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 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.

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.

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.

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.

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.

Economic Growth Performance and Economic Activities in Kosovo During the Covid-19 Pandemic in Kosovo

The paper addresses economic growth and developments of economic activities during the Covid-19 crisis in Kosovo.After the last war,Kosovo continues to remain among the countries with a low level of development and a high rate of unemployment.The low level of economic growth and the high rate of unemployment remain among the main economic challenges for solution.The importance of the paper consists in addressing economic issues and processes including developments in economic activities during the Covid-19 crisis in Kosovo.Kosovo was affected by Pandemia Covid-19 starting from March 2020.Undoubtedly,the Covid-19 crisis has had effects on economic processes,affecting the activity of various sectors of the economy.The main purpose of this paper is to analyze the performance of economic growth and economic activities during the Covid-19 crisis in Kosovo.In order to achieve the objectives,the analysis method is mainly used,tabular and graphic separately,comparative method,analyzing in dynamics the issue related to economic activities in the Republic of Kosovo.Through this study,the results and recommendations given are considered to be considered by policy makers in the Republic of Kosovo.

Nursing student volunteers and their level of involvement during the COVID-19 pandemic:a systematic review

Objective:Many strategic efforts were made to address nurses'shortage in controlling Coronavirus disease 2019(COVID-19),including recruiting student health volunteers.This review aimed to explore the contribution and involvement of nursing student volunteers during COVID-19.Methods:A systematic review was registered in PROSPERO International CRD42021283069.Electronic databases for ar ticle search included:SCOPUS,EBSCO MEDLINE,Pub Med,Pro Quest,Springer,Sage Pub,and hand searching.The critical appraisal study quality using The Joanna Briggs Institutes.Data extraction and synthesis used Population,Intervention,Comparison,Outcome,and Design(PICO and D)framework with thematic analysis.Results:Twelve studies were enrolled from 2545 retrieved,with 4 synthesized themes:(1)determinant of the involvement of nursing student volunteers during COVID-19,which includes 3 subthemes:motivations,perception,and barriers,(2)expectations and actual condition of nursing students as volunteers,(3)the need for nursing student volunteers,and(4)the impact and level of student volunteers'contribution.All student volunteers contribute to providing direct or indirect services to patients.Conclusions:This review provides an overview of nursing student volunteers'needs useful in developing competency frameworks and the role of culturally sensitive volunteers in education and training.In the future,student volunteers could choose the appropriate volunteer program and location according to their competence.

A Study on the Influences of the COVID-19 Pandemic-Related Depression, Anxiety, Stress, and Treatment-Crisis on Quality of Life in Cancer Patients - A Secondary Publication

Objective:To investigate the factors affecting the quality of life of cancer patients by examining the degree of the COVID-19 pandemic-related depression,anxiety,stress,and treatment crisis.Methods:Data were collected from 132 cancer patients undergoing surgery,chemotherapy,radiotherapy,and hormone therapy at K University Hospital in D City using a structured questionnaire.The period of data collection was from May 6 to May 28,2022.The collected data were analyzed using descriptive statistics,t-test,ANOVA,Pearson’s correlation,and stepwise multiple regression.Results:The mean scores of quality-of-life,depression,anxiety,stress,and treatment crisis during the COVID-19 pandemic were 84.64±29.09,15.14±6.49,4.66±5.27,75.83±17.70,and 78.52±19.95,respectively.In terms of factors affecting the quality of life related to the COVID-19 pandemic,COVID-19 pandemic-related stress(β=0.41,P<0.001)appeared to have the greatest impact,followed by COVID-19 pandemic-related treatment-crisis(β=0.28,P=0.002),anxiety(β=0.21,P=0.002),and gender(β=0.14,P=0.009),with a total explanatory power of 67.6%.Conclusion:To improve the quality of life during the COVID-19 pandemic,COVID-19 pandemic-related stress,treatment-crisis,and anxiety should be periodically monitored and nursing interventions such as education on infection prevention,management,and emotional support programs should be provided to decrease the COVID-19 pandemic-related stress,treatment-crisis,and anxiety.

