Healthcare providers’perspectives on factors influencing their critical care decision-making during the COVID-19 pandemic:An international pilot survey

BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpful in uncertain situations is clinical judgment.Clinicians must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies occur.AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical decision-making.METHODS This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19.The survey focused on topics related to their professional roles and personal relationships.We examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical decision-making.The collected data were analyzed using the χ^(2) test for categorical variables.RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey.Age was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were made.Most doctors reported maintaining patient confidentiality regarding privacy and informed consent.Approximately 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and relationships.Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries.Regarding personal experiences,some respondents noted that treatment plans and preferences changed from wave to wave,and that there was a rapid turnover of studies and evidence.Hospital and government policies also played a role in critical decision-making.Rather than assessing the appropriateness of treatment,some doctors observed that hospital policies regarding medications were driven by patient demand.CONCLUSION Factors other than medical considerations frequently affect management choices.The disparity in treatment choices,became more apparent during the pandemic.We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency.False information,large patient populations,and limited resources caused problems for clinicians.These factors impacted decision-making,which,in turn,affected patient care and healthcare staff well-being.

Posttraumatic stress symptoms among Chinese university students during the COVID-19 pandemic:Prevalence,correlates,and mental health help-seeking

BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking behavior of individuals with PTSSs has critical implications for public mental health strategies in future medical pandemics.AIM To investigate the prevalence and correlates of PTSSs among university students during the first wave of the COVID-19 pandemic in China and to examine mental health help-seeking behaviors among these students.METHODS A total of 2507 Chinese university students were recruited via snowball sampling.The students completed the Seven-item Screening Scale for Post-traumatic Stress Disorder during the first wave of the COVID-19 pandemic in China.Sociodemo-graphic characteristics,pandemic-related characteristics,and mental health help-seeking behaviors of students with PTSSs were also collected.RESULTS The prevalence of PTSSs among the participants was 28.0%.Seven significant correlates of PTSSs were identified(odds ratio=1.23-3.65,P≤0.024):Female sex,being 19 years old or older,living with others or alone,a low level of family economic status,fair or poor interpersonal relationships,severe or very severe local pandemic,and having family members diagnosed with COVID-19.However,only 3.28%of the students with PTSSs reported seeking help from mental health specialists.Among the 23 students who sought help from mental health specialists,13 opted for online or telephone-based psychological consultation.CONCLUSION Our data suggest that there was a high risk of PTSSs among university students and a high level of unmet mental health needs during the COVID-19 pandemic.The delivery of mental health services online or via telephone is a promising approach to address these unmet needs.

Depression levels of the general public increases during the COVID-19 pandemic in China:A web-based cross-sectional survey

BACKGROUND The coronavirus disease 2019(COVID-19)outbreak lasted several months,having started in December 2019.This study aimed to report the impacts of various factors on the depression levels of the general public and ascertain how emotional measures could be affected by psychosocial factors during the COVID-19 pandemic.AIM To investigate the depression levels of the general public in China during the COVID-19 pandemic.METHODS A total of 2001 self-reported questionnaires about Beck Depression Inventory(BDI)were collected on August 22,2022 via the website.Each questionnaire included four levels of depression and other demographic information.The BDI scores and incidences of different depression levels were compared between various groups of respondents.χ2 analysis and the two-tailed t-test were used to assess categorical and continuous data,respectively.Multiple linear regressions and logistic regressions were employed for correlation analysis.RESULTS The averaged BDI score in this study was higher than that for the non-epidemic periods,as reported in previous studies.Even higher BDI scores and incidences of moderate and severe depression were recorded for people who were quarantined for suspected COVID-19 infection,compared to the respondents who were not quarantined.The participants who did not take protective measures were associated with higher BDI scores than those who made efforts to keep themselves relatively safer.Similarly,the people who did not return to work had higher BDI scores compared to those managed to.A significant association existed between the depression levels of the subgroups and each of the factors,except gender and location of residence.However,quarantine was the most relative predictor for depression levels,followed by failure to take preventive measures and losing a partner,either through divorce or death.CONCLUSION Based on these data,psychological interventions for the various subpopulations in the general public can be implemented during and after the COVID-19 pandemic.Other countries can also use the data as a reference.

Risk and Protective Factors Associated with Depression and Anxiety among Pregnant Women during the COVID-19 Pandemic

Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ2 test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.

