhan, China. World J Emerg Med 2021; 12:293-298. [PMID: 34512826 PMCID: PMC8390351 DOI: 10.5847/wjem.j.1920-8642.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 04/16/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The study aims to illustrate the clinical characteristics and development of septic shock in intensive care unit (ICU) patients confirmed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and to perform a comprehensive analysis of the association between septic shock and clinical outcomes in critically ill patients with coronavirus disease (COVID-19). METHODS Patients confirmed with SARS-CoV-2 infection, who were admitted to the ICU of the Third People's Hospital of Shenzhen from January 1 to February 7, 2020, were enrolled. Clinical characteristics and outcomes were compared between patients with and without septic shock. RESULTS In this study, 35 critically ill patients with COVID-19 were included. Among them, the median age was 64 years (interquartile range [IQR] 59-67 years), and 10 (28.4%) patients were female. The median ICU length of stay was 16 days (IQR 8-23 days). Three (8.6%) patients died during hospitalization. Nine (25.7%) patients developed septic shock in the ICU, and these patients had a significantly higher incidence of organ dysfunction and a worse prognosis than patients without septic shock. CONCLUSIONS Septic shock is associated with a poor outcome in critically ill COVID-19 patients and is one of the hallmarks of the severity of patients receiving ICU care. A dysregulated immune response, uncontrolled inflammation, and coagulation disorders are strongly associated with the development and progression of COVID-19-related septic shock.
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Affiliation(s)
- Ren-qi Yao
- Department of Critical Care Medicine, the Second People’s Hospital of Shenzhen, Shenzhen 518035, China
- Trauma Research Center, the Fourth Medical Center and Medical Innovation Research Department of the Chinese PLA General Hospital, Beijing 100048, China
| | - Chao Ren
- Department of Critical Care Medicine, the Second People’s Hospital of Shenzhen, Shenzhen 518035, China
- Trauma Research Center, the Fourth Medical Center and Medical Innovation Research Department of the Chinese PLA General Hospital, Beijing 100048, China
| | - Di Ren
- Department of Critical Care Medicine, the Second People’s Hospital of Shenzhen, Shenzhen 518035, China
- Department of Critical Care Medicine, the Third People’s Hospital of Shenzhen, Shenzhen 518020, China
| | - Jin-xiu Li
- Department of Critical Care Medicine, the Third People’s Hospital of Shenzhen, Shenzhen 518020, China
| | - Ying Li
- Department of Critical Care Medicine, the Second People’s Hospital of Shenzhen, Shenzhen 518035, China
| | - Xue-yan Liu
- Department of Critical Care Medicine, the People’s Hospital of Shenzhen, Shenzhen 518020, China
| | - Lei Huang
- Department of Critical Care Medicine, Peking University Shenzhen Hospital, Shenzhen 518035, China
| | - Yong Liu
- Department of Critical Care Medicine, Shenzhen Hospital of Southern Medical University, Shenzhen 518110, China
| | - Mian Peng
- Department of Critical Care Medicine, the Third Affiliated Hospital of Shenzhen University, Shenzhen 518001, China
| | - Yong-wen Feng
- Department of Critical Care Medicine, the Second People’s Hospital of Shenzhen, Shenzhen 518035, China
| | - Yong-ming Yao
- Department of Critical Care Medicine, the Second People’s Hospital of Shenzhen, Shenzhen 518035, China
- Trauma Research Center, the Fourth Medical Center and Medical Innovation Research Department of the Chinese PLA General Hospital, Beijing 100048, China
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Tse DMS, Li Z, Lu Y, Li Y, Liu Y, Wong WCW. Fighting against COVID-19: preparedness and implications on clinical practice in primary care in Shenzhen, China. BMC FAMILY PRACTICE 2020; 21:271. [PMID: 33339508 PMCID: PMC7747774 DOI: 10.1186/s12875-020-01343-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 12/01/2020] [Indexed: 11/26/2022]
Abstract
