Sleep Quality and Emotional Adaptation among Freshmen in Elite Chinese Universities during Prolonged COVID-19 Lockdown:The Mediating Role of Anxiety Symptoms

Under the effects of COVID-19 and a number of ongoing lockdown tactics,anxiety symptoms and poor sleep quality have become common mental health issues among college freshmen and are intimately related to their emotional adaptation.To explore this connection,this study gathered data from a sample of 256 freshmen enrolled in an elite university in China in September 2022.The association between sleep quality,anxiety symptoms,and emotional adaptation was clarified using correlation analysis.Additionally,the mediating function of anxiety symptoms between sleep quality and emotional adaptation was investigated using a structural equation model.The results reveal that:(1)Chinese elite university freshmen who were subjected to prolonged lockdown had poor sleep quality and mild anxiety symptoms;(2)a significant positive correlation between poor sleep quality and anxiety symptoms was identified;(3)anxiety symptoms were found to have a significant negative impact on emotional adaptation;(4)poor sleep quality had a negative impact on emotional adaptation through anxiety symptoms.This research makes a valuable contribution by offering insights into the intricate relationship between sleep quality and emotional adaptation among freshmen in elite Chinese universities during prolonged lockdown conditions,and it is beneficial for schools and educators to further improve school schedules and psychological health initiatives.

Cardiovascular risk factors affecting COVID-19 outcomes at a tertiary referral hospital in northwest Iran: A prospective cohort study

Objective:To investigate cardiovascular risk factors affecting COVID-19 outcomes in a tertiary referral hospital.Methods:This prospective cohort study analyzed 269 participants with COVID-19.The primary outcomes were ICU admission,prolonged hospital stay duration,and in-hospital death.The secondary outcomes included death,chronic symptoms,and NYHA functional class during follow-up periods.Results:A total of 412 patients with COVID-19 symptoms were enrolled in the study,and out of which 269 patients had complete medical records and positive SARS-CoV-2 PCR test results,fulfilling the study criteria were analyzed.The patients were divided into two groups,with cardiovascular comorbidities(group A,n=122),such as established cardiovascular disease,diabetes mellitus,and hypertension,and without cardiovascular comorbidities(group B,n=147).Binary logistic regression analysis showed that patients with underlying hypertension,diabetes,and established cardiovascular disease had a 1.55(95%CI:1.28-2.26),1.62(95%CI:1.34-2.13),and 1.63(95%CI:1.07-5.34)-fold risk of mortality,respectively in the adjusted model.Conclusions:Hospitalized COVID-19 patients with predisposing cardiovascular risk factors are more susceptible to develop worse outcomes.More attention should be paid to the management and follow-up of these patients.

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.

Assessment of Persistence Symptoms in Recovered COVID-19 Patients by Yorkshire Rehabilitation Scale (C19‐YRS): A Cross-Sectional Study from Qassim Region, Saudi Arabia

Background: Earlier back at the beginning of COVID-19, the acute phase of infection was variable from one patient to another causing different symptoms. However, many patients are still suffering from Post COVID-19 Syndrome. Hence, this study aimed to assess the persistence of symptoms in patients who recovered from COVID-19 in the Qassim Region, Saudi Arabia. Methodology: A descriptive cross-sectional study of 413 confirmed PCR test-positive covid-19 patients enrolled in this study from the Ministry of Health Electronic Surveillance System (HESN). The Yorkshire Rehabilitation Scale (C19-YRS) checklist was used to record patients’ symptoms, functioning, and disability. Data were analyzed by the SPSS program. Functional and patient-reported outcome measures were correlated with certain items from C19-YRS, the severity of symptoms. Its distribution-based methods were used for responsiveness over time. The scaling and targeting assumptions were satisfied, and internal consistency was high (Cronbach’s α = 0.843). Results: After 4 weeks of infection, 50% of patients reported persistent symptoms such as laryngeal complications, 43.8% Swallowing changes, 31.3% fatigue, 18.8% pain, 18.8% loss of appetite, 12.5% breathlessness, and 6.3% depression, Moreover, 18.8% of patients experienced reduced mobility. At the beginning of the COVID-19 infection, fever was the most common complaint 332 (80.4%), followed by 267 (64.6%) fatigue, and loss of smell 230 (55.7%). The severity of the breathlessness symptoms was exaggerated during the patients’ walking or climbing stairs. Patients who were admitted to an intensive care unit (n = 5) were significantly elderly (P Conclusion: The study examined the severity of post covid syndrome by patients’ responsiveness to the scale items in C19-YRS. The majority of COVID-19 symptoms were still present but significantly reduced after 4 weeks of infection. Follow-up and long-term management of physical and psychological symptoms of hospitalized and non-hospitalized patients are very important.

