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.

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.

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.

Impact of COVID-19 on Safety Performance for Motorcycles: Pre-and during-Pandemic Conditions

Florida has the highest number of motorcycle fatalities in the United States and contains the second largest population of registered motorcycles. The COVID-19 pandemic influenced the roads, traffic, and driving behavior in the continental United States. Motorcycle crashes decreased during the COVID-19 years (2020 and 2021) while the fatality rates increased. The purpose of this study is to 1) investigate motorcycle crashes before and during the Pandemic period to understand the impacts on motorcycle safety and contributing factors to the crash severity levels;2) develop the crash predictive model for different degrees of severity in motorcycle crashes in Florida. Florida statewide crash data were collected. T tests have been conducted to compare the contributing factors between two periods. The injury severities are significantly different among all five levels between those during normal period and the Pandemic period. A crash predictive model has been developed to determine the facts to injury severity levels for motorcycle crashes. A total of eight variables are found to significantly increase the injury severity levels for motorcycle crashes during the Pandemic period.

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.

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.

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.

Occupational health risks among healthcare workers during the COVID-19 pandemic in Saudi Arabia: preparing for the future pandemics

Background:This study aimed to assess the occupational risks encountered by Healthcare Workers(HCWs)in Saudi Arabia during the COVID-19 pandemic.Methods:A cross-sectional survey was carried out from May to October 2021.Using a multi-stage stratified random sampling technique,an online questionnaire was sent to the recruited HCWs,across Saudi Arabia.Results:Of the 768 HCWs recruited,702 participated in the survey.A significant majority(over 80%)reported working beyond 8 hours daily.COVID-19 infection,confirmed via PCR,was identified in 25%of the participants.Notably,infection was significantly correlated with direct or close contact(p=0.0007).Psychological distress was reported by 81%,with anxiety being the most prevalent(33%),followed by stress(19%),depression(17%),and insomnia(12%).Around 20%experienced headaches post-PPE use,while 14%reported adverse skin reactions,predominantly allergy and dermatitis.A concerning one-third of respondents reported exposure to violence.Conclusion:High infection rate,physical and psychological risks among HCWs especially those in direct contact with patients,reflect the need for enhancing the entirety of outbreak preparedness and response,specifically training.Active surveillance system,is crucial to adequately monitor and support HCWs during pandemic scenarios.

The Performance of Extracorporeal Membrane Oxygenation in Various Viral Pneumonia Pandemics: A Meta-Analysis and Systematic Review

Objective: To compare the effects of extracorporeal membrane oxygenation (ECMO) and routine mechanical ventilation on mortality and the risk of associated adverse events in patients with severe viral pneumonia. Methods: PubMed, the Cochrane Library, Embase, Web of Science, and other databases were searched to collect case-control or cohort studies on prognoses associated with ECMO treatment for viral pneumonia. Search terms included extracorporeal membrane oxygenation, ECMO, viral pneumonia, COVID-19, influenza, MERS, and others. According to the PICOS principle, two evaluators independently screened the literature, extracted the data, cross-checked the data, and extracted the data again. Two researchers evaluated the risk of bias in the included studies according to the Newcastle-Ottawa Scale (NOS) and cross-checked the results. Meta-analysis was performed using RevMan 5.3 software. Results: Nine studies were included for analysis, encompassing a total of 4,330 patients, which were categorized into ECMO and CMV groups. There were no significant differences between the two groups in most baseline data;however, the ECMO group had a lower oxygenation index, and some studies reported higher SOFA scores in the ECMO group compared to the CMV group. There was no significant difference in in-hospital mortality between the two groups. The length of ICU stay, total hospital stay, and total mechanical ventilation time were longer in the ECMO group than in the CMV group. In terms of adverse events, there was no significant difference in the occurrence of kidney injury between the two groups. Bleeding events were reported in two studies, with more bleeding events occurring in the ECMO group. According to the subgroup analysis of different virus types, there were no statistical differences in the above aspects among patients with swine flu, novel coronavirus, and MERS. Conclusion: ECMO has a certain degree of positive significance in the treatment of severe viral pneumonia, but there is no significant difference in the treatment outcome of ECMO across different epidemic periods. The timing of ECMO treatment, patient management, and withdrawal evaluation still need further research.

Routine pediatric vaccinations during the COVID-19 pandemic:A review of the global impact

The coronavirus disease 2019(COVID-19)pandemic has put standard,routine childhood vaccinations at risk worldwide.The disruption in vaccine coverage has resulted in a negative impact on the health of children,with some races,ethnicities,age groups,areas of settlement,and parts of the world affected more than others.This literature review studied and examined the impact of COVID-19 on infant,child,and adolescent vaccinations.Retrospectively,the analysis showed a decline,delays,or interruptions in the coverage of vaccines during the pandemic and a decline in some countries'pre-pandemic and post-pandemic eras.Necessary attempts and efforts should be made for these delayed and missed vaccinations,as failure to do so could put children's health at risk.Thus,priority should be directed at instituting catch-up programs to support vaccine uptake and decrease the probability of acquiring vaccine-preventable diseases.

