ABSTRACT
Introduction: Coronavirus is an infection disease with respiratory symptoms and it is a virus that can be transmitted between humans as a mutated virus. Coronavirus-19 disease can lead to stress and anxiety among hospital staff. At present, one of the most important factors affected the occupational performance of the treatment staff and their ability to perform the overshadowed tasks effectively is Covid-19 disease. Therefore, this study was conducted to investigate the relationship between job stress and job performance of nurses in the covid-19 epidemic from the perspective of nurses in Zahedan teaching hospitals in 2021. Materials and Methods: This descriptive-analytical study was performed by available sampling method. Data were obtained using forms collected during three months in the inpatient ward of covid-19 in Zahedan teaching hospitals. The research samples were 235 nurses working in different wards of the hospital participated in this study and answered the three-part questionnaire containing demographic and job information, stress resulted by covid-19 and job performance. The collected data were statistically analyzed using SPSS software, version 20. There were used the descriptive and analytical statistics including frequency, mean, standard deviation and t test. Results: Most of the participants in this study were women (68%) under the age of 30 (59.4%). There is a significant relationship between the effect of Covid-19 on job stress and job performance. Thus, the effect of Covid-19 on job stress is direct, i.e. with the greater effect of Covid-19, the amount of stress increases by 39%) p = 0.00, r = 0.39(. The effect of Covid-19 on the job performance was inversely so that with increasing the effect of Covid-19, job performance decreased by -20% (-r= 0.20, p=0.01). The findings showed there is a significant relationship between stress resulted by Covid-19 and the job performance. Discussion: The level of stress in nurses working in Covid-19-related wards in Zahedan teaching hospitals is moderate. It seems that paying attention to nurses' education to deal with critical situations similar to Covid-19 and increasing personal protective equipment can be effective in preventing nurses from developing stress and anxiety, and then their job performance will be improved.
ABSTRACT
Background: The American College of Cardiology suggested physicians should only measure troponin and brain natriuretic peptide (BNP) if myocardial infarction or heart failure were suspected in people with COVID-19. We aimed to evaluate the use of biomarkers on admission to hospital and the impact on mortality and morbidity. Methods: Consecutive patients presenting with COVID-19(reverse transcription PCR positive) between Feb27-May20 2020 were included in this retrospective, observational, single-center study. Clinical information was collected on admission and during hospitalization by physicians and later analysed by specialist cardiology registrars. 1675 patients were PCR +ve with 1036 having a high sensitivity troponin T(hsTropT) on admission. 371(35.8%) patients were hs TropT negative(<15ng/L) and 664(64.1%) had evidence of myocardial injury on admission(hsTropT ≥15ng/L). Subsequently demographic details were compared, as well as primary outcomes of death, ICU admission and COVID severity. Secondary outcomes were ARDS, myocardial infarction (MI);comparison with other biomarkers: NT-proBNP, d-dimer, CRP,LDH and ferritin. Results: Demographic data revealed no significant increase in proportions of Black, Asian or ethnic minorities in the myocardial injury group, however, patients were older(74.9±13.5 v 54.7±13.7yrs;p <0.001) and had significantly more co-morbidities such as diabetes(37 v 13%), hypertension(34 v 29%), ischemic heart disease(16 v 2%), other cardiac conditions(59 v 5%), malignancy(11 v 1%), COPD(9 v 4%), CKD stage ≤3 (40 v 3%) (p <0.01). Mortality was significantly higher in the myocardial injury group, 302(45.5%) v 29(7.8%) p <0.001, as were secondary outcomes of critical COVID (47 v 19%;p<0.001), ARDS (20 v 4%;p<0.001), Type 1 MI (1.6 v 0.01%;p<0.01) and Type 2 MI (44 v 26%;p<0.001). Interestingly, ICU admission (19 v 23%;p=0.09), pulmonary embolism (11 v 6%;p=0.22), stroke (1.1 v 0.5%;p=0.05) did not reach significance. Analysis of bio-markers on admission (Fig 1.) demonstrated hs Trop T (AUC 0.75 CI 0.69-0.81) and NT-pro BNP (AUC 0.75 CI 0.69-0.81) had more sensitvity 83%;85% and specificty 52%;58%, respectively at predicting death than d-dimer, CRP, LDH and ferritin. Conclusion: Early detection of elevated hsTropT and NT-proBNP predicts mortality and morbidity in patient with COVID-19. Routine measurement of cardiac biomarkers should be considered in patients with COVID-19 at the time of hospital admission in order to optimise risk stratification and guide monitoring. (Figure Presented).