Work Ability Index and Work Ability Score: A Comparation between both Scores in a Persistent COVID-19 Cohort

Aims: The present study aims to compare the assessment of work ability based on the use of the Work Ability Index (WAI) with another questionnaire base only on the use of WAI’s first item, termed as the “Work Ability Score” (WAS). Study design: A cohort of 384 Spanish workers included in a Post COVID-19 condition or persistent COVID-19 multicenter research was utilized. Place and Duration of Study: This cohort was enlisted in four hospitals (Hospital Universitario 12 de Octubre, Madrid;Hospital Universitario Virgen Macarena, Sevilla, Andalucía;Hospital Universitario Gregorio Marañón, Madrid and Complejo Asistencial Universitario de Salamanca, Castilla y León), since 2021 until 2022. Methodology: 384 Spanish workers (176 men and 208 women;aged 20 to 70 years) with Post COVID-19 condition or persistent COVID-19 were included. Descriptive analysis of primary scores was conducted. Given the non-normal distribution of data, the Mann-Whitney and Kruskal-Wallis tests were employed. Spearman and Kendall correlations were employed to assess the relationship between WAI and WAS, also used weighted Kappa to estimate the degree agreement between WAI and WAS. Logistic regression models were utilized to study determinants influencing WAI and WAS, categorized as poor or moderate. Results: WAI had an average score of 32.98 (SD = 10.28), whereas WAS had an average of 5.95 (SD = 2.77). Significant differences were observed in both WAI and WAS across the same variables. Strong and statistically significant correlations were evident between WAI and WAS (rs = 0.83, p < 0.001). All the variables used in the logistic regression model (gender, the sector employment, and previous chronic diseases) were statistically significant in both questionnaires. Conclusion: WAS questionnaire could be used as a tool for reliable assessment of work ability among Spanish workers with Post COVID-19 condition or Persistent CO-VID-19.

Cardiovascular sequelae in post-COVID-19 patients with moderate to severe CT severity score: A follow-up study

Objective:To study cardiovascular sequelae of post-COVID-19 patients with moderate to severe computed tomography(CT)severity score.Methods:A prospective,non-randomized,observational study was conducted on 100 post-COVID-19 patients with moderate to severe CT severity scores from January 2021 to December 2021.Fifty-nine were male[mean age(54.1±12.2)years]and 41 were female[mean age(46.9±15.1)years].Patients with previous cardiovascular disease,previous chronic lung disease,and pre-existing primary or secondary pulmonary hypertension were excluded.Patients were examined,and serial electrocardiogram and 2D echocardiography were performed to detect any cardiovascular abnormality.Results:Post-COVID-19 patients had persistent symptoms,the most common being fatigue(59%).Most of these symptoms were relieved on follow-up.A rise in systolic,diastolic blood pressure,and pulse rate was observed.The electrocardiographic evaluation revealed ST-T segment changes,sinus tachycardia,ventricular hypertrophy,and arrhythmias among a considerable number of patients.On echocardiography,left ventricular diastolic dysfunction was most common(43%).Pulmonary hypertension,as evidenced by elevated pulmonary artery systolic pressure,was seen in 15%of patients.Conclusions:The present findings reveal an increased incidence of cardiovascular complications after recovery from COVID-19 infection in those without pre-existing cardiovascular or chronic lung disease.

