COVID-19 may lower quality of life when infections and deaths increase: A longitudinal study in the Peruvian jungle.

Background: Quality of life (QoL) is a multifactorial concept on the perception of the individual's wellbeing underpinned by environmental, psychological, and physical factors. Several studies have shown changes in QoL in the COVID-19 pandemic and may be due to increases in mortality rates, however, no study has investigated this among Peruvian jungle dwellers. Here, we have sought to estimate the QoL of individuals before and after the increase in cases and deaths from COVID-19. Methods: A questionnaire-based longitudinal study was conducted in 102 inhabitants (mean 40.75 ± 7.49 years). The Spanish version of the WHOQOL-BREF was used in two stages: April and June. The first stage was accomplished before the first confirmed case of COVID-19, and the second stage was when the daily mortality rate was 3.5% with an incidence of 87%. Results: Sixty (54.8%) participants were women, 67 (61.9%) were >31 years, and 38 (34.5%) and 32 (29.1%) participants had primary and secondary education, respectively. In the first and second stage we obtained an overall mean QoL of 46.65 ± 23.2 and 35 ± 27.7 points, respectively. Individuals had significantly lower QoL in the face of increased deaths in physical (p = 0.001), mental (p = 0.028) and environmental (p = 0.001) health domains, with the latter having the greatest impact (51.84 ± 5.81 vs. 16.66 ± 5.55 points). Conclusion: Quality of life of Peruvian jungle dwellers is reduced during periods of increased mortality and incidence by COVID-19. Preventive strategies aimed at reducing the impact of COVID-19 on the mental health and global wellbeing of individuals living in the Amazon are recommended to Peruvian authorities.

Alterations in the coagulation markers did not show differences with the severity of COVID‐19 in Peruvian patients: A cross‐sectional single‐center study

Background and Aims COVID‐19 is a pandemic disease that can lead to altered lung function, systemic inflammatory events, and altered coagulation. During severe stages of the disease, changes in coagulation homeostasis increase, leading to thrombosis, and increased risk of death. In this cross‐sectional study, we aimed to assess coagulation markers by COVID‐19 severity in Peruvian adults. Methods During the second wave of infections, we included 186 adults diagnosed with COVID‐19 (mean age 53.3 ± 16.3 years). Patients were divided into mild, moderate, and severe stages of COVID‐19, and coagulation markers included prothrombin time (PT), activated partial prothrombin time (aPTT), fibrinogen, d‐dimer, and platelet count. Results Of the total, 120 (64.5%) were males and 39 (21%) were in the intensive care unit. We determine 104 (55.9%), 43 (24.7%), and 36 (19.4%) patients in mild, moderate, and severe stages of COVID‐19, respectively. In the severe stage of COVID‐19, patients had an average concentration of PT, aPTT, fibrinogen, d‐dimer, and platelets of 13.2 ± 0.9 s, 28.9 ± 4.3 s, 679.4 ± 185.1 mg/dL, 1.9 ± 3.1 µg/mL, and 272.8 ± 88.9 cel/10 mm,3 respectively. We found no differences in the concentration of each marker according to severity (p < 0.05). Patients with severe COVID‐19 had altered the aPTT, fibrinogen, d‐dimer, and PT in 31 (57.4%), 48 (88.9%), 37 (68.5%), and 15 (27.8%) cases, respectively. Conclusions Our results showed that although there is an alteration in coagulation markers, mainly fibrinogen and d‐fiber, there are no differences in concentration according to the severity of COVID‐19.

Alterations in the coagulation markers did not show differences with the severity of COVID-19 in Peruvian patients: A cross-sectional single-center study.

Background and Aims: COVID-19 is a pandemic disease that can lead to altered lung function, systemic inflammatory events, and altered coagulation. During severe stages of the disease, changes in coagulation homeostasis increase, leading to thrombosis, and increased risk of death. In this cross-sectional study, we aimed to assess coagulation markers by COVID-19 severity in Peruvian adults. Methods: During the second wave of infections, we included 186 adults diagnosed with COVID-19 (mean age 53.3 ± 16.3 years). Patients were divided into mild, moderate, and severe stages of COVID-19, and coagulation markers included prothrombin time (PT), activated partial prothrombin time (aPTT), fibrinogen, d-dimer, and platelet count. Results: Of the total, 120 (64.5%) were males and 39 (21%) were in the intensive care unit. We determine 104 (55.9%), 43 (24.7%), and 36 (19.4%) patients in mild, moderate, and severe stages of COVID-19, respectively. In the severe stage of COVID-19, patients had an average concentration of PT, aPTT, fibrinogen, d-dimer, and platelets of 13.2 ± 0.9 s, 28.9 ± 4.3 s, 679.4 ± 185.1 mg/dL, 1.9 ± 3.1 µg/mL, and 272.8 ± 88.9 cel/10 mm,3 respectively. We found no differences in the concentration of each marker according to severity (p < 0.05). Patients with severe COVID-19 had altered the aPTT, fibrinogen, d-dimer, and PT in 31 (57.4%), 48 (88.9%), 37 (68.5%), and 15 (27.8%) cases, respectively. Conclusions: Our results showed that although there is an alteration in coagulation markers, mainly fibrinogen and d-fiber, there are no differences in concentration according to the severity of COVID-19.

