Covid-19 social isolation in brazil: effects on the physical activity routine of families with children / Distanciamento social covid-19 no brasil: efeitos sobre a rotina de atividade física de famílias com crianças

ABSTRACT Objective: To identify how Brazilian families with children aged under 13 years face the period of social isolation resulting from the COVID-19 pandemic, especially regarding the time spent on physical activity (PA), intellectual activity, games, outdoor activities and screen. Methods: An anonymous online survey was launched on March 24, 2020 in Brazil to assess how families with children aged up to 12 years are adjusting their daily routines to this situation. In the survey, each family reported the daily time each child spent in sedentary activity (sum of intellectual activities, play time on screen, playing without PA) and PA (sum of playing with PA and PA). Results: The main findings based on data from 816 children indicate that most parents consider there was a reduction in the time that children spend practicing PA; increase in screen play time and family activities, differences between sex were found regarding screen play time (boys>girls) and in playing without PA (girls>boys), and there was an age effect for all categories analyzed, with a tendency to increase the total time of sedentary lifestyle and complementary reducing the time of PA over age. Conclusions: The household routines of families during the period of social isolation resulting from the COVID-19 pandemic confirm the general reduction tendency in PA time during childhood.

RESUMO Objetivo: Identificar como as famílias brasileiras com crianças abaixo de 13 anos enfrentam o período de distanciamento social decorrente da pandemia de COVID-19, principalmente no que diz respeito ao tempo gasto em atividade física (AF), atividade intelectual, brincadeiras, atividades ao ar livre e em tela. Métodos: Uma pesquisa on-line anônima foi lançada em 24 de março de 2020 no Brasil para avaliar como as famílias com crianças de até 12 anos estão ajustando suas rotinas diárias a essa situação. Na pesquisa, cada família relatou o tempo diário em que cada criança esteve envolvida em atividade sedentária (somatório de atividades intelectuais, tempo lúdico de tela, brincar sem AF) e AF (somatório do brincar com AF e da AF). Resultados: Os principais achados com base em dados de 816 crianças indicam que a maioria dos pais considera que houve redução no tempo em que as crianças passam praticando AF e aumento do tempo lúdico de tela e das atividades em família. Diferenças entre o sexo foram encontradas no tempo lúdico de tela (meninos>meninas) e no brincar sem AF (meninas>meninos), bem como efeito da idade para todas as categorias analisadas, com tendência para aumento do tempo total de sedentarismo e diminuição complementar do tempo de AF ao longo da idade. Conclusões: As rotinas domiciliares das famílias durante o período de distanciamento social decorrente da pandemia de COVID-19 confirmam a tendência geral decrescente do tempo de AF na infância.

Daños colaterales de la pandemia por COVID-19: ¿consecuencias inevitables? / Collateral damage from the COVID-19 pandemic: inevitable consequences?

Esta revisión narrativa describe el daño colateral de la pandemia de COVID-19, tanto en aspectos de la salud, como también sociales, educativos o económicos. Comunicamos el impacto mundial y local. Consideramos que varias de estas consecuencias eran inevitables, especialmente las sucedidas durante los primeros meses de una pandemia que se difundió a gran velocidad y con graves consecuencias directas en la morbimortalidad de la población. Sin embargo, luego de seis meses de su llegada a la Argentina, es oportuno revaluar la situación y replantearse si no se debería cambiar el enfoque para balancear la minimización del impacto directo de COVID-19 junto con la del daño colateral que las medidas para paliarlo produjeron. Es un desafío que no debe limitarse al sistema de salud. Debe encararse con un abordaje intersectorial amplio y con participación activa de la sociedad. Así como aplanamos la curva de COVID-19, cuanto más nos demoremos en aplanar las otras curvas de problemas sanitarios y sociales que se están generando, mayor será su impacto, tanto en el corto como en el largo plazo. (AU)