Stressors in Nurse Students’ Formation in the New Normality Post COVID-19

Background: Mental health has been impaired and at risk due to the worldwide COVID-19 pandemic. The consequences due to confinement impacted every scenario, which directly influenced the daily routine of nurse students;in each setting students faced stressors that trigger fear, anxiety and others, since being in confinement learning of topics moved to the home, laboratory practices in hospitals were cancelled leaving the room that is uncertain up to their return to in-person activities. It is important to highlight the need for innovation and strengthening of theoretical-pedagogic aspects centered at the student’s context as a human being with their own needs and problems, who will interact with others in the continuous process of health-illness. Objective: the aim was to identify the stressors in the nurse students’ formation in the new normality post-COVID-19. Methods: Qualitative and phenomenological research with 27 participants aged 20 - 25 years, nurse students of a public university. The information collection was through four focal groups of 6-7 members each, data analysis was done according to Miles & Huberman after signed informed consent of each participant, and authorized by the chairperson of the Nurse’ career. Results: Category 1, Cumulative stressors with sub-categories 1.1 Uncertainty, 1.2 Isolation, 1.3 Invisibility, 1.4 Mockery, 1.5 Exclusion. Category 2, Expectancy states with sub-categories 2.1 Low self-esteem, 2.2 Insecurity, 2.3 Anxiety, 2.4 Depression, 2.5 Temporary leave, 2.6 Search for authenticity. Category 3, Internalization processes with sub-categories 3.1 Social rejection, 3.2 Self-censorship, 3.3 Discrediting, 3.4 Disempowerment. Category 4, Academic aspects affected with sub-categories 4.1 Deficient studying habits, 4.2 Deficient assimilations of knowledge, 4.3 Archived knowledge in the computer, 4.4 Absence of practice in previous semesters. Conclusion: Once identified the stressors in nurse students in the new normality post-COVID-19, it will allow the creation of settings that help in getting confidence for students, i.e., a safe surrounding promotes the development of abilities and competencies during formation, as well as recommendations of teachers in the classroom and laboratories that contribute to filling space that students perceive as empty, and to intensifying the companionship in clinical settings where students perceive most aggressiveness.

Psychological impacts of the COVID-19 epidemic on Chinese people: Exposure, post-traumatic stress symptom, and emotion regulation

Objective:To examine the effects of coronavirus disease-2019(COVID-19)exposure,expressive suppression/cognitive reappraisal,and demographic variables on post-traumatic stress symptoms(PTS)among Chinese.Methods:Participants were recruited by social media through We Chat and 6049 Chinese(aged from 17 to 63 years;median=24)from 31 provinces were included in the study.PTS symptoms,expressive suppression,and cognitive reappraisal were assessed after the outbreak of COVID-19.A regression mixture analysis was conducted in Mplus 7.Results:A regression mixture model identified three latent classes that were primarily distinguished by differential effects of COVID-19 exposures on PTS symptoms:(1)Class 1(mildly PTS symptoms,80.9%),(2)Class 2(moderate PTS symptoms,13.0%),and(3)Class 3(high PTS symptoms,6.1%).The results demonstrated that the young,women and people with responsibilities and concerns for others were more vulnerable to PTS symptoms;and they had more expression inhibition and less cognitive reappraisal in three latent classes.Conclusions:The findings suggest that more attention needs to be paid to vulnerable groups such as the young,women and people with responsibilities and concerns for others.Therapies to encourage emotional expression and increase cognitive reappraisal may also be helpful for trauma survivors.

Clinical characteristics of patients with COVID-19 presenting with gastrointestinal symptoms as initial symptoms: Retrospective case series

BACKGROUND A large number of pneumonia cases due to coronavirus disease 2019(COVID-19)have been first reported in China.Meanwhile,the virus is sweeping all around the world and has infected millions of people.Fever and pulmonary symptoms have been noticed as major and early signs of infection,whereas gastrointestinal symptoms were also observed in a significant portion of patients.The clinical investigation of disease onset was underestimated,especially due to the neglection of cases presenting with gastrointestinal symptoms.AIM To characterize the clinical features of coronavirus-infected patients with gastrointestinal symptoms as initial symptoms.METHODS This is a retrospective,single-center case series of the general consecutive hospitalized patients with confirmed COVID-19 at Wuhan Union Hospital from February 2,2020 to February 13,2020.According to their initial symptoms,these patients were classified into two groups.Patients in group one presented with pulmonary symptoms(PS)as initial symptoms,and group two presented with gastrointestinal symptoms(GS).Epidemiological,demographic,clinical,laboratory,and treatment data were collected for analysis.RESULTS Among the 50 patients recruited,no patient has been admitted to intensive care units,and no patient died during the study.The duration of hospitalization was longer in the GS group than in the PS group(12.13±2.44 vs 10.00±2.13,P<0.01).All of the 50 patients exhibited decreased lymphocytes.However,lymphocytes in the GS group were significantly lower compared to those in the PS group(0.94±0.06 vs 1.04±0.15,P<0.01).Procalcitonin and hs-CRP were both significantly higher in the GS group than in the PS group.Accordingly,the duration of viral shedding was significantly longer in the GS group compared to the PS group(10.22±1.93 vs 8.15±1.87,P<0.01).CONCLUSION COVID-19 patients presenting with gastrointestinal symptoms as initial symptoms need more days of viral shedding and hospitalization than the patients presenting with pulmonary symptoms.