Background The new coronavirus pneumonia (NCP) caused by COVID-19 has affected more than 46 million people worldwide. In China, primary care has played a vital role during the COVID-19 outbreak, and it is important to examine the challenges faced by general practitioners (GPs). This study investigated the roles, preparedness and training needs of GPs in China in managing the NCP outbreak. Based on the outcomes of the study, we hope to take lessons and identify how GPs could be supported in delivering their gatekeeping roles and clinical duties in times of infectious disease outbreak. Methods An online survey on the official website of Shenzhen Continuing Education Center. It included questions on GPs’ demographics, their awareness of COVID-19 and their preparedness in managing suspected cases of NCP, as well as referrals and their training needs. Conditional multi-variate logistic models were used to investigate the relationships between GPs’ preparedness, situational confidence and anxiety. Results GPs’ clinical practice was significantly affected. GPs endeavoured to answer a flood of COVID-19-related enquiries, while undertaking community preventive tasks. In addition to in-person consultations, GP promoted COVID-19 awareness and education through telephone consultations, physical posters and social media. Overall GPs in Shenzhen felt well supported with adequate Personal Protective Equipment (PPE) and resources from secondary care services. Higher levels of self-perceived preparedness (OR = 2.19; 95%CI, 1.04–4.61), lower level of anxiety (OR = 0.56; 95%CI, 0.29–1.09) and fewer perceived family worries (OR = 0.37; 95%CI, 0.12–1.12) were associated with better confidence in coping at work. Conclusions Training and supporting GPs while reducing their (and their families’) anxiety increase their confidence in delivering the important roles of gatekeeping in face of major disease outbreaks.
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Affiliation(s)
- Desiree Man-Sik Tse
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong
| | - Zhuo Li
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan 1st Rd, Futian District, Shenzhen, 518009, Guangdong Province, China
| | - Ye Lu
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan 1st Rd, Futian District, Shenzhen, 518009, Guangdong Province, China
| | - Yang Li
- Shenzhen Health Capacity Building and Continuing Education Center, National Health Commission, 21 Tian Bei Yi, LuLuohu Qu, Shenzhen Shi, 518041, Guangdong Sheng, China
| | - Ying Liu
- Shenzhen Health Capacity Building and Continuing Education Center, National Health Commission, 21 Tian Bei Yi, LuLuohu Qu, Shenzhen Shi, 518041, Guangdong Sheng, China
| | - William Chi Wai Wong
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong. .,Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan 1st Rd, Futian District, Shenzhen, 518009, Guangdong Province, China.
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Bader MK, Braun A, Fox C, Dwinell L, Cord J, Andersen M, Noakes B, Ponticiello D. A California Hospital's Response to COVID-19: From a Ripple to a Tsunami Warning. Crit Care Nurse 2020; 40:e1-e16. [PMID: 32803240 DOI: 10.4037/ccn2020799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The outbreak of coronavirus disease 2019 (COVID-19) rippled across the world from Wuhan, China, to the shores of the United States within a few months. Hospitals and intensive care units were suddenly faced with a "tsunami" warning requiring instantaneous implementation and escalation of disaster plans. EVIDENCE REVIEW An evidence-based question was developed and an extensive review of the literature was completed, resulting in a structured plan for the intensive care units to manage a surge of patients critically ill with COVID-19 in March 2020. Twenty-five sources of evidence focusing on pandemic intensive care unit and COVID-19 management laid the foundation for the team to navigate the crisis. IMPLEMENTATION The Critical Care Services task force adopted recommendations from the CHEST consensus statement on surge capacity principles and other sources, which served as the framework for the organized response. The 4 S's became the focus: space, staff, supplies, and systems. Development of algorithms, workflows, and new processes related to treating patients, staffing shortages, and limited supplies. New intensive care unit staffing solutions were adopted. EVALUATION Using a framework based on the literature reviewed, the Critical Care Services task force controlled the surge of patients with COVID-19 in March through May 2020. Patients received excellent care, and the mortality rate was 0.008%. The intensive care unit team had the needed respiratory and general supplies but had to continually adapt to shortages of personal protective equipment, cleaning products, and some medications. SUSTAINABILITY The intensive care unit pandemic response plan has been established and the team is prepared for the next wave of COVID-19.