Stress perceptions of nurses serving in home healthcare services during the COVID-19 pandemic:A qualitative research

Objective:To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods:This study was qualitative research with a phenomenological design.Data were collected and recorded through in-depth interviews with 6 nurses working in MuşState Hospital,Home Healthcare Services Unit using a form consisting of 12 questions on an online platform between May 2021 and July 2021.The audio recordings were transcribed by the researcher and content analysis was performed by creating codes,categories,and themes.Results:The interviews yielded 10 categories and 59 sub-codes.These codes were addressed under the theme of"COVID-19 pandemic".Under this main theme,nurses expressed the problems they experienced in issues such as stress,support mechanisms,and family and social problems during COVID-19.They mentioned that they experienced high stress in this process,as well as social isolation and negative thoughts of society about them and that they could not spare time for themselves and their families.Conclusions:Nurses working in home healthcare services frequently express negativities such as high stress,isolation from society,and increased workload.Therefore,actions should be taken to raise awareness of society on these issues,increase the number of personnel,conduct more research,and share the results with the public.

Relationship between depression,smartphone addiction,and sleep among Chinese engineering students during the COVID-19 pandemic

BACKGROUND Existing research has demonstrated that depression is positively related to smartphone addiction, but the role of sleep has not been discussed thoroughly, especially among engineering undergraduates affected by the coronavirus disease 2019 pandemic.AIM To evaluate sleep as a mediator of the association between smartphone addiction and depression among engineering undergraduates.METHODS Using a multistage stratified random sampling method, a cross-sectional survey was conducted among 692 engineering undergraduates from a top engineering university in China, and data were collected by self-reported electronic questionnaires. The data included demographic characteristics, such as age, gender, the Smartphone Addiction Scale-Short Version(SAS-SV), the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index. Pearson correlation and multiple linear regression analyses were used to examine the association between smartphone addiction and depression, while structural equation models were established to evaluate the possible mediating role of sleep.RESULTS Based on the cutoffs of the SAS-SV, the rate of smartphone addiction was 63.58 percent, with 56.21 percent for women and 65.68 percent for men, among 692 engineering students. The prevalence of depression among students was 14.16 percent, with 17.65 percent for women, and 13.18 percent for men. Smartphone addiction was positively correlated with depression, and sleep played a significant mediating effect between the two, accounting for 42.22 percent of the total effect. In addition, sleep latency, sleep disturbances, and daytime dysfunction significantly mediated the relationship between depression and smartphone addiction. The mediating effect of sleep latency was 0.014 [P < 0.01;95% confidence interval(CI): 0.006-0.027], the mediating effect of sleep disturbances was 0.022(P < 0.01;95%CI: 0.011-0.040), and the mediating effect of daytime dysfunction was 0.040(P < 0.01;95%CI: 0.024-0.059). The influence of sleep latency, sleep disturbances, and daytime dysfunction accounted for 18.42%, 28.95%, and 52.63% of the total mediating effect, respectively.CONCLUSION The results of the study suggest that reducing excessive smartphone use and improving sleep quality can help alleviate depression.

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.

Reconstruction surgery in head and neck cancer patients amidst the COVID-19 pandemic:Current practice and lessons for the future

The coronavirus disease 2019(COVID-19)pandemic has imposed a radical change in daily life and work routine.In this context,health systems have suffered important and serious repercussions in all fields.Among the changes brought about by the state of global health emergency,adjustments to guidelines,priorities,structures,professional teams,and epidemiological data stand out.In light of this,the oncological field has witnessed several changes in the approach to cancer,whether due to delay in diagnosis,screening deficit,personnel shortage or the psychological impact that the pandemic has had on cancer patients.This article focuses on the management of oral carcinoma and the surgical approaches that oral and maxillofacial specialists have had at their disposal during the health emergency.In this period,the oral and maxillofacial surgeons have faced many obstacles.The proximity of maxillofacial structures to the airways,the need of elective and punctual procedures in cancerous lesions,the aggressiveness of head and neck tumors,and the need for important healthcare costs to support such delicate surgeries are examples of some of the challenges imposed for this field.One of the possible surgical'solutions'to the difficulties in managing surgical cases of oral carcinoma during the pandemic is locoregional flaps,which in the pre-COVID-19 era were less used than free flaps.However,during the health emergency,its use has been widely reassessed.This setback may represent a precedent for opening up new reflections.In the course of a long-term pandemic,a reassessment of the validity of different medical and surgical therapeutic approaches should be considered.Finally,given that the pandemic has highlighted vulnerabilities and shortcomings in a number of ways,including the issues of essential resource shortages,underinvestment in public health services,lack of coordination and versatility among politicians,policymakers and health leaders,resulting in overloaded health systems,rapid case development,and high mortality,a more careful analysis of the changes needed in different health systems to satisfactorily face future emergencies is essential to be carried out.This should be directed especially towards improving the management of health systems,their coordination as well as reviewing related practices,even in the surgical field.