Gene Expression Profiles Comparison between 2009 Pandemic and Seasonal H1N1 Influenza Viruses in A549 Cells

Objective To perform gene expression profiles comparison so that to identify and understand the potential differences in pathogenesis between the pandemic and seasonal A （H1N1） influenza viruses. Methods A549 cells were infected with A/California/07/09 （H1N1） and A/GuangdongBaoan/51/08 （H1N1） respectively at the same MOI of 2 and collected at 2, 4, 8, and 24 h post infection （p.i.）. Gene expression profiles of A549 cells were obtained using the 22 K Human Genome Oligo Array, and differentially expressed genes were analyzed at selected time points. Results Microarrays results indicated that both of the viruses suppressed host immune response related pathways including cytokine production while pandemic H1N1 virus displayed weaker suppression of host immune response than seasonal H1N1 virus. Observation on similar anti-apoptotic events such as activation of apoptosis inhibitor and down-regulation of key genes of apoptosis pathways in both infections showed that activities of promoting apoptosis were different in later stage of infection. Conclusion The immuno-suppression and anti-apoptosis events of pandemic H1N1 virus were similar to those seen by seasonal H1N1 virus. The pandemic H1N1 virus had an ability to inhibit biological pathways associated with cytokine responses, NK activation and macrophage recognition .

Knowledge and Preventive Practice during COVID-19 Pandemic in Bagmati Province, Nepal

Introduction: COVID-19 has become a global public health concern. In Nepal, the government has imposed lockdown, school closures, non-pharmacological interventions, isolation, and quarantine. People were asked to accept self-care interventions. However, the effectiveness of these preventive measures depends on the knowledge and practice of an individual. Therefore, this study aimed to investigate the association between knowledge and practice among Bagmati province residents during the COVID-19 pandemic. Methods: A cross-sectional study was conducted using an online Google Form questionnaire. A total of 296 participants completed the surveys on social media, particularly Facebook. To assess the factors associated with knowledge and practices toward COVID-19, logistic regression analysis was applied. Results: The total scores of knowledge and practice were 7.62 ± 2.06 and 11 ± 1.91, respectively. Results showed that education, people having a medical background, and occupation were significantly associated with knowledge. While urban residence, older age, and living in a rental with a shared room were significantly associated with practice. Conclusions: People with higher education, medical backgrounds, and household workers had high knowledge about COVID-19;however, knowledge was not associated with practice. There was a gap between knowledge and practice.

Vaccine Hesitancy—A Persistant Pandemic and Continued Threat to Global Health

Last time the world faced a deadly pandemic was the H1N1 Spanish flu in 1918, which affected almost one third of the world’s population (500 million people). Since then, almost 100 years later, we are now facing another pandemic of the SARS-CoV2 virus (Covid-19), which is still endemic to this day. As technology evolved during those 100 years, an effective vaccine for Covid-19 was produced within only a year, a huge feat. But, unfortunately, due to its fast development, another force would arise limiting the impact of the vaccine: Vacccine hesitancy and anti-vaxxers, which John Hopkins and the World Health Organization call the biggest current threat to global health. From politics to social media, it is clear that there has been a rapid spread of misinformation, resulting in hesitancy, especially from sociopolitically motivated people popularly referred to as antivaccers. However, a second group of vaccine-hesitant people have also emerged, who are uneducated and remain undecided about vaccination mostly due to safety concerns. They come under the massive influence of anti-vaxxers and anti-vaccine propaganda through social media and politicians, which often make bold claims and huge headlines. To combat vaccine hesitancy, it is crucial that we debunk these conspiracy theories and misinformation that so many believe in, with factual, data-based information. Actively spreading correct information about the vaccines, such as disclosing the rigorous developmental processes and validation of safety data by the FDA, assurance for unlikeliness of getting a lethal side effect along with tremendous health benefits, will encourage people to safe vaccination against Covid-19 and other potentially infectious diseases in future. This article discusses the role of anti-vaxxers and vaccine hesitancy groups, electronic social media, and politics in vaccine hesitancy among people. It describes the strategies to combat the roadblocks in the vaccination programs and health benefits, offered by recent advances in scientific and technological developments.