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Affiliation(s)
- Mary Kay Bader
- Mary Kay Bader is a neuro/critical care clinical nurse specialist, Mission Hospital, Mission Viejo, California. She is the President of the Neurocritical Care Society
| | - Annabelle Braun
- Annabelle Braun is Executive Director of Critical Care and Emergency Services, Mission Hospital
| | - Cherie Fox
- Cherie Fox is Executive Director of Acute Care Services, Mission Hospital. She is Hospital Incident Command Structure incident commander and operations chief for Mission Hospital
| | - Lauren Dwinell
- Lauren Dwinell was the Executive Director, Patient Flow Operations, Mission Hospital at the time this article was written
| | - Jennifer Cord
- Jennifer Cord is Chief Nursing Officer, Mission Hospital
| | - Marne Andersen
- Marne Andersen is Nurse Manager, cardiac intensive care unit, Mission Hospital
| | - Bryan Noakes
- Bryan Noakes is Nurse Manager, surgical intensive care unit, Mission Hospital
| | - Daniel Ponticiello
- Daniel Ponticiello is Medical Director, Critical Care Services, Mission Hospital
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Bhagat S, Yadav N, Shah J, Dave H, Swaraj S, Tripathi S, Singh S. Novel corona virus (COVID-19) pandemic: current status and possible strategies for detection and treatment of the disease. Expert Rev Anti Infect Ther 2020; 20:1275-1298. [PMID: 33043740 DOI: 10.1080/14787210.2021.1835469] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION In December 2019, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak occurred and caused the coronavirus disease of 2019 (COVID-19), which affected ~ 190 countries. The World Health Organization (WHO) has declared COVID-19 a pandemic on 11 March 2020. AREA COVERED In the review, a comprehensive analysis of the recent developments of the COVID-19 pandemic has been provided, including the structural characterization of the virus, the current worldwide status of the disease, various detection strategies, drugs recommended for the effective treatment, and progress of vaccine development programs by different countries. This report was constructed by following a systematic literature search of bibliographic databases of published reports of relevance until 1 September 2020. EXPERT OPINION Currently, the countries are opening businesses despite a spike in the number of COVID-19 cases. The pharmaceutical industries are developing clinical diagnostic kits, medicines, and vaccines. They target different approaches, including repurposing the already approved diagnosis and treatment options for similar CoVs. At present, over ~200 vaccine candidates are being developed against COVID-19. Future research may unravel the genetic variations or polymorphisms that dictate these differences in susceptibilities to the disease.
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Affiliation(s)
- Stuti Bhagat
- Division of Biological and Life Sciences, School of Arts and Sciences, Central Campus, Ahmedabad University, Ahmedabad, Gujarat, India
| | - Nisha Yadav
- Division of Biological and Life Sciences, School of Arts and Sciences, Central Campus, Ahmedabad University, Ahmedabad, Gujarat, India
| | - Juhi Shah
- Division of Biological and Life Sciences, School of Arts and Sciences, Central Campus, Ahmedabad University, Ahmedabad, Gujarat, India
| | - Harsh Dave
- Division of Biological and Life Sciences, School of Arts and Sciences, Central Campus, Ahmedabad University, Ahmedabad, Gujarat, India
| | - Shachee Swaraj
- Department of Microbiology & Cell Biology, Indian Institute of Science, Bengaluru, India.,Centre for Infectious Disease Research, Indian Institute of Science, Bengaluru, India
| | - Shashank Tripathi
- Department of Microbiology & Cell Biology, Indian Institute of Science, Bengaluru, India.,Centre for Infectious Disease Research, Indian Institute of Science, Bengaluru, India
| | - Sanjay Singh
- Division of Biological and Life Sciences, School of Arts and Sciences, Central Campus, Ahmedabad University, Ahmedabad, Gujarat, India
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Richard SA, Kampo S, Esquijarosa Hechavarria M. Elucidating the pivotal role of convalescent plasma therapy in critically ill COVID-19 patients: A review. Hematol Rep 2020; 12:8630. [PMID: 33324480 PMCID: PMC7731664 DOI: 10.4081/hr.2020.8630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/30/2020] [Indexed: 12/12/2022] Open
Abstract
World Health Organization (WHO) declared coronavirus disease (COVID-19) a pandemic in March 2020. Currently almost every country in the world has reported cases with moderate to high mortality rates. The European Union (EU), the United States of America (USA) and the United Kingdom (UK) are the severely affected countries. Nevertheless, the WHO is very much concern about countries with weak health systems. The clinical characteristics of COVID-19 varies extensively, ranging from asymptomatic infections to severe as well as critical pneumonia with high mortality rates in the elderly and patients with co-morbid medical illness. Convalescent Plasma Therapy (CPT) has been successfully used in treating various viral disease outbreaks such as 1918 influenza pneumonia pandemic, poliomyelitis, measles, mumps, Machupo virus, Junin virus, Lassa virus, Ebola etc. High-titer specific antibodies maybe capable of binding to Coronavirus- 19 (CoV-19) and neutralize the viral particles, inhibit entry to uninfected cells, and trigger potent effector mechanisms such as complement activation as well as phagocytosis. Therefore, in most countries with very weak health systems with no Intensive Care Units (ICUs) or trained ICU physicians, early initiation of CPT for severely COVID- 19 patients may be rewarding. Therefore, solidarity control trials on CPT for COVID- 19 patients involving large number of patients are urgently needed.