This narrative review shows the collateral damage of the COVID-19 pandemic, whether in health, social, educational or economic aspects. We report on the impact at the global and local levels. Many of these consequences were inevitable, especially in the first months of a pandemic that spread at great speed and with serious direct consequences on the morbidity and mortality of the population. However, six months after the arrival in our country, it is an opportunity to reassess the situation and rethink whether the approach should not be changed to balance the minimization of the direct impact of COVID-19 with that of the collateral damage that mitigation measures produced. This is a challenge that should not be limited to the health system. It must be addressed with a broad intersectoral approach and active participation of society. Just as we flatten the COVID-19 curve, the longer we delay in flattening the other curves of health and social problems that are being generated, the greater the impact, both in the short and long term. (AU)

La repercusión de la COVID-19 en los servicios para los trastornos mentales, neurológicos y por consumo de sustancias psicoactivas en la Región de las Américas: resultados de una evaluación rápida, noviembre del 2020 / The impact of COVID-19 on mental, neurological and substance use services in the Americas: results of a rapid assessment, November 2020

Los eventos que causan un grado de estrés importante, como la pandemia de COVID-19, constituyen un factor de riesgo para la aparición, agudización o recaída de toda una gama de trastornos mentales, neurológicos y por consumo de sustancias psicoactivas, en especial en los grupos de población más vulnerables. En los estudios de ámbito nacional en la Región de las Américas se describe un aumento del desasosiego, la depresión, la ansiedad y el insomnio, entre otros, como resultado de la pandemia de COVID-19. Además, los casos de COVID-19 dan lugar a varias complicaciones neurológicas y mentales.Los eventos que causan un grado de estrés importante, como la pandemia de COVID-19, constituyen un factor de riesgo para la aparición, agudización o recaída de toda una gama de trastornos mentales, neurológicos y por consumo de sustancias psicoactivas, en especial en los grupos de población más vulnerables. En los estudios de ámbito nacional en la Región de las Américas se describe un aumento del desasosiego, la depresión, la ansiedad y el insomnio, entre otros, como resultado de la pandemia de COVID-19. Además, los casos de COVID-19 dan lugar a varias complicaciones neurológicas y mentales. Para comprender la repercusión de la pandemia en los servicios para los trastornos mentales, neurológicos y por consumo de sustancias psicoactivas, la OMS elaboró una encuesta, que fue realizada por la OMS y la OPS y se envió a los puntos focales de salud mental designados para ello en los ministerios de salud de todos los Estados Miembros de la OMS. Este informe utiliza los datos presentados por los Estados Miembros de la OPS en respuesta a la encuesta para presentar un panorama general de la repercusión de la COVID-19 en tales servicios en la Región de las Américas. Esta información será útil para fundamentar la planificación y las respuestas destinadas a atenuar los efectos de la pandemia por los países de la Región.

Major stressors such as the COVID-19 pandemic represent risk factors for the development, exacerbation and relapse of a range of mental, neurological and substance use (MNS) disorders, particularly in the most vulnerable groups. National studies from the Region of the Americas, demonstrate increases in distress, depression, anxiety, and insomnia, among other conditions, as a result of the COVID-19 pandemic. Furthermore, COVID-19 itself is associated with neurological and mental complications. This report is based on the results of a survey, developed by the World Health Organization (WHO) and implemented by the WHO and the Pan American Health Organization (PAHO), which was sent to designated mental health focal points in ministries of health of all WHO Member States. It uses data submitted by PAHO Member States in response to the survey to provide an overview of the impact of COVID-19 on MNS services in the Region of the Americas. This information will help to inform planning and response to mitigate the effects by countries in the Region.

Evaluación de un modelo remoto de seguimiento de pacientes embarazadas y puérperas con infección por SARS-CoV-2 / Evaluation of a remote control model for pregnant and post-partum patients with SARS-CoV-2infection