Subtle differences in receptor binding specificity and gene sequences of the 2009 pandemic H1N1 influenza virus

A recent phylogenetic inference indicated that the 2009 pandemic H1N1 strains circulating from March 2009 to September 2009 could be divided into two closely related but distinct clusters. Cluster one contained most strains from Mexico, Texas, and California, and cluster two had most strains from New York, both of which were reported to co-circulate in all continents. The same study further revealed nine nucleotide changes in six gene segments of the new virus specific for the two clusters. In the current study, the informational spectrum method (ISM), a bioinformatics technique, was employed to study the receptor binding patterns of the two clusters. It discovered that while both groups shared the same primary human binding affinity, their secondary binding preferences were different. Cluster one favored swine binding as its secondary binding pattern, whereas cluster two mostly exhibited the binding specificity of A/South Carolina/1/18 (H1N1) (one of the 1918 flu pandemic strains) as its secondary binding pattern. Besides all the nine nucleotide changes found in the previous study, Random Forests were applied to uncover several new nucleotide polymorphisms in 10 genes of the strains between the two clusters, and several amino acid changes in the HA protein that might be accountable for the discrepancy of the secondary receptor binding patterns of the two clusters. Finally, entropy analysis was conducted to present a global view of gene sequence variations between the two clusters, which illustrated that cluster one had much higher genetic divergence than cluster two. Furthermore, it suggested a significant overall correspondence between the nucleotide positions of high importance in differentiating the two clusters and nucleotide positions of high entropy in cluster one.

Mental Health Intervention in the Workplace amidst the COVID-19 Pandemic

The purpose of this project is to examine why the mental health of employees should be prioritized in the workplace. Most employees have likely experienced a visible illness or injury at some point during their careers. It is easier to identify these physical ailments that may adversely affect an employee’s performance at work, such as a broken leg or the common cold. However, there are conditions that are much less visible that negatively impact employees every day, and mental health is one of them. A person’s mental health is a significant factor in their work life that should not be ignored. While it may be difficult to recognize when someone is struggling with depression, anxiety, or another form of mental illness on the surface, employers should not automatically assume their entire staff is okay. As a result of the COVID-19 pandemic coupled with an increase in civil unrest in society, employers must reevaluate the way they conduct business, starting with the treatment of their employees. To aid employers with prioritizing mental health at work, this paper’s objectives are to address the stigma associated with mental health issues/illness, develop recommendations for inclusive work environments, increase an employer’s investment in mental health, reduce employee turnover, and normalize respect in the workplace. The findings are discussed, and recommendations are provided. Employers who intentionally prioritize and invest in their employees’ mental health will significantly reduce the costs associated with attracting and recruiting new staff due to high turnover rates. Additionally, their reputation as a preferred employer will increase.

Impact of the COVID-19 Pandemic on the Management Course of Paediatric Rheumatic Diseases in a Tertiary Care Hospital of Bangladesh

Background: The COVID-19 pandemic had a significant impact on every aspect of life. Like other chronic diseases, pediatric rheumatic diseases (PRDs) also faced unique challenges during the pandemic, including limited access to care, concerns regarding infection risk, drug shortages and social isolation. Objective: The objective of the study was to identify the impact of the COVID-19 pandemic on the management course of children with rheumatic diseases. Methods: This cross-sectional study was conducted in the department of paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from April 2021 to March 2022. Two hundred and twenty patients were enrolled. A predesigned questionnaire was completed which included socio-demographic, clinical and laboratory parameters. Disease activity was assessed clinically and from laboratory profile. Data were calculated manually and by using SPSS version 22. Z-proportion test and chi square test were done when applicable. Results: Among the enrolled PRD cases 87.7% were Juvenile Idiopathic Arthritis (JIA), 7.7% were Systemic Lupus Erythematosus (SLE) and 4.6% were other cases. Irregular follow-ups were found in 69.9% JIA cases, 82.4% SLE cases and 60% other PRD cases. Poor drug compliance was present in 18.2% of cases. A significant number of patients had higher disease activity or flare during the COVID-19 pandemic. Conclusion: During COVID-19 pandemic most (70.5%) of the PRD patients were irregular in their follow-ups. Poor drug compliance was also more than in the pre-COVID period. Disease activity status significantly worsened during this period.

The Mediating Role of Religious Beliefs in the Relationship between Well-Being and Fear of the Pandemic

Religion is one of the social entities that has had a significant impact on the pandemic.The study’s goals are to investigate the relationship between well-being and fear of COVID-19,as well as to test whether religious beliefs mediate the effect of wellbeing on fear of COVID-19.The sample comprised of 433 participants in Vietnam.Independent Sample t-Test,One-way ANOVA,mediation analysis were used to analyze the data.In the levels of well-being,individuals who engage in religious services daily have higher levels than those hardly and never attend,and people from the age of 18 to 30 have higher levels than individuals from 31 to above 60 years.In addition,people aged from 51 to above 60 have higher levels of religious beliefs than people aged from 18 to 50.Females experience more fear of COVID-19 compared to males.The latter illustrates that religious beliefs mediate the effect of well-being on fear of COVID-19.Social workers and clinicians must prioritize older adults and people with chronic diseases for early mental interventions,and they should be aware of the role of religion in psychological treatment integration.