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Affiliation(s)
| | - Sylvanus Kampo
- Department of Anesthesia and Critical care, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
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Lin F, Shen K. Type I interferon: From innate response to treatment for COVID-19. Pediatr Investig 2020; 4:275-280. [PMID: 33376955 PMCID: PMC7768291 DOI: 10.1002/ped4.12226] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/19/2020] [Indexed: 12/29/2022] Open
Abstract
Effective prophylactic and therapeutic interventions are urgently needed to address the coronavirus disease 2019 (COVID-19) pandemic. Various antiviral drugs have recently been tested. Type I interferon (IFN) is a regulatory protein involved in the innate immune response, with broad-spectrum antiviral activities and the ability to directly block viral replication and support the immune response to eliminate virus infection. Insufficient virus-induced type I IFN production is characteristic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, because SARS-CoV-2 suppresses the IFN response by interacting with essential IFN signaling pathways. Exogenous type I IFN is recommended for treating COVID-19. Unexpectedly however, angiotensin converting enzyme-2 (ACE2) receptor, which acts as a SARS-CoV-2 receptor, was shown to be stimulated by IFN, raising doubts about the suitability of IFN use. However, further studies have excluded concerns regarding IFN administration. Type I IFNs, including IFN-α1b, have been used clinically as antiviral drugs for many years and have shown strong antiviral activity against SARS-CoV-2 in vitro. Preliminary clinical studies of type I IFNs, especially when delivered via aerosol inhalation, have demonstrated efficacy for the treatment and prevention of COVID-19. Randomized controlled trials of IFN for COVID-19 treatment are ongoing.
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Affiliation(s)
- Fuyu Lin
- Beijing Engineering Research Center of Long‐acting IFNBeijingChina
| | - Kunling Shen
- Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
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43
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Mary A, Hénaut L, Macq PY, Badoux L, Cappe A, Porée T, Eckes M, Dupont H, Brazier M. Rationale for COVID-19 Treatment by Nebulized Interferon-β-1b-Literature Review and Personal Preliminary Experience. Front Pharmacol 2020; 11:592543. [PMID: 33329000 PMCID: PMC7734101 DOI: 10.3389/fphar.2020.592543] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/19/2020] [Indexed: 12/15/2022] Open
Abstract
The inflammatory response to COVID-19 is specifically associated with an impaired type I interferon (IFN) response and complete blockade of IFN-β secretion. Clinically, nebulization of IFN-α-2b has been historically used in China to treat viral pneumonia associated with SARS-CoV. Very recent data show that the use of inhaled type I IFN is associated with decreased mortality in Chinese COVID-19 patients. However, IFN nebulization is currently not standard in Europe and the United States. Therefore, our group has set up a project aimed to evaluate the possibility to nebulize IFN-β-1b (a drug currently used in Europe to treat multiple sclerosis via subcutaneous injections) and to assess the safety of this new mode of administration in SARS-CoV-2 infected patients. We present here literature data that allowed us to build our hypothesis and to develop collaboration between clinical pharmacists, intensivists and nebulization engineers in order to gain first pre-clinical and clinical experience of IFN-β-1b nebulization. After validation of the nebulization method and verification of droplet size compatible with nebulization, the method has been applied to four intensive care patients treated at our university hospital, for whom none of the COVID-19 therapies initially used in France led to significant clinical improvement. All patients exhibited negative viral carriage and experienced clinical improvement 7-16 days after having initiated nebulized IFN-β-1b inhalation therapy. No side effects were observed. All patients were alive within a 90-days follow-up. Although it is not possible to draw firm conclusions on treatment efficacy based on this case report, our study shows that pulmonary IFN-β-1b administration is feasible, with a good safety profile. This procedure, which presents the advantage of directly targeting the lungs and reducing the risks of systemic side effects, may represent a promising therapeutic strategy for the care of patients with severe COVID-19. However, our preliminary observation requires confirmation by randomized controlled trials.