Pathophysiological mechanisms underlying gastrointestinal symptoms in patients with COVID-19

Gastrointestinal(GI)symptoms,such as diarrhea,abdominal pain,vomiting,and anorexia,are frequently observed in patients with coronavirus disease 2019(COVID-19).However,the pathophysiological mechanisms connecting these GI symptoms to severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infections remain elusive.Previous studies indicate that the entry of SARS-CoV-2 into intestinal cells leads to downregulation of angiotensin converting enzyme 2(ACE2)receptors resulting in impaired barrier function.While intestinal ACE2 functions as a chaperone for the amino acid transporter B0AT1,the B0AT1/ACE2 complex within the intestinal epithelium acts as a regulator of gut microbiota composition and function.Alternations to the B0AT1/ACE2 complex lead to microbial dysbiosis through increased local and systemic immune responses.Previous studies have also suggested that altered serotonin metabolism may be the underlying cause of GI disorders involving diarrhea.The findings of elevated plasma serotonin levels and high fecal calprotectin in COVID-19 patients with diarrhea indicate that the viral infection evokes a systemic inflammatory response that specifically involves the GI.Interestingly,the elevated proinflammatory cytokines correlate with elevated serotonin and fecal calprotectin levels further supporting the evidence of GI inflammation,a hallmark of functional GI disorders.Moreover,the finding that rectal swabs of COVID-19 patients remain positive for SARS-CoV-2 even after the nasopharynx clears the virus,suggests that viral replication and shedding from the GI tract may be more robust than that of the respiratory tract,further indicating fecal-oral transmission as another important route of viral spread.This review summarized the evidence for pathophysiological mechanisms(impaired barrier function,gut inflammation,altered serotonin metabolism and gut microbiota dysbiosis)underlying the GI symptoms in patients with COVID-19.

Comparative profile for COVID-19 cases from China and North America: Clinical symptoms, comorbidities and disease biomarkers

BACKGROUND Large inter-individual and inter-population differences in the susceptibility to and outcome of severe acute respiratory syndrome coronavirus 2 or coronavirus disease 2019(COVID-19)have been noted.Understanding these differences and how they influence vulnerability to infection and disease severity is critical to public health intervention.AIM To analyze and compare the profile of COVID-19 cases between China and North America as two regions that differ in many environmental,host and healthcare factors related to disease risk.METHODS We conducted a meta-analysis to examine and compare demographic information,clinical symptoms,comorbidities,disease severity and levels of disease biomarkers of COVID-19 cases from clinical studies and data from China(105 studies)and North America(19 studies).RESULTS COVID-19 patients from North America were older than their Chinese counterparts and with higher male:Female ratio.Fever,cough,fatigue and dyspnea were the most common clinical symptoms in both study regions(present in about 30%to 75%of the cases in both regions).Meta-analysis for the prevalence of comorbidities(such as obesity,hypertension,diabetes,cardiovascular diseases,chronic obstructive pulmonary disease,cancer,and chronic kidney diseases)in COVID-19 patients were all significantly more prevalent in North America compared to China.Comorbidities were positively correlated with age but at a significantly younger age range in China compared to North American.The most prevalent infection outcome was acute respiratory distress syndrome which was 2-fold more frequent in North America than in China.Levels of C-reactive protein were 4.5-fold higher in the North American cases than in cases from China.CONCLUSION The differences in the profile of COVID-19 cases from China and North America may relate to differences in environmental-,host-and healthcare-related factors between the two regions.Such inter-population differences-together with intrapopulation variability-underline the need to characterize the effect of health inequities and inequalities on public health response to COVID-19 and can assist in preparing for the re-emergence of the epidemic.