Effect of fibrinolytic therapy on ST-elevation myocardial infarction clinical outcomes during the COVID-19 pandemic:A systematic review and meta-analysis

BACKGROUND ST-elevation myocardial infarction(STEMI)is the result of transmural ischemia of the myocardium and is associated with a high mortality rate.Primary percutaneous coronary intervention(PPCI)is the recommended first-line treatment strategy for patients with STEMI.The timely delivery of PPCI became extremely challenging for STEMI patients during the coronavirus disease 2019(COVID-19)pandemic,leading to a projected steep rise in mortality.These delays were overcome by the shift from first-line therapy and the development of modern fibrinolytic-based reperfusion.It is unclear whether fibrinolytic-based reperfusion therapy is effective in improving STEMI endpoints.AIM To determine the incidence of fibrinolytic therapy during the COVID-19 pandemic and its effects on STEMI clinical outcomes.METHODS PubMed,Google Scholar,Scopus,Web of Science,and Cochrane Central Register of Controlled Trials were queried from January 2020 up to February 2022 to identify studies investigating the effect of fibrinolytic therapy on the prognostic outcome of STEMI patients during the pandemic.Primary outcomes were the incidence of fibrinolysis and the risk of all-cause mortality.Data were meta-analyzed using the random effects model to derive odds ratios(OR)and 95%confidence intervals.Quality assessment was carried out using the Newcastle-Ottawa scale.RESULTS Fourteen studies including 50136 STEMI patients(n=15142 in the pandemic arm;n=34994 in the pre-pandemic arm)were included.The mean age was 61 years;79%were male,27%had type 2 diabetes,and 47%were smokers.Compared with the pre-pandemic period,there was a significantly increased overall incidence of fibrinolysis during the pandemic period[OR:1.80(1.18 to 2.75);I2=78%;P=0.00;GRADE:Very low].The incidence of fibrinolysis was not associated with the risk of all-cause mortality in any setting.The countries with a low-and middle-income status reported a higher incidence of fibrinolysis[OR:5.16(2.18 to 12.22);I2=81%;P=0.00;GRADE:Very low]and an increased risk of all-cause mortality in STEMI patients[OR:1.16(1.03 to 1.30);I2=0%;P=0.01;GRADE:Very low].Meta-regression analysis showed a positive correlation of hyperlipidemia(P=0.001)and hypertension(P<0.001)with all-cause mortality.CONCLUSION There is an increased incidence of fibrinolysis during the pandemic period,but it has no effect on the risk of all-cause mortality.The low-and middle-income status has a significant impact on the all-cause mortality rate and the incidence of fibrinolysis.

Hospitalizations for alcoholic liver disease during the COVID-19 pandemic increased more for women,especially young women,compared to men

BACKGROUND Alcoholic liver disease(ALD)remains one of the major indications for liver transplantation in the United States and continues to place a burden on the national healthcare system.There is evidence of increased alcohol consumption during the coronavirus disease 2019(COVID-19)pandemic,and the effect of this on the already burdened health systems remains unknown.AIM To assess the trends for ALD admissions during the COVID-19 pandemic,and compare it to a similar pre-pandemic period.METHODS This retrospective study analyzed all admissions at a tertiary health care system,which includes four regional hospitals.ALD admissions were identified by querying a multi-hospital health system’s electronic database using ICD-10 codes.ALD admissions were compared for two one-year periods;pre-COVID-19 from April 2019 to March 2020,and during-COVID-19 from April 2020 to March 2021.Data were analyzed using a Poisson regression model and admission rates were compared using the annual quarterly average for the two time periods,with stratification by age and gender.Percent increase or decrease in admissions from the Poisson regression model were reported as incident rate ratios.RESULTS One thousand three hundred and seventy-eight admissions for ALD were included.80.7%were Caucasian,and 34.3%were female.An increase in the number of admissions for ALD during the COVID-19 pandemic was detected.Among women,a sharp rise(33%)was noted in those below the age of 50 years,and an increase of 22%in those above 50 years.Among men,an increase of 24%was seen for those below 50 years,and a 24%decrease in those above 50 years.CONCLUSION The COVID-19 pandemic has had widespread implications,and an increase in ALD admissions is just one of them.However,given that women are often prone to rapid progression of ALD,this finding has important preventive health implications.