The Impact of COVID-19 Pandemic on Mother-Infant Bond: A Systematic Review

Background: The healthy bond that develops prenatally between the mother and her infant is important for the neuropsychological development and development of the child. In stressful situations and mental disorders, the development of this bond is inhibited. With this study, an attempt is made to investigate whether the COVID-19 pandemic affected the development of the mother-infant bond. Methods: We have searched in the databases, PubMed, Google Scholar, PsycINFO, from July to October 2023 and we have found 18 related articles. Results: Most studies supported a lower mother-infant attachment during the pandemic period. We also found increased rates of depressive symptoms, anxiety and post-traumatic stress during the pandemic. Conclusions: The period of the pandemic and the psychological factors were the right conditions for the reduced development of the mother-infant bond. In epidemiological outbreaks, the mental health of the mother and her relationship with the infant should be a priority for perinatal care professionals.

The dynamics of price discovery between the U.S.and Chinese soybean market:a wavelet approach to understanding the effects of Sino-US trade conflict and COVID-19 pandemic

During geopolitical crises,the price stability of agricultural commodities is critical for national security.Understanding the dynamics of pricing power between the U.S.and China and how it varies over time can help smaller nations navigate unpredictable moments.This study uses a unified framework and wavelet approach to examine soybean price discovery in the U.S.and China from the standpoints of price interdependence and information flows.We begin by illustrating the integrated link between the soybean futures markets in the U.S.and China,which includes multiple structural breaks.The pricing difference between the two nations acts as the primary information spillover route for their integrated relationship.Furthermore,we show that the direction and degree of information spillover change dramatically in proportion to the strength of the U.S.–Chinese soybean interaction.Finally,we find that China’s recent retaliatory tax on the U.S.soybeans gave the Chinese market a more powerful position in soybean futures price discovery.After the first-stage trade deal was reached,and during the epidemic phase of the coronavirus pandemic,the pricing power of the U.S.soybean market showed no signs of full recovery.

Excess non-COVID-19-related mortality among inflammatory bowel disease decedents during the COVID-19 pandemic

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic disrupted healthcare in the United States.AIM To investigate COVID-19-related and non-COVID-19-related death and characteristics associated with excess death among inflammatory bowel disease(IBD)decedents.METHODS We performed a register-based study using data from the National Vital Statistics System,which reports death data from over 99%of the United States population,from January 1,2006 through December 31,2021.IBD-related deaths among adults 25 years and older were stratified by age,sex,race/ethnicity,place of death,and primary cause of death.Predicted and actual age-standardized mortality rates(ASMRs)per 100000 persons were compared.RESULTS 49782 IBD-related deaths occurred during the study period.Non-COVID-19-related deaths increased by 13.14%in 2020 and 18.12%in 2021[2020 ASMR:1.55 actual vs 1.37 predicted,95%confidence interval(CI):1.26-1.49;2021 ASMR:1.63 actual vs 1.38 predicted,95%CI:1.26-1.49].In 2020,non-COVID-19-related mortality increased by 17.65%in ulcerative colitis(UC)patients between the ages of 25 and 65 and 36.36%in non-Hispanic black(NHB)Crohn’s disease(CD)patients.During the pandemic,deaths at home or on arrival and at medical facilities as well as deaths due to neoplasms also increased.CONCLUSION IBD patients suffered excess non-COVID-19-related death during the pandemic.Excess death was associated with younger age among UC patients,and with NHB race among CD patients.Increased death at home or on arrival and due to neoplasms suggests that delayed presentation and difficulty accessing healthcare may have led to increased IBD mortality.

Mental health and insomnia problems in healthcare workers after the COVID-19 pandemic:A multicenter cross-sectional study

BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.

Prothrombotic state and thrombotic events in COVID-19 pandemic period,including portal vein and splenic artery thromboses

