Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic review.

BACKGROUND: Patients with autoimmune rheumatic diseases (ARD) are at a potentially higher risk for COVID-19 infection complications. Given their inherent altered immune system and the use of immunomodulatory medications, vaccine immunogenicity could be unpredictable with a suboptimal or even an exaggerated immunological response. The aim of this study is to provide real-time data on the emerging evidence of COVID-19 vaccines' efficacy and safety in patients with ARDs. METHODS: We performed a literature search of the PubMed, EMBASE, and OVID databases up to 11-13 April 2022 on the efficacy and safety of both types of the mRNA-vaccines and the AstraZeneca COVID-19 vaccines in patients with ARD. The risk of bias in the retrieved studies was evaluated using the Quality in Prognostic Studies tool. Also, current clinical practice guidelines from multiple international professional societies were reviewed. RESULTS: We identified 60 prognostic studies, 69 case reports and case series, and eight international clinical practice guidelines. Our results demonstrated that most patients with ARDs were able to mount humoral and/or cellular responses after two doses of COVID-19 vaccine although this response was suboptimal in patients receiving certain disease-modifying medications including rituximab, methotrexate, mycophenolate mofetil, daily glucocorticoids >10 mg, abatacept, as well as in older individuals, and those with comorbid interstitial lung diseases. Safety reports on COVID-19 vaccines in patients with ARDs were largely reassuring with mostly self-limiting adverse events and very minimal post-vaccination disease flares. CONCLUSION: Both types of the mRNA-vaccines and the AstraZeneca COVID-19 vaccines are highly effective and safe in patients with ARD. However, due to their suboptimal response in some patients, alternative mitigation strategies such as booster vaccines and shielding practices should also be followed. Management of immunomodulatory treatment regimens during the peri vaccination period should be individualized through shared decision making with patients and their attending rheumatologists.

How do teleworkers escape burnout? A moderated-mediation model of the job demands and turnover intention

Purpose: Working remotely in a COVID-19-induced lockdown has been challenging for both organisations and their employees;studies report that job demands changed, and teleworkers experienced increased burnout. This paper explores the negative employee outcomes that this work arrangement brings along and offers possible solutions to counter such negative outcomes since they could be detrimental to the much-touted future of work. Design/methodology/approach: The study adopted a time-lagged longitudinal design and collected two-waved data from 403 quaternary sector employees. The data were analysed using structural equation modelling and model-21 in PROCESS macro for SPSS. Findings: Findings affirm that employees experienced increased job demands during this crisis. Employees reported an increase in turnover intention because of burnout caused by increased job demands. However, increased task interdependence alone did not have any effect on turnover intention. The perceived organisational task support (POTS) was found to forestall the negative effect of job demands on burnout, and employee resilience (ER) buffered the burnout and turnover intention relationship. Practical implications: Providing remote work task support and boosting resilience among employees will help in doing away with the negative effects of teleworking. However, managers shall prioritise reducing job demands for teleworkers. Originality/value: The linkage between work factors and turnover intention is well established. Drawing on the event system theory and using the COVID-19 context, the present study added to the existing knowledge by studying the role of job demands (workload pressure and task interdependence) on turnover intention through the mediation of burnout. The study goes beyond the existing literature by accounting for POTS as a first-level moderator between job demands and burnout relationship, and ER as a second-level moderator between burnout and turnover intention relationship. © 2023, Emerald Publishing Limited.

Association between diabetes-related distress and glycemic control in primary care patients with Type 2 diabetes during the coronavirus disease 2019 (COVID-19) pandemic in Egypt.

BACKGROUND: Diabetes-related distress and glycemic control are of a particular concern to primary care physicians because of the impact of the coronavirus disease 2019 pandemic on diabetic patients' lifestyle, psychological well-being and healthcare access. Our aim was to evaluate the relationship between diabetes-related distress and glycemic control in diabetic patients with Type 2 diabetes mellitus (T2DM) in primary care settings during the pandemic. MATERIALS AND METHODS: This cross-sectional study was conducted at primary healthcare clinics in a rural area in Egypt among 430 patients with T2DM during the period from September 2020 to June 2021. All patients were interviewed for their sociodemographic, lifestyle, and clinical characteristics. Diabetes-related distress was measured by the problem areas in the diabetes scale (PAID), where a total score of ≥40 indicated a severe diabetes-related distress. The most recent glycosylated hemoglobin (HbA1c) measurements were used to indicate the glycemic control. Quantile regression model (0.50 quantile) was used to perform the multivariate analysis to identify significant factors associated with HbA1c level. RESULTS: Most of the participants had a suboptimal glycemic control (92.3%), while 13.3% had severe diabetes-related distress. HbA1c level was significantly and positively correlated with the total PAID score and all its sub-domains. Multivariate quantile regression revealed that obesity, multi-morbidity, and severe diabetes-related distress were the only significant determinants of the HbA1c median level. Obese patients had significantly higher median HbA1c compared to patients who were not obese (coefficient = 0.25, P < 0.001). Patients with two or more comorbidities (i.e., multimorbidity) had a significantly higher median HbA1c than patients with single or no chronic comorbidities (coefficient = 0.41, P < 0.001). Severe diabetes-related distress was significantly associated with higher median HbA1c compared to nonsevere diabetes-related distress (coefficient = 0.20, P = 0.018). CONCLUSION: Diabetes-related distress had a significant association with HbA1c level. Family physicians should implement multifaceted programs to optimize diabetes control and reduce any associated distress.