INTRODUCCIÓN: Ante el escenario de pacientes obstétricas diagnosticadas por la nueva enfermedad por coronavirus (COVID-19), se hace imprescindible la necesidad de realizar un seguimiento adecuado tanto desde el punto de vista de obstétrico como del cuadro viral, durante el período de aislamiento domiciliario. Con este objetivo, se desarrolló un programa de seguimiento remoto por la Unidad de Medicina Materno Fetal (MMF) de nuestro centro, desde el diagnóstico de la infección hasta el alta médica según los criterios vigentes del Ministerio de Salud (MINSAL). OBJETIVO: Evaluar la satisfacción del paciente en el seguimiento remoto de embarazadas y puérperas con diagnóstico de infección por SARS-CoV-2. Material y Métodos: Estudio descriptivo mediante la aplicación de una encuesta anónima y voluntaria de satisfacción usuaria, a través de una plataforma online. El instrumento fue una adaptación de la versión en español del "Telehealth Usability Questionnaire" (TUQ) previamente validado. RESULTADOS: Se obtuvo un 94,5% de respuestas a la encuesta. El 86% de las pacientes evaluó como "Muy Bueno" o "Bueno" el control virtual. El 91% no experimentó problemas técnicos. El 14% de las pacientes prefiere un control virtual, el 26% presencial y el 60% un control mixto. El 80% cumplió todas sus necesidades con el control virtual. CONCLUSIONES: En el contexto de pandemia e infección por SARS-CoV-2, el seguimiento remoto ha sido evaluado globalmente en forma positiva con niveles aceptables de satisfacción de las pacientes.

INTRODUCTION: Given the scenario of obstetric patients diagnosed with the new coronavirus disease (COVID-19), the need for proper follow-up both obstetric and of the infection, during the period of home isolation, is essential. A remote monitoring program was developed by the Maternal Fetal Medicine Unit (MFM) of our center from the diagnosis of the infection until medical discharge according to the current criteria of the Ministry of Health (MINSAL). OBJECTIVE: To assess patient satisfaction of remote monitoring of pregnant and postpartum patients diagnosed with SARS-CoV-2 infection. METHODS: This is a descriptive-survey research. We performed a patient satisfaction survey through an online platform to pregnant and postpartum patients with remote monitoring for SARS-CoV-2 infection in our center. The survey was anonymous and voluntary. The instrument for this purpose was the Spanish adapted version of "Telehealth Usability Questionnaire" (TUQ) that has been previously validated. RESULTS: The survey was answered by 94,5% of the patients. The results show that 86% of the patients rated the virtual control as "Very Good" or "Good"; 91% did not experienced technical problems. 14% of the patients prefer virtual control, 26% prefer face-to-face control and 60% both virtual and face-to-face control. 80% fulfilled all their needs with virtual control. CONCLUSIONS: In the context of pandemic and SARS-CoV-2 infection, remote monitoring has been positively evaluated with acceptable levels of patient's satisfaction.

Neuropsychiatric changes during the COVID-19 pandemic in multiple sclerosis patients / Alterações neuropsiquiátricas durante a pandemia de COVID-19 em pacientes com esclerose múltipla

ABSTRACT Background: This study reported on a variety of psychological reactions related to anxiety, sleep quality, depression, fatigue, and quality of life in individuals with multiple sclerosis (MS), related to the Covid-19 quarantine experience. Objective: The aim of this study was to investigate the neuropsychiatric effects of the COVID-19 pandemic in MS patients and to analyze the risk factors contributing to psychological stress. Methods: The study was designed as a prospective, cross-sectional survey study. Multiple assessment tools that are used in neurological practice, including Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Fatigue Impact Scale (FIS), Pittsburgh Sleep Quality Index (PSQI), and Multiple Sclerosis Quality of Life-54 (MSQOL-54) were administered prospectively both during the early and the peak stages of COVID-19 outbreak (ESO and PSO, respectively). The survey forms were designed using SurveyMonkey and the participants were participating in the survey via a web link and QR code. Results: Fifty patients were included in the study. BDI scores, PSQI and FSI measurements, cognitive and social subscale scores and total FIS score, MSQOL-54 measurements, physical and mental subscale scores, and total MSQOL-54 score at PSO were significantly different than those at ESO. The body mass index values of the patients increased significantly at PSO compared to those measured at ESO. Conclusions: The results provide a basis for the development of psychological interventions that could minimize the prevalence of sleep disorders and depression and could improve patients' quality of life during the outbreak.