Early COVID-19 Symptoms Identification Using Hybrid Unsupervised Machine Learning Techniques

The COVID-19 virus exhibits pneumonia-like symptoms,including fever,cough,and shortness of breath,and may be fatal.Many COVID-19 contraction experiments require comprehensive clinical procedures at medical facilities.Clinical studies help to make a correct diagnosis of COVID-19,where the disease has already spread to the organs in most cases.Prompt and early diagnosis is indispensable for providing patients with the possibility of early clinical diagnosis and slowing down the disease spread.Therefore,clinical investigations in patients with COVID-19 have revealed distinct patterns of breathing relative to other diseases such as flu and cold,which are worth investigating.Current supervised Machine Learning(ML)based techniques mostly investigate clinical reports such as X-Rays and Computerized Tomography(CT)for disease detection.This strategy relies on a larger clinical dataset and does not focus on early symptom identification.Towards this end,an innovative hybrid unsupervised ML technique is introduced to uncover the probability of COVID-19 occurrence based on the breathing patterns and commonly reported symptoms,fever,and cough.Specifically,various metrics,including body temperature,breathing and cough patterns,and physical activity,were considered in this study.Finally,a lightweight ML algorithm based on the K-Means and Isolation Forest technique was implemented on relatively small data including 40 individuals.The proposed technique shows an outlier detection with an accuracy of 89%,on average.

Evaluation of botanicals as potential COVID-19 symptoms terminator

Information about the coronavirus disease 2019(COVID-19)pandemic is still evolving since its appearance in December 2019 and has affected the whole world.Particularly,a search for an effective and safe treatment for COVID-19 continues.Botanical mixtures contain secondary metabolites(such as flavonoids,phenolics,alkaloids,essential oils etc.)with many therapeutic effects.In this study,the use of herbal treatments against COVID-19 was evaluated.Medical synthetic drugs focus mainly on respiratory symptoms,however herbal therapy with plant extracts may be useful to relieve overall symptoms of COVID-19 due to the variety of bioactive ingredients.Since COVID-19 is a virus that affects the respiratory tract,the antiviral effects of botanicals/plants against respiratory viruses have been examined through clinical studies.Data about COVID-19 patients revealed that the virus not only affects the respiratory system but different organs including the gastrointestinal(GI)system.As GI symptoms seriously affect quality of life,herbal options that might eliminate these problems were also evaluated.Finally,computer modeling studies of plants and their active compounds on COVID-19 were included.In summary,herbal therapies were identified as potential options for both antiviral effects and control of COVID-19 symptoms.Further data will be needed to enlighten all aspects of COVID-19 pathogenesis,before determining the effects of plants on severe acute respiratory syndrome coronavirus 2.

Gastrointestinal symptoms in patients with COVID-19: Is there a relationship with mortality and new variations of SARS-CoV-2?

Coronavirus disease 2019(COVID-19)is caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Although,respiratory symptoms are typical the digestive system is also a susceptible target with gastrointestinal symptoms present even in the absence of respiratory symptoms.The gastrointestinal symptoms of COVID-19 include diarrhea,abdominal pain,anorexia,and nausea among other symptoms.Some questions that remain to be answered include:Do patients with gastrointestinal symptoms have a higher mortality?SARS-CoV-2 variants are already a global reality:Do these variants present with a greater prevalence of gastrointestinal symptoms?Do patients with these symptoms warrant more intensive care unit care?

A Machine Learning Approach for Early COVID-19 Symptoms Identification

Symptom identification and early detection are the first steps towards a health condition diagnosis.TheCOVID-19 virus causes pneumonialike symptoms such as fever,cough,and shortness of breath.ManyCOVID-19 contraction tests necessitate extensive clinical protocols in medical settings.Clinical studies help with the accurate analysis of COVID-19,where the virus has already spread to the lungs in most patients.The majority of existing supervised machine learning-based disease detection techniques are based on clinical data like x-rays and computerized tomography.This is heavily reliant on a larger clinical study and does not emphasize early symptom detection.The aim of this study is to investigate anomalies in patient physiological data for early COVID-19 symptoms identification.In this context,two of the most prevalent symptoms,fever and cough,were examined in a two-fold manner utilizing an unsupervised machine learningmodel.To examine disease progression,physiological features from a chest-worn device were analyzed.First,a Single Vector Activity Index(SVAI)parameter is proposed to monitor the breathing and cough patterns.Second,the dataset’s variance is examined using the DBSCAN method for clustering and outlier detection.Finally,the model accuracy is evaluated to identify outliers on real-time data based on feature dissimilarities,yielding an overall detection accuracy of 90.34%.