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Affiliation(s)
- Aurélien Mary
- Clinical Critical Care Pharmacy Department, Amiens-Picardie University Hospital, Amiens, France
- UR UPJV 7517, MP3CV, CURS, University of Picardie Jules Verne, Amiens, France
| | - Lucie Hénaut
- UR UPJV 7517, MP3CV, CURS, University of Picardie Jules Verne, Amiens, France
| | - Pierre Yves Macq
- Surgical Critical Care Department, Amiens-Picardie University Hospital, Amiens, France
| | - Louise Badoux
- Surgical Critical Care Department, Amiens-Picardie University Hospital, Amiens, France
| | - Arnaud Cappe
- Clinical Critical Care Pharmacy Department, Amiens-Picardie University Hospital, Amiens, France
| | | | | | - Hervé Dupont
- UR UPJV 7517, MP3CV, CURS, University of Picardie Jules Verne, Amiens, France
- Surgical Critical Care Department, Amiens-Picardie University Hospital, Amiens, France
| | - Michel Brazier
- UR UPJV 7517, MP3CV, CURS, University of Picardie Jules Verne, Amiens, France
- Department of Biochemistry, Amiens-Picardie University Hospital, Amiens, France
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44
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Bachilo EV. [Mental health of population during the COVID-19 pandemic]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:130-136. [PMID: 33244969 DOI: 10.17116/jnevro2020120101130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The coronovirus COVID-19 pandemic is a very strong challenge for the public health system and the general population. Despite the existing experience in eliminating epidemics and their consequences in the world, including experience in maintaining mental health, the new coronavirus infection entails new problems that need to be addressed as soon as possible. Important is the need to mobilize psychological and psychiatric service. The article is a review of literature published mainly in 2019-2020. The databases used were PubMed, Elsevierscience and Google Scholar. The paper presents relevant data on risk factors for mental disorders during a pandemic, the range of psychological reactions and symptoms of mental disorders in the population, the characteristics of the management of patients with mental disorders, and the role of the psychological and psychiatric unit during this period. The consolidation of efforts and the quickest possible start of solving mental health problems will help to avoid significant consequences in the future.
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Affiliation(s)
- E V Bachilo
- Educational and Research Center of Psychotherapy and Clinical Psychology, Moscow, Russia
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45
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Penteado CT, Loureiro JC, Pais MV, Carvalho CL, Sant'Ana LFG, Valiengo LCL, Stella F, Forlenza OV. Mental Health Status of Psychogeriatric Patients During the 2019 New Coronavirus Disease (COVID-19) Pandemic and Effects on Caregiver Burden. Front Psychiatry 2020; 11:578672. [PMID: 33312138 PMCID: PMC7704440 DOI: 10.3389/fpsyt.2020.578672] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/08/2020] [Indexed: 12/22/2022] Open
Abstract
Introduction: There is a growing awareness about the noxious effects of the 2019 Coronavirus Disease (COVID-19) pandemic on the mental health of the elderly. However, there is limited information from clinically driven research. The objectives of the present study were to examine the magnitude of psychiatric symptoms and to determine their association with caregiver distress, in a cross-section of community-dwelling older adults and a subsample of aging adults with Down syndrome (DS) attending a psychogeriatric service in São Paulo, Brazil. Method: Telephone-based interviews and electronically filled self-assessment questionnaires were used to collect information from patients and caregivers, addressing their impressions and concerns about the pandemic and related effects on the patient's emotional state and behavior. Clinical information was obtained from hospital charts, medical records, and psychometric tests administered through telephone interviews [Hospital Anxiety and Depression Scale (HADS) and Neuropsychiatric Inventory Questionnaire (NPI-Q)]. Results: We included 100 consecutive participants, comprising 71 older adults with psychogeriatric/neurocognitive disorders and 29 aging adults with DS. Higher HADS and NPI-Q scores were significantly associated