RESUMO Introdução: Este estudo relatou uma variedade de reações psicológicas relacionadas a ansiedade, qualidade do sono, depressão, fadiga e qualidade de vida em indivíduos com esclerose múltipla (EM), relacionadas à experiência de quarentena de COVID-19. Objetivo: O objetivo deste estudo foi investigar os efeitos neuropsiquiátricos da pandemia de Covid-19 em pacientes com EM e analisar os fatores de risco que contribuem para o estresse psicológico. Métodos: O estudo foi desenhado como um estudo prospectivo e transversal. Várias ferramentas de avaliação usadas na prática neurológica, incluindo Inventário de Depressão de Beck (Beck Depression Inventory - BDI), Inventário de Ansiedade de Beck (Beck Anxiety Inventory - BAI), Escala de Impacto de Fadiga (Fatigue Impact Scale - FIS), Índice de Qualidade de Sono de Pittsburgh (Pittsburgh Sleep Quality Index - PSQI) e Qualidade de Vida da Esclerose Múltipla-54 (Multiple Sclerosis Quality of Life-54 - MSQOL-54) foram administrados prospectivamente durante o estágio inicial do surto de COVID-19 (EIS) e o estágio de pico do surto de COVID-19 (EPS). Os formulários da pesquisa foram projetados usando o SurveyMonkey e os participantes participaram da pesquisa por meio de um link da web e código QR. Resultados: Foram incluídos 50 pacientes no estudo. Os escores BDI, PSQI, FSI, subescala cognitiva e social e escore total do FIS, MSQOL-54, subescala física e mental e MSQOL-54 total no PSO foram significativamente diferentes dos do EIS. Os valores do índice de massa corporal dos pacientes aumentaram significativamente na EPS em comparação com os medidos na EIS. Conclusões: Nossos resultados são uma base para o desenvolvimento de intervenções psicológicas que podem minimizar a prevalência de distúrbios do sono e depressão e melhorar a qualidade de vida dos pacientes durante o surto.

Symptoms of anxiety and depression and self-care behaviors during the COVID-19 pandemic in the general population / Síntomas de ansiedad, depresión y conductas de autocuidado durante la pandemia de COVID-19 en la población general

Abstract Introduction: The COVID-19 pandemic can have important psychosocial consequences in the population. Objective: To determine the levels anxiety and depression symptoms and self-care behaviors during the COVID-19 pandemic in the general population. Method: Online survey distributed over three weeks using a non-probability sampling. The PHQ-9 Patient Health Questionnaire, the GAD-7 Generalized Anxiety Disorder Scale and a self-care behaviors visual analogue scale were used. Between-group (anxiety and depression) descriptive and comparison analyses were carried out. Results: Out of 1508 included participants, 20.8 % had symptoms of severe anxiety, while 27.5 % showed symptoms of severe depression. Being a woman, being single, having no children, having medical comorbidities and a history of mental health care were associated with the presence of higher levels of anxiety and depression symptoms; 66 to 80 % of the population complied with self-care recommendations. A need for receiving mental health care was identified in our study population. Conclusion: A larger number of individuals with moderate to severe anxiety and depression symptoms were observed than in other pandemics. COVID-19 pandemic psychological effects are considered an emerging public mental health problem, and implementation of programs for their care is therefore recommended.

Resumen Introducción: La pandemia por COVID-19 puede tener consecuencias psicosociales importantes en la población. Objetivo: Determinar los niveles de síntomas de ansiedad, depresión y conductas de autocuidado durante la pandemia de COVID-19 en población general. Método: Encuesta en línea distribuida durante tres semanas mediante muestreo no probabilístico. Se empleó el Cuestionario sobre la Salud del Paciente PHQ-9, la Escala del Trastorno de Ansiedad Generalizada GAD-7 y la Escala análoga visual de conductas de autocuidado. Se realizaron análisis descriptivos y de comparación entre los grupos con ansiedad y depresión. Resultados: Se incluyeron 1508 participantes, 20.8 % presentó síntomas de ansiedad grave y 27.5 %, síntomas de depresión grave. Ser mujer, soltero(a) no tener hijos, presentar comorbilidad médica y antecedentes de atención a la salud mental estuvieron relacionados con la presencia de mayores niveles de síntomas de ansiedad y depresión; 66 a 80 % de la población cumplía con las recomendaciones de autocuidado. Se identificó la necesidad de recibir atención de salud mental. Conclusión: Se observó mayor número de individuos con síntomas de ansiedad y depresión moderadas a graves que en otras pandemias. Los efectos psicológicos de la pandemia de COVID-19 se consideran un problema de salud mental pública emergente, por lo que se recomienda la implementación de programas para su atención.

