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.

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.

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.

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.

Flare of the silent pandemic in the era of the COVID-19 pandemic:Obstacles and opportunities

A noteworthy public health problem,antimicrobial resistance(AMR)has been impeded in many ways by the coronavirus disease 2019(COVID-19)pandemic.This narrative review discusses the two-sided impact of COVID-19 on the magnitude of AMR.The pandemic has put tremendous strain on healthcare systems,diverting resources,personnel,and attention away from AMR diagnosis and management toward COVID-19 diagnosis and contact tracking and tracing.AMR research has been severely hampered,and surveillance and antimicrobial stewardship(AMS)programs have been de-emphasized,delayed,or halted.Antibiotics,particularly broad-spectrum,were prescribed more frequently without diagnostic confirmation of bacterial infection than before the pandemic.Nonetheless,the COVID-19 pandemic has highlighted the vulnerability of healthcare systems in controlling infectious disease threats and raised awareness of the importance of infection prevention and control.Yet,the pandemic has created opportunities to capitalize on positive effects on AMR management.The review concludes that it is now more important than ever to focus on AMR and strengthen AMS programs to ensure appropriate antibiotic use and other AMR prevention measures in healthcare.We must ensure that one of the COVID-19 legacies is increased support for AMR research,diagnostic implementation,appropriate diagnostic stewardship,and the strengthening of our health systems.The COVID-19 pandemic has demonstrated that prevention is better than cure.Countries will need to step up their efforts to combat AMR as a multidisciplinary community.We must prepare our public health systems to combat multiple threats at the same time.

Huu S. TIEU’s Predicting Outcome of Severe Acute Respiratory Syndrome (SARS) and Preparing the Treatment for COVID-19 (Coronavirus) and Other Viral Pandemics

This project paper is to give a prediction for the future of other viral pandemics and to provide recommendations for preparing therapies that could help in the success of effective treatments and benefits for patients in life-threatening situations. The theory of prediction was proposed by Huu S. TIEU on March 25, 2019, and he hypothesized that any malfunctioning cell in the body could have a damaging effect. This paper discusses the prediction that Localized Oxygen Deprivation could be a contributing factor for a future epidemic or other viral pandemics that could affect body function. This paper is based on opinion and does not have sufficient evidence to support the claims made. Therefore, further in-depth study is needed to prove the findings. The author cites Hypoxia to support his idea, but he is not claiming that Hypoxia-Inducible Factor (HIF) has worked on his predictions. The author also tested a theory using cow blood curd for body function, but this test was not a structured test and the findings were not supported by other evidence. To further prove the idea or theory, further study into the subject should be conducted.

Time Series Analysis and Prediction of COVID-19 Pandemic Using Dynamic Harmonic Regression Models

Rapidly spreading COVID-19 virus and its variants, especially in metropolitan areas around the world, became a major health public concern. The tendency of COVID-19 pandemic and statistical modelling represents an urgent challenge in the United States for which there are few solutions. In this paper, we demonstrate combining Fourier terms for capturing seasonality with ARIMA errors and other dynamics in the data. Therefore, we have analyzed 156 weeks COVID-19 dataset on national level using Dynamic Harmonic Regression model, including simulation analysis and accuracy improvement from 2020 to 2023. Most importantly, we provide new advanced pathways which may serve as targets for developing new solutions and approaches.

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.

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.

Burnout syndrome and anxiety among healthcare workers during global pandemics:An umbrella review

BACKGROUND Burnout syndrome and anxiety are two mental health symptoms experienced by healthcare workers(HCWs)that can be exacerbated during pandemics due to increased job demands and the global health workforce crisis.AIM To provide a comprehensive review and summary of evidence on burnout and anxiety in HCWs during previous global pandemics.METHODS A systematic search on electronic databases such as PubMed Central and MEDLINE was conducted to identify high-quality systematic review studies that reported on the prevalence of burnout and/or anxiety in HCWs during any previous global pandemic.RESULTS Twenty-four high quality systematic review articles were found to be suitable for inclusion.Twenty articles focused merely on Coronavirus disease 2019,while four articles examined multiple pandemics.Burnout was examined in nine articles,while anxiety was examined in the remaining 21 articles.Female HCWs and nurses were identified to be at a higher risk of developing burnout and anxiety during pandemic.We also observed a variation in the prevalence of burnouts and anxiety across different studies due to different mental health instruments were used in different studies.CONCLUSION Nurses and females HCWs had a high prevalence of burnout syndrome and anxiety during pandemic.More emphasis and attention should be paid to safeguarding the psychological well-being of these at-risk populations in the future pandemics.

COVID-19 pandemic in the intensive care unit:Psychological implications and interventions,a systematic review

BACKGROUND The coronavirus disease 2019(COVID-19) pandemic produced changes in intensive care units(ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff;this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.AIM To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.METHODS We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles,upon which we commented.RESULTS Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.CONCLUSION As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.