What innovations would enable hospitality in South Africa to rebuild? (Special Issue: What innovations would enable the tourism and hospitality industry to re-build?)

Purpose: This paper aims to address the following questions: What is the impact of the pandemic on the hospitality industry in South Africa? Which innovations and strategies are in place to rebuild hospitality in South Africa? Design/methodology/approach: This article emanates from the resent pandemic situation, and it is structured to include conceptual information drawn from the literature, empirical study and industry observation. These were conducted in 2020 and 2021 using, concepts from the literature, online questionnaires and observation to gather data about the impact of COVID-19 on hospitality operations across South Africa. Findings - Historically literature shows that the hospitality industry positively impacts the economy and employment However, the pandemic greatly affected these contributions. The findings reported in the empirical study revealed that the pandemic affected business operations and employment and caused financial hardship for the industry. Originality/value: There are relatively few studies that report on the issues relating to the pandemic and the hospitality industry in South Africa. This paper contributes to the literature regarding a pre-COVID-19 overview, the impact of the pandemic and the innovations and strategies in place to rebuild the hospitality industry.

Prevalence and Associated Factors of Diabetes Distress, Depression and Anxiety Among Primary Care Patients With Type 2 Diabetes During the COVID-19 Pandemic in Egypt: A Cross-Sectional Study.

The prevalence of type 2 diabetes mellitus (T2DM) is growing worldwide. T2DM is often complicated by a range of psychological disorders that interfere with glycemic control and self-care. Previous studies have reported diabetes distress, depression, and anxiety among patients with T2DM; however; little is known about the burden of these comorbid mental disorders in primary care patients with T2DM treated in Egypt during the COVID-19 era. Participants were selected by convenient sampling from eight rural primary healthcare facilities from Ismailia in Egypt. Symptoms of diabetes distress, depression and anxiety were assessed by using the Arabic version of the 20-item Problem Areas in Diabetes (PAID), Patient Health Questionnaire 9, and Generalized Anxiety Disorder Scales, respectively. Multiple hierarchical logistic regression models were used to estimate the significant factors associated with diabetes distress, depression, and anxiety. A total of 403 individuals with T2DM were interviewed. The prevalence of severe diabetes distress was 13.4% (95% CI: 10.1-16.7), while prevalence of depressive and anxiety symptoms was 9.2% (95% CI: 6.4-12.0%), and 4.0% (95% CI: 2.1-5.9), respectively. In a series of hierarchical logistic regression models, significant predictors for diabetes distress were being married, illiterate, not-working, living with insufficient income, and having multi-comorbidities. Likewise, the significant predictors for depression and anxiety were elevated glycated hemoglobin level and the higher PAID total score, while having multi-comorbidities was a significant predictor for anxiety only. Diabetes distress was more prevalent than depressive and anxiety symptoms in this study population. Several sociodemographic and clinical characteristics were identified to be related with psychological problems among patients with T2DM, which necessitate a multidisciplinary team-based approach for optimal screening and management.

The epidemiology of knee arthroscopy during coronavirus disease 2019 pandemic

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) has made a huge impact on global health services including in orthopedic surgical service. Knee surgery (including arthroscopy) is one of the emerging surgical services in Indonesia. As the pandemic goes on, some of the patients prefer to postpone or cancel the surgery planning. AIM: We tried to evaluate the epidemiology of knee arthroscopy procedure during the COVID-19 pandemic at our institution. MATERIALS AND METHODS: Retrospective data collection was performed on all patients who received knee arthroscopy procedures at Prof Dr. R. Soeharso Orthopaedic Hospital, Surakarta, Indonesia during the year 2020. The study evaluated the demographic data, the indication of surgery, and trends of the number of surgeries according to period time. This study also compared the data of knee arthroscopy procedures performed during the corresponding period before the pandemic in Indonesia (January to December 2019). RESULTS: There was a total of 88 knee arthroscopy surgery performed during the period January to December 2020. There was a decrease in the number of knee arthroscopy during April and May 2020. The decreasing number of surgeries also occurred in November 2020 which was later followed by the increasing number of surgeries in December 2020. Among all patient received knee arthroscopy during 2020, none have post-operative complication or infection due to SARS-Cov-2. CONCLUSION: There was some difference in the epidemiology of knee arthroscopy during the COVID-19 pandemic compared to the non-pandemic era. Comprehensive preoperative screening is needed before resume elective surgical service.