This editorial article is intended to perform a discussion on the manuscript entitled“Simultaneous portal vein thrombosis and splenic vein thrombosis in a COVID-19 patient:A case report and review of literature”written by Abramowitz et al.The article focuses on the diagnostic processes in a 77-year-old-male patient with a simultaneous portal vein and splenic artery thrombosis accompanying coronavirus disease 2019(COVID-19).The authors postulated that splanchnic thrombosis should be on the list of differential diagnoses in a patient presenting with abdominal pain in presence of a COVID-19 infection.The tendency for venous and arterial thrombosis in COVID-19 patients is encountered,largely attributed to hypercoagulopathy.In general,venous thromboembolism mostly manifest as deep vein thrombosis(DVT),pulmonary embolism(PE)or catheterrelated thromboembolic events.Acute PE,DVT,cerebrovascular events and myocardial infarction are seen as the most common thromboembolic complications in COVID-19 patients.COVID-19-associated hemostatic abnormalities include mild thrombocytopenia and increased D-dimer level.Similar to other coagulopathies,the treatment of the underlying condition is the mainstay.Addition of antiplatelet agents can be considered in critically ill patients at low bleeding risk,not on therapeutic anticoagulation,and receiving gastric acid suppression Early administration of antithrombotic drugs will have a beneficial effect in both the prevention and treatment of thrombotic events,especially in non-ambulatory patients.Low molecular weight heparin(LMWH)should be started if there is no contraindication,including in non-critical patients who are at risk of hospitalization LMWH(enoxaparin)is preferred to standard heparin.

The COVID-19 Pandemic: Present or Gone, Where Do Adolescents Stand?

Introduction: The initial global response to the SARS-CoV-2 pandemic focused on adults as adolescents mainly had subclinical infections. Adolescents, however, could transmit the virus and hence be a risk to the elderly, young children and immunocompromised. Adolescents are also at risk of long-term complications. This study sought to determine the prevalence of antibodies to SARS-CoV-2 among adolescents in Southern Nigeria, and to determine the association between SARS-CoV-2 seropositivity and age, gender, socioeconomic class, school type and nutritional status. Methods: This descriptive cross-sectional study was carried out in Edo state of southern Nigeria. We recruited 270 in-school adolescents aged 10 - 19 years. A WHO-adapted, pre-tested questionnaire was used to obtain data on participant history and risk factors. The questionnaire was interviewer-administered. Adolescents whose parents gave consent were recruited through a multi-stage randomized sampling method. Capillary blood for the assay was collected and analysed using a lateral-flow immunoassay device. The primary outcome was serostatus of the study. The positive predictors of serostatus were finally determined using a multiple logistics regression model. Statistical significance was set at p Results: The seroprevalence of SARS-CoV-2 was 45.9%. IgM antibodies were found in 5.6% of participants. Older adolescents had higher seropositivity rates than younger adolescents (2 = 8.101, p = 0.017). There was no association between gender and seropositivity. Adolescents in public schools were more likely to be seropositive than those in private schools (2 = 25.242, p = 0.001). A higher seroprevalence was noticed among study participants in the lower socioeconomic class (x2 = 6.928, p = 0.031), and those in overcrowded classes. (2 = 79.303, p = 0.001). Conclusion: This study showed a high seroprevalence of SARS-CoV-2 among in-school adolescents. Behavioural change communication on SARS-CoV-2, vaccination of adolescents, and standardization of classrooms are recommended.

Delay Times and Clinical Outcomes in Acute Myocardial Infarction: Comparison of Periods before and during the COVID-19 Pandemic—Myocardial Infarction and the Pandemic

Introduction: At the beginning of the COVID-19 pandemic, a drop in the number of patients treated for cardiac emergencies raised concern about cardiovascular mortality in that period. An increase in care delay for patients with ST-segment elevation myocardial infarction (STEMI) may have affected clinical outcomes. Objectives: To analyze delay times and clinical outcomes of patients with STEMI undergoing primary percutaneous coronary intervention (PPCI), before and during the COVID-19 pandemic. Methods: Retrospective observational study that included patients with STEMI undergoing PPCI from December 2018 to July 2021. The COVID-19 pandemic cases were divided into two groups: pandemic I—from March to August 2020;and pandemic II—from September 2020 to July 2021. Patients were compared according to the period of hospitalization. Primary outcomes were delay times in assistance and clinical outcomes (acute kidney injury [AKI], post-procedural vascular complications and in-hospital mortality). Results: 108 patients were included, 39 (36.1%) in the pre-pandemic period, 13 (12.1%) in pandemic I and 56 (51.8%) in pandemic II. Time from onset of symptoms to arrival at the service and door-to-balloon time did not differ significantly among groups. Vascular complications were more frequent during the pandemic (I and II) than in the pre-pandemic period (2.5% pre-pandemic vs 15.4% pandemic vs 12.5% pandemic II;p = 0.03). AKI incidence was similar in all three periods. There was a non-significant increase in in-hospital mortality during the COVID-19 pandemic. Conclusion: In patients with STEMI, there was an increase in vascular complications and a trend toward increased mortality during the COVID-19 pandemic. Delay times to admission and reperfusion did not differ significantly between before and during the pandemic.