Rueda de prensa semanal sobre COVID-19: palabras de apertura de la directora, 18 agosto 2020 / Weekly press conference on COVID-19: opening remarks from the director, August 18, 2020

Los casos de coronavirus en nuestra Región han llegado a casi 11,5 millones y más de 400.000 personas en el continente americano han muerto a causa de la pandemia.

The Psychosocial Impact of COVID-19 on health care workers

ABSTRACT At the end of 2019, a disease was identified, COVID-19, caused by a new type of easy and fast spreading virus, which led to the beginning of a worldwide pandemic. One of the most exposed groups to the virus and its psychosocial consequences is the healthcare workers, due to their implication in caring for affected people. Health workers are exposed to a fast and unpredictable situation that requires more human resources and materials than usual, however, the lack of means on account to this situation entails an increased probability of suffering different consequences, including the burnout syndrome, to which, generally, this professionals are already vulnerable. In addition, quarantine is added as a measure to prevent the spread of the pandemic, which is another handicap for healthcare workers. Quarantine means these professionals are more likely to suffer the foreseeable psychological consequences in general population, specifically, it has been observed that Post-Traumatic Stress Disorder (PTSD) is more prevalent, because of the stress load of the situation experienced.

Consideraciones sobre la salud mental en la pandemia de COVID-19

RESUMEN Desde diciembre de 2019 se han reportado 414 179 casos de personas con la enfermedad por coronavirus (COVID-19). Como resultado del rápido incremento de casos confirmados y muertes, la población general y el personal de salud experimentaron problemas psicológicos, como ansiedad, depresión y estrés. Si bien la información científica sobre la COVID-19 se incrementa constantemente, esta se centra en los aspectos genéticos y epidemiológicos del virus y en las medidas de salud pública, dejando de lado los posibles efectos en la salud mental. Con la finalidad de resumir la evidencia actual, presentamos una revisión narrativa de los efectos de la pandemia de COVID-19 sobre la salud mental. Hasta el momento, se ha informado la presencia de ansiedad, depresión y reacción al estrés en la población general. Además, en el personal de salud también se han encontrado problemas de salud mental, especialmente en las profesionales mujeres, el personal de enfermeria y aquellos que trabajan directamente con casos sospechosos o confirmados de COVID-19. En los esfuerzos realizados para disminuir la propagación de la enfermedad, se debe prestar atención al diagnóstico y tratamiento de los problemas de salud mental. Creemos que abordarlos adecuadamente empoderará al Perú en la contención y erradicación de la COVID-19.

ABSTRACT Since December 2019, 414,179 cases of people with coronavirus disease 2019 (COVID-19) have been reported. As a result of the rapid increase in confirmed cases and deaths, population and health personnel, have experienced psychological problems, such as anxiety, depression, and stress. Although scientific information on COVID-19 is constantly increasing, it mainly focuses on genetic, epidemiological aspects, and public health measures, leaving aside possible effects on mental health. In order to summarize the current evidence, we present a narrative review of the effects of the COVID-19 pandemic on mental health. So far, the presence of anxiety, depression, and stress has been reported mostly in general population. Nonetheless, mental health issues have also been reported in health care workers, especially among female professionals, nurses, and those who work directly with suspected or confirmed cases of COVID-19. In efforts to reduce the spread of the disease, attention should be paid to the diagnosis and treatment of mental health issues. We believe that addressing them adequately will empower Peru to contain and eradicate COVID-19.