Does the use of cysteine-rich whey protein supplements improve the health well-being of COVID-19 patients? A qualitative study

Introduction: In the context of SARS-CoV-2 infection, it has been proposed that oxidative stress may contribute to the management of COVID-19 severity. The impact on the well-being of patients with COVID-19 using cysteine-providing supplements has not yet been evaluated and there is a need to understand the benefits and limitations they may offer. Aim: The aim of this study is to understand the experiences of improved well-being with cysteine-rich whey protein supplementation (Immunocal®) in patients with COVID-19. Methods: A qualitative study was conducted by conducting semi-structured interviews with four participants taking Immunocal® while they had COVID-19. Participants were randomly recruited through internet networking. Ethical approval was obtained from the University ethics committee. Participants were informed of the study objectives two days in advance and consent was obtained before interviews began. We used the 16-item "Use of Immunocal supplement for COVID-19” (USIC-19) questionnaire to inquire about COVID-19 behavior (time of illness, symptoms, and severity of illness) and the experience of using the supplement during illness. Confidentiality was maintained throughout this study. Results: All participants presented mild discomfort such as headache, weakness, and tiredness when they had COVID-19 impacting most of them emotionally. The use of Immunocal® produced a partial improvement in all patients as only two continued to experience fatigue. Immunocal® improved the mood (50%) and physical health of the participants. In addition, participants reported that the supplement was recommended and dosed primarily by a consultant and that they did not feel hesitant to use it because of previous experiences of friends and family. The daily dosage of half of the participants was two sachets and all felt the need to consume the supplement which resulted in daily use. Conclusion: Following the daily dosage indications of the consultants, the participants who have consumed Inmunocal® have presented a partial improvement of the symptoms related to COVID-19, however, they feel the need to consume the supplement daily to improve their quality of life.

The End of Life Accompanied by COVID-19: A Qualitative Study on Grief During the First OutBreak In Peru (Part I).

Due to the massive deaths and high level of contagion brought about by COVID-19, burial practices and the way we bury our dead are being affected by SARS-CoV-2 confinement and control measures. Here, we aimed to examine the changing of death, dying, and mourning during the first wave and quarantine applied in Peru with the arrival of COVID-19 in 2020. Using a qualitative approach, 15 participants who lost a family member because of COVID-19 were interviewed by telephone and video call. Our results revealed that death in isolation, the loss of rituals, and the farewell to relatives have dramatically affected family members. Peruvian funeral practices were altered by health provisions, making it a challenge to accompany relatives at the end of life. This way of coping with death can affect family wellbeing, for which no interventions have yet been proposed to improve the quality of life during bereavement.

Depression in healthcare workers from the COVID-19 Care and Isolation Center - Villa Panamericana: a single-center prospective study in Peru.

OBJECTIVE: Depression is a mental problem that affects the well-being of healthcare workers, impacting the quality of care and even leading to commit suicide. We aim to the levels of depression in frontline healthcare workers during the first severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in Peru. METHODS: A prospective cohort study was designed in the coronavirus disease 2019 (COVID-19) Care and Isolation Center - Villa Panamericana in eastern Lima. Care and Isolation Center-Villa Panamericana houses about 150 healthcare workers and COVID-19 patients. The Montgomery-Asberg Depression Rating scale was used for depression assessment. RESULTS: A total of 96 participants (30±5.6 years) were analyzed: 15 (15.6%) physicians, 39 (40.6%) nurses, 14 (14.6%) medical technologists, and 28 (29.2%) nurse technicians. Mild, moderate, and severe depression were present in 35 (36.5%), 44 (45.8%), and 9 (9.4%) of the cases, respectively. The physicians and nurses reported more severe levels of depression: 8 (53.3%) physicians and 18 (46.2%) nurses presented moderate depression; and 2 (13.3%) physicians and 3 (7.7%) nurses presented severe depression (p=0.005). This study determined greater symptoms of depression according to years of work (p=0.001). Thirty-two healthcare workers had COVID-19, 4 (12.5%) physicians, 9 (28.1%) nurses, 7 (21.9%) medical technologists, and 12 (37.5%) nurse technicians. Twenty-four (75%) participants showed symptoms of COVID-19 and developed moderate (12 [37.5%]) and severe (3 [9.4%]) symptoms of depression (p=0.041). CONCLUSION: This study clearly demonstrated a high prevalence of depression in the Care and Isolation Center-Villa Panamericana frontline healthcare workers during the COVID-19 pandemic in Peru.