Food security amid the COVID-19 pandemic in Central Asia:Evidence from rural Tajikistan

Food security has been long understudied in the context of Central Asia.We present an analysis examining household-level food demand for Tajikistan and assessing the magnitude of its food security changes during the COVID-19 pandemic.Based on an extensive household survey data set from Tajikistan,we estimate the expenditure,income,and price elasticities for nine food categories using the QUAIDS model.Then,we develop a microsimulation model using the estimated elasticities to assess the dual impact of declining remittance income and rising food prices stemming from the pandemic shock.There are significant differences in demand elasticities across food groups,with high elasticities observed for nutritious foods,such as meat,fruit,eggs,and milk,in rural households.Moreover,our findings show that changes in remittance income and food prices significantly negatively affected food security for rural households during the COVID-19 pandemic.These findings have important implications for policymakers concerned about rural livelihoods and food security in remittance-receiving economies during the post-pandemic period.

Psychological Status and Warfarin Therapy in Patients after Valve Replacement during the COVID-19 Pandemic:A Cross-sectional Study

Objective The standardization of warfarin anticoagulant therapy is the key to lifelong treatment for patients after heart valve replacement.The present study explored the possible risk factors for anxiety and depression during the coronavirus disease 2019(COVID-19)pandemic and analyzed the influence of psychological state on medication safety.Methods Eligible patients received a web-based questionnaire survey via the Wenjuanxing platform during outpatient visits.Depression was evaluated by the Self-Rating Depression Scale(SDS).Anxiety was evaluated by the Self-Rating Anxiety Scale(SAS).Medication adherence was evaluated by the Morisky scale.Results A total of 309 patients(aged 52.2±11.4 years)were included in the present study.The SDS score of all included patients was 36.9±9.4 points,of which 11(3.6%)patients were diagnosed as having depression.The SAS score of all included patients was 43.1±9.3 points,of which 71(23%)patients were diagnosed as having anxiety.Seven patients(2.3%)had both anxiety and depression.Logistic regression analysis revealed that only monthly income was an independent influencing factor for depression.Regarding anxiety,patients who underwent repeated operations had a 2.264-fold greater risk,and patients who received combination medication had a 2.140-fold greater risk.More bleeding events and coagulation disorders could be observed in patients with anxiety,depression or both.When anxiety occurred,patients showed worse medication adherence.However,depression had no significant effect on medication adherence.Conclusion During the COVID-19 pandemic,the detection rate of mental illnesses such as anxiety and depression was high,which seriously affected the medication safety of warfarin.Analysis of its influencing factors will provide a reference for further standardized regulation of warfarin anticoagulant therapy after valve replacement.

COVID-19 pandemic amplified mortality rates among adolescents with bipolar disorder through family-related factors

BACKGROUND Recently,a growing number of adolescents have been afflicted with mental disorders,with annual morbidity rates on the rise.This trend has been exacerbated by the global coronavirus disease 2019(COVID-19)pandemic,leading to a surge in suicide and self-harm rates among this demographic.AIM To investigate the impact of the COVID-19 pandemic on adolescent bipolar disorder(BD),along with the underlying factors contributing to heightened rates of suicide and self-harm among adolescents.METHODS A comprehensive statistical analysis was conducted utilizing clinical interviews and self-reports obtained from patients or their guardians.Diagnostic criteria for BDs were based on the Diagnostic and statistical manual of mental disorders,international classification of diseases-11,and the National institute of mental health research domain criteria.Statistical analyses were performed using SPSS 26.0 software,with significance set at P<0.05.RESULTS A cohort of 171 adolescents diagnosed with BD between January 1,2018,and December 31,2022,was included in the analysis.The gender distribution was 2.8:1(female to male),with ages ranging from 11 to 18 years old.Major factors contributing to adolescent BDs included familial influences,academic stress,genetic predisposition and exposure to school-related violence.Notably,a significant increase in suicide attempts and self-harm incidents was observed among adolescents with BD during the COVID-19 pandemic.Statistical analysis indicated that the pandemic exacerbated familial discord and heightened academic stress,thereby amplifying the prevalence of suicidal behavior and self-harm among adolescents.CONCLUSION The COVID-19 pandemic has exacerbated familial tensions and intensified the incidence of suicide and self-harm among adolescents diagnosed with BD.This study underscores the urgent need for societal,familial and educational support systems to prioritize the well-being of adolescents and offers valuable insights and guidelines for the prevention,diagnosis and treatment of adolescent BDs.