Posttraumatic stress symptom trajectories of Chinese university students during the first eight months of the COVID-19 pandemic and their association with cognitive reappraisal,expressive suppression,and posttraumatic growth

Objective: To identify the moderating effects of cognitive reappraisal(CR) and expressive suppression(ES) on the relationship between posttraumatic stress(PTS) symptoms and posttraumatic growth(PTG) in university students. Methods: The survey included 1 987 Chinese university students who completed questionnaires on PTS symptoms in February 2020, with three follow-up surveys at two-month intervals until August 2020. We assessed CR and ES at February 2020 and PTG at August 2020. Growth mixture modeling was used to classify the PTS symptom trajectories. Multinomial logistic regression was used to recognize the predictors of class membership. The relationships among PTS symptoms, CR, ES, and PTG were examined using multi-group path analysis.Results: Sex, SARS-Co V-2 infection of a family member or friend, number of siblings, CR, and ES were significantly associated with PTS symptoms. Three latent classes were identified: ‘Increasing PTS’(n=205, 10.0%) who had rapid deterioration of PTS symptoms, ‘Moderate PTS’(n=149, 8.0%) who had a high level of PTS symptoms at the beginning and slightly increasing, and ‘Persistent Minimal PTS’(n=1 633, 82.0%), who had slow resolution of PTS symptoms over time. Male, SARS-Co V-2 infection of a family member or friend, and having a lower CR and a higher ES, were more likely to have ‘Increasing PTS’. PTS at February 2020 predicted PTG only in ‘Increasing PTS’ class, and both CR and ES had moderating effects on the conversion between them.Conclusions: Most students recovered from posttraumatic stress of COVID-19 pandemic, but a small proportion expeienced increasing PTS symptoms, and those with this condition may benefit from emotional regulation intervention.

Legacy of neuropsychiatric symptoms associated with past COVID-19 infection:A cause of concern

Although primarily affecting the respiratory system,growing attention is being paid to the neuropsychiatric consequences of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infections.Acute and sub-acute neuropsychiatric manifestations of coronavirus disease 2019(COVID-19)disease and their mechanisms are better studied and understood currently than they had been when the pandemic began;however,many months or years will be necessary to fully comprehend how significant the consequences of such complications will be.In this editorial,we discuss the possible long-term sequelae of the COVID-19 pandemic,deriving our considerations on experiences drawn from past coronaviruses’outbreaks,such as the SARS and the middle east respiratory syndrome,and from the knowledge of the mechanisms of neurotropism and invasiveness of SARS-CoV-2.Acknowledging the global spread of COVID-19 and the vast number of people affected,to date amounting to many millions,the matter of this pandemic’s neuropsychiatric legacy appears concerning.Public health monitoring strategies and early interventions seem to be necessary to manage the possible emergence of a severe wave of neuropsychiatric distress among the survivors.

Diagnostic Accuracy and Predictive Value of Clinical Symptoms for the Diagnosis of Mild COVID-19

Objective: To assess the diagnostic accuracy and predictive values of clinical symptoms in patients with suspected mild COVID-19 to identify target groups for self-isolation and outpatient treatment without additional testing. Methods: We conducted an open-label prospective study in patients aged 18 to 72 years with suspected mild COVID-19. The clinical diagnosis was based on the acute onset of such symptoms as olfactory dysfunction, hyperthermia, myalgia, nasal congestion, nasal discharge, cough, rhinolalia, sore throat, without pneumonia in persons in contact with a confirmed case of COVID-19. The physician assessed clinical symptoms using a 4-point scale. The patient self-assessed clinical symptoms using a ten-point visual analogue scale (VAS). All enrolled patients underwent laboratory testing to confirm the diagnosis of COVID-19. Results: Of the 120 patients underwent testing, the diagnosis of mild COVID-19 was confirmed in 96 patients and ruled out in 24 patients. When assessing symptoms by a physician according to the correlation analysis, hyperthermia, myalgia, nasal congestion and rhinolalia have a positive predictive value with a significance level of more than 0.6. When self-assessing symptoms by a patient, fever, myalgia and nasal congestion have a diagnostic accuracy with a significance level of more than 0.5. Nasal discharge, cough and sore throat have negative predictive values. Conclusion: The presence of these symptoms in patients with an acute onset of the disease can help to make a clinical diagnosis of coronavirus disease and identify target groups for self-isolation and outpatient treatment without additional testing. Highly suspect asymptomatic patients are not considered as those who have possible mild COVID-19 infection.