Has global deforestation accelerated due to the COVID-19 pandemic?

As the COVID-19 pandemic unfolded,questions arose as to whether the pandemic would amplify or pacify tropical deforestation.Early reports warned of increased deforestation rates;however,these studies were limited to a few months in 2020 or to selected regions.To better understand how the pandemic infl uenced tropical deforestation globally,this study used historical deforestation data(2004–2019)from the Terra-i pantropical land cover change monitoring system to project expected deforestation trends for 2020,which were used to determine whether observed deforestation deviated from expected trajectories after the fi rst COVID-19 cases were reported.Time series analyses were conducted at the regional level for the Americas,Africa and Asia and at the country level for Brazil,Colombia,Peru,the Democratic Republic of Congo and Indonesia.Our results suggest that the pandemic did not alter the course of deforestation trends in some countries(e.g.,Brazil,Indonesia),while it did in others(e.g.,Peru).We posit the importance of monitoring the long-term eff ects of the pandemic on deforestation trends as countries prioritize economic recovery in the aftermath of the pandemic.

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.

Multiple influences of the COVID-19 pandemic on children with diabetes:Changes in epidemiology,metabolic control and medical care

The coronavirus disease 2019(COVID-19)pandemic has heavily affected health worldwide,with the various forms of diabetes in children experiencing changes at various levels,including epidemiology,diabetic ketoacidosis rates and medical care.Type 1 diabetes showed an apparent increase in incidence,possibly owing to a direct damage of the virus to theβ-cell.Diabetic ketoacidosis also increased in association with the general fear of referring patients to the hospital.Most children with diabetes(both type 1 and type 2)did not show a worsening in metabolic control during the first lockdown,possibly owing to a more controlled diet by their parents.Glucose sensor and hybrid closed loop pump technology proved to be effective in all patients with type 1 diabetes during the pandemic,especially because the downloading of data allowed for the practice of telemedicine.Telemedicine has in fact grown around the world and National Health Systems have started to consider it as a routine activity in clinical practice.The present review encompasses all the aspects related to the effects of the pandemic on the different forms of diabetes in children.

The COVID-19 Pandemic: A Double Threat to Chinese Americans’ Mental Health

Objective:To explore the double psychosocial threats of the COVID-19 pandemic,targeted behavior toward Chinese Americans,and the correlates to their mental health.Methods:A quantitative,cross-sectional,and descriptive design was utilized by using a purposive convenience sample of 301 Chinese Americans over the age of 18 residing in the United States.Online data collection was conducted through the social media platform WeChat from April 8–21,2021.Descriptive statistical analysis was used for the participants’demographic charac-teristics,Multidimensional Scale of Perceived Social Support(MSPSS),Double Threat Situations,COVID-19 Racial Discrimination,and General Anxiety Disorder-7(GAD-7).Stepwise logistic regression was conducted to verify predictors for anxiety levels by GAD-7.Results:In this sample(N=301),127(42.19%)were male and 174(57.81%)were female.The average age was 41.67(SD=5.89).Among MSPSS subscales,social support from family(MSPSS-Fam,79.73%,n=240)and social support from significant others(MSPSS-SO,73.75%,n=222)were high.231(76.74%)reported threats due to their Chinese ethnic background during the COVID-19 outbreak.Predictors for the high anxiety level by GAD-7 were COVID-19 racial discrimination from the local community(OR=0.47,95%CI=0.39–0.71,p<0.001),media/online(OR=0.36,95%CI=0.26–0.53,p<0.001),the perceived threat from the COVID-19 virus(OR=0.33,95%CI=0.23–0.51,p<0.001)and Perceived racism threat from Chinese back-ground related to COVID-19(OR=0.31,95%CI=0.21–0.49,p<0.001).Conclusions:COVID-19 double-threats(The virus and racial discrimination)situations are significantly related to the high level of anxiety among Chinese Americans.The sense of belonging and social perceptions of Chinese immigrants is closely related to public health problems in Western societies and needs to be addressed at all levels.Ourfindings call for the attention of health-care workers to specific racism double-threatened situations and high mental health risks,as well as direct and indirect ethnic discrimination that Chinese Americans are experiencing during this pandemic,the long-term influ-ences and effective coping ways related to this issue should be explored in further research.