ABSTRACT
Objective. International studies have found an increased risk of puerperal depression during COVID-19 pandemic. The present research aims to investigate the risk of puerperal depression within the obstetrics ward of Ospedale dell’Angelo (Venice Mestre), between March and June, 2020. Patients and Methods. 98 new mothers (average age: 33 y/o, SD: 5) were asked to complete the 10 item version of the EPDS, 2-3 days after delivery and again 3 months later. Results. The percentage of women with high score is 26.5%, less than what was found in 2016. The risk of puerperal depression does not change significantly 3 months after delivery. However, high scores on EPDS do not seem to be connected either to the type of birth or to the condition of primiparity of the mothers. Conclusions. Some hypotheses have been proposed to explain the results obtained, such as quality of the assistance offered and/or the compliance and the coping skills acquired by families, which could be evaluated in future research. © 2022, EDRA S.p.A. All rights reserved.
ABSTRACT
Background: COVID-19 (C-19) infection can acutely cause organ dysfunctions, especially cardiorespiratory, even with a long recovery period, inducing a significant functional deficit. Aim of the study was to evaluate the impact of a holistic hospital intensive rehabilitation program, based on CR, on C-19 patients (P), after acute care, to improve their fitness, in order to return to their life in the best conditions. Methods: In the period april-august 2020, 30 P (mean age 73 years, 60% male) were admitted to the rehabilitation centre at a mean distance of 31±11 days from the onset of C-19;34% of them had undergone prolonged invasive ventilation, 34% non invasive ventilation and 32% required high flow oxygen. Comorbidities were: hypertension (77%), diabetes (13%) and chronic coronary syndrome (10%);18 P were unable to stand, and 12 showed impaired trunk control. No P had impaired LVEF or significant valvular disease. Initially, the program focused on training for trunk and sitting control;then on exercises for straightening the upper and lower limbs. From the second week, started a CR training on the cycle ergometer 10- 20 minutes a day for 6 days a week, similar protocol to that used in P with heart failure. The aerobic training was of moderate intensity, not exceeding 40-60% of the maximum heart rate, Borg scale 10-12, starting with zero load, gradually increasing by 10-15 watts and up to a minimum target of 25-30 watts. The impact of the protocol on motor functions [MRC Muscle Strenght Scale, Short Physical Performance Battery (SPPB)] on functional capacity [6 Minutes Walking Test (6MWT)] on anxiety (A) and depression (D) [Hamilton Anxiety Rating scale (HAMA) and Hamilton Depression Rating scale (HAMD)] and on basic activities of daily life [Barthel Index (BI)] were evaluated. The assessment was done on the admission (T0), at the discharge (T1, on average after 31 days) and after a follow-up of 55 days (T3). Results: The results are shown in the table below. Only 4 P were able to perform the 6MWT at T0. The motor function improves rapidly and then reaches a plateau and its trend is reflected in the BI. Functional capacity, on the other hand, improves significantly even at a distance. A and D decreased rapidly but increased over time. Conclusions: A rehabilitation protocol, centered on CR, induces a rapid increase in motor capacity, even in severely compromised subjects such as C-19. The improvement in fitness over time, as demonstrated by the 6MWT, probably is due to the severe muscle deconditioning, for the long stay in acute care. The long-term worsening of A and D may depend on various causes: no longer living in a “protected and safe” place, the fear of relapse, returning home and discovering new deaths and mournings. A program, CR-like, can counteract many of the negative consequences of C-19;however these P deserve an outpatient rehabilitation to maintain and consolidate the positive results over time. (Figure Presented).