with caregiver distress (p < 0.05) in both groups. Correlation analyses indicated strong, positive associations between caregiver burden and scores in HADS anxiety (HADS-A) and HADS depression (HADS-D) scales in the subsamples of euploid and DS subjects. Higher NPI-Q scores in the former group were also correlated with caregiver distress, with stronger associations for neuropsychiatric symptoms. Similar findings were observed among DS subjects. ANOVA tests indicated significant associations between NPI-Q scores and caregiver distress among dementia patients, as well as with HADS scores. Similar results were found after multiple linear regressions; as such, among the elderly subsample, higher scores in HADS-A (p = 0.002) and HADS-D (p = 0.001) predict a significant impact on caregiver burden (p < 0.00001, R 2 0.46); taking into consideration caregiver burden as a dependent variable and NPI-Q total score as an independent variable, we obtained significant strong prediction values for either DS (p < 0.00001, R 2 0.95) or elderly adults (p < 0.00001, R 2 0.88). Conclusion: During the COVID-19 pandemic, patients with neurocognitive disorders present with clinically relevant neuropsychiatric symptoms, with significant impact on caregiver distress. Apathy, aberrant motor behavior, sleep disorders, and psychoses were the main psychopathological domains, which had determined caregiver burden worsening.
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Affiliation(s)
- Camila T. Penteado
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Julia C. Loureiro
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Marcos V. Pais
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Cláudia L. Carvalho
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Lívea F. G. Sant'Ana
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Leandro C. L. Valiengo
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Florindo Stella
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Orestes V. Forlenza
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
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Fang Z, Gu Z, Zhang T, Lei J, Lin L, Yan Z, Feng K, Xie M, Guo S, Liu Z, Hong Z, Li X. The impact of new modes of electronic communication in the treatment of severe acute respiratory syndrome coronavirus 2 infection. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1239. [PMID: 33178771 PMCID: PMC7607116 DOI: 10.21037/atm-20-6413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background More than 26,760,000 cases of SARS-CoV-2 infection have been reported globally to date. This study aimed to analyze the impact of new electronic communication tools in the diagnosis and treatment of patients with SARS-CoV-2 infection. Methods From January 20 to February 26, 2020, adult patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were treated in The Fifth Affiliated Hospital, Sun Yat-sen University, in Zhuhai, China, were recruited. Forty-seven eligible patients were enrolled and randomly classified into either the test group or the control group. All of the patients received the standard therapeutic regimen and routine ward rounds. The test group was subdivided into three subgroups: the first subgroup (5-minute group) was given an extra 5-minute ward round by WeChat voice call once daily for basic disease communication; the second subgroup (10-minute group) received an extra 10-minute ward round by WeChat voice call once daily for further detail; and the third subgroup (20-minute group) was given an extra 10-minute ward round via WeChat voice call once daily, as well as an extra 10 minutes every 3 days. The primary outcome was the duration of positive-to-negative conversion of SARS-CoV-2 nucleic acid diagnosed by the NAT (nucleic acid testing). Results In the test groups, the median time from diagnosis to the endpoint was 7.0 days [interquartile range (IQR), 3.8–10.8], compared with 10.0 days (IQR, 6.5–14.5) in the control group. It showed significant reduced the duration time of virus from positive to negative by the NAT (nucleic acid testing), (P=0.032) especially between the 10-minute subgroup (3.0 days; IQR, 3.0–7.5) and the control group (P=0.0065). Conclusions The use of new modes of electronic communication can benefit patients during the COVID-19 pandemic and could be extremely valuable in addressing the shortage of medical protective equipment and reducing occupational risk of exposure to infection.