Depression in healthcare workers from the COVID-19 Care and Isolation Center - Villa Panamericana: a single-center prospective study in Peru

Objective Depression is a mental problem that affects the well-being of healthcare workers, impacting the quality of care and even leading to commit suicide. We aim to the levels of depression in frontline healthcare workers during the first severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in Peru. Methods A prospective cohort study was designed in the coronavirus disease 2019 (COVID-19) Care and Isolation Center – Villa Panamericana in eastern Lima. Care and Isolation Center-Villa Panamericana houses about 150 healthcare workers and COVID-19 patients. The Montgomery-Asberg Depression Rating scale was used for depression assessment. Results A total of 96 participants (30±5.6 years) were analyzed: 15 (15.6%) physicians, 39 (40.6%) nurses, 14 (14.6%) medical technologists, and 28 (29.2%) nurse technicians. Mild, moderate, and severe depression were present in 35 (36.5%), 44 (45.8%), and 9 (9.4%) of the cases, respectively. The physicians and nurses reported more severe levels of depression: 8 (53.3%) physicians and 18 (46.2%) nurses presented moderate depression;and 2 (13.3%) physicians and 3 (7.7%) nurses presented severe depression (p=0.005). This study determined greater symptoms of depression according to years of work (p=0.001). Thirty-two healthcare workers had COVID-19, 4 (12.5%) physicians, 9 (28.1%) nurses, 7 (21.9%) medical technologists, and 12 (37.5%) nurse technicians. Twenty-four (75%) participants showed symptoms of COVID-19 and developed moderate (12 [37.5%]) and severe (3 [9.4%]) symptoms of depression (p=0.041). Conclusion This study clearly demonstrated a high prevalence of depression in the Care and Isolation Center-Villa Panamericana frontline healthcare workers during the COVID-19 pandemic in Peru.

Substance Use in Healthcare Professionals During the COVID-19 Pandemic in Latin America: A Systematic Review and a Call for Reports.

Background: The COVID-19 pandemic has generated a remarkable change in the behaviour of Healthcare workers (HCWs) around the world. However, there is a lack of evidence on substance use among HCWs in Latin America. Therefore, this study aimed to determine the current frequency of substance use among Latin American among HCWs. Methods: We searched 8 databases (PubMed, Scopus, ScientDirect, Web of Science, Cochrane, Scielo, LILACS and Latindex), 4 public prepublication servers (SocArXiv, medRxiv, bioRxiv and Preprints) and Google scholar from 1/9/2019 to 11/1/2021. We determined the frequency of each study based on original studies, scientific letters, and clinical trials in English, Spanish and Portuguese. Results: A total of 17 175 study articles were identified from electronic databases and preprints, and 2 cross-sectional studies conducted in 2020 were included in the qualitative analysis. Both studies included HCWs but did not perform a differential analysis. The first was developed by the Pan-American Health Organization and included interviewees from 35 countries, while the second was conducted with 1145 Brazilian participants. Both studies showed increases in substance use during the pandemic, with alcohol being the most commonly used substance (30%), but PAHO's study reported a 13.8% increase in self-reported heavy-episodic drinking, with differences among genders (males, 15.4%), age groups (highest increase in the 40-49 age group, 16.5%) and area of residence (urban with 14%). The second study showed that 21 32% of participants reported initiating psychoactive substance use, 29.3% added some substance to their initial use and 4% of them had to replace the substance, mainly due to difficulty of access. Other substances of abuse that showed significant increases were tobacco (0.5%) and marijuana (0.3%). Conclusion: Overall, despite the analysis of the 2 studies, the results provided are not a conclusive description of the frequency of substance use by HCWs in Latin America during the COVID-19 pandemic. Further research is required to understand the impact of the pandemic on drug abuse in the region. Protocol Registration: The protocol has been registered on 30 November 2021 on the International Prospective Register of Systematic Reviews (PROSPERO) with ID: CRD420212919700.