COVID-19 pandemic impact on ocular trauma in a tertiary hospital

AIM:To analyze the impact of the coronavirus disease-2019(COVID-19)pandemic on the presentation and characteristics of patients hospitalized for ocular trauma in a tertiary hospital in China between 2019 and 2020.METHODS:A retrospective case study was designed to collect information on all cases of ocular trauma in a tertiary hospital from 2019 to 2020 and compare differences in inpatients’data(age,sex,admission vision acuity,type of diagnosis,hospital stays,mechanism of injury and location of injury).RESULTS:The total number of patients admitted to the Ophthalmology Department was 883(mean 73.58±11.25patients per month)in 2019 and 714(59.50±17.92patients per month)in 2020.The injury number of in work was also the most within the four types of location in this two year(42.36%in 2019,43.84%in 2020).The mean hospital stays were 12.66d in 2019 and 10.81d in 2020.The highest incidence of ocular trauma was the middleaged(41-65y)groups in 2019 and 2020.The most common cause of ocular trauma was sharp object in 2019(47.34%)and 2020(47.58%).The mechanical ocular trauma reaches98.98%in 2019 and 99.72%in 2020.CONCLUSION:The number of patients with ocular trauma decreased in 2020,but middle-aged(41-65y)are still high incident groups.Mechanical ocular trauma remains the leading cause of hospitalization for ocular trauma patients and the proportion of patients injured at home increases.It is necessary to arouse social attention and the public’s awareness of eye trauma protection should be strengthened during the pandemic.

Comparing Basic Social Competencies among Nursing Students before and during the Pandemic

Background: Due to the COVID-19 pandemic, the practical curriculum in over 80% of Japanese nursing universities is shorted. The study aimed to clarify the change in basic social competencies among nursing students by comparing their scores before and during the pandemic. Method: Retrospective data from 235 responses from 3rd-grade nursing students were analyzed. The data were separated into two groups—158 respondents before-pandemic and 77 respondents during-pandemic. Respondents were asked to complete a measurement scale two months after the beginning of the 3rd-grade module. Results: Our results showed the during-pandemic group’s averages were higher than the before-pandemic group’s. During the pandemic, nursing students using home-based online learning could not self-evaluate accurately because they could not practice in the field. Conclusion: Nursing students who were studying during the during-pandemic self-assessed themselves higher than those who were studying during the before-pandemic because they could not compare with the other students, and the results showed that misunderstandings may arise.

Prevalence of Antimicrobial Resistance of ESKAPE Pathogens before and during Pandemic COVID-19 Pandemic in a University Affiliated Hospital in Tangerang, Indonesia

Introduction: Antimicrobial resistance is the most important health problems currently. Antibiotic prophylaxis to prevent bacterial co-infections in hospitalized COVID-19 patients, and lack of surveillance were associated with antimicrobial resistance. ESKAPE pathogens consisting of E. faecium, S. aureus, K. pneumoniae, A. baumanii, P. aeruginosa and Enterobacter spp. are associated with healthcare-associated infections. Patients and Methods: This descriptive, retrospective, longitudinal study aims to describe the resistance rates of bloodstream infection due to ESKAPE pathogens from patients admitted in Siloam Hospital Karawaci, before and during COVID-19 pandemic (January 1st, 2019 until December 31st, 2022). Out of 296 ESKAPE pathogens collected from blood samples, S. aureus was the most frequent species, followed by K. pneumoniae, A. baumannii, P. aeruginosa, Enterobacter spp., and E. faecium. Results: Resistance rates of E. faecium were alarmingly high from 2019 until 2021, but in 2022 no sample was found. Resistance rates of S. aureus and MRSA decreased from 2019 until 2021 and then increased again in 2022 while for K. pneumoniae it peaked in 2020 and reached the lowest in 2022. Resistance pattern of A. baumanii was not favorable from 2019 until 2021, but decreased dramatically in 2022. Resistance pattern of P. aeruginosa was quite variable in 2021 and 2022 while for Enterobacter spp. it was variable in 2020 to 2022. Conclusion: The COVID-19 pandemic affected the antimicrobial resistance pattern of ESKAPE pathogens in Banten province, Indonesia. Resistance rates increased as the pandemic peaked in 2020 to 2021, and decreased as the pandemic resolves in 2022.