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Affiliation(s)
- Zhaoxiong Fang
- Department of Gastroenterology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Zhiqiang Gu
- Department of Gastroenterology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Tian Zhang
- Department of Oncology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Junjie Lei
- Department of Neurology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Lu Lin
- Department of Gastroenterology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Zhixiang Yan
- Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Keke Feng
- Department of Rehabilitation Medicine, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Mengsha Xie
- Department of Gerontology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Shuanshuan Guo
- Department of Oncology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Zhigang Liu
- Department of Oncology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Zhongsi Hong
- Department of Infectious Disease, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Xiaofeng Li
- Department of Gastroenterology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
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Czech M, Balcerzak M, Antczak A, Byliniak M, Piotrowska-Rutkowska E, Drozd M, Juszczyk G, Religioni U, Vaillancourt R, Merks P. Flu Vaccinations in Pharmacies-A Review of Pharmacists Fighting Pandemics and Infectious Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7945. [PMID: 33138198 PMCID: PMC7662566 DOI: 10.3390/ijerph17217945] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 12/23/2022]
Abstract
The phenomenon of population ageing observed over recent years involves growing healthcare needs and the limited staffing and financing of healthcare systems, and as such demands some functional changes in the healthcare model in many countries. This situation is particularly significant in the face of a pandemic, e.g., flu, and currently COVID-19.As well as social education, preventive vaccinations are the most effective method of fighting the infectious diseases posing a special threat to seniors. Despite this, the vaccination coverage level in most European countries is relatively low. This is largely due to patients having limited access to vaccinations. In some countries, implementing vaccinations in pharmacies and by authorized pharmacists has significantly improved vaccination coverage rates and herd immunity, while lowering the cost of treating infections and the resulting complications, as well as minimizing the phenomenon of inappropriate antibiotic therapies. This article presents the role of pharmacists in the prevention of infectious diseases, pointing out the measurable effects of engaging pharmacists in conducting preventive vaccinations, as well as analyzing the models of implementing and conducting vaccinations in pharmacies in selected countries, and depicting recommendations regarding vaccinations developed by international organizations. The presented data is used to suggest requirements for the implementation of preventive vaccinations in community pharmacies.
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Affiliation(s)
- Marcin Czech
- Department of Pharmacoeconomics, Institute of Mother and Child, 01-211 Warsaw, Poland;
| | | | - Adam Antczak
- Polish Flu Vaccination Coalition, 00-061 Warsaw, Poland;
| | - Michał Byliniak
- Polish Pharmaceutical Chamber, 00-238 Warsaw, Polska; (M.B.); (E.P.-R.)
| | | | - Mariola Drozd
- Didactic Center, Department of Ethics and Medical Law, Department of Social Medicine, Inter-Faculty, Medical University of Lublin, 20-081 Lublin, Poland;
| | - Grzegorz Juszczyk
- Department of Public Health, Medical University of Warsaw, 02-097 Warsaw, Poland;
- National Institute of Public Health—National Institute of Hygiene, 00-791 Warsaw, Poland
| | - Urszula Religioni
- Collegium of Business Administration, Warsaw School of Economics, 02-513 Warsaw, Poland;
| | - Regis Vaillancourt
- Pharmacie Children’s Hospital of Eastern Ontario, Centre Hospitalier Pour Enfants de l’est de l’Ontario, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada;
| | - Piotr Merks
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, 85-067 Bydgoszcz, Poland
- Trade Union of Pharmacy Workers, 01-315 Warsaw, Poland
- Employed Pharmacist in Europe (EPhEU) Verband Angestellter Apotheker Österreichs (VAAÖ) Berufliche Interessenvertretung Spitalgasse 31/4, 1090 Vienna, Austria
- Polish Pharmaceutical Group, 91-342 Łódź, Poland
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Semenova Y, Pivina L, Khismetova Z, Auyezova A, Nurbakyt A, Kauysheva A, Ospanova D, Kuziyeva G, Kushkarova A, Ivankov A, Glushkova N. Anticipating the Need for Healthcare Resources Following the Escalation of the COVID-19 Outbreak in the Republic of Kazakhstan. J Prev Med Public Health 2020; 53:387-396. [PMID: 33296578 PMCID: PMC7733753 DOI: 10.3961/jpmph.20.395] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives The lack of advance planning in a public health emergency can lead to wasted resources and inadvertent loss of lives. This study is aimed at forecasting the needs for healthcare resources following the expansion of the coronavirus disease 2019 (COVID-19) outbreak in the Republic of Kazakhstan, focusing on hospital beds, equipment, and the professional workforce in light of the developing epidemiological situation and the data on resources currently available. Methods We constructed a forecast model of the epidemiological scenario via the classic susceptible-exposed-infected-removed (SEIR) approach. The World Health Organization’s COVID-19 Essential Supplies Forecasting Tool was used to evaluate the healthcare resources needed for the next 12 weeks. Results Over the forecast period, there will be 104 713.7 hospital admissions due to severe disease and 34 904.5 hospital admissions due to critical disease. This will require 47 247.7 beds for severe disease and 1929.9 beds for critical disease at the peak of the COVID-19 outbreak. There will also be high needs for all categories of healthcare workers and for both diagnostic and treatment equipment. Thus, Republic of Kazakhstan faces the need for a rapid increase in available healthcare resources and/or for finding ways to redistribute resources effectively. Conclusions Republic of Kazakhstan will be able to reduce the rates of infections and deaths among its population by developing and following a consistent strategy targeting COVID-19 in a number of inter-related directions.