Rationales and uncertainties for aspirin use in COVID-19: a narrative review.

OBJECTIVES: To review the pathophysiology of COVID-19 disease, potential aspirin targets on this pathogenesis and the potential role of aspirin in patients with COVID-19. DESIGN: Narrative review. SETTING: The online databases PubMed, OVID Medline and Cochrane Library were searched using relevant headlines from 1 January 2016 to 1 January 2021. International guidelines from relevant societies, journals and forums were also assessed for relevance. PARTICIPANTS: Not applicable. RESULTS: A review of the selected literature revealed that clinical deterioration in COVID-19 is attributed to the interplay between endothelial dysfunction, coagulopathy and dysregulated inflammation. Aspirin has anti-inflammatory effects, antiplatelet aggregation, anticoagulant properties as well as pleiotropic effects on endothelial function. During the COVID-19 pandemic, low-dose aspirin is used effectively in secondary prevention of atherosclerotic cardiovascular disease, prevention of venous thromboembolism after total hip or knee replacement, prevention of pre-eclampsia and postdischarge treatment for multisystem inflammatory syndrome in children. Prehospital low-dose aspirin therapy may reduce the risk of intensive care unit admission and mechanical ventilation in hospitalised patients with COVID-19, whereas aspirin association with mortality is still debatable. CONCLUSION: The authors recommend a low-dose aspirin regimen for primary prevention of arterial thromboembolism in patients aged 40-70 years who are at high atherosclerotic cardiovascular disease risk, or an intermediate risk with a risk-enhancer and have a low risk of bleeding. Aspirin's protective roles in COVID-19 associated with acute lung injury, vascular thrombosis without previous cardiovascular disease and mortality need further randomised controlled trials to establish causal conclusions.

Effect of coronavirus disease-19 pandemic to the volume of total hip and knee arthroplasty surgical service: experience from a single tertiary orthopedic hospital in Indonesia

The difficult situation of the coronavirus disease (COVID)-19 pandemic may affect to hip and knee arthroplasty service. Retrospective study was performed to patients who received elective total hip/total knee arthroplasty (THA/ TKA) from January to September 2020 at Prof. Dr. R. Soeharso Orthopaedic Hospital, Surakarta, Indonesia. There were a total of 64 THA and 227 TKA from January to September of 2020. There was an extreme decrease in the number of TKA surgery during April, May, and June in 2020. The effect of coronavirus disease-19 pandemic to the decrease of arthroplasty service was mainly in the first 3 months period.

Work during COVID-19: assessing the influence of job demands and resources on practical and psychological outcomes for employees

Purpose: A sudden shift of work from the office to home amid global lockdown demands exploration of factors that facilitate or obstruct remote working and their impact on practical and psychological outcomes for the employee when individual mandatorily telecommutes full-time with no prior experience of the same. Based on job demands and resources model (JD-R), the present study explores the role of certain job demands and resources on negative and positive outcomes through mediating role of strain and well-being, respectively. Design/methodology/approach: A data sample of 371 IT sector employees was collected and confirmatory factor analysis model was run to assess the model fit indices, convergent and divergent validities of the data. While proposed hypotheses of the study were tested using structural equations modeling (SEM) technique. Findings: It was found that workload pressure, task interdependence, professional isolation and family interference in work lead to exhaustion and further stress, whereas the presence of autonomy and schedule flexibility and sufficient technology resources improve employee work-life balance and further better productivity and performance and job satisfaction. Improved well-being was also found to reduce stress for full-time telecommuters. Practical implications: This study provides implications that will help in doing away with exhaustion and stress for employees and ensure business continuity in emergencies like COVID-19 pandemic. Originality/value: There are no past instances of mandatory full-time telecommuting arrangement by organizations, and researchers never had the opportunity to study it. This research, based on the JD-R model provides for the first time empirical insights into the experiences of mandatory full-time telecommuting during COVID-19 induced lockdown. © 2021, Emerald Publishing Limited.