Lockdown Fatigue in Pediatric Respiratory Patients: Lessons from the First COVID-19 Year.

Lockdown policies have been implemented worldwide to limit the spread of COVID-19. "Lockdown fatigue" is a state of exhaustion related to the accumulating effects of repeated lockdowns. The aim of the current study was to examine the effects of repeated lockdowns on children with respiratory disorders. Data on children aged 0−18 years old with respiratory disorders were collected by an electronic survey during the third lockdown in Israel. The retrieved information included demographics and baseline medical status, respiratory clinical status during the third lockdown compared to pre-lockdown periods, lockdown adherence, lifestyle modifications and caregiver emotional status. The results were compared to those of a similar questionnaire distributed during the first lockdown. A total of 234 patients (62% males, 37% females, mean age 6.8 years (confidence interval 6.1−7.5)) were enrolled. Respiratory symptoms and exacerbation frequency were reduced in 76 (35.5%) and 58 (27.4%) patients, respectively, compared to the pre-lockdown period and similar to the first lockdown (p = 0.840 and p = 0.063, respectively). However, compared to the first lockdown, the third lockdown was associated with greater use of reliever medications (p = 0.006), less use of inhaled corticosteroids as routine treatment (p = 0.027), and more pediatric emergency room visits and hospitalizations (p = 0.001 and p < 0.001, respectively). The results also showed an increase in sedentary lifestyle (e.g., reduced physical activity (p = 0.025), less healthy eating habits (p = 0.001)) and reduced adherence to lockdown policies (p < 0.001). These data show that the continuing stability of clinical improvement during lockdown was accompanied by deleterious sequelae that potentially indicate "lockdown fatigue" among children with respiratory disorders.

SARS-CoV-2 Omicron Variant: Clinical Presentation and Occupational Implications in Young and Healthy IDF Soldiers.

INTRODUCTION: To this date, there is little known about the symptoms, their duration, and occupational implications of Coronavirus disease (COVID-19) in the military population. Decisions regarding implementing precaution measures are based on data deriving from the general population. Moreover, the Omicron variant seems to cause a disease with lesser severity than previous variants. We aimed to describe the clinical presentation and estimate the loss of workdays due to mild COVID-19 during an Omicron predominant wave among a young, healthy, and mostly vaccinated military population. MATERIALS AND METHODS: A cross-sectional, survey-based study among IDF soldiers who replied to an online questionnaire following recovery from COVID-19. Data included self-reported vaccination status, symptoms presentation and duration, and service-related sick days. Student's t-test and chi-square test of independence were used to compare differences in continuous and categorical variables, respectively. A binary logistic regression analysis was performed to estimate the odds ratio and 95% CIs for prolonged symptom duration (4 days and above) by participants' characteristics. The IDF medical corps institutional review board approved this study. RESULTS: A total of 199 soldiers, with a mean age of 21.9 years, were included in the study. Upper respiratory tract symptoms, headache, and constitutional symptoms were found to be the most common among symptomatic soldiers. The median reported time for inability to continue the daily routine, including work, was 5 days [Interquartile range (IQR), 0-10]. Median duration of symptoms was 4 days (IQR, 0-10). In addition, women were found to have longer symptomatic disease (odds ratio = 2.34; 95% CI, 1.20-4.52). CONCLUSIONS: Our findings demonstrate that even among a young and fully vaccinated population, COVID-19 caused by the Omicron variant may result in substantial medical leave from military service, compared to common cold or influenza virus infection. Our study sample was relatively small; however, the response rate was high and our results shed light on the yet-to-be fully characterized Omicron variant-related COVID-19. Despite the current common perception of COVID-19 as a self-limiting mild disease with low burden of symptoms, our findings show the potential occupational burden of infection with COVID-19 on military units and their readiness and could be considered when discussing public health restrictions and further steps taken to minimize outbreaks ramifications.

Hope During COVID-19 Lockdown.

Introduction The COVID-19 pandemic has changed daily life in unexpected ways including strict lockdowns periods that may shape hope. Method This study compared hope levels among an online sample of 584 adults in late April 2020 during the COVID-19 lockdown (2020 survey) to 884 adult internet users who participated in the 2019 Hope Barometer survey which was performed six months prior to the COVID-19 pandemic (2019 survey). Both surveys used identical validated hope and depression measures. Results Despite high degrees of depression, hope levels slightly but significantly increased in the 2020 survey compared to the 2019 survey. Differences between the 2019 and 2020 surveys appeared across all demographic groups, with no differences related to age, sex, or education. Conclusions Despite the increased depression, the COVID-19 lockdown was associated with significantly higher hope levels.

Real-time effects of COVID-19 pandemic lockdown on pediatric respiratory patients.

OBJECTIVE: A national lockdown was implemented in Israel to slow the viral spread of COVID-19. We assessed the real-time effects of the lockdown on disease expression and lifestyle modifications in pediatric patients with chronic respiratory disorders. METHODS: An anonymous electronic questionnaire was distributed during lockdown (March-May 2020) to caregivers of patients with chronic respiratory disorders. The primary outcome was change in disease expression and the secondary outcomes were changes in lifestyle and caregivers' emotional status. RESULTS: The clinical status of one-third of the 445 participating patients (age 0-18 years) reportedly improved, including decreased respiratory symptoms (n = 133, 33%), exacerbation frequency (n = 147, 35%), and use of reliever medications (n = 101, 27.4%). The condition of ~10% of the patients worsened. Clinical improvement was noted mostly in young patients <5 years (p = .001), asthmatic patients (p = .033), and patients with multiple underlying respiratory disorders (p = .015). Patients whose condition significantly worsened were more likely to be >5 years (p < .001), had increased screen time, decreased physical activity, and shorter sleep duration compared to their younger counterparts (p = .008, <.001, and .001, respectively). Caregivers' reports (n = 236 [58%]) of their own anxiety levels and perceptions of the patients' elevated health risk were increased, regardless of the children's actual clinical status. CONCLUSION: COVID-19 lockdown was associated with clinical improvement/stability for most of the surveyed children; however, their caregivers' anxiety level was heightened. An increased sedentary lifestyle was reported mostly in older children.