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Affiliation(s)
- Yuliya Semenova
- Department of Neurology, Ophthalmology and Otolaryngology, Semey Medical University, Semey, Kazakhstan
| | - Lyudmila Pivina
- Department of Internal Medicine, Semey Medical University, Semey, Kazakhstan
| | - Zaituna Khismetova
- Department of Public Health, Semey Medical University, Semey, Kazakhstan
| | - Ardak Auyezova
- Head Office, Kazakhstan Medical University Higher School of Public Health, Almaty, Kazakhstan
| | - Ardak Nurbakyt
- Department of Epidemiology, Evidence Medicine and Biostatistics, Kazakhstan Medical University Higher School of Public Health, Almaty, Kazakhstan
| | - Almagul Kauysheva
- Department of Research and International Affairs Kazakhstan Medical University Higher School of Public Health, Almaty, Kazakhstan
| | - Dinara Ospanova
- Department of Public Health, Kazakh Medical University of Continuing Education, Almaty, Kazakhstan
| | - Gulmira Kuziyeva
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | | | - Alexandr Ivankov
- Department of Postgraduate Education, Kazakh Medical University of Continuing Education, Almaty, Kazakhstan
| | - Natalya Glushkova
- Department of Epidemiology, Evidence Medicine and Biostatistics, Kazakhstan Medical University Higher School of Public Health, Almaty, Kazakhstan
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Forlenza OV, Stella F. Impact of SARS-CoV-2 pandemic on mental health in the elderly: perspective from a psychogeriatric clinic at a tertiary hospital in São Paulo, Brazil. Int Psychogeriatr 2020; 32:1147-1151. [PMID: 32522304 PMCID: PMC7327163 DOI: 10.1017/s1041610220001180] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Orestes V. Forlenza
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Florindo Stella
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
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Ha JF. The COVID-19 pandemic, personal protective equipment and respirator: A narrative review. Int J Clin Pract 2020; 74:e13578. [PMID: 32511834 PMCID: PMC7300506 DOI: 10.1111/ijcp.13578] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/18/2020] [Accepted: 06/03/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION The coronavirus disease 2019 pandemic has touched almost every continent. Personal protective equipment (PPE) is the final line of protection of healthcare workers (HCW). There is variation as well as controversy of infection control recommendation with regards to the use of PPE for HCW between institutions. The aim of this narrative review is to of examine and summarise the available evidence to guide recommendation for the safety of HCW. METHOD A literature search was conducted on the PubMed, MedLine and Embase databases with the keywords "personal protective equipment," "COVID 19," "n95," "health care worker" and "mortality." RESULTS SARS-nCoV-2 is highly contagious. About 3.5%-20% of HCW has been reported to be infected. The mortality ranges from 0.53% to 1.94%. PPE is part of the measure within a package of prevention and control of pandemic, rather than a replacement of. Respirators are more effective than masks in preventing aerosol transmission to HCWs. Extended use may be considered if guidelines are adhered. Powered air-purifying respirators if available should be used in high-risk procedures. CONCLUSION Transmission of viruses is multimodal and in the setting of a novel pathogen with high case fatality with no proven effective interventions, PPE that affords the best protection should be available to HCWs.
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Affiliation(s)
- Jennifer F. Ha
- Department of Paediatrics Otolaryngology Head & Neck SurgeryPerth Children’s HospitalNedlandsWAAustralia
- Wexford Medical CenterMurdoch ENTMurdochWAAustralia
- Department of SurgeryUniversity of Western AustraliaNedlandsWAAustralia
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