Clinical Characteristics of COVID-19 Patients with Digestive Symptoms in a Tertiary Level Hospital

Background: The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has greatly challenged public health worldwide. A growing number of studies have reported gastrointestinal (GI) symptoms. The study aimed to estimate the various digestive symptoms frequently reported in Covid-19 patients among the adult population of Bangladesh. Methods: In this descriptive, cross-sectional study, we enrolled confirmed patients with COVID-19 who were admitted to the COVID unit of Shaheed Suhrawardy Medical college hospital, Dhaka from July 2020 to December 2020. All patients were COVID confirmed by real-time polymerase chain reaction (RT-PCR) and were analyzed for clinical characteristics, laboratory findings and imaging study. Results: The study population consisted of 121 COVID-19-positive patients, among them, 57.85% were male and 42.15% female. The majority (43%) of the study population were in the age group of 31 - 40 years. The male to female ratio was 1.4:1. Nearly 94.2% of the sample population were married, among them 92.9% were male and 96.1% were female. Out of 121 Covid-19 patients, 30.65% had a contact history, 17.4% had a history of traveling or residing in an area reporting COVID-19 and 11.6% of family members were affected by Covid-19. Most of the patients had a fever (95%), cough (88.4%) and dyspnoea (43.8%), pneumonia (37.4%) and severe pneumonia (36.4%). In this study, 40% patients reported a digestive symptom including diarrhea 47.9%, vomiting 55.5%, loss of appetite 16.5%, abdominal pain 29.8%, abdominal bloating 24.8%, reflux 0%, jaundice 3.3%. Regarding co-morbidities, the majority had bronchial asthma (50%) followed by hypertension 46%, diabetes 38%, obesity 23%, and CKD 14% and heart disease 3%. Among 121 COVID-19 patients, 98% had recovered from the disease and 2% of patients expired. Conclusion: Gastrointestinal symptoms are common among patients with COVID-19 and this group of patients had a long time of hospital stay from onset to admission, and higher liver enzyme levels. During the management of COVID-19 patients, clinicians need to be alert regarding suspicion of the GI features among COVID-19, so that they can diagnose early and treat effectively and immediately.

Symptoms associated with nucleic acid turning-negative-time in COVID-19 patients?

Objective:To explore on the association between nucleic acid turning-negative-time and traditional Chinese medicine(TCM)symptoms in coronavirus disease 2019(COVID-19)patients with the Omicron variant.Method:For this retrospective cross-sectional study,we enrolled 189 patients with COVID-19(age 20-90 years)were included.multiple linear regression models were used to investigate the TCM symptoms affecting the nucleic acid turning-negative-time of COVID-19 patients,during the process of data analysis,taking with nucleic acid turning-negative-time as the dependent variable,and TCM symptoms as independent variables,and at the same time,sex,age,hypertension,diabetes,and coronary heart disease were as confounding variables.Results:The study found that the most common TCM symptoms of COVID-19 patients with Omicron were cough,dry throat,expectoration,fever,sore throat,pharyngeal itching,running nose,and nasal congestion.Regression analysis showed that the fit regressive equation showed a significant difference(F=4.286,P<0.001),R=0.400,the adjusted R^(2)=0.123,and three variables in the regression equation showed significant difference(P<0.05).The results showed that nucleic acid turningnegative-time was mostly related to constipation,fever,and expectoration.If the patients had the symptoms of constipation,fever,and expectoration;that is,if patients showed these symptoms,the turning-negative-time of nucleic acid in patients with Omicron will be prolonged.Conclusions:Treatment based on symptoms for patients with constipation,fever,and expectoration may have important clinical significance for the COVID-19 patients with Omicron.