Paradigm shift in transfusion practices during early COVID-19 pandemic:A single center retrospective study

BACKGROUND The advent of coronavirus disease 2019(COVID-19)unveiled the worst national blood crisis that the United States had witnessed in over a decade.With the pandemic influencing the different stages of the acquisition of blood products outside the hospital setting,we aimed to explore the possible barriers contributing to the shortage of blood products within the medical community.the COVID era and pre-COVID era.METHODS We conducted a retrospective cross-sectional study on hospitalized patients distinguishing the pattern of blood transfusion during the COVID and pre-COVID era in a community hospital.Data was tabulated to include the number of red blood cell(RBC)transfusions and if transfusions met restrictive blood transfusion criteria as per institutional guidelines.Chi-square was applied to test the statistical association between qualitative variables.Unpaired t test and Mann Whitney U test were applied respectively to test the mean difference of quantitative variables.RESULTS A total of 208 patients were included in the study,of which 108 were during COVID era and 100 were during pre-COVID era.The leading reason for admission in both the COVID era and pre-COVID era transfused patients was shortness of breath(53.7%and 36%P=0.001),followed by gastrointestinal bleeding(25.9%and 21%P=0.001).There was a higher percentage of RBC transfusions in the intensive care unit in the COVID-era group than in the pre-COVID era group(38.9%vs 22%,P=0.008).The restrictive transfusion criteria were met in 62%vs 79%in the COVID and pre-COVID eras,respectively(P=0.008).CONCLUSION The COVID-era group received RBC transfusions with less stringent adherence to restrictive blood transfusion practices in comparison to pre-COVID era group.

Impact of COVID-19 pandemic on routine childhood vaccinations

Routine pediatric vaccination is one of the most effective public health inter-ventions for the control of a number of fatal diseases.However,during the coronavirus disease 2019 pandemic,routine pediatric vaccination rates were severely affected by disruptions of health services and vaccine confidence issues.Governments and the United Nations have taken measures to re-establish routine pediatric vaccination,while additional efforts are needed to catch up and develop plans to ensure routine vaccination services for the future pandemics.

Increased alcohol consumption during the COVID-19 pandemic:A cross-sectional study

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has significantly impacted health,mental well-being,and societal functioning,particularly for individuals with psychiatric conditions and substance use disorders.Recent evidence highlights a concerning increase in alcohol consumption during the pandemic,with a study spanning 2015-2020 indicating heightened usage,especially among young and middle-aged adults,for relaxation and tension relief.Additionally,addressing challenges exacerbated by the pandemic,another study underscored persistent barriers to healthcare access,resulting in increased alcohol and tobacco use rates and limited healthcare options.These findings shed light on the unique vulnerabilities exposed by the pandemic,emphasizing the need to investigate further its impact on alcohol consumption in diverse non-urban American communities.AIM To investigate the impact of the COVID-19 pandemic on alcohol abuse using socioeconomic and medical parameters in diverse non-urban community in America.METHODS Based on a cross-sectional analysis of 416 participants the United States in 2021,the study utilized The Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition criteria to categorize alcohol consumption levels.Participants aged 21 years and above were surveyed through an online platform due to COVID-19 challenges.The survey was conducted from January 14 to January 31,2022,recruiting participants via social media and ensuring anonymity.Informed consent was secured,emphasizing the voluntary nature of participation,and participants could only take the survey once.RESULTS Out of 416 survey respondents,396 met eligibility criteria,with 62.9%reporting increased alcohol consumption during COVID-19.Males(68.8%)and ages 21-29 years(34.6%)predominated.Low alcohol consumption decreased by 2.8%(P=0.237),moderate by 21.4%(P<0.001),and heavy increased by 14.9%(P<0.001).Alcohol abuse rose by 6.5%(P=0.0439),with a 7%increase in self-identified alcohol abusers/alcoholics.Seeking treatment during COVID-19 rose by 6.9%.Easier alcohol access(76.0%)was reported,while 80.7%found it harder to access medical care for alcohol-related issues.These findings highlight the pandemic's impact on alcohol consumption and healthcare access,emphasizing the need for targeted interventions during public health crises.CONCLUSION The COVID-19 pandemic exacerbated alcoholism and abuse,with increased heavy consumption(P<0.001)and abuse(P=0.0439).Access to medical programs for addressing alcohol abuse declined,highlighting the need for targeted intervention.

The Impact of Binge Drinking among Brazilian University Students on Mental Health and Quality of Life: A Post-COVID-19 Pandemic Study

Background: The restrictive lockdown measures that were introduced as a response to the COVID-19 pandemic imposed constraints that affected university students’ drinking habits and mental health. Methods: The current study evaluated the rate of binge drinking among university students as they returned to normal life post-lockdown and whether binge drinking affected their mental health and quality of life. A cross-sectional study included 1382 university students (18 - 24 years) of one private Southwestern university in Brazil. Alcohol Use Disorders Identification, the Beck Depression Inventory-II, and the World Health Organization Quality of Life Brief were used. Data were collected after the COVID-19 pandemic lockdown period (from October 2021 to May 2022). Results: 52.6% of the students reported binge drinking, and 35.6% reported symptoms of depression. Binge drinkers were 1.41 times more likely to experience depressive symptoms when compared with non-binge drinkers, and binge drinking was a risk factor for lower quality of life in all three domains (physical, psychological and environmental). Conclusion: Our study highlights an increased prevalence of binge drinking in university students after the pandemic lockdown. The rise in binge drinking rates was linked to depressive symptoms and worsening of quality of life.

Burnout and mental distress among community health workers in low- and middle-income countries: a scoping review of studies during the COVID-19 pandemic

Community health workers(CHWs)represent the backbone of primary health systems,especially in many low-and middle-income countries(LMICs).The coronavirus disease 2019(COVID-19)pandemic stretched health sys-tems and increased the workload for CHWs.The objective of this scoping review was to identify the mental health symptoms experienced among CHWs in LMICs during the COVID-19 pandemic.We searched PubMed for published literature,from January 1,2020 to December 31,2022 that focused on documenting the experiences of burnout,distress,and mental health symptoms among CHWs in LMICs.The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tool.Included studies were grouped into the follow-ing broad thematic categories:(1)symptoms experienced;(2)drivers of different mental health symptoms;and(3)strategies for coping with different symptoms.We identified 10 cross-sectional,qualitative,and observational studies from 11 LMICs in South and Southeast Asia,South America,and Eastern/Southern Africa that assessed the mental health burden CHWs faced during the pandemic.The studies identified disorders and symptoms such as depression,anxiety,fear,burnout,worsened stress,and fatigue.Contributing factors included increased work-load,financial constraints,and an understaffed and underequipped workplace.CHWs reported using different adaptive responses like humor,support from family and colleagues,denial,and substance use,and asked for recommended regular mental health checkups and counseling.More research and policies should be targeted to-wards promoting the mental wellbeing of CHWs to help ensure responsive and resilient health systems in LMICs in the face of future emerging public health threats.

Impact of the COVID-19 Pandemic on Cancer Patients: Experience of the medical oncology department of CHU HASSAN II Fez.

Introduction: In December 2019, COVID 19 spread worldwide, but did not officially start in MOROCCO until March 02, 2020. Since then, this pandemic has significantly impacted the health status of patients in general and cancer patients in particular. The main objective of our study is to evaluate the prognosis of patients treated for cancer and infected with COVID-19. Material and method: A descriptive study with prospective collection was carried out at the medical oncology department of CHU Hassan II in FEZ over a period of two years, from March 2020 to March 2022. Data was carried out on the software SPSS. Results: One hundred cancer patients tested positive for COVID-19 infection and were collected within our department. The average age was 56 years [22-91]. The sex ratio was 1.2. Patients with breast cancer were the most affected by this infection (34%). The clinical symptomatology was dominated by the respiratory syndrome (45%).The diagnosis was made through thoracic CT scan in 62% of cases. 76% of patients were in a metastatic stage. 96% of patients were undergoing oncological treatment. For symptomatique patients, the standard treatment approach involved using antibiotics in 76% of cases. Evolution was marked by recovery in 79% of patients, with a death rate of 12% in this cancer patient population. Conclusion: COVID-19 infection is particularly severe in cancer patients. Mortality among these patients remains high and is associated with overall patient characteristics. However, anticancer treatments have not shown deleterious effects on the course of COVID-19.